Filing Number: 810283
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| Filing Accepted: 3/10/2025 |
| Last/Business Name
*
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HOWARD
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First Name |
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BRADLEY & BILLIE |
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| Street Address
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21227 SKY VISTA DRIVE |
| City, State Zip
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LAND O' LAKES,
FL
34637
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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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HOWARD |
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First Name |
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BRADLEY & BILLIE |
| Policy # * |
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988701765 |
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Claim #* |
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0776495904 |
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Attorney is Applicable
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| Last Name* |
DE LAS SALAS
First Name *
GABRIEL
Initial
M
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| Street Address* |
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1930 HARRISON STREET, SUITE 204 |
| City, State Zip* |
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HOLLYWOOD
,
FL
33020
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| Email Address * |
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GMS@GMSLAWYER.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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CASTLE KEY INDEMNITY 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 10835 |
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| Name of individual responsible for violation (if any):*
THERESA HERNANDEZ AND ALL OTHER ADJUSTERS INVOLVED 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 Denial
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Other
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Bad Faith
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Other
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Unfair Claim Settlement Practices
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Other
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Breach of the Adjuster Code of Ethics
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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)(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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| 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.
Policies must be read in their entirety. Accordingly, the entire policy is relevant to the violation. Specifically: the insuring Agreement; Loss Settlement provisions; and Loss Payment provisions.
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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.
Failure to act in good faith to resolve and pay the claim;
Failure to promptly and properly investigate the subject claim;
Failure to properly adjust the loss;
Failure to adopt and implement standards for the proper investigation of claims;
Placing financial interest of insurer before that of policyholders and claimants; and,
Breaches of the adjuster code of ethics.
The reasons for the foregoing may be attributed to improper training, supervision, and/or motivation of adjusters and claims supervisors to promptly and fairly investigate, adjust and pay full benefits available to all beneficiaries. The insurer failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because the insurer is not acting with honesty and integrity. The insurer’s acts and/or omissions, as detailed in this CRN, are committed and/or performed with such frequency as to indicate they are general business practices.
Bradley S. Howard and Billie Howard (the “Insured”) purchased an insurance policy from Castle Key Indemnity Company (the “Insurer”) bearing policy number 988701765 (the “Policy”). At all times material hereto, the Policy provided property insurance for the property located at 21227 Sky Vista Drive Land O' Lakes, FL 34637 (the “Property”).
On or about 10/9/2024, the Property suffered a covered cause of loss; namely, windstorm damages in connection with a hurricane. The Insured timely notified the Insurer of the loss under the circumstances and the Insurer assigned claim number 0776495904 to the loss (the “Claim”).
The insurer wrongfully denied coverage for the Claim. Prior to this storm, the Insured did not experience any roof leaks. Prior to this storm, the Insured did not have any damage to their chimney. Prior to this storm, the Insured did not have any damage to their roof and the roofing system operated as intended. Notwithstanding the foregoing, the Insurer denied coverage for the loss by inaccurately asserting the damages at the home were the result of wear and tear and deterioration not a sudden and accidental event. A complete and thorough investigation by the Insurer would have shown that the Insured suffered covered losses because of a hurricane.
For these reasons, and those stated in detail above, the insurer is failing to act in good faith.
The adjuster(s) involved in this claim have breached the adjuster code of ethics as found in 69B-220.201, F.A.C. In addition to the statutes cited in this CRN, the adjusters involved in this claim breached the adjuster code of ethics as set forth in 69B-220.201, F.A.C. Pursuant to the code, a breach of any of provision of the ethical rules constitutes unfair claims settlement practices. They have breached the following ethical obligation as set forth in 69B-220.201, F.A.C.: an adjuster shall act with dispatch and due diligence in achieving a proper disposition of the claim.
The adjusters involved in this claim have breached this ethical obligation due to their failure to ensure payment was issued in accordance with the policy and Florida law and in an amount which reasonably restores the insured(s) to their pre-loss condition.
Due to the aforementioned facts and circumstances, and those more fully stated in detail above, the insurer’s adjusters breached the adjuster code of ethics. Accordingly, this ethical breach constitutes an unfair claims settlement practice as provided in 69B-220.201, F.A.C.
The circumstances giving rising to the violations can be cured if the insurer: (1) acknowledges coverage for the loss and (2) acknowledges the insured’s entitlement to prejudgment interest and tenders payment for this interest. If the insurer disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, the insurer should cure to the extent it believes it must under the Policy and Florida law to correct the allegations of bad faith contained herein. While it is not being requested as a cure for the bad faith alleged herein, the insured remains willing to entertain any reasonable counteroffer of settlement.
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*
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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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