Filing Number: 826213
|
| Filing Accepted: 6/10/2025 |
| Last/Business Name
*
|
|
|
HONDO CREEK REAL ESTATE OPERATIONS LLC
|
|
First Name |
|
|
|
| Street Address
*
|
|
3880 E. COUNTY HIGHWAY 30A, UNIT 104 |
| City, State Zip
*
|
|
SANTA ROSA BEACH,
FL
32459
|
| Email Address
*
|
|
DONNYJ@YAHOO.COM |
| Complainant Type:
*
|
|
Insured |
|
| Last/Business Name* |
|
HONDO CREEK REAL ESTATE OPERATIONS LLC |
|
First Name |
|
|
| Policy # * |
|
LSP4818000D |
|
Claim #* |
|
1276167 |
|
Attorney is Applicable
|
| Last Name* |
OLADIPO
First Name *
ABIDEMI
Initial
A.
|
| Street Address* |
|
12226 N. 56TH STREET |
| City, State Zip* |
|
TAMPA
,
FLORIDA
33617
|
| Email Address * |
|
AOLADIPO@MSO.LAW |
|
|
| Insurer Type
*
|
|
Authorized Insurer
Unauthorized Insurer
|
|
|
| Insurer Name |
|
|
| Insurer Name* |
|
UNDERWRITERS AT LLOYD'S, LONDON
|
| Insurer Name* |
|
|
| Street Address* |
|
|
| City, State Zip* |
|
,
|
|
NAIC Company Code |
|
|
| Name of individual responsible for violation (if any):*
UNDERWRITERS AT LLOYD’S, LONDON; DAVIES, KEVIN CASE, LYNN ROTHMAN; ALONG WITH ALL ADJUSTERS, SUPERVISORS, MANAGERS, AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY THE INSURER IN THE CLAIM.
|
| Type of Insurance
*
Commercial Property & Casualty
|
|
|
| Reason for Notice
*
|
|
Claim Denial
|
|
Claim Delay
|
|
Unsatisfactory Settlement Offer
|
|
Unfair Trade Practice
|
|
|
*
Statutory provision(s) which the insurer allegedly violated.
|
|
|
| 624.155(1)(b)(1) |
|
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.
|
| 624.155(1)(b)(3) |
|
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.
|
| 626.9541(1)(i)(3)(a) |
|
Failing to adopt and implement standards for the proper investigation of claims.
|
| 626.9541(1)(i)(3)(b) |
|
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
|
| 626.9541(1)(i)(3)(c) |
|
Failing to acknowledge and act promptly upon communications with respect to claims.
|
| 626.9541(1)(i)(3)(d) |
|
Denying claims without conducting reasonable investigations based upon available information.
|
| 626.9541(1)(i)(3)(e) |
|
Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
|
| 626.9541(1)(i)(3)(f) |
|
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.
|
| 626.9541(1)(i)(3)(g) |
|
Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
|
| 626.9541(1)(i)(3)(h) |
|
Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
|
|
*
Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
HOMEOWNERS 6 – UNIT-OWNERS FORM
AGREEMENT
We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy.
SECTION I – PROPERTY COVERAGES
A. Coverage A – Dwelling
1. We cover:
a. The alterations, appliances, fixtures and improvements which are part of the building contained within the "residence premises";
b. Items of real property which pertain exclusively to the "residence premises";
c. Property which is your insurance responsibility under a corporation or association of property owners agreement; or
d. Structures owned solely by you, other than the "residence premises", at the location of the "residence premises"
…
B. Coverage C – Personal Property
1. Covered Property
We cover personal property owned or used by an "insured" while it is anywhere in the world. After a loss and at your request, we will cover personal property owned by:
a. Others while the property is on the part of the "residence premises" occupied by an "insured"; or
b. A guest or a "residence employee", while the property is in any residence occupied by an "insured".
