Filing Number: 818945
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| Filing Accepted: 5/1/2025 |
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TRUEVINE TEMPLE MINISTRIES INC.
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First Name |
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| Street Address
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855 GEORGE INGRAM BLVD |
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DAYTONA BEACH,
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32114
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| Email Address
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WITHHELD |
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Insured |
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| Last/Business Name* |
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TRUEVINE TEMPLE MINISTRIES INC. |
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First Name |
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| Policy # * |
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FSF16631401 001 |
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Claim #* |
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KY22K2943402 |
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Attorney is Applicable
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| Last Name* |
SIGEL
First Name *
MELANIE
Initial
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| Street Address* |
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800 E. BROWARD BLVD. STE. 510 |
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FORT LAUDERDALE
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FL
33301
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| Email Address * |
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MDS@WEKLAW.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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WESTCHESTER SURPLUS LINES INSURANCE COMPANY
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| Insurer Name* |
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NAIC Company Code 10172 |
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| Name of individual responsible for violation (if any):*
CHRIS FITZPATRICK; AMY WISSNER; MICHAEL WYNARCZUK; ZACH WASHAM; KACIE DITTMAR; JON PETERSON
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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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Claim Delay
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Claim Denial
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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)(2) |
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A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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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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| 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)(f) |
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Failing 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 a claim or for the offer of a compromise settlement.
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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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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
We will pay for direct physical loss of or damage to
Covered Property at the premises described in the
Declarations caused by or resulting from any
Covered Cause of Loss.
1. Covered Property
Covered Property, as used in this Coverage
Part, means the type of property described in
this section, A.1., and limited in A.2. Property
Not Covered, if a Limit Of Insurance is shown
in the Declarations for that type of property.
a. Building, meaning the building or structure
described in the Declarations, including:
(1) Completed additions;
(2) Fixtures, including outdoor fixtures;
(3) Permanently installed:
(a) Machinery; and
(b) Equipment;
***
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;
(2) Pay the cost of repairing or replacing the
lost or damaged property, subject to b.
below;
(3) Take all or any part of the property at an
agreed or appraised value; or
(4) Repair, rebuild or replace the property
with other property of like kind and
quality, subject to b. below.
We will determine the value of lost or
damaged property, or the cost of its repair
or replacement, in accordance with the
applicable terms of the Valuation Condition
in this Coverage Form or any applicable
provision which amends or supersedes the
Valuation Condition.
b. The cost to repair, rebuild or replace does
not include the increased cost attributable
to enforcement of or compliance with any
ordinance or law regulating the
construction, use or repair of any property.
c. We will give notice of our intentions within
30 days after we receive the sworn proof of
loss.
d. We will not pay you more than your
financial interest in the Covered Property.
e. We may adjust losses with the owners of
lost or damaged property if other than you.
If we pay the owners, such payments will
satisfy your claims against us for the
owners' property. We will not pay the
owners more than their financial interest in
the Covered Property.
***
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 a final judgment;
or
(b) There is a filing of an appraisal
award with us; or
(3) Within 90 days of receiving notice of an
initial, reopened or supplemental claim,
unless we deny the claim during that
time or factors beyond our control
reasonably prevent such payment. If a
portion of the claim is denied, then the
90-day time period for payment of claim
relates to the portion of the claim that is
not denied.
***
A. Covered Causes Of Loss
When Basic is shown in the Declarations, Covered
Causes of Loss means the following:
1. Fire.
2. Lightning.
3. Explosion, including the explosion of gases or
fuel within the furnace of any fired vessel or
within the flues or passages through which the
gases of combustion pass. This cause of loss
does not include loss or damage by:
a. Rupture, bursting or operation of pressurerelief
devices; or
b. Rupture or bursting due to expansion or
swelling of the contents of any building or
structure, caused by or resulting from
water.
4. Windstorm or Hail, but not including:
a. Frost or cold weather;
b. Ice (other than hail), snow or sleet, whether
driven by wind or not;
c. Loss or damage to the interior of any
building or structure, or the property inside
the building or structure, caused by rain,
snow, sand or dust, whether driven by wind
or not, unless the building or structure first
sustains wind or hail damage to its roof or
walls through which the rain, snow, sand or
dust enters; or
d. Loss or damage by hail to lawns, trees,
shrubs or plants which are part of a
vegetated roof.
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h. "Fungus", Wet Rot, Dry Rot And
Bacteria
Presence, growth, proliferation, spread or
any activity of "fungus", wet or dry rot or
bacteria.
