Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 811987

Filing Accepted: 3/19/2025

Print Filing

Complainant

Last/Business Name *

SCOTT

First Name

JULIA AND MARK

Street Address *

24970 DIVOT DRIVE

City, State Zip *

BONITA SPRINGS, FL 34135

Email Address *

MYSTINGRAY@COMCAST.NET

Complainant Type: *

Insured

Last/Business Name*		SCOTT		First Name		JULIA AND MARK
Policy # *		ARK101561		Claim #*		1333769-241013

Attorney

Attorney is Applicable

Last Name*	ELAZAR First Name * SAPIR Initial
Street Address*		800 E BROWARD BLVD., STE. 510
City, State Zip*		FORT LAUDERDALE , FLORIDA 33301
Email Address *		SE@WEKLAW.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		ASI PREFERRED INSURANCE CORP.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 13142

Name of individual responsible for violation (if any):* N/A
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	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)(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)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Loss Payment Provision. 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.

Julia and Mark Scott (the "Insureds") purchased an insurance policy ("Policy") from ASI Preferred Insurance Corp. (“ASI”), with effective coverage on the date of loss, on or about September 28th, 2022, under policy number ARK101561, to insure their home located at 24970 Divot Drive, Bonita Springs, FL 34135 (the "Property"). On or about that date, the Property sustained catastrophic damage due to the devastating impact of Hurricane Ian. The storm caused extensive damage including but not limited to the interior, exterior and roofing system of the Property, leaving the Insureds in a dire situation. The Insureds promptly reported their claim to ASI in good faith, expecting fair treatment under their Policy. ASI acknowledged receipt of the claim and assigned claim number 1333769-241013, yet immediately set the tone for bad-faith handling. Following its inspection, ASI deliberately undervalued the damages, issuing an egregiously low estimate of just $1,394.93—an insultingly inadequate amount given the extent of the destruction. From the outset, ASI made a calculated decision to minimize its financial liability, blatantly disregarding the clear and substantial damage suffered by the Insureds' Property. Frustrated by ASI’s bad-faith tactics and refusal to honor its contractual obligations, the Insureds retained Elevate Claim Adjusters (“Elevate”) as their public adjuster to conduct an independent assessment of the loss. Elevate’s thorough investigation revealed that the true cost to restore the Property amounted to $168,156.30—a figure more than ONE HUNDRED TIMES ASI’s intentionally misleading valuation. Elevate immediately submitted their findings to ASI, along with a request for proper compensation, yet ASI continued its pattern of deliberate underpayment and obstruction, refusing to issue any meaningful adjustment to its initial payment. ASI’s grossly inadequate coverage decision and continued refusal to properly compensate the Insureds has not only prevented them from restoring their home to its pre-loss condition, but has also placed them under unnecessary financial and emotional strain. Instead of engaging in the settlement process in good faith, ASI has deliberately engaged in delay tactics, deceptive valuation practices, and an overall bad-faith approach to claims handling, violating its obligations under the Policy and Florida law. As a direct consequence of ASI’s failure to adjust this loss in good faith and pay what it owed under the policy, the Insureds and their family are continuing to sustain considerable hardship. Upon information and belief, ASI, as part of its general business practice, initially low-balls its policyholders. ASI does this in a calculated and systematic scheme that begins with manipulating the software system used in estimating its property damage claims. It appears that ASI issues its adjusters estimating software which contains construction pricing below the fair market value. It also appears that ASI trains its claim adjusters to overlook and/or turn a blind eye to a number of routine costs that ASI knows most policyholders generally would not know to request but are actually covered under the Insureds’ policy. Moreover, as part of this scheme, after ASI one initial low-ball payment – ASI stalls and intentionally delays the claim, changing adjusters, all under the false pretense that it’s “investigating” the claim. ASI has violated Florida Statute § 624.155(1)(b)(1) by continuously not attempting in good faith to settle this claim when it should have done so if it had acted fairly and honestly towards its Insureds. ASI has also violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented all of the indisputable evidence of the amount of damage sustained by this Property, it is a disgrace that the Insureds have been treated in this manner by their insurance company after sustaining an obviously covered loss, submitting to every demand of ASI, and making a good faith effort to resolve in an attempt to amicably come to a fair resolution. ASI violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insureds