Filing Number: 810140
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| Filing Accepted: 3/7/2025 |
| Last/Business Name
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ZECHEL
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First Name |
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ADOLF AND BARBARA |
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| Street Address
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16152 SW 288TH STREET |
| City, State Zip
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HOMESTEAD,
FL
33030
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| Email Address
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WITHHELD |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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ZECHEL |
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First Name |
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ADOLF AND BARBARA |
| Policy # * |
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540527 |
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Claim #* |
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9410831 |
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Attorney is Applicable
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| Last Name* |
SHERMAN
First Name *
RYAN
Initial
H
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| Street Address* |
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18801 NE 21ST AVENUE |
| City, State Zip* |
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MIAMI
,
FL
33179
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| Email Address * |
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RYANSHERMANFL@GMAIL.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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HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
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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 12944 |
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| Name of individual responsible for violation (if any):*
DAISY PRINCESA
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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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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)(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)(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.
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; however, we do not insure loss:
1. involving collapse, other than as provided in Other Coverages 10;
2. caused by:
...
h. (1) wear and tear, marring, deterioration;
(2) inherent vice, latent defect, mechanical breakdown;
(3) smog, rust or other corrosion, mold, wet or dry rot;
...
(6) se ling, shrinking, bulging or expansion, including resultant cracking, of
pavements, patios, foundations, walls, floors, roofs or ceilings; or
...
If any of these cause water damage not otherwise excluded, from a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance, we cover loss caused by the water including the cost of tearing out and replacing any part of a building necessary to repair the system or appliance. We do not cover loss to the system or appliance from which this water escaped.
3. excluded under General Exclusions.
Under items 1 and 2, any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered.
...
GENERAL EXCLUSIONS
1. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss
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e. Neglect, meaning your neglect to use all reasonable means to save and preserve
property at and a er the me of a loss.
...
2. We do not insure for loss to property described in Coverages A and B caused by any of
the following. However, any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered.
...
c. Faulty, inadequate or defective;
...
(2) design, specifications, workmanship, repair, construction, renovation,
remodeling, grading, compaction;
(3) materials used in repair, construction, renovation or remodeling; or (4) maintenance;
of part or all of any property whether on or off the Described Loca on. ...
CONDITIONS ...
4. Your Du es A er Loss. In case of a loss to covered property, you must see that the following are done:
a. give prompt notice to us or our agent;
b. (1) protect the property from further damage;
(2) make reasonable and necessary repairs to protect the property; and (3) keep an accurate record of repair expenses;
...
d. as often as we reasonably require:
(1) show the damaged property;
(2) provide us with records and documents we request and permit us to make
copies; and
(3) submit to examination under oath, while not in the presence of any other
named insured, and sign the same;
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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 December 13, 2024, the Insureds suffered a loss on account of a plumbing leak causing water damage to Insureds’ property (hereinafter “PLUMBING LEAK CLAIM”). The Insurer assigned claim number 9410831 to the PLUMBING LEAK CLAIM.
However, Insurer failed to honor Insureds’ claim and compensate them for the covered losses and, instead, denied said claim in full. As such, Insurer failed to fully, or even partially, indemnify the Insureds for their PLUMBING LEAK CLAIM as it was contractually obligated to do pursuant to the subject Policy.
Insurer violated numerous Florida Statutes in its handling of Insureds’ Plumbing Leak Claim.
Insurer did not attempt in good faith to settle claims when, under all circumstances, it could and should have done so, made a material misrepresentation for the purpose and with the intent of effecting settlement of such claims, loss or damage on less favorable terms than those provided in the policy, and misrepresented pertinent facts or insurance policy provisions relating to Coverages at issue.
Further, by ignoring obvious interior damages resulting from the wind loss claim, Insurer failed to adopt and implement standards for the proper investigation of claims, and denied Insureds’ claim without conducting reasonable investigations based on available information.
Insurer made a material misrepresentation, and misrepresented pertinent facts or insurance policy provisions relating to Coverages at issue, when it stated there was no coverage for the Insureds’ claimed loss, and did so for the purpose and with the intent of effecting settlement of such claims, loss or damage on less favorable terms than those provided in the policy.
Insurer can cure this breach by paying insurance monies due and owed to the Insureds that would reasonably place Insureds back to their pre-loss condition, as well as compensating the Insureds for all Additional Living Expenses, as well as any and all reasonable attorney’s fees and costs incurred by them to date in connection with this claim and stemming from the aforementioned violations by the Insurer. This notice is given in order to perfect the right to pursue the Civil Remedy Authorized by this section.
NOTE: As any information contained herein becomes part of the public record, the Insureds have withheld their email address(es) so as to not make same available for public review. Furthermore, as the Insureds are represented by counsel, it would be improper for any representative of the Insurer to contact the Insureds directly for any reason utilizing their email address(es) and, as such, the information is neither material to the Insurer’s ability to correct the violations contained herein nor required by the Department of Financial Services. The Insurer should direct all follow up correspondences to the attorney listed above.
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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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