But if "fungus", wet or dry rot or bacteria
result in a Covered Cause of Loss, we will
pay for the loss or damage caused by that
Covered Cause of Loss.
This exclusion does not apply:
(1) When "fungus", wet or dry rot or bacteria
result from fire or lightning; or
(2) To the extent that coverage is provided
in the Additional Coverage, Limited
Coverage For "Fungus", Wet Rot, Dry
Rot And Bacteria, with respect to loss or
damage by a cause of loss other than
fire or lightning.
Exclusions B.1.a. through B.1.h. apply whether
or not the loss event results in widespread
damage or affects a substantial area.
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C. Additional Coverage – Limited Coverage For
"Fungus", Wet Rot, Dry Rot And Bacteria
1. The coverage described in C.2. and C.6. only
applies when the "fungus", wet or dry rot or
bacteria are the result of one or more of the
following causes that occur during the policy
period and only if all reasonable means were
used to save and preserve the property from
further damage at the time of and after that
occurrence:
a. A Covered Cause of Loss other than fire or
lightning; or
b. Flood, if the Flood Coverage Endorsement
applies to the affected premises.
This Additional Coverage does not apply to
lawns, trees, shrubs or plants which are part of
a vegetated roof.
2. We will pay for loss or damage by "fungus",
wet or dry rot or bacteria. As used in this
Limited Coverage, the term loss or damage
means:
a. Direct physical loss or damage to Covered
Property caused by "fungus", wet or dry rot
or bacteria, including the cost of removal of
the "fungus", wet or dry rot or bacteria;
b. The cost to tear out and replace any part of
the building or other property as needed to
gain access to the "fungus", wet or dry rot
or bacteria; and
c. The cost of testing performed after removal,
repair, replacement or restoration of the
damaged property is completed, provided
there is a reason to believe that "fungus",
wet or dry rot or bacteria are present.
3. The coverage described under C.2. of this
Limited Coverage is limited to $15,000.
Regardless of the number of claims, this limit is
the most we will pay for the total of all loss or
damage arising out of all occurrences of
Covered Causes of Loss (other than fire or
lightning) and Flood which take place in a 12-
month period (starting with the beginning of the
present annual policy period). With respect to a
particular occurrence of losswhich results in
"fungus", wet or dry rot or bacteria, we will not
pay more than a total of $15,000 even if the
"fungus", wet or dry rot or bacteria continue to
be present or active, or recur, in a later policy
period.
***
A. Covered Causes Of Loss
When Special is shown in the Declarations,
Covered Causes of Loss means direct physical
loss unless the loss is excluded or limited in this
policy.
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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.
TRUEVINE TEMPLE MINISTRIES, INC. (the "Insured") purchased an insurance policy ("Policy") from WESTCHESTER SURPLUS LINES INSURANCE COMPANY ("Westchester"), with effective coverage on the date of the loss, on or about September 28, 2022, and policy number FSF16631401 001 to insure its property, which consists of buildings located at 357 Rose Ave Daytona Beach, FL 32114 855 and George Ingram Boulevard, Daytona Beach, FL 32114 (the "Property").
Throughout the claim handling process, Westchester has engaged in bad faith claims handling practices in violation of Florida Statutes §§ 624.155 and 626.9541. Despite acknowledging covered hurricane damages, Westchester failed to promptly and properly adjust the claim, undervalued the claim, delayed the issuance of undisputed payments, misapplied policy exclusions to deny legitimate mitigation expenses, improperly assessed and enforced a coinsurance penalty, and otherwise acted with disregard for its insured’s interests.
On or about September 28, 2022, the aforementioned Property suffered severe damage as the result of Hurricane Ian, which caused ensuing damages to the Property, including but not limited to the exterior and interior of the property. The Insured promptly reported its claim to Westchester. Westchester acknowledged receipt of the claim by generating claim number KY22K2943402 (the “Claim”). Westchester went to inspect the property and generated an estimate for the damage suffered to both buildings at the property.
Westchester made a low-ball coverage decision that broadly ignored the damage sustained to the Property, valuing the damage at $75,740.15, resulting in net payments altogether totaling $46,657.72 over the course of several months. It was clear that Westchester was trying to reduce their contractual obligation by undervaluing the damage to the Insured Property from the start, despite the fact that the Insured actively provided all information needed to have its claim evaluated fairly. The Insured retained a public adjuster, Elevate Claims, to act as its public adjuster, to assist in the evaluation and inspection of damage to the property. Elevate investigated the property and generated an estimate for the damages. Elevate immediately sent their estimate to Westchester, which estimated the scope of damage to be $171,171.05, more than double the evaluation made by Westchester. Despite receiving detailed estimates and photographic documentation showing damage exceeding Westchester’s valuation across both buildings, Westchester failed to meaningfully adjust its initial lowball payments, resulting in a significant documented shortfall relative to the insured’s actual repair needs.
