Filing Number: 822346
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| Filing Accepted: 5/20/2025 |
| Last/Business Name
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1936 PREMIER ROW, LLC
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First Name |
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| Street Address
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1936 PREMIER ROW |
| City, State Zip
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ORLANDO,
FL
32809
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| Email Address
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FIRM@FLORIDAINSLAW.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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1936 PREMIER ROW, LLC |
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First Name |
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| Policy # * |
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AMR-73016-01 |
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Claim #* |
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4235824 |
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Attorney is Applicable
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| Last Name* |
CIOCCHETTI
First Name *
MICHAEL
Initial
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| Street Address* |
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125 NORTH RIDGEWOOD AVENUE, SUITE 100 |
| City, State Zip* |
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DAYTONA BEACH
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FLORIDA
32114
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| Email Address * |
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FIRM@FLORIDAINSLAW.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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UNDERWRITERS AT LLOYD'S, LONDON
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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 |
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| Name of individual responsible for violation (if any):*
ESTER MUNUO
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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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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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| 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)(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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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 Building Coverage and Business Interruption Coverage portions of the multiple Policies are relevant to the Claims.
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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.
This complaint is made on behalf of the insured, 1936 PREMIER ROW LLC. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155.
In consideration of the premium paid to it, CERTAIN UNDERWRITERS AT LLOYDS, LONDON; QBE SPECIALTY INSURANCE COMPANY (“Carrier”), issued a policy, Policy No. AMR-73016-01; and MSP-37875 (“Policy”), to the Insured where the Policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 1936 Premier Row, Orlando, FL 32809 (“Insured Property”). The policy was in full force and effect at the time the damage occurred from A Hurricane Ian, and the ensuing damages as a direct result thereof, to the Insured Property, on or about September 29, 2022.
Thereafter, the Carrier was timely notified of the Loss. In particular, the Carrier was put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policy. Claim number 4235824 (“Claim”) was assigned to the Loss.
The Carrier sent an adjuster to the Insured Property to perform an inspection. The Carrier performed a cursory inspection of the Insured Property and failed to retain unbiased experts necessary to trigger the cause of the Loss and covered repairs necessary to restore the Insured Property to its pre-loss condition. The Carrier deliberately denied the claim. The Carrier knows its aforementioned investigation is insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition. This inspection placed The Carrier on notice of the severity of the Loss. The Carrier subsequently denied the Insured’s claim and issued no payment for the Loss.
Thereafter, the insured sought the assistance of a public adjuster who ensured the proper estimating of the loss and compliance with all Policy conditions. The public adjuster submitted a comprehensive estimate to the Carrier for the full scope of damages to the Insured Property. In addition, a Sworn Statement and Proof of Loss (“SPOL”) was provided, on or about December 11, 2024. The Carrier disregarded this comprehensive estimate and SPOL and, instead, denied the Claim. The Carrier has refused to reassess its denial of benefits and the basis of the denial and has refused to properly adjust and settle the Claim.
The Carrier violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insured with a due regard for their interest. When the Carrier was confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier chose to deny the Insured’s valid Claim.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insured that Policy coverage was unavailable for the Insured’s Claim and Loss to the Insured Property. This misrepresentation was made in an attempt to deny the Insureds’ Claim and escape without paying for the full extent of substantial damage.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier apparently had no system or standards prepared or implemented which would allow it to evaluate the Claim as submitted by its Insured.
The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or Policy provisions relating to the coverage at issue. This has been discussed fully hereinabove.
The Carrier violated the provisions of Florida Statute 626.9541(1)(i)(3)(d) by denying the Insured’s Claim without conducting reasonable investigation into the basis for the Claim.
The Carrier violated the provisions of Florida Statute 626.9541 (1)(i)(3)(f) by failing to promptly provide a reasonable explanation in writing to the Insured of the basis in the Policy, in relation to the facts or applicable law, for denial of the Claim.
The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.
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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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