Filing Number: 809782
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| Filing Accepted: 3/5/2025 |
| Last/Business Name
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BRUNETTE
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First Name |
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DONALD W. |
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| Street Address
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1002 ORCHID LN |
| City, State Zip
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BRADENTON,
FL
34208
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| Email Address
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BARB62BRUNETTE@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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BRUNETTE |
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First Name |
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DONALD W. |
| Policy # * |
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2MR192923001 |
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Claim #* |
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00201847196 |
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Attorney is Applicable
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| Last Name* |
INNOCENT
First Name *
KIMBERLY
Initial
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| Street Address* |
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1580 SAWGRASS CORPORATE PARKWAY, SUITE 130 |
| City, State Zip* |
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SUNRISE
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FL
33323
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| Email Address * |
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KIMBERLY@INNOCENTLAWFIRM.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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AMERICAN SECURITY INSURANCE 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 42978 |
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| Name of individual responsible for violation (if any):*
STACY BARNES
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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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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)(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)(3)(f) |
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Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
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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.
Despite requests for a certified copy of the Insured’s Policy, the Carrier has yet to provide the same. Notwithstanding, based on information and belief, the INSURED believes the specific policy language that is relevant to the violation is as follows:
COVERAGE A - Dwelling
1. Property Covered
We cover
a. The 1-4 family dwelling on the described location shown in the Declarations, used principally for dwelling purposes, including structures attached to the dwelling;
b. Materials and supplies located on or next to the described location used to construct, alter or repair the dwelling or other structures on the described location; and
c. If not otherwise covered in this Certificate, building equipment and outdoor equipment used for the service of and located on the described location.
2. Property Not Covered
a. Personal property of any kind.
b. Outdoor trees, shrubs, plants and lawns.
c. Outdoor swimming pools; fences, piers, wharves and docks; beach or diving platforms or appurtenances; retaining walls not constituting a part of buildings; walks, roadway; and other paved surfaces.
d. Cost of excavations, grading or filling.
e. Foundations of buildings, machinery, boilers or engines which foundations are below the surface of the ground.
f. Pilings, piers, pipes, flues and drains which are underground.
g. Pilings which are below the low water mark.
h. Land, including land on which the residential property is located.
PERILS INSURED AGAINST
COVERAGE A - DWELLING and COVERAGE B - OTHER STRUCTURES
We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.
THIS ENDORSEMENT CHANGES THE CERTIFICATE. PLEASE READ IT CAREFULLY.
It is understood and agreed that throughout this Certificate you and your refer to the financial
institution as named insured and the borrower shown in the Declarations.
No coverage will be afforded to any borrower other than shown in the Declarations.
CONDITIONS
5. Loss Settlement, paragraph b. is replaced by the following:
b. Buildings under Coverage A or B at replacement cost without deduction for
depreciation, subject to the following:
We will pay the cost to repair or replace, after application of any deductible and without deduction for depreciation, but not more than the least of the following amounts:
(1) The Limit of Liability under this Certificate that applies to the
residential property;
(2) The replacement cost of that part of the residential property damaged with material of like kind and quality and for like use; or
(3) The necessary amount actually spent to repair or replace the damaged residential property.
(4) If the loss or damage occurs to pool enclosures, cabanas, screened porches or other shelter-type structures attached to the dwelling, we will pay no more than ten percent (10%) of the Limit of Liability of this Certificate applying to the Dwelling. This Condition does not increase the Limit of Liability applying to the Dwelling.
12. Loss Payment is deleted and replaced by
the following:
12. Loss Payment. We will adjust all losses with the named insured. Loss will be made payable to the named insured and the borrower as their interests appear, either by a single instrument or by separate instruments payable respectively to the named insured and the borrower, at our option.
No coverage will be available to any mortgagee other than that shown as the named insured on the Declarations.
Provided you have complied with all the terms of this Certificate, we will pay for
covered loss or damage upon the earliest of the following:
a. Within 20 days after we receive the sworn proof of loss and reach written
agreement with you;
b. Within 30 days after we receive the sworn proof of loss and:
(1) There is an entry of a final judgment; or
(2) There is a filing of an appraisal award with us; or
c. Within 60 days of receiving notice of an initial, reopened or supplemental claim, unless we deny the claim during that time or factors beyond our control. If a portion of the claim is denied, then the 60-day time period for payment of claim relates to the portion of the claim that is not denied.
