Filing Number: 812094
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| Filing Accepted: 3/20/2025 |
| Last/Business Name
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BERARDI
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First Name |
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EUGENE |
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| Street Address
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2708 BAY DRIVE |
| City, State Zip
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BRADENTON,
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34207-56
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| Email Address
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BIK@TRAILWAYSNY.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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BERARDI |
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First Name |
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EUGENE AND LILLIAN |
| Policy # * |
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1747376413 |
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Claim #* |
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01000128156 |
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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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FRONTLINE INSURANCE UNLIMITED 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 10074 |
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| Name of individual responsible for violation (if any):*
OLIVIA RODGERS, ADJUSTOR
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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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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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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
B. Coverage B – Other Structures
1. We cover other structures on the "residence
premises" set apart from the dwelling by clear
space. This includes structures connected to
the dwelling by only a fence, utility line, or
similar connection.
2. We do not cover:
a. Land, including land on which the other
structures are located;
b. Other structures rented or held for rental to
any person not a tenant of the dwelling,
unless used solely as a private garage;
c. Other structures from which any "business"
is conducted; or
d. Other structures used to store "business"
property. However, we do cover a structure
that contains "business" property solely
owned by an "insured" or a tenant of the
dwelling, provided that "business" property
does not include gaseous or liquid fuel,
other than fuel in a permanently installed
fuel tank of a vehicle or craft parked or
stored in the structure.
3. The limit of liability for this coverage will not be
more than 10% of the limit of liability that
applies to Coverage A. Use of this coverage
does not reduce the Coverage A limit of
liability
11. "Residence premises" means:
a. The one-family dwelling where you reside;
b. The two-, three- or four-family dwelling
where you reside in at least one of the
family units; or
c. That part of any other building where you
reside;
and which is shown as the "residence
premises" in the Declarations.
"Residence premises" also includes other
structures and grounds at that location.
E. Additional Coverages
1. Debris Removal
a. We will pay your reasonable expense for
the removal of:
(1) Debris of covered property if a Peril
Insured Against that applies to the
damaged property causes the loss; or
(2) Ash, dust or particles from a volcanic
eruption that has caused direct loss to a
building or property contained in a
building.
This expense is included in the limit of
liability that applies to the damaged
property. If the amount to be paid for the
actual damage to the property plus the
debris removal expense is more than the
limit of liability for the damaged property,
an additional 5% of that limit is available for
such expense.
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.
B. COVERAGE B – Other Structures is deleted and replaced by the following:
1. We cover other structures on the “residence premises” set apart from the dwelling by clear space.
This includes structures connected to the dwelling by only a fence, utility line, or similar connection.
This coverage does not apply to in-ground swimming pools.
This coverage does not apply to land, including land on which the other structures are located.
2. We do not cover other structures:
a. Used in whole or in part for “business”; or
b. Rented or held for rental to any person not a tenant of the dwelling, unless used solely as a
private garage.
3. The limit of liability for this coverage will not be more than the limit of liability shown in the
Declarations for Coverage B. Use of this coverage does not reduce the Coverage A limit of liability.
SECTION I – PERILS INSURED AGAINST
A. COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES
Paragraph 2.c.(5) is deleted and replaced by the following:
NCPT HO 07 23 Page 4 of 25
(5) Repeated seepage or leakage of water or the presence or condensation of humidity, moisture, or
vapor, that occurs or develops over a period of 14 or more days, whether hidden or not.
The Exception to c.(6) second paragraph is deleted and replaced by the following:
Exception to c.(6)
The cost that we will pay for the tear out and repair above is only that cost necessary to access and
repair only that specific point of that system or appliance that caused the covered loss, whether the
system or appliance, or any part or portion of the system or appliance, is repairable or not. However,
such tear out and repair coverage only applies to other structures if the water or steam causes actual
damage to a covered building on the “residence premises.”
J. Loss Payment is deleted and replaced by the following:
J. 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 and we have not elected our option to repair.
1. Loss will be payable upon the earlier of the following:
a. 20 days after we receive your proof of loss in compliance with SECTION I – CONDITIONS, C.
Duties After Loss, paragraph 9, and reach written agreement with you; or
b. 60 days after we receive your proof of loss in compliance with SECTION I – CONDITIONS, C.
Duties After Loss, paragraph 9; and
(1) There is an entry of a final judgment; or
(2) There is a filing of an appraisal award or a mediation settlement with us.
c. If payment is not denied, within 60 days after we receive notice of an initial, reopened or
supplemental claim.
However, this provision c. does not apply if factors beyond our control reasonably prevent such
payment.
The Florida Office of Insurance Regulation may extend the 60 day period up to 30 additional
days if a state emergency, cyberattack, or computer systems failure prevents the insurer from
meeting the 60 day time frame.
Failure to comply with this provision c. does not form the sole basis of a private cause of action
against us.
2. If payment is denied in part, we will pay the undisputed amounts within the same time stated unless
we have exercised our option under SECTION I – CONDITIONS, I.
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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.
I have a home in Sarasota Florida at 2708 Bay Drive, Bradenton, Fl 34207. My insurance company, Frontline insurance, refuses to pay a significant portion of a claim for damage caused by Hurricane Milton a claim that is clearly covered under the terms of my policy.
The Baseless Denial of My Claim
Hurricane Milton made landfall after Hurricane Helene (September 26, 2024). There was damage to my dock, the lift, the canopy and other incidental damage from both hurricanes. At issue is an estimated $36,649 for repairs to damage to the dock that resulted from Milton (October 9, 2024).
Two damage estimates from an experienced, local, vendor distinguish between the damage caused by Helene and Milton. One estimate is for damage to the dock following Helene and prior to Milton. The second estimate is from the same vendor for additional damage to the dock following Milton. In the face of the evidence establishing that the damage at issue was caused by Milton, the insurance company is falsely attributing the additional damage to a storm surge during Milton. It is undisputed that the damage at issue could only have been caused by wind or storm surge. My policy has coverage for secondary structures and hurricane damage. The insurance company is hiding behind “storm surge” because storm surge damage is not covered by my policy, whereas wind damage is covered.
The insurance company, however, is ignoring ample evidence demonstrating that there was no surge from Milton. Some of that evidence, readily available online from NOAA (National Oceanic and Atmospheric Administration), shows that, after Milton, my canopy is out in the water and there is no debris in the yard. Had the damage actually been caused by a storm surge and not wind, the water would have come towards the land (my yard), the canopy would have been moved in the direction of the land and there would have been debris in the yard. There is also evidence showing that the high-water mark from Milton cannot support the theory that the additional estimated $36,649 of damage to the dock was caused by a surge. The insurance company not only persists in denying the claim, but persists in refusing to provide to me copies of the photos it appraiser(s) took following Helene and Milton.
Being Ignored By The Insurance Company
Frontline insurance received my notice of an initial claim on October 11, 2024. It is now March 20, 2025, more than five months (160 days) since filing my claim with Frontline. During the 160 days since filing my claim, I have made numerous calls to my broker, and my broker (Tina Gonzalez of Wallace Welch & Willingham) and a colleague broker from a sister agency (Ernest Schwartz from IMA) and I have made numerous calls to Frontline to ascertain the status of my claim and when I will be paid in full for the damage caused by Hurricane Milton. All of which have gone unanswered.
Conclusion
The insurance company’s persistent denial of my claim in the face of irrefutable evidence and its persistently ignoring my attempts to communicate and resolve the claim leaves me no recourse but to file suit. Accordingly, I am filing the required statutory notice prior to filing suit against the insurance company.
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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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