Filing Number: 812017
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| Filing Accepted: 3/20/2025 |
| Last/Business Name
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| Street Address
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2065 EMERALD GREEN CIR |
| City, State Zip
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OVIEDO,
FL
32765
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| Email Address
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LAWNPATROLLANDSCAPING@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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CARL |
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First Name |
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ERIC |
| Policy # * |
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7709HR001557 |
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Claim #* |
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172914-GQ |
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Attorney is Applicable
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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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NATIONWIDE PROPERTY AND CASUALTY 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 37877 |
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| Name of individual responsible for violation (if any):*
JACOB ASHLEY, JENNIFER L WOOD AND ALL OTHER NATIONWIDE EMPLOYEES, REPRESENTATIVES, AGENTS, AND VENDORS WHO HANDLED 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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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Claim Denial
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Statutory provision(s) which the insurer allegedly violated.
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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)(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.
AGREEMENT
We will provide the insurance described in this policy, which includes the Declarations and
attached endorsements or schedules, in return for the premium and fees, and compliance
with all applicable provisions of this policy.
SECTION I — PROPERTY COVERAGES
A. Coverage A — Dwelling
1. We cover:a. The dwelling on the "residence premises" shown in the Declarations, including
structures attached to the dwelling; and
b. Materials and supplies located on or next to the "residence premises" used to
construct, alter or repair the dwelling or other structures on the "residence
premises".
SECTION I — PERILS INSURED AGAINST
A. Coverage A — Dwelling And Coverage B — Other Structures
1. We insure against direct physical loss to property described in Coverages A and B.
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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.
Eric Carl (“the insured”) is a homeowner insured under an all-risks policy issued by Nationwide Insurance. The insured property, located at 2065 Emerald Green Cir, Oviedo, FL 32765, sustained significant hail and wind damage during a severe storm on February 4, 2024. As a result of the storm, the property suffered extensive damage, including hail and wind impacts to the roof, damage to the gutters, interior leaks caused by roofing damage, and hail-related damage to exterior window screens. The insured promptly reported the loss and has complied with all post-loss obligations under the policy. Despite clear and documented evidence of the full extent of the damage, Nationwide has failed to properly investigate and indemnify the insured, significantly undervaluing the claim and denying the insured the full benefits to which they are entitled.
Following Nationwide’s initial inspection, the insurer acknowledged certain damage, including impacts to the window screens, metal gutters, roofing shingles, and interior leaks. However, despite these admissions, Nationwide has failed to issue payment commensurate with the necessary repairs, instead providing a grossly inadequate estimate of $2,206.70. Recognizing that Nationwide’s assessment failed to account for the full scope of damage, the insured retained a licensed Florida roofing contractor and a licensed public adjuster to conduct independent inspections of the property. Both professionals confirmed extensive hail and wind damage that Nationwide overlooked, including compromised roofing materials requiring full replacement. The insured, in good faith, requested a re-inspection based on these findings, yet Nationwide improperly denied this request, demonstrating a clear bias in claims handling and a failure to conduct a thorough and fair investigation.
Nationwide’s refusal to adequately re-evaluate the damage and issue proper indemnification constitutes a violation of Florida Statutes, including but not limited to § 626.9541(1)(i)(3), which prohibits insurers from failing to adopt and implement standards for the proper investigation of claims, and § 624.155(1)(b)(1), which requires insurers to act in good faith in settling claims. By agreeing that damage exists but then failing to properly account for the necessary repairs, Nationwide has engaged in unfair claim settlement practices and failed to act in accordance with the reasonable expectations of the insured under the policy. Additionally, Nationwide’s failure to properly investigate the full extent of the damages, including denying a re-inspection despite additional expert assessments, directly violates Florida Statute § 627.70131, which mandates prompt and fair investigations of claims.
The insured’s estimate for repairs, based on independent evaluations by qualified professionals, is $60,518.96. Nationwide’s failure to recognize and properly compensate for the actual damages leaves the insured unable to restore the property to its pre-loss condition, causing undue financial and emotional hardship. The insurer’s deliberate undervaluation and improper handling of this claim are clear examples of bad-faith insurance practices.
To cure this civil remedy notice, Nationwide must immediately acknowledge full coverage for the insured’s loss and conduct a fair and thorough re-inspection of the property, taking into account the independent assessments provided by the licensed roofing contractor and public adjuster. Nationwide must issue payment for the full amount necessary to restore the property, in accordance with the insured’s estimate of $60,518.96. Additionally, Nationwide must take corrective action to ensure compliance with Florida law and industry standards to prevent similar bad-faith practices in the future.
Failure to cure the violations outlined in this notice within the statutory timeframe may result in legal action, including but not limited to a bad-faith lawsuit seeking additional damages, interest, and attorney’s fees.
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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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