Universal Property & Casualty: the denial record

IN LIGHT OF UNIVERSAL'S FAIULRE OR REFUSAL TO ADJUST THE CLAIM IN GOOD FAITH, THE INSURED ENGAGED LEGAL COUNSEL AND FILED A NOTICE OF INTENT TO INITIATE LITIGATION ("NOITL") REQUESTING PAYMENT IN THE AMOUNT OF AT LEAST $905,000 ON OR ABOUT DECEMBER 12, 2024 (APPROXIMATELY 430-DAYS AFTER FIRST NOTICE

THE JURY CALCULATED ACTUAL CASH VALUE ("ACV") DAMAGES IN THE AMOUNT OF $200,000, AND REPLACEMENT COST VALUE ("RCV") DAMAGES IN THE AMOUNT OF $455,800.

Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $19,968.91 only, leaving a remainder in the amount of $211,710.32 to be paid in order to cure the breach, less any applicable policy deductible.

ILGPA, on behalf of the Insureds, forwarded said estimate which fully detailed the Insureds' damages and total $227,216.49.

After initially contending that the damages were under deductible, UPCIC would tender a $3,050.80 payment to MS. [name redacted] but fail to explain how it got this amount and refuse to provide the updated estimate from its field adjuster.

IN LIGHT OF UNIVERSAL'S FAIULRE OR REFUSAL TO ADJUST THE CLAIM IN GOOD FAITH, THE INSURED ENGAGED LEGAL COUNSEL AND FILED A NOTICE OF INTENT TO INITIATE LITIGATION ("NOITL") REQUESTING PAYMENT IN THE AMOUNT OF AT LEAST $206,065 ON OR ABOUT DECEMBER 12, 2024 (APPROXIMATELY 430-DAYS AFTER FIRST NOTICE

Based on the insufficient adjustment of the claim as outlined herein, Universal issued a wholly unsatisfactory valuation of $4,896.13 replacement cost value for the loss.

Subsequently, the insured prepared a loss package in the amount of $178,928.66 needed to restore the property back to its pre-loss condition.

Thereafter, denied the claim based on the insured's public adjuster not being at the residence when Universal's plumber went out to inspect the property.

This estimate totaled $5,411.14, and after deductible and depreciation, Universal paid only $1,901.87 to indemnify the Insured for her unfortunate loss.

The carrier still owes $92,816.97 after the previous payment and the deductible was applied.

Despite same, the Insurer responded with a wrongful denial letter, dated June 17, 2022 incorrectly alleging there was no physical damage to the property caused by the water loss.

Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $13,285.14 only, leaving a remainder in the amount of $135,461.66 to be paid in order to cure the breach, less any applicable policy deductible.

Given the scope and nature of the damage, the Insured retained a public adjuster, obtained estimates for repairs, and prepared a Sworn Statement in Proof of Loss, dated August 6, 2020, showing $148,371.39 in damage after application of the policy deductible.

The check was in the amount of $9,395.63 and issued on or about 10/19/24.

After the carrier's inspection, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY opened coverage for the loss and offered a miniscule payment of $4,253.10 to repair all the damages.

THE ESTIMATED COST OF REPAIRS TO THE INSURED PROPERTY CURRENTLY STANDS AT APPROXIMATELY $ 137,572.88.

Specifically, the Insured, with assistance from their public adjuster, submitted an estimate for $136,113.16, which was a fair and reasonable assessment for the repair/replacement of damages.

On or about August 3, 2022, without sufficient explanation, insurer provided insured with an undisputed actual cash value (ACV) estimate of $6,459.49, which it said was the net amount due after application of the deductible and recoverable depreciation. 72.

After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $129,020.41 in covered damage to the dwelling.

The Insurer ultimately inspected the Property through field adjuster Michael McDowell to evaluate the damages, who prepared a woefully deficient initial estimate that failed to address the full scope of damages and repairs necessary to return the Property to its pre-loss condition.

United Damage Adjusters, on behalf of the Insured, forwarded said estimate which fully detailed the Insured's damages and total $127,150.62.

Wicks estimated the total cost to restore the Property back to its pre-loss condition at $124,110.12 ACV $125,236.25 RCV for the dwelling.

Stellar inspected the property and prepared an estimate totaling $124,774.08, and submitted this estimate along with photos and other documentation to Universal.

AS AN ALTERNATIVE CURE OPTION, [name redacted] MAY CURE THE ALLEGATIONS GIVING RISE TO THIS NOTICE BY TENDERING A CHECK IN THE AMOUNT OF $173,789.60, LESS THE APPLICABLE DEDUCTIBLE, WITHIN THE 60 DAY CURE PERIOD, JOINTLY PAYABLE TO THE INSURED AND CONSTABLE LAW.

