Filing Number: 813324
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| Filing Accepted: 3/26/2025 |
| Last/Business Name
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JORDAN
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First Name |
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MICHELE & TOM |
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| Street Address
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120 12TH ST E. |
| City, State Zip
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TIERRA VERDE,
FL
33715
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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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JORDAN |
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First Name |
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MICHELE & TOM |
| Policy # * |
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12-1048765-24 |
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Claim #* |
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12-3028765-24 |
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Attorney is Applicable
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| Last Name* |
WALLACE
First Name *
BLAKE
Initial
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| Street Address* |
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8635 W. HILLSBOROUGH AVE., STE. 401 |
| City, State Zip* |
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TAMPA
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FLORIDA
33615
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| Email Address * |
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BLAKE@KLINGLAW.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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TYPTAP 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 15885 |
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| Name of individual responsible for violation (if any):*
KENSHATTA WHITE
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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)(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)(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)(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)(4) |
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Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
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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.
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".
2. We do not cover land, including land on which the dwelling is located.
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 Coverage A limit of liability. The paragraphs above do not apply to Other Structures and there is no coverage when the limit of liability for Coverage B shown in the Declarations is $0.
C. Coverage C – Personal Property.
1. Covered Property.
We cover personal property owned or used by an "insured" while it is anywhere in the world. After a loss and at your request, we will cover personal property owned by:
a. Others while the property is on the part of the "residence premises" occupied by an "insured"; or
b. A guest or a "residence employee", while the property is in any residence occupied by an "insured"
A. Coverage A – Dwelling and Coverage B – Other Structures.
We insure against direct physical loss to property described in Coverages A and B. We do not insure, however, for loss: 1. Excluded under Section I – Exclusions;
B. Coverage C – Personal Property.
We insure for direct physical loss to the property described in Coverage C caused by any of the following perils unless the loss is excluded in Section I – Exclusions.
D. Loss Settlement.
In this Condition D., the terms "cost to repair or replace" and "replacement cost" do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.11. Ordinance or Law under Section I – Property Coverages. Covered property losses are settled as follows:
1. Property of the following types:
a. Personal property;
b. Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings;
c. Structures that are not buildings; and
d. Grave markers, including mausoleums;
at actual cash value at the time of loss but not more than the amount required to repair or replace.
2. Buildings covered under Coverage A or B at replacement cost without deduction for depreciation, subject to the following:
a. If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, without deduction for depreciation, but not more than the least of the following amounts:
(1) The limit of liability under this policy that applies to the building;
(2) The replacement cost of that part of the building damaged with material of like kind and quality and for like use; or
(3) The necessary amount actually spent to repair or replace the damaged building.
If the building is rebuilt at a new premises, the cost described in (2) above is limited to the cost which would have been incurred if the building had been built at the original premises.
b. If, at the time of loss, the amount of insurance in this policy on the damaged building is less than 80% of the full replacement cost of the building immediately before the loss, we will pay the greater of the following amounts, but not more than the limit of liability under this policy that applies to the building:
(1) The actual cash value of that part of the building damaged; or
(2) That proportion of the cost to repair or replace, without deduction for depreciation, that part of the building damaged, which the total amount of insurance in this policy on the damaged building bears to 80% of the replacement cost of the building.
c. To determine the amount of insurance required to equal 80% of the full replacement cost of the building immediately before the loss, do not include the value of:
(1) Excavations, footings, foundations, piers, or any other structures or devices that support all or part of the building, which are below the undersurface of the lowest basement floor;
(2) Those supports described in (1) above which are below the surface of the ground inside the
foundation walls, if there is no basement; and
(3) Underground flues, pipes, wiring and drains.
d. We will initially pay the actual cash value of the building damage, minus any applicable deductible.
We will then pay the necessary amounts actually spent to repair or replace the damaged building as work is performed and expenses are incurred.
D. Application of Calendar Year Hurricane Deductible
1. In the event of the first windstorm loss caused by a single hurricane occurrence during a calendar year, we will pay only that part of the total of all loss payable under Section I – Property Coverages that exceeds the calendar year hurricane deductible stated in the Schedule.
