Filing Number: 811230
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| Filing Accepted: 3/14/2025 |
| Last/Business Name
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HOLT
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First Name |
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BRANNON AND AMY |
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| Street Address
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20715 MARINA ROAD |
| City, State Zip
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PERRY,
FL
32348
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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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HOLT |
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First Name |
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BRANNON AND AMY |
| Policy # * |
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P000696322 |
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Claim #* |
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258332 |
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Attorney is Applicable
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| Last Name* |
REEVES
First Name *
NICHOLAS
Initial
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| Street Address* |
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4000 HOLLYWOOD BLVD, STE 685-S |
| City, State Zip* |
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HOLLYWOOD
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FLORIDA
33021
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| Email Address * |
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NREEVES@CASSEL.LAW |
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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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SECURITY FIRST INSURANCE 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 10117 |
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| Name of individual responsible for violation (if any):*
JOHN JOINER, MS. MOULTRY, INDEPENDENT FORENSICS GROUP, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SECURITY FIRST INSURANCE COMPANY INVOLVED IN 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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Claim Delay
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Unfair Trade Practice
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Other
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Violation of Adjusters' Ethical Requirements
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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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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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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 violations asserted herein regarding Security First Insurance Company's bad faith actions are based heavily on the facts and circumstances asserted in the below section designated for same as well as violations of the portions of Florida Insurance Code and Florida Administrative Code upon which the bad faith statutes contained within Sections 624.155 & 626.9541, Florida Statutes, are based.
Despite requests for a complete copy of the policy, Security First Insurance Company has not provided same and, as such, the exact verbiage of the terms of the subject policy are “UNKNOWN.” With that said, the based on prior experiences with policies issued by Security First Insurance Company or its related companies, it is anticipated that the following policy language is relevant to Security First Insurance Company's statutory violations and bad faith conduct:
SECTION I – CONDITIONS
10. Loss Payment. We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be paid upon the earliest of the following:
a. 20 days after we receive your written proof of loss and reach a written executed agreement of
settlement with you according to the terms of the written agreement; or
b. 60 days after we receive your written proof of loss and:
(1) There is an entry of a final judgment or, in the case of an appeal from such judgment, within 60 days from and after the affirmance of the same by the appellate court; or
(2) There is a written executed mediation settlement agreement with you according to the terms of the written mediation settlement; or
c. Within 90 days after we receive written notice of an initial claim, “reopened claim” or “supplemental claim” from you, we will pay or deny such claim or a portion of the claim unless the failure to pay such claim or portion of claim is caused by factors beyond our control which reasonably prevent such payment.
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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.
Form DFS-10-363, Rev. 10/14/2008, contains a field for the insureds to include their email addresses. Prior to filing the CRN, said form contains an instruction that, in the event the insureds do not with for certain information to become part of the public record, the insureds must simply include the term “WITHHELD” to satisfy the filing requirement. This is further established through the following statement with appears on Civil Remedy Notices which have been filed:
Warning! Information submitted as part of this civil remedy notice is a public record. Data entered into this form will be displayed on the DFS website for public review. Please DO NOT enter Social Security Numbers, personal medical information, personal financial information or any other information you do not want available for public review.
As any information contained herein becomes part of the public record, the insureds have withheld their email addresses so as not to make same available for public review and indicated same accordingly. Furthermore, as the insureds are represented by counsel, it would be improper for any representative of Security First Insurance Company to contact the insureds directly for any reason utilizing their email addresses and, as such, the information is neither material to Security First Insurance Company’s ability to correct the violations contained herein nor required by the Department of Financial Services. Security First Insurance Company should direct all follow-up correspondences to the attorney listed above.
Furthermore, as the above section requesting people with knowledge as to the allegations in the instant CRN often gets cut off, the following are those responsible for the violations alleged herein:
John Joiner, Ms. Moultry, Independent Forensics Group, and all other adjusters, supervisors, management and individuals associated with or retained by Security First Insurance Company involved in this claim.
The facts and circumstances giving rise to the insurer's violation as the insureds understand them at this time:
Brannon Holt and Amy Holt (hereinafter the “insureds”) purchased an all-risk property insurance policy, policy number P000696322 (hereinafter the “Subject Policy”) from Security First Insurance Company (hereinafter “Security First”) which, at all times material hereto, provided property insurance for the property located at 20715 Marina Road, Perry, FL 32348 (hereinafter the “Subject Property”).
On or about September 26, 2024, Hurricane Helene caused direct physical loss and resultant/ensuing damages to the Subject Property (hereinafter the "Loss").
The insureds timely notified Security First of the loss. Security First assigned claim number 258332 to the loss (hereinafter the "claim") and assigned adjustment of the claim to Ms. Moultry who, in turn, enlisted the assistance of a field adjuster employed by Security First, to perform an inspection of the Subject Property. The carrier also retained Independent Forensics Group, a biased engineering firm routinely used to confirm the carrier’s coverage decisions, to perform an inspection
On October 2, 2024, Independent Forensics Group performed an inspection of the Subject Property.
On October 5, 2024, the assigned field adjuster inspected the Subject Property.
