Filing Number: 811567
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| Filing Accepted: 3/17/2025 |
| Last/Business Name
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ALLWEISS
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First Name |
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ALLEN & HELENE |
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| Street Address
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28 PARADISE LANE |
| City, State Zip
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TREASURE ISLAND,
FL
33706
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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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ALLWEISS |
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First Name |
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ALLEN & HELENE |
| Policy # * |
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LCHA-FL-0000767-00 |
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Claim #* |
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LCHA-FL-0000767-00 |
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Attorney is Applicable
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| Last Name* |
MULLINAX
First Name *
MATTHEW
Initial
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| Street Address* |
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908 W HORATIO STREET |
| City, State Zip* |
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TAMPA
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FLORIDA
33606
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| Email Address * |
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MATT@MAKRISMULLINAX.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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UNDERWRITERS AT LLOYD'S, LONDON
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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 |
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| Name of individual responsible for violation (if any):*
CHRISTOPHER BROWN
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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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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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| 624.155(1)(b)(3) |
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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.
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| 626.9541(1)(i)(2) |
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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.
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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)(e) |
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Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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| 626.9541(1)(i)(3)(f) |
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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.
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| 626.9541(1)(i)(3)(g) |
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Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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| 626.9541(1)(i)(3)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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| 626.9541(1)(i)(3)(j) |
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Altering or amending an insurance adjuster’s report without:
(I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and
(II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or
(III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;
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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 PERILS INSURED AGAINST SECTION.
THE LOSS PAYMENT PROVISION.
THE LOSS SETTLEMENT PROVISION.
THE POLICY PROVISIONS CITED IN ANY LETTERS SENT BY CERTAIN UNDERWRITER’S AT LLOYD’S, LONDON AND/OR ITS AFFILIATES (“LLOYD’S”).
ANY OTHER PROVISIONS OF THE POLICY WHICH LLOYD’S BELIEVES LIMIT OR PROVIDE COVERAGE FOR THE INSUREDS’ LOSS.
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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 OCTOBER 9, 2024, WHILE THE POLICY WAS IN FULL FORCE AND EFFECT, THE SUBJECT PROPERTY SUSTAINED A COVERED LOSS TO THE PROPERTY, WHICH THE CAUSE OF LOSS INCLUDES BUT NOT LIMITED TO, WIND, RAIN, AND HURRICANE FORCES. THIS RESULTED IN DAMAGE TO THE INSUREDS’ HOME. THE INSUREDS PROVIDED TIMELY NOTICE OF THE LOSS TO LLOYD’S AND LLOYD’S ASSIGNED CLAIM NUMBER LCHA-FL-0000767-00 TO THE CLAIM.
LLOYD’S INSPECTED, ADJUSTED, AND ACCEPTED COVERAGE FOR THE CLAIM AND LOSS. HOWEVER, LLOYD’S IMROPERLY ESTIMATED THE DAMAGE TO BE FAR LESS THAN NEEDED TO RESTORE THE PROPERTY TO ITS PRELOSS CONDITION. ON OCTOBER 26, 2024, LLOYD’S PREPARED AN ESTIAMTE THAT TOTALED $6,499.19 RECPLACEMENT COST VALUE. LLOYD’S MADE NO PAYMENT AS THE ESTIMATE FELL BELOW THE POLICY’S DEDUCTIBLE OF $75,000.00.
THE INSUREDS RETAINED THEIR OWN PROFESSIONALS, WHO DOCUMENTED THE LOSS, PHOTOGRAPHED, AND PREPARED A DETAILED ESTIMATE DATED JANUARY 28, 2025 THAT AMOUNTED TO $277,270.48 TO RESTORE THE DAMAGE AND RETURN THE INSURED PROPERTY TO ITS PRELOSS CONDITION. THIS WAS PROVIDED TO LLOYD’S WITH A PROOF OF LOSS WHICH ACCOUNTED FOR THE POLICY’S DEDUCTIBLE AND CLAIMED $202,270.48, BUT STILL LLOYD’S REFUSED TO PROPERLY INDEMNIFY THE INSURED.
INSTEAD, LLOYD’S REVISED IT’S ESTIMATE AND ON MARCH 5, 2025, LLOYD’S PREARED AN ESTIMATE THAT TOTALLED $72,589.68 REPLACEMENT COST VALUE. AGAIN, LLOYD’S MADE NO PAYMENT AS THIS WAS LESS THAN THE POLICY’S DEDUCTIBLE.
