Filing Number: 824924
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| Filing Accepted: 6/3/2025 |
| Last/Business Name
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| Street Address
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14901 REFLECTION KEY UNIT 1011 |
| City, State Zip
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FORT MYERS,
FL
33907
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| Email Address
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AMT@BOATMANRICCI.COM |
| Complainant Type:
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Third Party |
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| Last/Business Name* |
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CLYDE JOHNSON CONTRACTING LLC |
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First Name |
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DANIEL |
| Policy # * |
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ATN2221887 |
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Claim #* |
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ATN2221887 |
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Attorney is Applicable
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| Last Name* |
HOGAN
First Name *
DANIEL
Initial
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| Street Address* |
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411 E COLLEGE AVE |
| City, State Zip* |
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TALLAHASSEE
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FL
32301
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| Email Address * |
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RDH@BOATMANRICCI.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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UNITED 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 12537 |
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| Name of individual responsible for violation (if any):*
ADJUSTER
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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 Delay
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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.
SECTION I – COVERAGES
COVERAGE A BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured becomes
legally obligated to pay as damages because of
"bodily injury" or "property damage" to which this
insurance applies. We will have the right and duty
to defend the insured against any "suit" seeking
those damages. However, we will have no duty to
defend the insured against any "suit" seeking damages
for "bodily injury" or "property damage" to
which this insurance does not apply. We may, at our
discretion, investigate any "occurrence" and settle
any claim or "suit" that may result. But:
(1) The amount we will pay for damages is limited
as described in Section III – Limits Of Insurance;
and
(2) Our right and duty to defend ends when we have
used up the applicable limit of insurance in the
payment of judgments or settlements under
Coverages A or B or medical expenses under
Coverage C.
No other obligation or liability to pay sums or perform
acts or services is covered unless explicitly
provided for under Supplementary Payments –
Coverages A and B.
b. This insurance applies to "bodily injury" and "property
damage" only if:
(1) The "bodily injury" or "property damage" is
caused by an "occurrence" that takes place in
the "coverage territory";
(2) The "bodily injury" or "property damage" occurs
during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II – Who Is An
Insured and no "employee" authorized by you to
give or receive notice of an "occurrence" or
claim, knew that the "bodily injury" or "property
damage" had occurred, in whole or in part. If
such a listed insured or authorized "employee"
knew, prior to the policy period, that the "bodily
injury" or "property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during or
after the policy period will be deemed to have
been known prior to the policy period.
c. "Bodily injury" or "property damage" which occurs
during the policy period and was not, prior to the
policy period, known to have occurred by any insured
listed under Paragraph 1. of Section II – Who
Is An Insured or any "employee" authorized by you
to give or receive notice of an "occurrence" or
claim, includes any continuation, change or resumption
of that "bodily injury" or "property damage" after
the end of the policy period.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred at the
earliest time when any insured listed under Paragraph
1. of Section II – Who Is An Insured or any
"employee" authorized by you to give or receive notice
of an "occurrence" or claim:
(1) Reports all, or any part, of the "bodily injury" or
"property damage" to us or any other insurer;
(2) Receives a written or verbal demand or claim
for damages because of the "bodily injury" or
"property damage"; or
(3) Becomes aware by any other means that "bodily
injury" or "property damage" has occurred or
has begun to occur.
e. Damages because of "bodily injury" include damages
claimed by any person or organization for care,
loss of services or death resulting at any time from
the "bodily injury".
COVERAGE C MEDICAL PAYMENTS
1. Insuring Agreement
a. We will pay medical expenses as described below
for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent; or
(3) Because of your operations;
provided that:
(a) The accident takes place in the "coverage
territory" and during the policy period;
(b) The expenses are incurred and reported to us
within one year of the date of the accident;
and
(c) The injured person submits to examination,
at our expense, by physicians of our choice
as often as we reasonably require.
b. We will make these payments regardless of fault.
These payments will not exceed the applicable limit
of insurance. We will pay reasonable expenses for:
(1) First aid administered at the time of an accident;
(2) Necessary medical, surgical, x-ray and dental
services, including prosthetic devices; and
(3) Necessary ambulance, hospital, professional
nursing and funeral services.
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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.
Claimant entered the home of Mary Ann Shaffrey to assist with interior decoration while the property was under renovations being completed by insured. A pile of unsecured sheetrock was left by insured and fell on Claimant's leg resulting in injury that has ongoing complications leading to multiple surgeries and ongoing treatment.
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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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