On November 2, 2024, Security First sent a letter to the insureds indicating that the assigned field adjuster observed a total loss of the dwelling due to flood and storm surge from Hurricane Helene. Not surprisingly, the letter further stated that Independent Forensics Group agreed and also observed that the proximate cause of damage to the property, including all major structural and cladding components, was the result of rising water due to the storm surge. The letter concluded that there was no coverage for the claim.
On November 6, 2024, in shock and extreme disappointment at Security First’s cursory investigation and summary denial, the insureds retained Coastal Claim Consultants (“Coastal”) for assistance with the claim.
On November 7, 2024, Coastal sent a letter to Security First notifying the carrier of their retention, providing a letter of representation and making a formal request for documentation.
On or about January 8, 2025, Coastal prepared a repair estimate to return the Subject Property to its pre-loss condition as a result of the destruction caused by the winds associated with Hurricane Helene, including the damaged contents and fair rental value, which totaled $594,180.05.
On January 9, 2025, the insureds executed a sworn proof of loss which was supported by the estimate prepared by Coastal.
On January 10, 2025, Coastal sent correspondence to the carrier including a payment request letter, the repair estimate, damaged contents list, competing engineering report, loss damage photographs, the sworn proof of loss, and a property held for rent confirmation.
The January 10, 2025, payment request letter advised that the insureds hired their own forensic engineer, The Harris Solution, to inspect the property for the total loss caused by Hurricane Helene. The insureds’ engineer concluded that the damage to the subject structure was due solely to Hurricane Helene with the wind from the hurricane as the proximate cause of total destruction to the home. The engineering report indicated that Hurricane Helene had 89 mph sustained winds and 121 mph gusts that lasted a total of five hours. The insureds’ engineer conclusively determined that wind caused the total destruction of the home. As such, the letter respectfully requested that Security First reverse their initial denial of the claim and extend full coverage and payment for the loss according to the limits of the policy: $211,000.00 under Coverage A; $30,000.00 under Coverage C; and $21,100.00 under Coverage D.
On January 16, 2025, John Joiner from Security First, responded to Coastal advising that he had been re-assigned to the insureds’ re-opened claim. Mr. Joiner acknowledged receipt of the numerous documents and information submitted by Coastal and also inquired whether the insureds had a flood policy and made a flood claim.
Also on January 16, 2025, Coastal responded immediately advising that the insureds had no other insurance policies on the property and requested a phone call upon review of the documentation submitted by Coastal in support of the claim.
On January 27, 2025, Coastal called Mr. Joiner and left a voicemail. Coastal also sent a follow up email requesting a status on the review of the claim and requesting that Mr. Joiner advise if any further information was needed to assist with the review process.
On January 28, 2025, Mr. Joiner sent correspondence to Coastal advising that the insureds’ engineering report had been sent to the carrier’s engineer, Independent Forensics Group for review.
On January 29, 2025, Costal responded to Mr. Joiner inquiring as to the potential timeframe in which Mr. Joiner expected to hear back from Independent Forensics Group regarding the review.
On February 20, 2025, 41 days after Costal submitted the supporting documentation to the carrier, Mr. Joiner sent a letter to Coastal indicating that Security First had reviewed the documentation provided by Coastal, but that it did not alter the prior coverage determination based on the carrier’s initial investigation.
Despite the overwhelming amount of information and documentation submitted to Security First by Coastal on behalf of the insureds, it is clear that the carrier made no real effort to continue its evaluation of the claim, choosing instead to rely wholly on its initially cursory investigation the conclusory opinions of its biased engineering firm.
Security First denied the insureds’ claim through their actions also in violation of Florida’s Valued Policy Law (hereinafter "VPL"). Florida’s VPL, which has been in existence since 1899, provides, in pertinent part:
In the event of the total loss of any building… located in this state and insured by any insurer as to a covered peril, in the absence of any change increasing the risk without the insurer’s consent and in the absence of fraudulent or criminal fault on the part of the insured or one acting in her or his behalf, the insurer’s liability under the policy for such total loss, if caused by a covered peril, shall be in the amount of money for which such property was so insured as specified in the policy and for which a premium has been charged and paid.
Fla. Stat. § 627.702(1)(a) (2022). Furthermore, “if the covered perils alone would have caused the total loss,” coverage shall be afforded in the amount of the applicable policy limits. Id. at (b).
The VPL requires an insurance company to set its maximum liability, for which it sets an appropriate premium, in order to eliminate any dispute over the amount of loss payable where the insured loss is total.
The Valued Policy Law... sets the amount payable when there is a total loss. ‘Its principle object and purpose is to fix the measure of damages in case of loss total, or partial; and, to this end, it requires the insurer to ascertain the insurable value at the time of writing the policy, and to write it therein.’***Undoubtedly an important object of the statute is also to simplify and facilitate prompt settlement of insurance claims when a total loss occurs… Thus vexatious contest on this [value of the property] issue would persist when the best interests of all demanded prompt settlement and relief from the loss. A solution to this is found in the statute which in effect requires the parties to ascertain and agree in advance what the value is and in the case of total loss by the insured peril this amount shall be paid as liquidated damages. This is not an unfair scheme, as the insured is stating the limits of his recovery and at the same time the insurer is basing his premium charges on his maximum exposure. When the total loss occurs neither can contend the value of the destroyed property is any different from what they had previously specified.
