Filing Number: 811087
|
| Filing Accepted: 3/13/2025 |
| Last/Business Name
*
|
|
|
SOUTH SHORE CONDOMINIUM ASSOCIATION INC.
|
|
First Name |
|
|
|
| Street Address
*
|
|
12450-12456 SW KINGSWAY CIR ARCADIA, FLORIDA 34269 |
| City, State Zip
*
|
|
ARCADIA,
FL
34269
|
| Email Address
*
|
|
LSANBORN0214@GMAIL.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
SOUTH SHORE CONDOMINIUM ASSOCIATION INC. |
|
First Name |
|
|
| Policy # * |
|
3311907452 |
|
Claim #* |
|
05000001021 |
|
Attorney is Applicable
|
| Last Name* |
MCELWEE
First Name *
JARED
Initial
|
| Street Address* |
|
350 NORTH LAKE DESTINY ROAD |
| City, State Zip* |
|
MAITLAND
,
FLORIDA
32751
|
| Email Address * |
|
JMCELWEE@ITSABOUTJUSTICE.LAW |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
FRONTLINE INSURANCE UNLIMITED COMPANY
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code 10074 |
|
|
| Name of individual responsible for violation (if any):*
N/A
|
| Type of Insurance
*
Commercial Property & Casualty
|
|
|
| Reason for Notice
*
|
|
Claim Denial
|
|
Claim Delay
|
|
Unsatisfactory Settlement Offer
|
|
Unfair Trade Practice
|
|
|
*
Statutory provision(s) which the insurer allegedly violated.
|
|
|
| 626.9541(1)(i)(2) |
|
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.
|
| 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)(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)(g) |
|
Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
|
| 626.9541(1)(i)(4) |
|
Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
|
|
*
Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
A. Coverage
1. Covered Property
E. Loss Conditions
2. Appraisal
4. Loss Payment
3. Replacement Cost
Florida Changes D. The Loss Payment Condition
|
| |
*
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 9/28/2022, South Shore Condominium Association Inc. (“Insureds”), suffered damage to their home located at 12450-12456 SW Kingsway Cir Arcadia, Florida 34269 as a result of a storm event.
Prior to the loss, Frontline Insurance Unlimited Company, had issued a policy of insurance (Policy No.: 3311907452) for the Insureds’ property. Said policy, which was issued prior to the loss, was in full force and effect and afforded coverage for damage caused by the storm.
Frontline was timely notified of the loss by the Insureds and assigned claim number 05000001021. During the course of Frontline’s investigation, the Insureds made their property available for inspection, provided facts and information surrounding the loss, and complied with the Insurer’s adjustment of the claim.
Although Frontline acknowledged the Insureds’ property was damaged by the storm, Frontline inexplicably underpaid a majority of the damages claimed by the Insureds. Frontline came to its coverage determination by ignoring relevant facts and information provided by the Insureds and their contractors that established the damages to the property were substantial and required a full replacement. Most concerning, Frontline and its representatives intentionally downplayed and misrepresented the scope of the damages. Frontline failed to conduct a thorough evaluation as to the age and reparability of the damaged property that caused it to substantially undervalue the loss as a whole. Frontline also omitted key facts from its coverage decision and misapplied exclusions to minimize its financial exposure in the claim.
Frontline proceeded to invoke appraisal but refused to cooperate in completing the appraisal panel selection. As a result of Frontline’s flawed investigation, refusal to tender the benefits owed under the policy, and refusal to cooperate in selecting the appraisal panel, the Insureds were forced to pursue litigation against Frontline for breach of contract. Frontline, following the initiation of litigation, cooperated with the appraisal process and the appraisal was completed. The appraisal panel awarded $1,302,759.86 as a replacement cost value after Frontline originally concluded South Shore was only entitled to $154,504.89. The appraisal award called for $385,174.12 in recoverable depreciation which Frontline withheld even though in possession of documentation showing Insureds had already incurred those amounts. On August 20, 2024, Insureds provided documentation once again to Frontline showing they have incurred costs of $1,415,398.93 in completing repairs to the property, well in excess of the appraisal award. Frontline continues to refuse to release the recoverable depreciation.
It is clear that Frontline has not acted honestly or fairly towards its Insureds. Frontline and its representatives have failed to conduct a proper investigation of the loss, misrepresented the cause and scope of damages at the residence, and misapplied exclusions in the policy in order to wrongfully underpay the Insureds’ claim. It has become a general business practice of Frontline to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. As is the case here, it is a pattern and practice for Frontline to arbitrarily undervalue claims without conducting reasonable investigations based upon information and evidence available to it. It is also a general business practice of Frontline to not respond to claim communications, to not explain what information is necessary to process the claim, and to not explain why benefits are continuing to be withheld under the policy. Frontline’s actions are part of a broader scheme to delay claims and avoid issuing payment that Frontline knows is owed to its insureds.
In order to cure this civil remedy notice, Frontline must tender the recoverable depreciation in the amount of $385,174.12. The written explanation of benefits and payment should be issued to the Insureds’ counsel, Jared McElwee, Esq., at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751.
|
|
*
|
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
|