American Coastal: the denial record

The Carrier valued the claim at $517,994.13 less recoverable depreciation and deductible, which lead to an Actual Cash Value of $48,396.80.

On December 15, 2022, AmCoastal issued a $100,000 advance on the Claim.

Didion's estimate is $2,908,503.89, less the $10,000.00 policy deductible, recoverable depreciation in the amount of $648,327.21, and items which fall under Ordinance or Law Coverage in the amount of $132,306.72.

American Coastal has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured's insurance claim for damages.

American Coastal decided to accept the risk, write coverage and accepted a premium of $786,334.00.

American Coastal 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.

Upon reporting the loss, the Carrier denied the claim and failed to issue payment to Insured.

As of October 24th, 2024 the Insurer had failed to pay or provide satisfactory explanation as to the $2,127,929.80 shortfall for costs incurred and estimated to be incurred by the [name redacted] .

As of October 24th, 2024 the Insurer had failed to pay or provide satisfactory explanation as to the $2,127,929.80 shortfall for costs incurred and estimated to be incurred by the [name redacted] .

Essentially, ACIC misrepresented to [name redacted] that approximately $1,702,830 of necessary subsurface repairs were not covered under the insurance policy.

The public adjuster presented an estimate of damages for $1,147,971.10, which outlined all the damages caused by Hurricane Ian.

Insurer failed to retain the experts needed to perform the inspection and needed to address the damage at issue and determine the repairs needed to restore the property.

In this case, the carrier not only failed to meet this deadline but then took well over a year to render its final estimate.

THE LETTER MEMORIALIZED ANOTHER PAYMENT IN THE AMOUNT OF $31,000 (BUT DID NOT INCLUDE ANY INTEREST), AND PROVIDED NO EXPLANATION AS TO WHY IT PAID ONLY $31,000 FOR TARP REMOVAL, OR WHY IT REFUSED TO REIMBURSE THE OTHER COSTS OF TEMPORARY REPAIRS.

On February 20, 2025, the Insured (through counsel) advised American Coastal that it had retained Helicon to repair the depression at building 25 at an initial invoice cost of $10,000 today, with an estimated total cost of $30,000.

This claim has been delayed for many years and not dealt with properly.

On April 24, 2023 the Insured filed a [address redacted]ated "American Coastal has had field adjusters and engineers inspect the insured properties, but has failed to issue a coverage decision and over 90 days have passed and there are no circumstances beyond the control of American Coastal.

Insurance coverages, policy declarations/copy, and determinations for coverage for July 10, 2024, date of loss were requested in writing on August 1, 2024.

Based on the cursory inspection by the Carrier's Field adjuster and engineer, the carrier denied all damages associated with the claim.

In other words, it seems the field adjuster and engineer both inspected in tandem with each other, but their findings did not correspond accordingly.

AM Coastal must withdraw the false statements presented in the denial letter and honor this claim as should have been done many years ago.