Filing Number: 810011
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| Filing Accepted: 3/7/2025 |
| Last/Business Name
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JEHALUDI
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First Name |
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SICELY AND SHAZAD |
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| Street Address
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2544 SOUTHWEST CALENDER STREET |
| City, State Zip
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PORT SAINT LUCIE,
FL
34953
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| Email Address
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JEHALUDI72@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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JEHALUDI |
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First Name |
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SICELY AND SHAZAD |
| Policy # * |
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D2LG04X0432488 |
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Claim #* |
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M32324 |
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Attorney is Applicable
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| Last Name* |
ELAZAR
First Name *
SAPIR
Initial
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| Street Address* |
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800 E BROWARD BLVD., STE. 510 |
| City, State Zip* |
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FORT LAUDERDALE
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FLORIDA
33301
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| Email Address * |
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SE@WEKLAW.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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CENTAURI SPECIALTY 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 12573 |
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| Name of individual responsible for violation (if any):*
N/A
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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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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)(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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| 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.
Loss Payment Provision. Loss Settlement Provision.
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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.
Shazad A Jehaludi and Sicely J. Jehaludi (the "Insureds") purchased an insurance policy ("Policy") from Centauri Insurance ("Centauri"), with effective coverage on the date of the loss, on or about October 9, 2024, and policy number D2LG04X0432488 to insure the property located at 2544 SW Calendar St., Port St. Lucie, FL 34953 (the "Property").
On or about October 9, 2024, the Property suffered severe damage as the result of wind and rain from Hurricane Milton, which caused ensuing damage to the Property, including but not limited to the roof, exterior and interior of the Property (the "Loss"). Centauri was timely notified of the Loss. Centauri acknowledged the claim and assigned claim number M32324 ("Claim") to the Loss.
From the onset, it was clear to the Insureds that Centauri had one goal - to reduce or eliminate their liability in the claim. Centauri delivered a coverage determination that misrepresented the material facts of the claim and relied on a faulty and disingenuous inspection report. Centauri thus denied the Insureds the full benefits they are rightfully entitled to without properly evaluating the documentation and proof provided by the insureds.
Frustrated with Centauri’s refusal to pay the full damages and confused as to their rights under the policy, the Insureds were forced to retain the services of a public adjuster, 5 Star Public Adjusters and legal counsel. The property was inspected by 5 Star as to the damage to the property and generated a true and accurate estimate of the damage in the amount of $105,911.71. Despite multiple requests from the Insureds requesting that Centauri reconsider their position, Centauri refused to provide the Insureds with the funds needed to return the property to its pre-loss condition.
The Insureds have fully complied with all applicable policy provisions requiring cooperation with the investigation, however Centauri is unjustifiably and unreasonably denying full payment to the Insureds. Rather than paying the actual damages and/or trying to settle with the Insureds, Centauri is delaying a prompt resolution of the claim. Additionally, Centauri has not attempted, in good faith, to settle this claim when, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholder and with due regard to the policyholder’s interests.
As a direct consequence of Centauri’s failure to adjust this loss in good faith and make the necessary supplemental payment, the Insureds continue to be without adequate compensation for the damage sustained at their Property.
By stating the above detailed facts, it is clear that Centauri has violated the following Florida Statutes:
• 624.155(1)(b)(1) 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 Insureds and with due regard for their interest, when Centauri denied the necessary coverage for damages on the Insureds’ claim.
• 624.155(1)(b)(3) 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;
• 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims;
• 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
• 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims, by failing to respond to the Insureds’ public adjuster, and Insureds’ counsel with respect to supplemental requests for payments;
• 626.9541(1)(i)(3)(d) Denying to fully pay claims without conducting reasonable investigations based upon available information.
• 626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the Insureds and/or their public adjuster of the basis in the insurance policy, in relation to the facts or applicable law, for the offer of a compromise settlement;
To date, Centauri has in bad faith failed to provide sufficient coverage determination to the Insureds. The Insureds property continues to be in disarray as the Insureds are without funds to put their property into its pre-loss condition. As a direct result of Centauri denial of the required damages for coverage and breach of Florida Statutes, the Insureds were forced to seek the help of licensed professionals to assist them, including a public adjuster and legal counsel. Due to the amount of time that has passed since the date of loss, the information discussed above is irrefutable evidence that Centauri knowingly and intentionally, and in bad faith, delays the claims process to further disadvantage the Insureds. The financial detriment caused to the Insureds is a direct result of Centauri reckless treatment of the claims process. The Insureds submitted all documents requested in a timely fashion, made their property available for inspection, submitted supplemental invoices, estimates and requests. However, Centauri failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim.
To deny the Insureds the benefit clearly due and owing under the Policy, for which they have time and time again been making premium payments for and after they have satisfied all their obligations is morally and ethically reprehensible, and reeks of Unfair Claims Practice and Bad Faith. Upon information and belief, the aforementioned actions complained of, among others, were made by Centauri so often as to constitute a general business practice, evidencing a motive to enhance Centauri’s profits, and designed to cause a detrimental effect on its policyholders. The above clearly shows that Centauri adjusted this claim in bad faith and that Centauri is in direct violation of Unfair Claims Practices.
This notice was given to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Centauri fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Centauri must: (1) Immediately tender all proceeds due and owing the Insureds that are fairly owed to the Insureds under the insurance policy that would reasonably compensate the Insureds in order to put the loss property back to its pre-loss condition; (2) Agree to reimburse the Insureds reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insureds for interest on the amount of benefits that was found to be due and owing to the Insureds, relating back to the date of loss.
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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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