Civil Remedy Notice of Insurer Violations
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Filing Number:     811056
Filing Accepted:  3/13/2025
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Complainant
Last/Business Name *  
EDGEWATER BEACH RESORT COMMUNITY ASSOCIATION, INC.   First Name  
Street Address * 11212 FRONT BEACH RD.
City, State Zip * PANAMA CITY BEACH, FL 32407
Email Address * BOBSONNESON@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   EDGEWATER BEACH RESORT COMMUNITY ASSOCIATION, INC.   First Name  
Policy # * BPR160009-1 Claim #* 267996 / 923999
Attorney
Attorney is Applicable
Last Name* CLAUSEN LOZIER First Name * GINA Initial
Street Address* 8603 LAKE WORTH RD. SUITE 310
City, State Zip* GREENACRES , FL 33467
Email Address * GCLAUSEN@CCATTORNEYS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   PELEUS INSURANCE COMPANY
NAIC Company Code 34118
 
Name of individual responsible for violation (if any):* CHRIS MCQUEENEY, TIM SWIFT, JOANNE MASSEY
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
Unsatisfactory Settlement Offer
* 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)(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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Peleus Insurance Company (the “Insurance Company”) issued policy of insurance number BPR160009-1 (the “Policy”) to Edgewater Beach Resort Community Association, Inc. (“Edgewater”) to provide coverage for all risks, including hurricane, to the property located at 11483 Front Beach Road, Panama City Beach, FL 32407, which consists of three twelve-story residential towers, thirty-four residential villa buildings, and other non-residential common area structures (the “Property”). On or about October 10, 2018, the Property sustained catastrophic damages as a result of Hurricane Michael. Although the Policy provides coverage for all of the losses, damages, and expenses Edgewater suffered and incurred, the Insurance Company has failed to adequately compensate Edgewater for the damage to the Property. In addition to the Policy sections specifically cited herein, any endorsements or changes to said sections are relevant to Edgewater’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered. The specific policy language at issue includes, but may not be limited to, the following: SECTION II – COVERED CAUSES OF LOSS A. PERILS INSURED: This Policy insures against risks of direct physical loss or damage, occurring during the policy term, to Insured Property, except as excluded.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Edgewater’s insurance claim results from Hurricane Michael, which ravaged the Property on or about October 10, 2018. The hurricane caused catastrophic damages to the roofs, windows, doors, exteriors, interiors, and numerous other building components and structures throughout the Property, resulting in more than $40,000,000 in damages. Edgewater timely reported the claim to the Insurance Company on or about October 10, 2018. The Insurance Company acknowledged receipt of the claim and assigned claim number 267996 / 923999. The Insurance Company also assigned numerous adjusters and consultants to the claim. But instead of retaining objective and qualified consultants to conduct thorough inspections of the Property and render unbiased opinions concerning Edgewater’s catastrophic loss, Chris McQueeney on behalf of the Insurance Company assigned Tim Swift of J.S. Held, a self-proclaimed building consultant in Maryland who works exclusively for insurance companies with no engineering license, no contracting license, no college degree, and no relevant hands-on construction experience. Although Mr. Swift lacked the necessary qualifications, he was apparently contacted by Chris McQueeney within one week of the date of loss to serve as the “cost consultant” on Edgewater’s insurance claim. Remarkably, Mr. McQueeney even assigned Mr. Swift the sole responsibility of preparing the final cost estimate that would ultimately support the Insurance Company’s improper and inadequate coverage determination. Mr. McQueeney and others at the Insurance Company either knew or should have known that Mr. Swift’s bias and lack of experience rendered him unqualified to serve in this pivotal role. The Insurance Company’s failure to assign an objective and qualified cost consultant constitutes unfair claims handling and is evidence of its failure to adopt and implement standards for the proper investigations of claims. The Insurance Company also retained engineering firm, Halliwell Engineering Associates (“Halliwell”), from its preferred vendor list to perform a cursory, outcome-oriented investigation that was designed to provide justification for Mr. Swift to severely underpay Edgewater’s claim. For example, the Insurance Company utilized Halliwell’s limited investigation of the roof tiles on thirty-four villa buildings to advance inconsequential issues relating to “golf ball damage” and justify its plan to cover only partial repairs to certain villa roofs that it knew or should have known failed to address the full extent of damages associated with Hurricane Michael. Indeed, if the Insurance Company retained objective and qualified consultants to investigate Edgewater’s loss instead of Mr. Swift and Halliwell, it would have known the roofs to all thirty-four villa buildings needed to be replaced as a result of Hurricane Michael. Mr. McQueeney and Mr. Swift used Halliwell’s incomplete investigation as a ploy and pretext to take advantage of unsuspecting and inexperienced representatives at Edgewater, resulting in heavily negotiated one-sided “agreements” they both knew financially benefitted the Insurance Company to the detriment of Edgewater, and which they knew conflicted with the opinions and repair recommendations of Edgewater’s preferred roofing contractor at the time, Robert Miller of Ameritech Enterprises. In fact, Mr. Miller testified that he believed the roofs to all thirty-four villa buildings needed to be completely replaced as a result of Hurricane Michael, and that he disagreed with the “repair plan” created by Mr. McQueeney and Mr. Swift, which involved only replacing the roofs on a small