IT IS TELLING THAT BY LLOYD’S OWN CALCULATION IT INITIALLY UNDERVALUED THE COST TO REPAIR BY 90%. ONLY AFTER THE INSURED OBTAINED A SECOND OPINION DID LLOYD’S INCREASE IT’S ADJUSTMENT TO OVER TEN TIMES THE ORIGINAL AMOUNT. BASED ON UPON THE ESTIMATE BY THE INSUREDS’ PUBLIC ADJUSTER, LLOYD’S HAS STILL GROSSLY UNDERPAID THE INSUREDS’ CLAIM.
THE FOLLOWING IS ALLEGED UPON INFORMATION AND BELIEF. THESE ACTIONS DESCRIBED ABOVE, AND OTHERS THAT OCCURRED IN THIS CLAIM, AMOUNT TO A FAILURE TO ADJUST THE INSUREDS’ CLAIM IN GOOD FAITH. LLOYD’S REFUSAL TO CONDUCT A REASONABLE INVESTIGATION BASED UPON AVAILABLE INFORMATION AND FAILURE TO PAY THE INSUREDS FOR THE DAMAGE AND COVERED LOSS UNDER THE POLICY ISSUED BY LLOYD’S EXHIBITS BAD FAITH. FURTHER, LLOYD’S FAILED TO COMPLY WITH ITS LOSS SETTLEMENT PROVISION. RATHER THAN ISSUING THE PROPER PAYMENT OR ATTEMPTING TO REACH AN AGREEMENT WITH ITS INSUREDS, LLOYD’S IMPROPERLY ADJUSTED THE CLAIM. UPON INFORMATION AND BELIEF, LLOYD’S PERFORMS THE SUBJECT ACTIONS AS A BUSINESS PRACTICE, INCLUDING DELAYING THE CLAIM, UNDERVALUING THE CLAIM, AND PARTIALLY DENYING THE CLAIM IN AN ATTEMPT TO DISSUADE ITS INSUREDS FROM PURSUING THE CLAIM TO THE DETRIMENT OF ITS INSUREDS TO INCREASE FINANCIAL PROFITS.
IN THE EVENT LLOYD’S BELIEVES THIS CIVIL REMEDY NOTICE LACKS INFORMATION NECESSARY FOR LLOYD’S TO CURE THE DEFECTS OUTLINED IN THIS NOTICE, OR THAT IT LACKS REQUIRED SPECIFICS IN ANY WAY, LLOYD’S SHOULD CONTACT THE FILER OF THIS NOTICE DIRECTLY AND ALERT THEM TO THAT AS SOON AS POSSIBLE, PRIOR TO ANY FORMAL RESPONSE.
THIS NOTICE IS FILED AND GIVEN TO LLOYD’S TO PERFECT THE RIGHT TO PURSUE THE CIVIL REMEDY THAT SECTION 624.155 AUTHORIZES.
TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, LLOYD’S MUST:
(1). ADMIT FULL COVERAGE FOR THE INSUREDS’ LOSS;
(2). PAY IN THE PROPER AMOUNT NECESSARY TO RESTORE THE PROPERTY TO ITS PRELOSS CONDITIONS, WHICH THE INSURED BELIEVES TO BE IN ACCORDANCE WITH THE ESTIMATE PREPARED BY THE INSUREDS’ PUBLIC ADJUSTER IN THE AMOUNT OF $277,270.48, LESS ANY APPLICABLE DEDUCTIBLE, FOR THE DURATION OF THE SIXTY-DAY CURE PERIOD;
(3). PAY STATUTORY INTEREST ON THE AMOUNT OF UNPAID CONTRACT DAMAGES FROM THE DATE OF THE LOSS TO THE PRESENT TIME PURSUANT TO F.S. §627.70131.
A COPY OF THIS FORM SUBMITTED TO THE FDFS HAS BEEN PROVIDED TO THE FOLLOWING PARTIES PROVIDING THEM NOTICE OF THE FILING OF THE CIVIL REMEDY NOTICE:
CERTAIN UNDERWRITERS AT LLOYD’S, LONDON
VIA EMAIL TO: cbrown@bridgewatergroup.net
ATTN: CHRISTOPHER BROWN, W903486
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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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