Filing Number: 813684
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| Filing Accepted: 3/28/2025 |
| Last/Business Name
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NWC PROPERTIES II, LLC
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First Name |
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| Street Address
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434 GOLDEN BEACH DRIVE |
| City, State Zip
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GOLDEN BEACH,
FL
33160
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| Email Address
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CHRIS@MARANGESLAW.COM |
| Complainant Type:
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Third Party |
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| Last/Business Name* |
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THUNDER DEMOLITION, INC. |
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First Name |
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| Policy # * |
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ECP204083711 |
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Claim #* |
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74 PC 4097924 |
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Attorney is Applicable
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| Last Name* |
MARANGES
First Name *
CHRISTOPHER
Initial
J
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| Street Address* |
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2255 GLADES ROAD, SUITE 324A |
| City, State Zip* |
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BOCA RATON
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FLORIDA
33434
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| Email Address * |
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CHRIS@MARANGESLAW.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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NAUTILUS 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 17370 |
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| Name of individual responsible for violation (if any):*
HELEN A. FARRELL
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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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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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Other
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Using an adjuster that has no qualifying appointment
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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)(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)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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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.
As the filer is a third party claimant, it does not have a copy of the policy at issue here.
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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.
NWC Properties II, LLC "Claimant") hired the insured, Thunder Demolition, Inc. (the "Insured"), to perform certain services at the property it owns located at 16449 NE 31st Avenue, North Miami Beach, Florida (the "Property"). The insured caused significant damage to the Property which led the seawall on the Property to collapse. The Claimant promptly notified Nautilus of the claim, and Nautilus acknowledge the claim, assigning it claim number 74 PC 4097924 (the "Claim"). Nautilus also assigned Helen A. Farrell to adjust the loss on its behalf. Despite holding a non-resident adjuster licenses for the state of Florida, however, Ms. Farrell does not have a valid, qualifying appointment. In fact, Ms. Farrell's last valid, active appointment expired on December 27, 2021.
By failing to fully compensate the Claimaint for the loss to the Property and by improperly using an adjuster without an active, qualifying appointment, the Insurance Company has not only breached its own Policy, but it has also violated Section 627.70131 (5)(a), Florida Statutes. Further, the Insurance Company’s refusal to properly and timely investigate, adjust, and compensate the Insured for the claim undoubtedly evidences the Insurance Company’s violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, which requires the Insurance Company to “adopt and implement standards for the proper investigation of claims.” All available information leads to one conclusion—the Property suffered damages as the result of a covered cause of loss for which the Claimant is entitled to full and complete compensation. The Insurance Company’s obligation to promptly settle the Claim is undeniable and, therefore, the Insurance Company has also violated Fla. Stat. Sections 624. 155(1)(b)(1) and 624.155(1)(b)(3).
The actions taken by the Insurance Company in the handling and adjustment of the Claim are willful, wanton, and in disregard for the Insured’s rights, and have occurred with such frequency as to indicate a general business practice in violation of the law. The Insurance Company’s actions amount to, but are not limited to:
A. “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 the insured[s] and with due regard for [their] interests;”
B. “Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear;”
C. “Failing to acknowledge and act promptly upon communications with respect to claims;”
D. “Denying claims without conducting reasonable investigations based upon available information;”
E. “Failing to promptly provide a reasonable explanation in writing to the insured[s] of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement;”
F. “Failing to adopt and implement standards for the proper investigation of claims;”
G. Claim Denial;
H. Claim Delay; and
I. Unfair Trade Practices
In addition to the above statutory violations, the Insurance Company’s adjuster violated the following ethical requirements of Florida Administrative Code 69B-220.201:
(3) Code of Ethics . . . An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters:
(b) An adjuster shall treat all claimants equally.
2. An adjuster shall adjust all claims strictly in accordance with the insurance contract.
(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insureds.
(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.
(e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled.
(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim.
(o) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.
In Florida, the work of adjusting insurance claims engages the public trust. During the adjustment of this claim, the Insurance Company breached this duty by failing to adhere to and comply with the above referenced obligations. To cure the defects outlined above, the Insurance Company must:
A. Immediately pay the Claimant or all of the losses suffered as a result of the subject claim, and
B. Assign this Claim to a licensed adjuster with an active, qualifying appointment.
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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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