Further, Westchester improperly denied payment for roof tarping and emergency mitigation services, wrongfully invoking a continuous seepage exclusion without evidence to support its applicability. These mitigation efforts were directly connected to the covered hurricane damages and were necessary to mitigate further loss. By denying payment for these mitigation efforts while simultaneously acknowledging covered damage and the need for a rebuild, Westchester placed its own financial interests ahead of its insured’s, exposing the insured to loss and hardship. Moreover, Westchester's partial denial under the continuous and repeated seepage exclusion is a blatant misapplication of the policy, as there is no evidence of the same; especially as all parties already agreed that a covered hurricane loss is the true cause of the damage.
Westchester further acted in bad faith by misrepresenting and mishandling the calculation of benefits owed. Internal carrier communications expressly admitted that the initial claim payment was improperly calculated by applying a coinsurance penalty rather than paying the insured on an Actual Cash Value ("ACV") basis, which would have resulted in a higher recovery for the insured. Specifically, Westchester stated internally: "The supplement is because the initial calculation of RC less the co-insurance penalty was paid to the Insured, when the ACV amount favors them and should have been paid." Further, even in the co-insurance penalty application was warranted – which it was not -- Westchester mechanically applied the coinsurance formula without offering the insured any meaningful opportunity to contest the underlying valuation or submit supplemental documentation, despite the insured’s active engagement. Westchester failed to act reasonably or in the insured’s best interest before enforcing a substantial penalty that slashed the insured’s recovery.
Westchester failed to substantively respond and attempt to correct its shortcomings until March 11, 2024, well beyond the deadlines mandated by § 627.70131. Westchester’s repeated references to a pending “management review” while ignoring substantial correspondence constituted an intentional delay tactic and a failure to act promptly upon communications concerning the claim in violation of § 626.9541(1)(i)(3)(c), Fla. Stat.
Although Westchester eventually issued a supplemental payment to pay for ACV, it did not do so until March 2024, months after it knew or should have known of the error. Westchester’s failure to promptly correct the admitted underpayment deprived the insured of timely benefits, prolonged the adjustment unnecessarily, and constituted a failure to act fairly and honestly toward its insured in violation of Florida Statutes §§ 624.155 and 626.9541. This conduct evidences both a lack of reasonable standards for investigating and adjusting claims and an intentional effort to delay payments properly due under the policy. This conduct violates Florida law requiring insurers to fairly settle claims where liability is clear and to conduct reasonable investigations based upon all available information (§ 626.9541(1)(i)(3)(d) and (f)).
Moreover, Westchester’s internal communications demonstrate systemic mismanagement and failure to adequately investigate or process the insured’s claim, including but not limited to a lack of communication and understanding as to whether mitigation invoices were considered and whether the claim should have been closed while disputes remained outstanding. Westchester’s mismanagement of the file, combined with their failure to address the insured’s submissions, improperly closing the claim while invoices were pending, and ultimately issuing delayed and incomplete payments, constitutes a broader pattern of bad faith conduct designed to delay, underpay, and frustrate the insured’s rights under the policy.
Finally, Westchester continued its bad faith tactics in litigation. For example, Westchester asserted a pre-existing damage defense, despite its own claim file stating that “No pre-existing or excluded damages were identified,” and “The insured does have a pre-existing roof damage exclusion; however, we the damages observed were for only new wind damages.”
As a result of these actions, the insured was deprived of timely benefits owed under the policy, forced to endure unnecessary delays, and exposed to additional financial harm. Westchester has failed to implement and follow standards for the proper investigation and settlement of claims and has placed its own financial interests ahead of its insured’s rights and interests at every stage of the adjustment.
As a result of Westchester’s actions, the insured was deprived of timely insurance benefits, incurred unnecessary financial strain, and was forced to expend significant additional effort to obtain partial benefits already owed under the policy. Westchester’s handling of this claim reflects a general business practice of delay, underpayment, misrepresentation of policy provisions, and failure to act in the insured’s best interest, all in violation of its duties under Florida law. Westchester failed to adopt and implement proper standards for the investigation of claims, misrepresented pertinent facts and policy provisions, and failed to promptly and properly settle the claim when under an obligation to do so.
Westchester’s dramatically insufficient coverage decision has resulted in further damages to the Insured by preventing them from returning their Property to its pre-loss condition, rather than participating in the settlement process in good faith.
