Filing Number: 809946
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| Filing Accepted: 3/6/2025 |
| Last/Business Name
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TERRE NEUVE PROPERTIES
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First Name |
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| Street Address
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1905 10TH STREET WEST |
| City, State Zip
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PALMETTO,
FL
34221
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| Email Address
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TERRENEUVEPROPERTIES@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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TERRE NEUVE PROPERTIES |
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First Name |
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| Policy # * |
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ABLD108961 |
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Claim #* |
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054290 |
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Attorney is Applicable
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| Last Name* |
ROSS
First Name *
VANESSA
Initial
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| Street Address* |
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2501 S. TAMIAMI TRAIL |
| City, State Zip* |
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SARASOTA
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FL
34239
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| Email Address * |
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ESERVICE@ROSSLEGALFL.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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UNDERWRITERS AT LLOYD'S, LONDON
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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 |
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| Name of individual responsible for violation (if any):*
SHAUN PAIGE, JESSICA BOLTE, JESSE COLWELL, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNDERWRITERS AT LLOYD'S, LONDON INVOLVED IN THE CLAIM.
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| Type of Insurance
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Commercial Property & Casualty
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| Reason for Notice
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Unsatisfactory Settlement Offer
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Claim Denial
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Claim Delay
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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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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| 626.9541(1)(i)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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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.
Builders Risk Coverage Form
Perils Insured Against
Loss Payment
Loss Settlement
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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. Underwriters at Lloyd's, London (“INSURER”) has breached the public’s trust by its adjustment of Terre Neuve Properties (“INSURED”) claim of loss. Underwriters at Lloyd's, London’s mailing address is One Lime Street, London EC3M 7HA, United Kingdom.
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 INSURED’S 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 INSUREDS’ property located at 1905 10th Street West, Palmetto, FL 34221 which sustained significant damage from a windstorm on or about October 9, 2024. The carrier accepted coverage for the loss, however, determined that the amount of damage did not exceed the deductible.
Storm One Claims was retained by the INSURED to prepare an estimate of damage sustained by wind during the storm. Storm One prepared an estimate in the amount of $114,697.49 ACV. Attached please find a copy of Storm One’s estimate along with photos taken of the loss.
In Florida, the work of adjusting insurance claims engages the public trust. The INSURER has breached this duty in the adjustment of this loss by refusing to provide any indemnity, unnecessarily delaying resolution of the claim, and failing to take into consideration documentation provided to them which would support compensation. The INSURER has failed to create and implement adequate guidelines for proper investigation of claims handling and for training and supervision of employees and representatives which have resulted in some of the statutory violations set forth above. INSURER charged the INSURED a substantial premium for these coverages but has refused to tender proper payment when under all circumstances it could have and should have done so had it acted fairly and honestly.
Therefore, demand is hereby made as follows:
Estimate $114,697.49
Less Prior Payments $0.00
Less Deductible $23,750.00
TOTAL $90,947.49
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 monies to submit her insurance claim, e.g., retaining 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 has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. 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 towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must:
(1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future;
(2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully;
(3) INSURER must tender to the INSURED $90,947.49 as set forth above; and,
(4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim.
Attachments: PA Estimate, photos
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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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