2. With respect to a windstorm loss caused by the second, and each subsequent, hurricane occurrence during the same calendar year, we will pay only that part of the total of all loss payable under Section I - Property Coverages that exceeds the greater of:
a. The remaining dollar amount of the calendar year hurricane deductible; or
b. The deductible that applies to fire that is in effect at the time of the loss.
3. If:
a. Covered property is insured under more than one policy issued by us or another insurer in our insurer group; and
b. Different hurricane deductibles apply to the same property under such policies;
Then the hurricane deductible applicable under all such policies, used to determine the total of all loss payable under Section I - Property Coverages shall be the highest amount stated in any one of the policies.
4. When a renewal policy is issued by us or an insurer in our insurer group, or we issue a policy that replaces one issued by us or an insurer in our insurer group, and the renewal or replacement policy takes effect on a date other than January 1st of a calendar year, the following provisions apply:
a. If the renewal or replacement policy provides a lower hurricane deductible than the prior policy, and you incurred loss from a hurricane under the prior policy in that same calendar year, the lower hurricane deductible will not take effect until January 1st of the following calendar year.
b. If the renewal or replacement policy provides a lower hurricane deductible than the prior policy and you have not incurred a hurricane loss in that same calendar year, the lower hurricane deductible will take effect on the effective date of the renewal or replacement policy.
c. If the renewal or replacement policy provides a higher hurricane deductible than the prior policy, the higher hurricane deductible:
(1) Will take effect on the effective date of the renewal or replacement policy; and
(2) Shall be used to calculate the remaining dollar amount of the hurricane deductible described in Paragraph 2.
5. We require that you promptly report any windstorm loss caused by a hurricane occurrence that is below the hurricane deductible so that we may consider the amount of such loss when adjusting claims for subsequent hurricane occurrences that occur during the calendar year.
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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.
March 26,2025
Sent Via Email
TYPTAP INSURANCE COMPANY
claims@typtap.com
RE: Insureds : MICHELE JORDAN & TOM JORDAN
(hereinafter, “Insureds”)
Policy # : 12-1048348-05
Claim # : 12-3028765-24
Property Address : 120 12TH ST E., TIERRA VERDE, FL 33715
Persons most knowledgeable of facts giving rise to the Violations: Kenshatta White
Dear TYPTAP INSURANCE COMPANY:
Please find enclosed the civil remedy notice filed for the above referenced claim. This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statute §624.155 As discussed in greater detail in the notice, the carrier has not attempted in good faith to settle the claimant’s claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its claimant and with due regard for its interests. The carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005) (“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insured…”).
The carrier was first put on notice of the insured’s Hurricane Milton claim prior to November 7, 2024. Since the commencement of the claim the carrier has failed to timely communicate with the insured.
On or about, November 7, 2024, the carrier assigned an unnamed field adjuster, who is not an engineer, to inspect the loss. On December 6, 2024, the carrier’s assigned desk adjuster sent a communication to the insureds stating that the claim would be investigated under Claim #12-3028765-24. Since the previously mentioned inspection, there has been no explanation whatsoever as to how the field adjuster or desk adjuster have determined which items of damage were caused by covered or excluded perils. Instead, the carrier has failed to assert its coverage determination and provide it as requested. This is in violation of F.S. §626.9541(1)(i)(3)(f) as the carrier failed 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 the claim. Moreover, in failing to reach a claim determination, TypTap failed to adopt and implement standards for the proper investigation of claims. There was no explanation whatsoever as to how TypTap determined which items of damage were caused by covered or excluded perils. Furthermore, the carrier’s failure to assign a qualified and experienced engineer further violates F.S. §626.9541(1)(i)(3)(a). Moreover, as the carrier failed to conduct a reasonable investigation based upon available information, the carrier violated F.S. §626.9541(1)(i)(3)(d).
On February 12, 2025, after retaining and through counsel, the insureds requested a complete copy of the file with respect to the investigation of the claim, including, but not limited to any estimates generated, any reports given by the assigned field adjuster, any claim-related communications made between the insureds and the carrier, and any engineering report generated. To date, the only documentation the carrier’s adjuster has turned over and only communication so far has been a copy of the insureds’ policy. This failure to communicate in kind is in violation of F.S. §626.9541(1)(i)(3)(c) as the carrier has failed to acknowledge and act promptly upon communications with respect to claims. It is also in further violation of F.S. §626.9541(1)(i)(3)(g) as the carrier has failed to promptly notify the insured of any additional information necessary for the processing of the claim so that a claim determination may be reached.