2. Limit For Property At Other Residences
Our limit of liability for personal property usually located at an "insured's" residence, other than the "residence premises", is 10% of the limit of liability for Coverage C, or $1,000, whichever is greater. (…)
…
C. Coverage D – Loss Of Use
The limit of liability for Coverage D is the total limit for the coverages in 1. Additional Living Expense, 2. Fair Rental Value and 3. Civil Authority Prohibits Use below.
|
| |
*
Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
On May 6, 2023, Underwriters at Lloyd’s, London (“Lloyd’s”) issued policy number LSP4818000D (the “Policy”) to Hondo Creek Real Estate Operations LLC (“Insured”) for its property located at 3880 E. County Highway 30A, Unit 104, Santa Rosa Beach, Florida 32459 (“Insured Property”) for the period of May 6, 2023, to May 6, 2024. The Policy provides Coverage A – Additions & Alterations (RCV) limits of $241,500.00; Coverage C – Personal Property (RCV) limits of $50,000.00; and Coverage D – Loss of Use limits of $23,000.00. The Policy provides coverage for direct damage to the Insured Property as a result of water damage.
On March 9, 2024, the sewer line running through the building ruptured, causing significant damage to the Insured Property. The resulting sewage backup affected multiple units, permeating drywall and causing leaks throughout the Insured Property. The Insured Property sustained extensive damage, particularly in the kitchen, where the cabinetry was rendered unusable and the countertop was compromised. The affected kitchen wall was removed along with the damaged cabinets, and all kitchen appliances were found sitting in sewage. Additionally, the master bedroom and its wood flooring were saturated with sewage, necessitating the removal of flooring in every bedroom.
Upon discovering the damage, the property manager of the Insured Property, Real Joy Vacations, retained Coastal Cottage Maintenance to conduct an initial inspection, as reflected in Invoice No. 2384. As part of their efforts, Coastal Cottage Maintenance removed the toilet in the master bedroom, drained the line, and attempted to clear the obstruction, for which they charged $509.00. Ultimately, due to the extent of the damage described above, the Insured Property was rendered uninhabitable and could not be rented.
Upon discovering the damages, the Insured’s representative promptly reported the claim to Lloyd’s and provided Lloyd’s and its agents with unfettered access to the Insured Property to adjust the loss. Lloyd’s acknowledged the claim and assigned it Claim No. 1276167. Lloyd’s also appointed a third-party claims administrator, Davies, to handle the adjustment process. Davies, in turn, assigned field adjuster Kevin Case to inspect and assess the loss. Mr. Case conducted an inspection of the Insured Property on April 9, 2024.
Unfortunately, Mr. Case was either unable or unqualified to properly identify the full extent of the damage or to competently adjust the loss. This became apparent on May 29, 2024, when he issued an itemized estimate that substantially overlooked the majority of the damage to the Insured Property. The estimate also grossly undervalued the cost of repairs, failing to reflect current local prices for materials, labor, and required permits. The May 29, 2024, estimate totaled $59,750.28. After applying depreciation in the amount of $7,253.43, a $2,500 deductible, and accounting for amounts exceeding policy limits totaling $44,996.85, Lloyd’s calculated a net payment of only $5,000.00—an amount wholly insufficient to restore the Insured Property to its pre-loss condition.
Regrettably, the retention of adjusters and agents, including Davies and Mr. Case, who routinely undervalue and misrepresent claim damages, appears to be a recurring business practice by Lloyd’s—not only in connection with this claim, but in numerous others across the state of Florida. This conduct reflects a failure to adopt and implement standards for the proper investigation of claims, in direct violation of Section 626.9541(1)(i)(3)(a), Florida Statutes. Moreover, it constitutes a misrepresentation of pertinent facts or insurance policy provisions relating to the coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes.
Due to Lloyd’s ongoing failure to properly adjust the loss and to consider all relevant facts and circumstances surrounding the claim, the Insured was compelled to undertake the adjustment of its own loss. To that end, the Insured retained a licensed public adjuster, Noble Public Adjusting Group (“NPAG”), to assist in the presentation of the claim to Lloyd’s. On March 21, 2024, NPAG conducted an inspection of the Insured Property. Subsequently, on March 25, 2024, the Insured obtained an itemized estimate of damages totaling $159,589.24—an amount that more accurately reflects the true scope and nature of the loss. In further support of the claim, the Insured executed a Sworn Statement in Proof of Loss on May 10, 2024, attesting to the extent of the damages sustained. Despite being provided with all relevant documentation, Lloyd’s failed to meaningfully consider the Insured’s submission in its adjustment of the claim. This matter constitutes an instance wherein Lloyd’s has persistently and unjustifiably denied claims without undertaking reasonable investigations based upon the available information, thereby violating Section 626.9541(1)(i)(3)(d) of the Florida Statutes.