Springfield Fire and Marine Ins. Co. v. Boswell, 167 So.2d 780, 783-84 (1st DCA 1964); see also Ceballo v. Citizens Prop. Ins. Corp., 967 So.2d 811, 813 (2007)(“Florida’s VPL was originally enacted in 1899 to promote clarity and predictability for property insurers and insureds alike by predetermining the value of insured real property and having that value set out in the policy of insurance.”); Citizens Prop. Ins. Corp. v. Hamilton, 43 So.3d 746, 756 (1st DCA 2010)(“Once the jury found a total loss caused by wind, damages were fixed by statute.”).
With Hurricane Helene, wind and wind-driven debris occurred first. This wind damage would have caused a total loss on its own, and as such, Florida’s VPL is triggered and policy limits are owed.
This is further supported by the Informational Memorandum Notification to Authorized Residential Property Insurers, including Security First, issued by the Florida Office of Insurance Regulation (hereinafter “FOIR”) on February 20, 2025: https://content.govdelivery.com/accounts/FLOIR/bulletins/3d319a7. In the bulletin, the FOIR instructs that it “expects insurers, before denying a total loss claim for wind damage when flood or storm surge damage may have also damages the building . . . to be mindful of and apply the language contained in” the Florida Valued Policy Law statute. The FOIR further warns that “[i]nsurers failing to comply with Florida law and inappropriately denying coverage due to concurrent causation will be subject to additional regulatory action.” The actions of Security First with regard to the instant claim violate the very issues warned about by the FOIR’s bulletin. Should Security First fail to rectify this in response to the instant Notice, the FOIR will be notified regarding same, especially considering the pattern of conduct evident through counsel’s other files with Security First.
The insureds have been left with no choice but to hire an attorney in order to file a notice of intent to initiate litigation subject to Fla. Stat. § 627.70152. Based on the documentation previously submitted, Security First could have reversed its coverage position and afforded coverage in line with the terms and conditions of the Subject Policy and governing Florida law or, at a minimum, requested a further inspection in order to attempt to find coverage by viewing the circumstances in the light most favorable to the insureds; instead, Security First chose to sit back and wait before Security First ever thought to act in a manner inconsistent with their own self-interest, forcing the insureds into hiring an attorney, thereby coming further out of pocket and leaving less of the outstanding due and owing insurance proceeds for actual repairs. This delay in claims adjustment constitutes a pattern of de facto bad faith conduct.
Through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Security First has violated the following sections of Florida Statutes:
§624.155(1)(b)(1)
Not attempting in good faith to settle claims when, under all circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insured and with due regard.
§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;
Additionally, through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Security First has failed to comply with the following sections of Florida Administrative Code:
69B-220.201(3)(b)
An adjuster shall treat all claimants equally.
69B-220.201(3)(b)(2)
An adjuster shall adjust all claims strictly in accordance with the insurance contract.
69B-220.201(3)(c)
An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured.
69B-220.201(3)(d)
An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.
69B-220.201(3)(f)
An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim.
69B-220.201(3)(k)
An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.
As a direct result of Security First's actions, the insureds have sustained irreparable harm. Upon information and belief, the aforementioned actions complained of herein, among others, are effectuated by Security First so often as to constitute a general business practice evidencing a motive to enhance Security First's profits and cause a detrimental effect to its policyholders. Security First clearly failed to adopt and implement standards for the proper investigations of claims. As a direct and proximate result of Security First's handling of the claim, the insureds sustained extra-contractual damages, including, but not limited to, a public adjuster's fee and attorneys’ fees and costs. Security First's implemented claims programs and practices that were improper which directly resulted in additional losses to its insureds. Security First, as part of its routine business pattern and practices, employs outcome-oriented adjusters/vendors/experts who purposely looked for ways to minimize coverage instead of affording coverage to its policyholders. In contrast to the legislative intent which motivated the enumeration of an insurance adjuster’s responsibilities outlined in the Florida Administrative Code, the insureds were not afforded the professional duties entrusted and imposed on Security First by the Public Trust. The outcome-oriented claim adjustment practices undertaken by Security First led to Security First's failure to adequately adjust the Claim.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Security First fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. In order to cure the defects outlined in this Civil Remedy Notice, Security First must act as follows: immediately deliver payment of all insurance proceeds due and owing to the insureds which would reasonably place the Subject Property back in its pre-loss condition or, alternatively, if appraisal is or has been requested, complete the appraisal process and deliver payment of the executed award; deliver payment for lost rental income; and keep the claim open for the adjustment of any supplemental claim and payment of any as of yet unincurred costs. If Security First disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, Security First should cure to the extent it believes it must under the Subject Policy and governing laws 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 insureds remain willing to entertain any reasonable counteroffer of settlement.
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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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