Florida Statute 627.70131(3)(e) requires the carrier to provide an estimate within 7 days after the estimate is generated by the insurer’s adjuster. However, it is clear that TypTap failed to provide any estimate or report from its initial field adjuster. The insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by an insurer’s adjuster.
On February 12, 2025, through the Letter of Representation, insureds counsel informed the insurer of its duty to adjust and provide the estimate for the claim pursuant to F.S. §627.70131(3)(e) and F.S. §627.70131(7)(a), as the carrier had neither failed to finish its adjustment and provided any estimate or explanation of coverage prior to said date. To the date of the filing of this civil remedy notice no coverage determination has been reached and/or provided to counsel of the insured by the carrier. Instead the carrier’s failure to come to a timely decision was in violation of F.S. §626.9541(1)(i)(4) as the carrier has failed to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determine the amounts of partial or full benefits, and agree to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in F.S. §627.70131(5). Furthermore, this undue continual delay and failure to inspect is in violation of F.S. §624.155(1)(b)(1), as the delay was in direct disregard of the insured’s interests and F.S. §624.155(1)(b)(3), as the carrier has failed to promptly settle the claim. Moreover, in failing to reach a coverage determination in the statutorily allotted time, TypTap failed to adopt and implement standards pursuant to F.S. §626.9541(1)(i)(3)(a) for the proper investigation of claims.
The insured has been compelled to obtain an independently adjusted estimate totaling in the amount of $251,862.12 that would be needed to repair the property back to its pre-loss condition. The insured has complied with all the carrier’s requests to date. The carrier has still refused to pay the fully covered amount owed under the policy, instead electing to stand by its unilaterally determined deficient valuation of the loss while denying the rest of the loss. This is in violation of F.S. 624.155(1)(b)(1) and 624.155(1)(b)(3) as the carrier is clearly placing the company’s interests before the claimant’s interests and not attempting in good faith to settle claims.
It is clear that the carrier is not treating the claimant with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the claimant; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the claimant’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the claimant’s loss in a timely manner. The Carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(d), 627.4137(1), and Fla. Stat. §627.70131.
The actions taken by TypTap in the handling/adjustment of the insured’s claim were willful, wanton, malicious, and in reckless disregard for the rights of any insureds and occur with such frequency as to indicate a general business practice, and further are in violation of Florida Statutes §624.155 and F.S. §626.954. Indeed, when performing a search on the Florida Department of Financial Services website’s Civil Remedy Notice of Insurer Violation page the results of searches of violations of the statutes referenced herein by the carrier returned the following results thereby indicating that the number of times they occur rise to the level of a general business practice, and warrant punitive damages:
§624.155(1)(b)(1) = 1721
§624.155(1)(b)(3) = 1166
§626.9541(1)(i)(3)(a) = 1644
§626.9541(1)(i)(3)(c) = 1074
§626.9541(1)(i)(3)(d) = 788
§626.9541(1)(i)(3)(g) = 516
§626.9541(1)(i)(4) = 176
Based upon the above-referenced acts and omissions, the carrier has breached the insurance contract by failing to pay the amount due to the insured, by denying coverage which existed under the insurance contract with the insured in the instant dispute, by failing to adjust the loss with the insureds, and by failing to perform and adequate investigation. These are violations and breaches of the policy language cited above.
Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay the complete covered loss in the amount of $251,862.12 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) Provide any additional claim documents to the insureds and the insureds’ counsel. A copy of this letter and filed form submitted to the FDFS has been emailed to the carrier.
The specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. Specifically, the loss payment provision states “we will adjust all losses with you.” Yet, the carrier did not consult the homeowner in deciding who would investigate the cause or amount of damages, and what the ultimate payment should be. The other provisions are pasted on the pages following the signature block.
If you have any questions or concerns, please send all correspondence via email to Blake@klinglaw.com and Jorlyn@KlingLaw.com to ensure a prompt response. We ask that all correspondence be done via email rather than regular mail. Should you need to send something regular mail, please advise us prior to sending same via the emails above.
Sincerely,
Blake M. Wallace, Esq.
Blake M. Wallace
Attorney at Law
Enclosed: Civil Remedy Filing
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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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