Civil Remedy Notice of Insurer Violations
Login

Filing Number:     810943
Filing Accepted:  3/13/2025
         Print Filing
Complainant
Last/Business Name *  
KING   First Name   JOSEPH
Street Address * 4899 VENETIAN PL. NE
City, State Zip * ST. PETERSBURG, FL 33703
Email Address * JODI@LAWHUGGINS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   KING   First Name   JOSEPH
Policy # * FLD597257 Claim #* 24851-241001
Attorney
Attorney is Applicable
Last Name* PETERS First Name * JODI Initial
Street Address* 6421 N FLORIDA AVE D-598
City, State Zip* TAMPA , FLORDIA 33604
Email Address * JODI@LAWHUGGINS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN STRATEGIC INSURANCE CORP.
NAIC Company Code 10872
 
Name of individual responsible for violation (if any):* TARA REAM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
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 insured and with due regard for her or his interests.
624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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.
626.9541(1)(i)(3)(d) Denying 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 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.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insurer has not provided a copy of the Policy, despite the Insureds’ request. The violations described herein derive from Florida law concerning insurers’ obligations to their insured. See, e.g., Fla. Stat. Chapters 626, 627. Specific policy language that may be relevant to the violations include, but are not limited to, the following: Building Coverage provisions, All Additional Coverages provisions, All Coverages provided by Endorsement or Rider, The Declarations, Page Loss Payment, Settlement provision, and the insurance policy's definition section.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insurer’s adjuster(s) assigned to this claim were/are: Tara Ream,. Hereinafter referred to as the “Adjuster” or “Adjusters”. - The Insured suffered a loss due to storms that occurred on or about September 26, 2024. The Insured’s covered property was damaged by the loss. On October 4, 2024, the Insurer admitted that the Property sustained damage from the Loss that was covered by the Insured’s insurance policy (policy number stated above; hereinafter the “Policy”)—for which the Insurer assessed a replacement cost value of $64,782.28 for the dwelling (“Insurer Estimate”), a mere 53% of the eventual cost incurred to repair the property. The Insurer Estimate was prepared and authored by Adjuster Ream. The Insurer Estimate was patently deficient in that it omitted entire categories of damage that would have been visible to and recognizable by any person viewing the damaged Property, let alone a qualified insurance adjuster. It is important to note that some of these damages are not latent; they are patent and easily observable through cursory investigation. Upon review of the Insurer’s estimate, it became clear to the Insured that the Insurer patently undervalued the replacement cost value of the Property by omitting obvious damages and that the Insured would not fully restore the Property to the condition it was in prior to the loss by failing to pay the Insured all the benefits to which the Insured is entitled under the Policy for the loss. Here, the insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests; the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims; the Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(2) by making a misrepresentation 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; the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information; the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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; and the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - On October 4, 2024, Adjuster Ream sent a letter underpaying the claim based upon a report from the insurer’s field adjuster that failed to account for the proper repair of the observed damages. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices as a result. - The roof damage is consistent with hurricane force wind, showing impact from flying debris. Due to the extent of damages and the requirement of a proper repair under Florida law, a full roof replacement would be warranted under the Policy Adjuster Ream wrongfully underpaid the insurance claim by making the above misrepresentations. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(3) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - On October 4, 2024, Adjuster Ream sent the Insured correspondence indicating that $54,877.22 (approximately 45%) of the Claim for the dwelling would be paid. However, she provided scant rationale as to how she arrived at this figure/percentage despite the detailed corroborative information provided by the Insured. In this way, the insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 624.155(1)(b)(2) by making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. - Moreover, Adjuster Ream denied approximately 55% of the Claim for the dwelling. However, in this correspondence or at no point did Adjuster Ream meaningfully explain why 55% of the Claim was being denied. Here, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. And, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - The Insurer’s conduct in this case is one instance a pattern of business practice designed to avoid or delay coverage determinations for claims, supplemental claims, and/or additional claims by failing to render a determination when requested, failing to make payments of undisputed amounts of claims, and 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. - To cure the conduct giving rise to the violations described herein, insurer must: (i) pay the total replacement cost value of the Insured’s Claim in the amount of $122,000.00 for the dwelling, less prior payments for the dwelling only and the deductible this demand does not include damages for personal property; (ii) make payment of any pre-judgment interest owed under Florida law; (iii) make payment for the additional expense incurred by the Insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim.
Comments
User Id Date Added Comment
emily@lawhuggins.com 07-08-2026 The Insureds hereby withdraw this CRN in its entirety.
lashawna_e_nesbitt@progressive.com 03-13-2025 While American Strategic Insurance Company believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to Jodi Peters, Esq, on March 13, 2025.
Acknowledgement
* 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.




DFS-10-363
Rev. 10/14/2008