number of villa buildings and harvesting tiles to perform only partial repairs on the remaining villa roofs. Mr. Miller further testified that he believed the “repair plan” touted by Mr. Swift and Mr. McQueeney was not viable or consistent with Florida’s Building Code, and that the Insurance Company was simply “trying to get out of paying a claim” by inducing Edgewater’s representatives to accept only partial tile repairs to the roofs of certain villa buildings following Hurricane Michael. Knowing that Mr. Miller held these opinions regarding the repairability of the villa roofs, Mr. McQueeney and Mr. Swift sought to exclude him from their meetings and negotiations with Edgewater’s representatives rather than utilize his roofing experience and intimate knowledge of the villa roofs to fairly and honestly evaluate Edgewater’s claim. The statements made by Mr. McQueeney and Mr. Swift during their negotiations with Edgewater’s representatives regarding the repairability of the villa roofs constitute bad faith and material misrepresentations by the Insurance Company in violation of Florida Statutes. At all material times during the Insurance Company’s so-called investigation, Mr. Swift and Mr. McQueeney sought to wrongfully induce Edgewater’s reliance upon their “hired gun” engineering firm in a bad faith attempt to dissuade Edgewater from retaining its own insurance consultants to perform a fair and reasonable assessment of the claim. Indeed, Mr. Swift has since testified that he knew the scope of damages prepared by Halliwell was critically insufficient, particularly with respect to the villa roofs, and that he was forced to unilaterally expand Halliwell’s scope in an effort to secure the above referenced “agreements” with Edgewater’s representatives. . The Insurance Company’s failure to adequately investigate the claim and retain new consultants when it knew or should have known that the Halliwell assessment was insufficient and riddled with inaccuracies demonstrates its bad faith conduct and deliberate efforts to undervalue Edgewater’s claim. By knowingly utilizing an incomplete and inaccurate damages assessment as a ploy and pretext to secure once-sided “agreements” that severely undervalue Edgewater’s claim, the Insurance Company has engaged in deceptive and unfair claims handling practices. Its actions demonstrate a willful disregard for Edgewater’s rights, as well as a failure to conduct a full, fair, and objective evaluation of the claim. Rather than honoring its obligations under the policy, the Insurance Company has deployed bad faith schemes and maneuvers to avoid paying Edgewater what it is rightfully owed under the policy. Such conduct is not only in direct violation of the Insurance Company’s duty to act in good faith but also evidences an intentional strategy to frustrate and discourage Edgewater from obtaining its rights under the policy. The Insurance Company’s refusal to properly investigate, adjust, and compensate Edgewater evidences the Insurance Company’s violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, which requires the Insurance Company to “adopt and implement standards for the proper investigation of claims.” In addition, the Insurance Company has retained an outcome-oriented consultant to perform inspections and provide self-serving reports to the Insurance Company. The Insurance Company’s low-ball payment to the Insureds and inadequate investigation have resulted in the Insurance Company’s unreasonable withholding of payments to Edgewater. The Insurance Company’s obligation to promptly settle Edgewater’s claim is undeniable, and therefore, the Insurance Company has also violated Fla. Stat. Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(g), and 626.9541(1)(i)(3)(d). The actions taken by the Insurance Company in the handling and adjustment of Edgewater’s claim are willful, wanton, and in disregard for the rights of Edgewater, and have occurred with such frequency as to indicate a general business practice in violation of the law. The Insurance Company’s actions amount to, but are not limited to: A. “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 the insured and with due regard for her or his interests;” B. “Failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear;” C. “Failing to adopt and implement standards for the proper investigation of claims;” D. “Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;” E. “Failing to promptly notify the insured of any additional information necessary for the processing of a claim;” F. “Failing to clearly explain the nature of the requested information and the reasons why such information is necessary;” G. and other unfair claim settlement practices. In Florida, the work of adjusting insurance claims engages the public trust. During the adjustment of Edgewater’s claim, the Insurance Company breached this duty by failing to adhere to and comply with the above referenced obligations. To cure the defects outlined above, the Insurance Company must: A. Immediately issue payment to the Insured in the amount of $4,700,000 for the replacement of the Villa Roofs on the following buildings: 800; 900; 950; 1000; 1100; 1500; 1600; 2200; 2300; 2400; 2600; 2900 and 3000. B. Immediately issue payment for overhead and profit on the remaining Villas Roofs referenced in Paragraph A in the amount of $940,000. C. Immediately issue payment for interest on the costs to replace the remaining Villas Roofs referenced in Paragraph A, including overhead and profit in Paragraph B from the date of the last payment March 20, 2020 until Monday March 10, 2025 in the amount of $1,773,122.78.
Comments
User Id Date Added Comment
gclausen@ccattorneys.com 04-17-2025 Pursuant to an agreement reached between the parties, Edgewater Beach Resort Community Association, Inc. withdraws all allegations set forth herein.
gclausen@ccattorneys.com 03-13-2025 The insured also states that a reason for this Notice is the insurer's Claim Denial. Further, all cures are made subject to Peleus Insurance Company's participating share in the applicable policy coverages.
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.

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