Filing Number: 823446
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| Filing Accepted: 5/27/2025 |
| Last/Business Name
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| Street Address
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15916 HALSEY ROAD |
| City, State Zip
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TAMPA,
FL
33647
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| Email Address
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ZOEMCGEE@YAHOO.COM |
| Complainant Type:
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Third Party |
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| Last/Business Name* |
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FLAGSHIP ENTERPRISES HOLDING, INC. |
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First Name |
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| Policy # * |
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GL0829847720 |
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Claim #* |
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9510201941 |
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Attorney is Applicable
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| Last Name* |
GRANT
First Name *
LARRY
Initial
J
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| Street Address* |
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2600 CYPRESS RIDGE BLVD., SUITE D |
| City, State Zip* |
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WESLEY CHAPEL
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FL
33544
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| Email Address * |
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JGRANT@SLATERGRANT.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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ZURICH AMERICAN 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 16535 |
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| Name of individual responsible for violation (if any):*
ANDREW PHILLIPS GARTNER
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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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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)(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)(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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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 policy language of this part is incorporated in its entirety and must confirm with Florida Statues section 627.727.
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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 is a third-party insurance claim of Adriane Mcgee (“Ms. Mcgee” or “Complainant”) against Flagship Enterprises Holding, Inc., who is insured by Zurich American Insurance Company (“Zurich” or “Insurer”). On June 17, 2022, Ms. Mcgee was walking through Orlando International Airport when she suddenly slipped and violently fell after stepping into liquids on the floor. Following her fall, she was assisted by a gate agent and a cleaning lady approached the area and began cleaning up the spill. Based on the appearance of the liquid after the fall, it appears to have been there for quite some time.
As a result of the fall, Ms. Mcgee was evaluated by urgent care emergency physicians, chiropractor, radiologists, physical therapists, and orthopedic physician and has been diagnosed with injuries to her lower back, right hip and right shoulder. Her economic damage exceeds $18,000 and continues to escalate.
Complainant sent a demand to Insurer on December 20, 2024, demanding an amount within the policy limits. All accident-related medical records and medical bills were forwarded to Insurer.
Complainant has exchanged communications with Insurer but has yet to be provided a reasonable analysis of the claim, or a reasonable settlement offer. In fact, despite acknowledging it is responsible for maintaining the floor, it continues to refer Complainant to a subcontractor hired by the Insurer. As the Insurer surely knows, maintaining the property in a reasonably safe condition is a non-delegable duty for which it remains liable. Despite its legal responsibility, Insurer is unfairly delaying the claim adjustment and payment process to achieve underpayment, delay of payment, or settlement due under the commercial policy. See Florida Statute section 626.9541(1)(i)(3). Specifically, Complainant made a demand for an amount within the policy limits (and provided substantial documentation in support of such a demand) and has all around not been met with a good faith handling of her claim. Ultimately, it seems Insurer seeks to delay the claims process in hopes of achieving an underpayment of the claim.
Instead of fairly and honestly evaluating the claim with due regard to the interest of Complainant, Insurer has done nothing more than make bad faith offers that do not even cover Complainant’s medical expenses. Moreover, Insurer has failed to respond to this firm’s multiple requests for an explanation of its valuation of Complainant’s claim and demand.
Complainant files this Civil Remedy Notice naming Insurer and the adjusters involved triggering the 60-day cure period. Insurer may "cure" by tendering payment of $87,500.00, which is an amount within Insurer's commercial policy and an amount that is a reasonable reflection of the value of Complainant’s claim when one gives good faith consideration to the economic and non-economic damages that have been suffered.
Upon information and belief, one or more of the violations complained of occur with sufficient frequency to constitute general business practice. These facts and circumstances are intended to provide reasonable notice of support for the violations. Complainant has not reviewed the claim file, manuals, and other information that may further support a violation. The statements herein are not intended to be complete or limiting in the event legal action is instituted.
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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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