As a direct consequence of Westchester’s failure to adjust this loss in good faith and pay what it owed under the policy, the Insured is continuing to sustain considerable hardship. Upon information and belief, Westchester, as part of its general business practice, initially low-balls its policyholders. Westchester does this in a calculated and systematic scheme that begins with manipulating the software system used in estimating its property damage claims. It appears that Westchester issues its adjusters estimating software which contains construction pricing below the fair market value. It also appears that Westchester trains its claim adjusters to overlook and/or turn a blind eye to a number of routine costs that Westchester knows most policyholders generally would not know to request but are actually covered under the insured’s policy. Moreover, as part of this scheme, after making one initial low-ball payment – Westchester stalls and intentionally delays the claim, changing adjusters, all under the false pretense that it’s “investigating” the claim. Westchester has violated Florida Statute § 624.155(1)(b)(1) by continuously not attempting in good faith to settle this claim when it should have done so if it had acted fairly and honestly towards its Insured. Westchester has also violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented all of the indisputable evidence of the amount of damage sustained by this Property, it is a disgrace that the Insured has been treated in this manner by their insurance company after sustaining an obviously covered loss, submitting to every demand of Westchester, and making a good faith effort to resolve in an attempt to amicably come to a fair resolution. Westchester violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insured for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. Westchester was informed multiple times of the discrepancies and inconsistencies of the low-ball payment issued to the Insured. While Westchester was made aware of this information for the purpose of obtaining the money contractually owed to the Insured under its insurance policy to attempt to return their property to its pre-loss condition in a timely fashion, Westchester accepted that information and has used it to play the delay game with the Insured, knowing all too well the additional damage and hardship that was being placed on the Insured by its actions. Westchester violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Under no circumstances is there an excuse for the lack of a proper investigation in this case. Westchester and their representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insured. In addition, after being placed on notice as to the blatant underpayment of the Insured’s claim, Westchester has yet to rectify their actions and do right by the Insured by paying the money they are contractually owed.
Westchester violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. There still has yet to be significant action taken by Westchester to this date, despite Westchester being presented with the flawed rationale behind their underpayment of the Insured’ claim. Westchester violated § 626.9541(1)(i)(3)(g) by failing to promptly notify the Insured of any additional information necessary for processing the claim. The Insured have more than complied with each and every request and there has still been no action by Westchester. In the event Westchester is in need of additional information, they have failed to promptly notify the Insured in a timely manner. This pattern of behavior is perpetuated by Westchester and their representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insured throughout the insurance claim process. Several duties and responsibilities to the Insured were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from Westchester approaching the investigation and settlement in a manner prejudicial to the Insured, failing to allow a fair settlement with the Insured, and acting with due diligence in achieving a proper disposition of the claim.
In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insured were not afforded the professional duties entrusted on Westchester by the public. To date, Westchester has failed to adequately compensate the Insured for the damage that occurred on September 28, 2022. As a direct result of Westchester’s delay, the Insured were forced to seek the help of legal counsel to assist them. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that Westchester knowingly and intentionally are delaying the claims process in order to further disadvantage the Insured. The financial detriment caused to the Insured is a direct result of Westchester’s reckless delay of the claim process. The Insured is a dutiful customer who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their property would be covered. The Insured timely filed their claim and fulfilled all of their post-loss obligations. All requested information and documentation has been turned over to Westchester and their representatives promptly by the Insured. However, Westchester failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insured how they may remedy any deficiencies in their claim, and failed to provide them with qualified representatives to ensure the claim was initially adjusted, evaluated, and estimated properly.
To deny the Insured the benefit of their bargain after they satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the aforementioned actions complained of, among others, were made by Westchester so often as to constitute a general business practice, evidencing a motive to enhance Westchester’s profits, and designed to cause a detrimental effect to its policy holders. Westchester was aware that the Insured’s damages were covered and took advantage of its Insured in an attempt to force them into an irreparably disadvantaged position, which they hope will force the Insured to settle for less coverage than they are contractually entitled to under the policy.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Westchester fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Westchester must: (1) Immediately tender all insurance proceeds due and owing to the Insured that are fairly owed to the Insured under the insurance policy that would reasonably place the Insured back to a pre-loss condition (2) Agree to reimburse the Insured’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insured for interest on the amount of benefits that was found to be due and owing to the Insured, relating back to the date of loss; (4) Agree to pay all invoices for services performed by third-party vendors in connection with the claim including water mitigation, and mold remediation and tarping services.
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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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