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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.
In Florida, the work of adjusting insurance claims engages the public trust. American Security Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Donald W. Brunette’s (“INSURED”) claim of loss. INSURER’S principal address is 260 Interstate North Circle SE, Atlanta, GA 30339. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED'S insurance claim for damages. INSURER has failed to promptly settle the INSUREDS’ insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED'S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy.
This claim involves the INSURED'S property located at 1002 Orchid Ln, Bradenton, FL 34208, which sustained significant damage from wind and water damage due to Hurricane Milton on or around October 9, 2024. Specifically, the Property's roof system and awnings were damaged by Hurricane Milton, resulting in substantial water intrusion and interior water damage. The INSURED timely reported the loss to the INSURER. The INSURER acknowledged the claim and assigned a field adjuster to inspect the loss.
After an investigation, the INSURER acknowledged that the roof sustained wind damage and that water had intruded into the home’s interior as a direct result of this wind damage. Despite this acknowledgment, the INSURER has only afforded coverage for a partial repair of the roof rather than a full replacement, ignoring the fact that the roof tiles are no longer manufactured and cannot be matched. The INSURER’s refusal to replace the roof contradicts industry standards, Florida Building Code requirements, and the terms of the policy, which require repairs to restore the Property to its pre-loss condition.
Additionally, the INSURER has under-scoped and undervalued the interior damages caused by the water intrusion. Despite clear evidence of extensive interior damage, the INSURER has failed to fully indemnify the INSURED for the necessary repairs, instead offering an inadequate payment that does not reflect the full extent of the loss.
Further, the INSURER has failed to cite any policy exclusions that would justify its failure to properly adjust the scope of the loss. At no point has the INSURER advised the INSURED that any particular provision of the policy precludes full indemnification for the covered damages.
On October 30, 2024, Claims Examiner Stacy Barnes, on behalf of Claims Examiner Rashamir Thibodeaux, sent correspondence stating:
"Please give your repairer a copy of the enclosed estimate before repairs begin. If the repairer believes there are additional damages or costs attributed to this loss, please contact us to discuss the differences. Before we can consider any additional payment, we must agree the damage is related to this loss."
In good faith reliance on this statement, the INSURED's designated repairer, Kyle Cherone, representing Green Coast Roofing and Contracting, provided a comparative estimate and photographic documentation of supplementary damage resulting from Hurricane Milton. Mr. Cherone also included an ITEL report confirming that the existing roof tiles were obsolete on or about October 31, 2024. Notwithstanding, the INSURER has taken no action regarding these submissions and has failed to issue any additional payments.
The INSURER’s conduct constitutes bad faith and an improper attempt to minimize its financial exposure at the expense of the INSURED, who has complied with all policy obligations. The INSURER has engaged in delay tactics and wrongful underpayment of the claim, leaving the INSURED with damaged property and forcing them to bear significant out-of-pocket expenses.
To date, it has been one hundred and forty two (142) days since the claim was reported, and INSURER has failed to fully indemnify its INSURED for this loss. The INSURED, of course, is very disappointed with INSURER’s poor investigation and nonpayment of the claim. The INSURED has retained a repairer, Kyle Cherone of Green Coast Roofing and Contracting who has prepared an estimate of the INSURED'S damages, which totals $100,197.12. Therefore, demand is hereby made as follows: Estimate $100,197.12, Less Deductible $15,619.00, Less Prior Payments $4,641.97, TOTAL $79,936.15.
The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty.
The INSURED was and still is, forced to expend out-of-pocket funds to submit his insurance claim, e.g., retaining a public adjuster, an attorney, and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them.
INSURER’s refusal and/or failure to settle the insurance claim, when under all circumstances it could have and should have done so, had it acted fairly and honestly toward the INSURED, is wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must tender to the INSURED $79,936.15 as set forth above plus interest. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Failure to tender the demanded amount within the cure period will result in the insured pursuing all available legal remedies, including but not limited to a bad-faith lawsuit pursuant to Florida law. Additionally, this notice will be submitted to the Florida Department of Financial Services and may result in further regulatory review of the INSURER’s handling of claims.
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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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