Filing Number: 811065
|
| Filing Accepted: 3/13/2025 |
| Last/Business Name
*
|
|
|
| Street Address
*
|
|
1066 SW MCCALL RD |
| City, State Zip
*
|
|
PORT SAINT LUCIE,
FL
34953
|
| Email Address
*
|
|
CJNSERVICESLLC@GMAIL.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
NELSON RUIZ |
|
First Name |
|
|
| Policy # * |
|
HCPCHO337206713 |
|
Claim #* |
|
944911 |
|
Attorney is Applicable
|
| Last Name* |
GONZALEZ ESQ.
First Name *
ROBERT F.
Initial
|
| Street Address* |
|
8950 SW 74TH CT., STE 2267 |
| City, State Zip* |
|
MIAMI
,
FLORIDA
33156
|
| Email Address * |
|
INTAKE@FLINSLAW.COM |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 12944 |
|
|
| Name of individual responsible for violation (if any):*
UNKNOWN
|
| 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)(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)(d) |
|
Denying claims without conducting reasonable investigations based upon available information.
|
|
*
Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Section 1 - Perlis Insured Against Section 1 - Property Coverages Loss Settlement Provision
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
Page 1 of 1On August 4, 2024, Nelson Ruiz suffered a loss due to covered perils contemplated under thePolicy; and timely reported the damage to Defendant. Nelson Ruiz presented evidence toHomeowners Choice Property & Casualty Insurance Company, Inc. that the loss occurred duringthe policy period and coverage for the loss was contemplated under the policy. Nelson Ruizcomplied with all required post-loss conditions. Homeowners Choice Property & CasualtyInsurance Company, Inc. sent an unqualified person to make determinations of causation ofdamage in violations of 626.9541(1)(i)(3)(d). After completing its deficient investigationHomeowners Choice Property & Casualty Insurance Company, Inc. should have providedcoverage for the loss. Homeowners Choice Property & Casualty Insurance Company, Inc. hasunduly delayed full payment and coverage over the claim in violation of the insurance contractand has done so in a manner which violates multiple Florida Statutes. Furthermore, HomeownersChoice Property & Casualty Insurance Company, Inc. failed to promptly provide a reasonableexplanation in writing to the insured of the basis in the insurance policy, in relation to the facts orapplicable law, for denial of a claim or for the offer of a compromise settlement.The failure to issue full payment when there was no applicable exclusion for the type of servicerendered in relation to the covered claim is a violation of 624.155(1)(b)(1) and 624.155(1)(b)(3).Homeowners Choice Property & Casualty Insurance Company, Inc. has made it a businesspractice to deny covered claims without proper justification in direct violation of 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(b).Homeowners Choice Property & Casualty Insurance Company, Inc. has repeatedly andcontinuously acted in bad faith in this matter and others like it. Despite the fact that the allegeddamages were related to a covered loss and not excluded under the policy of insurance,Homeowners Choice Property & Casualty Insurance Company, Inc. refuses to pay the fullamount of insurance benefits owed for same. In order to cure Homeowners Choice Property &Casualty Insurance Company, Inc.’s continuous acts of bad faith, Homeowners Choice Property& Casualty Insurance Company, Inc. must issue payment in the amount of $ 71,356.62; as wellas, statutory interest. In addition, Homeowners Choice Property & Casualty Insurance Company,Inc. must cease its unfair trade practice of citing to irrelevant policy provisions in order tomisrepresent the coverages afforded under its policies of insurance.HOS24-000766
|
|
*
|
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
|