Filing Number: 809697
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| Filing Accepted: 3/5/2025 |
| Last/Business Name
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| Street Address
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17085 DOLPHIN DRIVE |
| City, State Zip
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NORTH REDINGTON BEACH,
FL
33708
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| Email Address
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LDDUCHEINE@DIENERFIRM.COM |
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Insured |
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| Last/Business Name* |
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DRAPER |
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First Name |
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RICKY |
| Policy # * |
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FPH3-000106393 |
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Claim #* |
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01000119695 |
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Attorney is Applicable
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| Last Name* |
DUCHEINE
First Name *
L. DICK
Initial
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| Street Address* |
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5599 SOUTH UNIVERSITY DRIVE SUITE 304/305 |
| City, State Zip* |
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DAVIE
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FLORIDA
33328
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| Email Address * |
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LDDUCHEINE@DIENERFIRM.COM |
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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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FRONTLINE INSURANCE UNLIMITED COMPANY
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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 10074 |
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| Name of individual responsible for violation (if any):*
FRONT LINE ADJUSTER, BROOKE WOLDROP, JENNA COKER THE CLAIMS EXAMINER AND ALL FRONTLINE INSURANCE AGENTS AND REPRESENTATIVES TINVOLVED IN THE ADJUSTMENT OF THIS CLAIM
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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 Delay
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Unfair Trade Practice
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Unsatisfactory Settlement Offer
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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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| 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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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 PERIL INSURED AGAINST
A. Coverage A – Dwelling and Coverage B – Other Structures
1. We insure for sudden and accidental loss direct physical loss to covered property described in Coverage A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we will not pay for, any “diminution in value.”
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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 October 10, 2024, the home of Oksana and Ricky Draper (hereinafter referred to as “Insured” ), located at 17085 Dolphin Drive, North Redington Beach, Florida 33708 was damaged as a result of Hurricane Milton, resulting in physical damage to the dwelling. The property in question is insured by First Protective Insurance d/b/a Frontline Insurance Company, whose address is P.O. Box 958405, Lake Mary, Florida 32795 (hereinafter referred to as “Frontline” ) under Policy No. FPH3- 000106393.
On or about October 10, 2024, the insured property sustained damage as a result of Hurricane Milton. More specifically, the roof of the dwelling suffered damage as a result of the hurricane-force winds. The roof damage in turn resulted in rainwater entering the dwelling, causing further interior damage to the master bedroom, the breakfast area and other areas within the interior dwelling. The Insured timely reported the loss to Frontline. Frontline acknowledged the claim and assigned claim No.: 01000119695 to the loss. The policy covers Windstorm and Hurricane losses up to the limit of coverage “A.” The insured mitigated damages, allowed inspection, and otherwise complied with all obligations under the policy.
The subject policy provides coverage for sudden and accidental losses and damages arising from windstorms. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages. See Doe v. Allstate Ins. Co., 653 So. 2d 371, 374 (Fla. 1995) (stating that the obligation of insurance company toward insured is a "fiduciary duty requiring the exercise of good faith").
Frontline from the very onset of the claim began setting the stage to limit and/or deny coverage. The Frontline Adjuster, Brooke Waldrop, conducted a substandard inspection of the loss. The inspection itself was wholly insufficient in both a) the length of time spent at the home by the adjuster, and b) the scope of their inspection.
Here, there is significant and extensive damage from the loss in plain view. As such, the insured retained WGAI, LLC as their public adjuster, to assist with the loss. Despite express notice that the insured was represented by WGAI LLC, Frontline continued to communicate with the insured to coordinate and schedule events, inspections despite being told that they are represented by WGAI, and that WGAI needs to be included in all communications and coordination, a wilful violation of Fla. Stat. § 626.854(14)(a) which provides as follows:
(14) The public adjuster must ensure that prompt notice is given of the claim to the insurer, the public adjuster’s contract is provided to the insurer, the property is available for inspection of the loss or damage by the insurer, and the insurer is given an opportunity to interview the insured directly about the loss and claim. The insurer must be allowed to obtain necessary information to investigate and respond to the claim.