for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. ASI was informed multiple times of the discrepancies and inconsistencies of the low-ball payment issued to the Insureds. While ASI was made aware of this information for the purpose of obtaining the money contractually owed to the Insureds under its insurance policy to attempt to return their home to its pre-loss condition in a timely fashion, ASI accepted that information and has used it to play the delay game with the Insureds, knowing all too well the additional damage and hardship that was being placed on the Insureds by its actions. ASI violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Under no circumstances is there an excuse for the lack of a proper investigation in this case. ASI and their representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insureds. In addition, after being placed on notice as to the blatant underpayment of the Insureds’ claim, ASI has yet to rectify their actions and do right by the Insureds by paying the money they are contractually owed. ASI violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. There still has yet to be significant action taken by ASI to this date, despite ASI being presented with the flawed rationale behind their underpayment of the Insureds claim. ASI violated § 626.9541(1)(i)(3)(g) by failing to promptly notify the Insureds of any additional information necessary for processing the claim. The Insureds have more than complied with each and every request and there has still been no action by ASI. In the event ASI is in need of additional information, they have failed to promptly notify the Insureds in a timely manner. This pattern of behavior is perpetuated by ASI and their representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insureds throughout the insurance claim process. Several duties and responsibilities to the Insureds were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from ASI approaching the investigation and settlement in a manner prejudicial to the Insureds, failing to allow a fair settlement with the Insureds, and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insureds were not afforded the professional duties entrusted on ASI by the public. To date, ASI has failed to adequately compensate the Insureds for the damage that occurred on September 28th, 2022. As a direct result of ASI’s delay, the Insureds were forced to seek the help of legal counsel to assist them. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that ASI knowingly and intentionally are delaying the claims process in order to further disadvantage the Insureds. The financial detriment caused to the Insureds and their family is a direct result of ASI’s reckless delay of the claim process. The Insureds are dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. The Insureds promptly filed their claim and fulfilled all of their post-loss obligations. All requested information and documentation has been turned over to ASI and their representatives promptly by the Insureds. However, ASI failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insureds how they may remedy any deficiencies in their claim, and failed to provide them with qualified representatives to ensure the claim was initially adjusted, evaluated, and estimated properly. To deny the Insureds the benefit of their bargain after they satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the aforementioned actions complained of, among others, were made by ASI so often as to constitute a general business practice, evidencing a motive to enhance ASI’s profits, and designed to cause a detrimental effect to its policy holders. ASI was aware that the Insureds’ damages were covered and took advantage of its Insureds in an attempt to force them into an irreparably disadvantaged position, which they hope will force the Insureds to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should ASI fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, ASI must: (1) Immediately tender all insurance proceeds due and owing to the Insureds that are fairly owed to the Insureds under the insurance policy that would reasonably place the Insureds back to a pre-loss condition ($168,156.30); (2) Agree to reimburse the Insureds’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insureds for interest on the amount of benefits that was found to be due and owing to the Insureds, relating back to the date of loss; (4) Although the Insureds have made a demand herein and have previously provided ASI with all the necessary estimates, invoices, receipts, etc. in support thereof, the Insureds are still willing to consider and to potentially accept any reasonable counter-offer made by ASI. Therefore, if ASI is not in agreement with the Insureds’ reasonable demand for payment of their rightfully-owed insurance benefits being submitted at this time, the Insureds hereby request that ASI now make a reasonable counter-offer before the expiration of the cure period.

Comments

User Id		Date Added		Comment
lashawna_e_nesbitt@progressive.com		04-18-2025		While ASI Preferred Insurance Corp. believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to Sapir Elazar, Esquire, on April 18, 2025.

Acknowledgement
*	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