Filing Number: 817159
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| Filing Accepted: 4/22/2025 |
| Last/Business Name
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SHORELINE FOOD STORE
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First Name |
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| Street Address
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1180 W MAIN STREET |
| City, State Zip
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PENSACOLA,
FL
35202
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| Email Address
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C_VATSOLAKIS@YAHOO.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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SHORELINE FOOD STORE |
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First Name |
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| Policy # * |
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VBA96294300 |
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Claim #* |
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7030201148 |
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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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COVINGTON 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 13027 |
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| Name of individual responsible for violation (if any):*
AJ SALTALAMACCHIA
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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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Unsatisfactory Settlement Offer
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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.
4. Loss Payment
a. In the event of loss or damage covered by this Coverage Form, at our option, we will either:
(1) Pay the value of lost or damaged property.
...
g. We will pay for covered loss or damage within 30 days after we receive the sworn proof of loss, if you have complied with all terms of the Coverage Part, and:
(1) we have reached an agreement with you; or
(2) an appraisal award has been made.
...
D. The Loss Payment Condition dealing with the number of days within which we must pay for covered loss or damage is replaced by the following:
Provided you have complied with all the terms of this Coverage Part, we will pay for covered loss or damage upon the earliest of the following:
(1) Within 20 days after we receive the sworn proof of loss and reach written agreement with you;
(2) Within 30 days after we receive the sworn proof of loss and:
(a) There is an entry of final judgment; or
(b) There is a filing of an appraisal award with us; or
(3) Within 60 days of receiving notice of an initial, reopened or supplemental claim, unless we deny the claim during that time or factors beyond our control prevent such payment.
...
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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.
The Complainants promptly notified the Respondent of the loss. The Respondent conducted its investigation of the loss. The Complainants fully complied with all applicable policy provisions requiring their cooperation with the investigation including, but not limited to, prompt notification of the loss, inspection of the damaged property, provision of documents in support of the claim, proof of loss, estimate, etc. At the conclusion of the claim the Respondent issued a "low ball" payment which is woefully inadequate and does not permit the Complainants to return their property back to its pre-loss condition. The Complainant has provided a sworn proof of loss and supporting estimate. The Respondent only performed a cursory inspection and failed to retain qualified individuals to fully apprise it of the full extent of the Complainants' damages. Further, it knew, or should have known, the payment was insufficient to cover all covered damages pursuant to the policy and Florida law. The Complainants and their representatives completed a thorough evaluation of the damages and provided documentation in support of the full/true extent of damages sustained by the loss, which the Respondent failed to address. The Respondent has thereby violated its loss payment and loss settlement provisions. Rather than paying the actual damages and/or trying to settle with the Complainants the Respondent is delaying a prompt resolution of the claim. The Respondent has engaged in this as a standard business practice in an attempt to dissuade its policyholders from pursuing claims solely to increase profits. The only cure is payment in full of all damages sustained by the Complainants as represented in the documents provided to the Respondent during the course of their claim
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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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