ILGPA, on behalf of the Insured, forwarded said estimate which fully detailed the Insured's damages and total $107,294.81.

After inspection by Universal's representatives, coverage for the loss was afforded and a paltry payment of $399.39 was made after application of the $1,000.00 deductible.

The Public Adjuster conducted a thorough investigation, including and preparing a repair estimate totaling $102,899.77.

To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $102,588.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property.

The second letter opened coverage under the subject policy for the interior water damage, and after reduction for "recoverable depreciation" and application of the deductible, issued payment in the amount of $6,780.41 to repair the interior water damage.

However, the estimated cost of repair for the direct physical loss to property for the above-referenced claim does not exceed your applicable policy deductible of $2,500.00.

The carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim.

Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from the loss, the Insured through its retained representatives disputed the coverage determination and submitted an estimate prepared by Hunter Cl

INSURER inspected the property and wrongfully denied coverage for the claim without a good faith investigation into the cause of the observed damages.

This field adjuster's name does not appear on their estimate, which completely failed to account for the scope of the damages.

Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $31,530.25 only, leaving a remainder in the amount of $62,856.20 to be paid in order to cure the breach, less any applicable policy deductible.

During Universal's investigation, the Insureds made their property available for inspection, provided facts and information surrounding the loss, and complied with Universal's adjustment of the claim.

Ordman calculated a Replacement Cost Value of $51,968.01 for Coverage A - Dwelling.

The Insurer sent an adjuster to inspect the damages and although the Insurer acknowledged damage to the roof and jack and jill bathroom totaling $23,941.00.

On July 29, 2022, the Insurer sent a letter to the Insureds advising that the damages to the Property totaled $17,513.67.

The interior water damage was covered however, the adjuster estimated repairs to be $1,790.12, falling below the deductible of $6,920.00.

After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $82,807.57 in covered damage to the dwelling.

Subsequently, the insureds prepared a loss package in the amount of $81,268.46 needed to restore the property back to its pre-loss condition.

Following said inspection, on April 12, 2023, the Carrier issued payment of $6,727.73 to the Insured, after deducting $2,382.44 in recoverable depreciation and applying her $2,500.00 Policy deductible.

Subsequently, the insured prepared a loss package in the amount of $79,171.42 needed to restore the property back to its pre-loss condition.

The Carrier can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy and by paying the Insureds $78,520.00, which reflects the full amount of the proposals plus the estimated loss of use, minus the Carrier's prior payment and the Insureds' $2,500.00

Based upon UPCIC's investigation and property inspection, which confirmed property damages, UPCIC's third-party adjuster, Alder Adjusting, nevertheless sent correspondence to the Insured dated August 6, 2024, confirming partial coverage for the claim, and failing and refusing to issue full payment t

The Insureds obtained representation from a public adjuster and an estimate for repair of dwelling for $76,446.22, deductible subtracted, with supporting documentation and photographs.

After the carrier's inspection, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY opened coverage for the loss and offered a miniscule payment of $7,912.21 to repair all the damages.

HSC immediately sent their estimate to UPCIC, which estimated the scope or damage to be $75,485.47 along with a request for supplemental payment, but UPCIC failed to issue any additional payment to the Insured.

After the inspection, Fairwinds Construction Services, LLC, provided an estimate for repairs in the amount of $73,598.91, which is the full amount to return Timmermans' home back to pre-loss condition.

Based on this flawed assessment, UPCIC issued only a partial payment, deducting the $7,083.92 hurricane deductible and withholding $8,135.15 for recoverable depreciation, resulting in a net disbursement of $13,227.21.

After reducing the estimate, the carrier represented to the insured the covered damages only totaled $1,080.57.

Additionally, on July 25, 2024, notwithstanding carrier's previous denial to the roof portion of this claim, the carrier made the decision to open coverage for remediation services provided by ACE Restoration Services, LLC ("ACE") in the amount $9,990.00.

Specifically, on July 19, 2023, Universal set a letter with an estimate and advised that they would "be forwarding our undisputed Actual Cash Value estimate in the amount of $6,789.14.

After the inspection, the public adjuster provided an estimate for repairs in the amount of $67,965.46, which is the full amount to return Cognettis' home back to pre-loss condition.

Specifically, the Insureds, with assistance from their public adjuster, submitted an estimate for $67,492.12, which was a fair and reasonable assessment for the repair/replacement of damages.

Specifically, the Insured, with assistance from their public adjuster, submitted an estimate for $67,395.80, which was a fair and reasonable assessment for the repair/replacement of damages.

ILGPA, on behalf of the Insured, forwarded said estimate which fully detailed the Insured's damages and total $67,200.41.

Even if the disputed labor costs were excluded, Insurer's revised coverage determination still fell over $55,847.40 short of the Public Adjuster's estimate after accounting for deductibles and the prior payment.