Collapse and sinkhole: the denial record

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

SEI'S SECOND OPTION WAS ESTIMATED TO COST $484,315.00, EXCLUSIVE OF COSMETIC REPAIRS TO THE STRUCTURE FOLLOWING STABILIZATION.

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.

Therefore, demand is hereby made as follows: Estimate $317,000.00 Less Prior Payments $14,119.93 Less Deductible n/a TOTAL $302,880.07 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss.

He inspected the loss on October 5, 2023, and coverage was opened based on his estimate of damages drafted October 11, 2023 totaling $3,062.04 RCV.

This offer is based on an estimate from their adjuster for repairs totaling $12,110.51 after application of non-recoverable depreciation and deductible.

Count 2: Failure to negotiate in good faith The carrier invoked a $10,000 sublimit for water damage under the policy.

Based upon the findings and conclusions of ESi, the Insurers, through Sedgwick and [name redacted] wrongfully denied coverage for the Insured's claim in a letter dated September 28, 2023.

It is not entirely clear what Castle Key's claim determination was because it has failed to issue a written coverage determination.

His medical expenses total $40,722.37, and potential spinal surgery may increase costs to over $100,000.00.

Perez submitted the claim to Sedgwick on 07/15/2024.The cause of loss was reported as a collapse that caused damage to walls, flooring, electrical, ceiling, ceiling tiles, etc.

(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.

Perez submitted the claim to Sedgwick on 07/15/2024.The cause of loss was reported as a collapse that caused damage to walls, flooring, electrical, ceiling, ceiling tiles, etc.

Furthermore, despite being well aware that a part of the property collapsed, [name redacted] failed to extend any coverage under the additional coverage that expressly covers collapse in the policy and failed to include this applicable coverage in its coverage letters.

However, the Carrier's denial letter fails to mention or address this critical extension of coverage.

Management was notified of the leak and the source was identified as a leaking pipe coming from the unit located directly above Ms.