Filing Number: 809535
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| Filing Accepted: 3/4/2025 |
| Last/Business Name
*
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KUJALA
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First Name |
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KENT AND KAREN |
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| Street Address
*
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13824 LILY PAD CIRCLE |
| City, State Zip
*
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FORT MYERS,
FL
33906
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| Email Address
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KENTKUJALA@GMAIL.COM |
| Complainant Type:
*
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Insured |
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| Last/Business Name* |
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KUJALA |
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First Name |
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KENT AND KAREN |
| Policy # * |
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KIN-HO-FL-112520428 |
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Claim #* |
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HO-4594627 |
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Attorney is Applicable
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| Last Name* |
SMITH
First Name *
RYAN
Initial
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| Street Address* |
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350 N LAKE DESTINY ROAD |
| City, State Zip* |
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MAITLAND
,
FL
32751
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| Email Address * |
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RSMITH@ITSABOUTJUSTICE.LAW |
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| Insurer Type
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Authorized Insurer
Unauthorized Insurer
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| Insurer Name |
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| Insurer Name* |
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KIN INTERINSURANCE NETWORK
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| Insurer Name* |
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| Street Address* |
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| City, State Zip* |
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,
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NAIC Company Code 16603 |
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| Name of individual responsible for violation (if any):*
SASHA KNIGHT
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| Type of Insurance
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Residential Property & Casualty
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| Reason for Notice
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Claim Denial
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Claim Delay
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
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| 624.155(1)(b)(3) |
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Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
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| 626.9541(1)(i)(2) |
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A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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| 626.9541(1)(i)(3)(a) |
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Failing to adopt and implement standards for the proper investigation of claims.
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| 626.9541(1)(i)(3)(b) |
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Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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| 626.9541(1)(i)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Section 1 - Property Coverages – Coverage A – Dwelling
Section 1 – Perils Insured Against – Coverage A-Dwelling and Coverage B-Other Structures
Section 1- Conditions – Loss Settlement
Section 1 – Conditions –Loss Payment
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Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
On or about September 28, 2022, Kent and Karen Kujala (“Insured”), suffered damage to their home located at 13824 Lily Pad Circle, Fort Myers, FL 33906 as a result of Hurricane Ian. Prior to the loss, KIN Insurance company (hereinafter, "KIN"), had issued a policy of insurance (Policy No.: KIN-HO-FL-112520428) for the Insureds’ property. Said policy, which was issued prior to the loss, was in full force and effect and afforded coverage for damage caused by the loss. KIN was timely notified of the loss by the Insureds and assigned claim number HO-4594627.
During the course of KIN's investigation, the Insureds made their property available for inspection, provided facts and information surrounding the loss, including but not limited to proof of repairs and their efforts to protect the property from further damage, and submitting to a recorded statement. The insureds further submitted all requested documentation in their possession in response to KIN's March 20, 2024 request for information - a request which KIN's corporate representative (during his March 4, 2025 deposition) admitted had been fully complied with and was not supplemented with any other requests for information. Despite fully cooperating with KIN's investigation, KIN inexplicably failed to extend coverage for the entirety of the Insureds’ insurance claim even though the facts of the claim made known to KIN and the policy language clearly demonstrate extensive covered damage to property. KIN apparently came to its coverage determination based solely upon the decision of photographs by its desk adjuster -- Sasha Knight. In doing so, KIN deliberately ignored relevant facts and information proving that replacement of the roof and windows were necessary, and were caused and directly attributable to Hurricane Ian.
Even more concerning, the insureds advised KIN of the damages during their recorded statement -- which was requested by and given to KIN the day after the claim had been reported. For more than twenty minutes, the insureds answered KIN's questions and advised of the damages that they were alleging. In addition to conducting a substandard inspection of the covered damages to the roof, KIN also documented damages to the windows of the property and the screen enclosure. Notwithstanding their adjuster's documentation of damages to covered areas of the premises, KIN wholly disregarded the covered portions of damage to the roof. More troublesome is the fact that KIN entirely ignored the claimed window damages at the property, by failing to prepare an estimate of the necessity to replace the windows. During the deposition of KIN's corporate representative, the witness openly admitted that there were no cause or origin determinations made as to the covered/excluded portions of the roof. The witness further admitted that there was no cause/origin determination made or utilized with respect to the windows; perhaps it is because KIN entirely ignored relevant information provided to it regarding the investigation and decided to selectively adjust portions of the loss in a manner which suited its needs -- which is to retain premiums which it does by arbitrarily denying claims.
Throughout this claim, KIN has engaged in a calculated effort to purposely downplay and misrepresent evidence at the property to avoid tendering payment on a claim it knew was covered pursuant to the terms of the policy. KIN instead decided to engage in a deliberate tactic of hide and seek investigations of the insured's claim for widespread Hurricane damage on the roof and windows. As of the date of this writing, KIN continues to engage in bad faith hide and seek/sword and shield tactics by now contesting the insureds' rightful inquiry to obtain the entirety of the materials which KIN relies upon to deny the subject claim. It is common knowledge that KIN chooses to engage in calculated conduct by handling and adjusting claims in bad faith. At no point in this claim has KIN acted honestly or fairly towards its Insureds. Instead, KIN and its representatives have failed to conduct a proper investigation of the loss, misrepresented the scope of damages and repairs, and misapplied policy provisions to wrongfully deny payment for the Insureds’ claim.
It has become a general business practice of KIN to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. As is the case here, it is a pattern and practice for KIN to arbitrarily deny claims based upon misleading information withheld by KIN. KIN does this as part of a calculated measure to force insureds into litigation by way of deliberately retaining premiums and deciding to not pay legitimate claims. Furthermore, KIN's actions are part of a broader scheme to delay claims and avoid issuing payment that it knows is owed to its insureds. KIN's actions are widespread sufficient to constitute a general business practice, which come to the detriment of policy holders to restore their property to pre-loss condition.
In order to cure this civil remedy notice, KIN must acknowledge that the Insureds’ property was damaged by Hurricane Ian and that replacement of the roof and windows as covered by the policy. KIN must further tender the full contractual amount owed to replace the roof and window damages to the property pursuant to the terms of the policy. Payment should be issued to the “Cohen Law Group Trust Account f/b/o Kent and Karen Kujala.” The written explanation of benefits and payment should be sent to the Insureds’ counsel’s office at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.
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The submitter hereby states that this notice is given in order to perfect the rights of the
person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.
Before submitting a Notice using this system, please verify that all text has been entered
correctly and completely. Once the Notice has been submitted, the text cannot be changed
or deleted.
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DFS-10-363
Rev. 10/14/2008
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