On October 21, 2024, due to Lloyd’s failure to adhere to adequate standards for investigating and adjusting claims, the Insured was compelled to retain legal representation to assist in presenting its claim to Lloyd’s. Upon receipt of the Insured’s legal representative’s letter of representation, Lloyd’s, through its desk adjuster Lynn Rothman, merely resubmitted its initial estimate and a copy of the Policy. However, Lloyd’s failed to provide a correspondence articulating the basis for its coverage determination or explaining its refusal to consider the Insured’s own efforts to adjust the loss, despite such consideration not being the Insured’s responsibility. This omission has left the Insured without the necessary resources to recover from the loss.
The burden imposed upon the Insured has been substantial. As a result of the damage to the Insured Property stemming from the loss on March 9, 2024, the Insured was unable to rent the property until repairs were completed at the end of April, incurring costs exceeding $75,000.00 to effectuate said repairs. Notwithstanding these developments, Lloyd’s has continued to refrain from fairly adjusting the claim and has not made a good faith effort to settle the claim when, under all circumstances, it could and should have done so, had it acted fairly, honestly, and with due regard for the Insured’s interests, thereby violating Section 624.155(1)(b)(1) of the Florida Statutes
In Florida, the work of adjusting insurance claims engages the public trust. Lloyd’s has breached the public’s trust by its adjustment of the Insured’s claim of loss. Lloyd’s has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees, resulting in statutory violations as set forth above. Lloyd’s has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s claim for damages. Lloyd’s has failed to promptly settle the Insured’s claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the Insured’s pleas otherwise, Lloyd’s has continued to refuse to acknowledge its obligation to conduct a proper investigation.
Moreover, Lloyd’s has not attempted in good faith to settle the Insured’s claim 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 their interests. Lloyd’s has done everything possible to delay and/or deny the claim. Furthermore, Lloyd’s is required to properly investigate and adjust claims and cannot place that burden upon the insureds. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). Lloyd’s was timely put on notice of the Insured’s loss and claim for damages. The Insured has complied with all of Lloyd’s’ requests to date and the carrier has still failed to treat this claim with good-faith. This intentional delay with the claim has led to direct prejudice of the Insured, who continues to be held hostage unless/until Lloyd’s engages in good faith claims handling. To date, Lloyd’s has still refused to fully pay the amount owed under the Policy. To make matters worse, the Insured has incurred incredible costs and efforts to adjust their own loss, with detailed and substantiated damages presented to Lloyd’s in the form of a repair estimate evidencing $159,589.24 in Replacement Cost Valuation. Lloyd’s’ stubborn and/or negligent refusal to fully indemnify the Insured for the covered damages has resulted in a confluence of consequential damages including, but not limited to, excess damages stemming from Lloyd’s’ maladroit adjustment of the claim, the unaffordability of the Insured Property given the loss of utility and the indefinite delay to address the ongoing dispute, additional costs and expenses to adjust its own loss that include retaining a public adjuster and an attorney, among many other otherwise unnecessary consequences but for the negligence and nefarious business practices of Lloyd’s.
It is clear that Lloyd’s is not treating the Insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; and ignoring the Insured’s pleas for assistance; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing Lloyd’s’ interests before the Insured’s interests; refusing to pay the full amount owed to the Insured despite the fact that Lloyd’s has been on notice of the damages and looking for ways to delay and/or deny full recovery to the Insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. Lloyd’s’ actions are in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(e), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), and 626.9541(1)(i)(3)(h), Florida Statutes.
All of the aforementioned are part of what appears to be an ongoing pattern and practice of behavior by Lloyd’s that demonstrates a wanton and reckless disregard for insured’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, Lloyd’s must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) Lloyd’s must create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees with regard to these type of claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other insureds from being treated unfairly and wrongfully; (3) Lloyd’s must pay the Insured $159,589.24 for all of the damages sustained as a result of the loss, less the applicable deductible, limitations, plus all contractual damages owed, attorney’s fees, costs and interest, under Sections 57.041 and 627.70131(5)(a) Florida Statutes; and (4) Lloyd’s must act fairly and honestly towards its Insured and with due regard for their interests in attempting to settle its Insured’s claim.
|
|
*
|
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.
|
DFS-10-363
Rev. 10/14/2008
|