Florida Peninsula: the denial record

INITIALLY AND IMMEDIATELY THE FULL VALUE OF THE PUBLIC ADJUSTER'S ESTIMATE, $749,271.88, LESS ANY APPLICABLE DEDUCTIBLE.

The INSURER inspected the property and determined that the property suffered damage totaling $5,796.76, which fell below the deductible amount.

The insured has been compelled to obtain an independently adjusted estimate totaling in the amount of $237,227.74 that would be needed to repair the property back to its pre-loss condition.

Having conducted thorough investigations and analysis, DAC prepared an estimate of costs to repair the damaged property in the amount of RCV $187,351.95.

Despite this clear evidence of wind-related damage, Florida Peninsula denied coverage for the claimed roofing damage and issued payment for the undisputed amount of loss in the sum for exterior damage in the sum of $9,828.83 Coverage A; $2,197.36 Coverage B and $10K for screen enclosure.

Mr. [name redacted] timely notified Florida Peninsula of the damages sustained to the property and provided a report of the cost of repairs amounting to $156,331.00.

The insured submitted an estimate totaling approximately $143,911.81 in actual cash value, which received no response.

However, the coverage determination received by the public adjuster for the insureds, was below deductible and contrary to the understanding that the public adjuster thought he had with Mr.

To date, MR. [name redacted] has incurred out-of-pocket expenses in the amount of $9,159.60 for mitigation of his damages.

AND MRS. [name redacted] damage estimate in the amount of $107,047.97 RCV (less any prior payments, depreciation, excess policy limits, and/or deductible), which accurately reflects the true nature and extent of the damages to the Dwelling / Other Structures; (2) Agrees to reimburse MR.

After being provided plenty of evidence (including photos, estimates, and immediate access to the property upon discovery) showing that damage from Hurricane Ian occurred at the property that will require extensive repairs, FPIC continues to refuse to provide any money in order to complete these rep

The Insured retained an adjuster to assist with her claim and prepared an estimate of storm damages totaling storm damages totaling $66,312.07 RCV and $64,945.01 ACV, which far exceeds that $6,120 deductible.

To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $59,158.36, less any applicable deductible and prior payment to the Insured, to complete the repairs for the Insured property.

To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $ 55,833.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property.

Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $18,285.38 only, leaving a remainder in the amount of $35,197.84 to be paid in order to cure the breach, less any applicable policy deductible.

The Complainant retained a license contractor who then inspected the property and determined that there were substantial damages the replacement cost value in the amount of $43,909.91, which included a full roof replacement and other damages.

After the inspection, the public adjuster provided an estimate for repairs in the amount of $43,264.03 which is the full amount to return [name redacted] 's home back to pre-loss condition.

In order to cure Florida Peninsula Insurance Company'scontinuous acts of bad faith, Florida Peninsula Insurance Company must issue payment for theinvoiced amount of $ 3,000.00 and which has a current balance of $ 3,000.00; as well as,statutory interest.

However, the Insurer wrongfully determined it would only require $1,001.90 to restore the property to its pre-loss condition, which resulted in no payment being issued to the Insured as the amount of covered damage allegedly fell below the policy deductible.

The Insured promptly reported his claim for Hurricane Milton damages to Florida Peninsula Insurance Company.

Although it is clear that the damages are covered, the carrier 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.

The Insurance Company has failed to issue proper payment for the claim and has failed to issue sufficient payment to include damages and repairs covered by the policy and Florida law.

The adjuster for the claims company refused to even inspect the ares complained of, including the roof truss and underlayment.

Florida Peninsula denied all but the roof claim for Helene - which was NOT the cause of the damage to the home that was recorded in his report.

In order to cure this civil remedy notice, FPIC must immediately tender $208,021.29, less the applicable deductible and prior payment(s), to "[name redacted] Law Group".

(k.) INSURER, as a general business practice, opens coverage for a limited amount, typically at or around the deductible, for the purpose of availing itself to the appraisal provision of the policy, whereby, it treats an Insured who is represented different from unrepresented Insureds.

The estimate in support of this coverage determination erroneously included incorrect data, deductible information, and otherwise lacked the required information to reflect the correct adjustment of the claim, let alone failed to fully indemnify the Insured for their losses.

Therefore, to cure the defects outlined in this Civil Remedy Notice, within the next 60 days, the Insurer must tender a settlement draft in the total amount of $40,000.77 made payable to "Weber, Crabb & Wein, P.A. [name redacted] " and deliver it to Claimant's counsel.

Specifically, the denial letter attributed the damages to the following exclusions, "the policy does not afford coverage for loss that are caused by wear and tear, chipping, scratches, dents or deterioration.

An initial Field Adjuster's Estimate of $78K was mistakenly sent to us before being revised to an amount below the deductible.

To cure the defects outlined in this Civil Remedy Notice, within the next 60 days, the Insurer must deliver to Weber, Crabb & Wein, P.A. a settlement draft for $69,873.32, made payable to "Weber, Crabb & Wein, P.A. [name redacted] ".