Filing Number: 813456
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| Filing Accepted: 3/27/2025 |
| Last/Business Name
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3064 DAYTONA, LLC
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First Name |
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| Street Address
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999 PONCE DE LEON BLVD, SUITE 945, CORAL GABLES, FL 33134 |
| City, State Zip
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CORAL GABLES,
FL
33134
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| Email Address
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AMEDEROS@MOISESGROSS.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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3064 DAYTONA, LLC |
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First Name |
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| Policy # * |
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AL92-001152-00 |
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Claim #* |
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SWYCSCP00156 |
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Attorney is Applicable
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| Last Name* |
MEDEROS
First Name *
ANTOINETTE
Initial
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| Street Address* |
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999 PONCE DE LEON BLVD, SUITE 945 |
| City, State Zip* |
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CORAL GABLES
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FLORIDA
33134
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| Email Address * |
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AMEDEROS@MOISESGROSS.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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CLEAR BLUE SPECIALTY 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 37745 |
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| Name of individual responsible for violation (if any):*
N/A
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| Type of Insurance
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Commercial Property & Casualty
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| Reason for Notice
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Unfair Trade Practice
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Unsatisfactory Settlement Offer
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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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| 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)(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)(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 subject insuring agreement in the policy, and that portion of the policy that provides coverage for the
damage to the dwelling caused by and as a result of Hurricane Irma.
BUILDING COVERAGE PROVISION
BUSINESS INCOME COVERAGE PROVISION
All additional coverage provisions;
All coverage provided by endorsement or rider;
The declarations page;
Loss payment or settlement provision;
Duties in the event of loss;
All terms and conditions of Section 1 of the insurance policy;
The insurance policy definition section;
The insurance policy exclusion of coverage provisions;
All insurance Policy provisions that provide coverage to the insured property.
All policy provisions
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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.
In consideration of the premium paid to it by 3064 DAYTONA, LLC, ("Insured"), CLEAR BLUE SPECIALTY INSURANCE COMPANY ("Insurer"), issued a policy of insurance number AL92-001152-00 for the property located at 3064 SOUTH ATLANTIC AVENUE, DAYTONA BEACH SHORES, FL 32118. Said policy was in full force and effect when the Insures suffered damage to the property as a result of Hurricane IAN on or around 9/28/2022. The Insured timely reported the loss and requested the Insurer investigate the loss and promptly issue payment in order to bring the property back to its pre-loss condition and prevent further damage to the property. The Insurer's subsequent handling and adjustment (or lack thereof) of the above referenced claim is indicative of what can only be described as a broad and systemic failure to adopt and/or implement standards for the proper and timely investigation of its insured's claims. Specifically, the subject underpayment of the alleged damages were intentional and deliberate. These actions on the part of the Insurer were done in an effort to
manipulate the Insured into accepting less indemnification value than what the policy affords knowing that this would be insufficient to return the Insured's property to its pre-loss condition. Considering the above, it is abundantly clear that the Insurer has breached its duty of good faith and fair dealing to the Insured by failing to thoroughly, accurately, and promptly investigate and settle the Insured's claim. Moreover, Insurer has failed to adjust this loss consistent with the terms of their own policy. Such violations are willful and intentional and not only represent a breach of the policy of insurance, but also a breach of its statutory duties. Furthermore, it has become apparent that the insured had an estimate of damages in excess of what was initially paid out as early as March of 2023 and refused to issue additional funds to the insured. Due to the foregoing, the Insured has been damaged.
In order to remedy the above defects, Insurer must do the following:
1. Pay the full value of the insured's claim;
2. Pay statutory interest on the amount of unpaid damages;
3. Act fairly and honestly toward the Insured with due regard for their interests in attempting to resolve the
claim;
4. Cease and desist all present and future bad faith actions with regard to the claim;
5. Implement standards for the proper investigation of claims;
6. Stipulate to the Insured's entitlement to attorney's fees and court costs pursuant to Florida Statutes,
627.428 and pay the amount of fees and costs incurred.
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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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