(a) The insurer may not exclude the public adjuster from its in-person meetings with the insured. The insurer shall meet or communicate with the public adjuster in an effort to reach agreement as to the scope of the covered loss under the insurance policy. The public adjuster shall meet or communicate with the insurer in an effort to reach agreement as to the scope of the covered loss under the insurance policy. This section does not impair the terms and conditions of the insurance policy in effect at the time the claim is filed.
Fla. Stat. § 626.854(14)(a)
After completing its investigation into claim no. 01000119695, Frontline determined that the insured a covered loss. Jenna Coker, Frontline’s claim adjuster, sent correspondence dated October 31, 2024, relying solely on Their Field Adjuster’s inspection unilaterally estimated that the insured sustained $9,789.73 in damage, a below deductible amount resulting in no benefits to the insured. An amount woefully inadequate to bring the insured property back to Pre-loss conditions. The Frontline estimate, excluded numerous areas affected by the loss from their repair estimate. Frontline, excluded, the Breakfast area, the Master Bedroom, the Stairway, the Shower, Vanity room among numerous other areas affected by the loss.
To date, the insured have provided with numerous documents and fully or substantially complied with all requests or and policy conditions. Nonetheless, FRONTLINE, to date has issued no additional insurance benefits beyond the undisputed payment it provided to the insured. The insured has fully or substantially complied with all requests from FRONTLINE. The insured has provided FRONTLINE with the following:
• Promptly allowing FRONTLINE to inspect the loss
• WGAI, LLC Estimate of repairs in the amount of $176,395.10 RCV adjusted to $159,790.10 after adjusting for depreciation and the deductible.
• Public Adjuster contact information
• A Notarized Sworn Proof of Loss
• Approximately 246 Photographs of the loss,
The insured has provided FRONTLINE with all relevant information needed to investigate the claim and at all times have cooperated and made the property available for inspection. The insured has faithfully paid the policy premiums with the understanding that in the event of a covered loss to their home, they would be able to rely on FRONTLINE to extend the insurance benefits which they are entitled to, and to assist them during this extremely difficult time. FRONTLINE’s intentional poor handling of the claim are not unique to this claim, but rather appear to be a global strategy employed by which to limit their liabilities and payouts.
FRONTLINE, as a business practice, routinely ignores claims, under pays covered claims and unnecessarily delays payment on a claim until they are forced to pay. FRONTLINE as a business practice intentionally drags out claims in order to make the insured suffer in hopes that the insured will give up and simply go away. Here, FRONTLINE has repeated a pattern of immoral, deceptive and unlawful behavior generally described as bad faith conduct which is part of a general business practice that is knowingly being utilized by FRONTLINE for self gain.
That said, to the detriment of its insureds and to maximize its financial interests, Insurer disregards the obvious and known obligations by way of the Bad Faith general business practices that are further delineated, described and specified as follows:
(a.) Not developing, maintaining and/or instituting policies, procedures, protocol or guidelines to determine whether adjusters/personnel/vendors utilized to protect its insureds were even qualified and trained to duly assess the scope, cause and/or value of the loss;
(b.) Insurer has and does arbitrarily and without fixed protocol hire experts to establish a lack of coverage as it relates to a specific claim;
(c.) Insurer deliberately undervalues/under adjusts claims, including this Claim, so that it does not have to set proper and fair reserves for the Claim, which has the effect of devaluing Insurer’s stock price because of the excess liability on its books;
To cure the above stated immoral, deceptive, unlawful and bad faith conduct which is part of a general business practice that is knowingly being utilized by FRONTLINE, FRONTLINE must issue payment for the full amount of $176,395.10 RCV adjusted to $159,790.10, as set forth in all pending estimates obtained by the Insured (subject to the loss payment provision, as well as policy limits and applicable deductibles).
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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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