Filing Number: 811300
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| Filing Accepted: 3/14/2025 |
| Last/Business Name
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600 SW DARWIN BLVD LLC
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First Name |
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| Street Address
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600 SW DARWIN BLVD |
| City, State Zip
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PORT ST. LUCIE,
FL
34953
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| Email Address
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CLAIMS@WINDLAWGROUP.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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600 SW DARWIN |
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First Name |
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| Policy # * |
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ESC109111 |
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Claim #* |
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AWAX23110018 |
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Attorney is Applicable
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| Last Name* |
GALLAGHER
First Name *
ROBERT
Initial
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| Street Address* |
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8570 STIRLING ROAD, SUITE 102-406 |
| City, State Zip* |
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HOLLYWOOD
,
FL
33024
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| Email Address * |
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ROBERT@WINDLAWGROUP.COM |
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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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AXIS SURPLUS 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 26620 |
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| Name of individual responsible for violation (if any):*
THE ASSIGNED DESK ADJUSTER, FIELD ADJUSTER, SUPERVISOR(S) AND/OR MANAGER(S); AND ANY OTHER THAT HAS REVIEWED THIS CLAIM OR MADE DETERMINATIONS WITH RESPECT TO 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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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Other
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Unfair Settlement Practice
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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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| 626.9541(1)(i)(3)(i) |
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Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
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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.
AXIS SURPLUS INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, AXIS SURPLUS INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections, all endorsements and changes to the subject policy are relevant to the insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.
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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.
On or about November 9, 2022, while the insurance policy (Policy Number: ESC109111 ) was in full force and effect, the subject property located at 600 SW DARWIN BLVD PORT ST. LUCIE, FL 34953 sustained a covered loss as a result of wind and water damage from Hurricane Nicole. This hurricane’s strong winds devastated properties across the state of Florida. The insured filed a claim (Claim Number: AWAX23110018) per the terms of the insurance policy with AXIS SURPLUS INSURANCE COMPANY (the “carrier”). AXIS SURPLUS INSURANCE COMPANY received timely notice of the claim but failed to perform a thorough and prompt investigation so the subject property could be restored to its pre-loss condition. The carrier’s adjuster did not properly adjust the loss to include obviously related damages resulting from Hurricane Nicole. The insured retained a representative, who performed a comprehensive investigation of the property that identified the damage that the carrier knew existed but failed to address. The insured’s representative determined there were damages and repairs necessary to restore the property to its pre-loss condition and submitted claim-related documentation to AXIS SURPLUS INSURANCE COMPANY, including a detailed estimate for repairs. AXIS SURPLUS INSURANCE COMPANY knows that it is acting in direct violation of Florida Statute 624.155(1)(b)(1) and that it has failed to issue proper payment for the claim to include damages and repairs covered by the insurance policy and Florida law. Rather than issuing the proper payment or attempting to reach an agreement with the insured, AXIS SURPLUS INSURANCE COMPANY is delaying and denying the claim. The carrier refuses to make any fair settlement offer to resolve this claim. Not made whole by the carrier per the terms of the insurance policy, the insured has been forced to seek legal counsel to protect the insured’s rights and interests. The above are all examples of AXIS SURPLUS INSURANCE COMPANY’S unfair trade practices, improper investigation and adjustment of the claim, and unfair claim settlement practices. These actions demonstrate the carrier is 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. The insured gives this notice to perfect the right to pursue the civil remedy authorized by Florida Statute § 624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: (1) Pay the complete covered loss in the amount of $526,678.26, less any prior payments and less any applicable policy deductible; (2) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made; and (3) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this claim.
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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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