Fire: the denial record

To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $1,420,390.41 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property.

On or about July 29, 2024, Insured executed a requested notarized Sworn Proof of Loss in the amount of $1,322,431.70 (the "SPOL").

State Farm Florida Insurance Company also routinely refuses to pay claims in full when it has the ability to do so, waits to see if its insureds contest their coverage determination, as was necessary here, and, only then, will it capriciously invoke appraisal.

Instead, a junior adjuster named [name redacted] ([email redacted] / [phone redacted]), provided a grossly inadequate estimate of approx $11,000 for the entire damage to the plaza.

Insurer submitted an Adjuster Estimate Report in which the Insurer reduced the claim value ($519,967.05) by $150,250.66 based on an assertion of depreciation.

Based on the egregiously low Compass estimate, the Insurance Company issued correspondence to its Insured acknowledging coverage for the loss and issuing payment in the amount of $112,962.55.

Based upon SIC's investigation and property inspection SIC has denied the claim and in fact "closed" the claim.

The Insurer's payment letter and estimate evaluated the loss at an actual cash value of $80,116.22 after applying the deductible.

The insureds were devastated and hired the assistance of a public adjuster who provided Universal with an accurate and comprehensive estimate of damages in the amount of $247,976.37.

Subsequently, the insured submitted a loss package in the amount of $244,152.25 needed to restore the property back to its pre-loss condition to the carrier.

Indeed, invoices for smoke and fire remediation, textile and electronic cleaning, ALE, storage, appliances, as well as a list of personal property contents and an estimate for repair of all damages were prepared on behalf of Ms. [name redacted] totaling $230,240.[address redacted]ate Farm; well abov

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

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

THE CARRIER'S FIELD ADJUSTER PREPARED AN ESTIMATE TOTALING $132,458.50 IN COVERED DAMAGES TO THE PROPERTY AS A RESULT OF THE SUBJECT LOSS.

The carrier determined the damages to the Contents totaled $327,743.88, but made payment in the amount of $48,528.98.

As the result of that reinspection, Stillwater provided a supplemental adjustment of the claim in the net payable amount of $14,455.64 (computed as $19,329.32 RCV, less $4,373.68 for recoverable depreciation and $500 for the policy deductible).

On May 31, 2023, the Insurer sent a letter to the Insureds advising of their preliminary estimate, in which the damages to the Property totaled $25,222.52 for the dwelling and $4,512.27 for ordinance and law.

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

Lic. #E017211)) confirming partial coverage, denying the remainder, and issuing payment(s) for only $23,944.93.

After careful and considered analysis and review of financial statements, income statements, distribution reports, general ledgers, and other business records, Burrell & Associates conservatively estimated the Insured experienced a loss of income of $73,929.00 for the months of May through August 20

However, when the Insurer conducted its inspection of the insured property, the Insurer's representatives failed to conduct a thorough and adequate investigation, or the representatives intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after inve

Howell concluded that a water loss caused the damages to the Property and estimated that at least $23,814.96 was needed to restore the dwelling to its pre-loss condition.

State Farm must admit that they did not properly investigate the claim or request information in a timely manner and as a result they continued to investigate the claim after issuing the denial letter.

Further, while the Insurer acknowledged coverage for the interior damages, it undervalued the loss by asserting that the repair costs fell below the $2,500 deductible, thereby issuing no payment to the Insureds.

To date, ARCH has failed to provide either [name redacted] or Victors with a defense in the Lawsuit.

Auto-Owners has refused to provide [name redacted] Coverage as it related to the incident on December 20, 2023.

The damages identified in Plaintiffs' [name redacted] are $20,985,654. [name redacted] failed to provide any offer and did not engage in any settlement discussions. [name redacted] conduct is unreasonable and unfair to the beneficiaries of the Estate of [name redacted] .

In consideration of the premium paid to it by the Insured, Berkshire Hathaway Direct Insurance Company issued to the Insured an insurance policy, Policy no. [redacted] (the "Policy").

Since that time, Clear Blue has refused to issue a coverage determination as to [name redacted] 's tender of defense, nor provide [name redacted] with a defense in the Lawsuit.

This civil remedy notice is being filed because Clear Blue Specialty Insurance Company ("Clear Blue") has failed to address [name redacted] Inc.'s ("[name redacted] ") tender of defense in good faith.

The most recent estimate from the Insured's licensed general contractor totals $1,238,824.39.

The damages identified in Plaintiffs' [name redacted] are $20,985,654. [name redacted] National Insurance failed to provide any offer and did not engage in any settlement discussions. [name redacted] National Insurance's conduct is unreasonable and unfair to the beneficiaries of the Estate of [name

THE INSURANCE COMPANY FAILED TO PERFORM A PROPER INVESTIGATION AND EVALUATION OF THE CLAIM AND THEREFORE, IMPROPERLY UNDER ESTIMATE FOR PLAINTIFF'S LOSS AND DAMAGES.

Upon learning of the damage, Insured promptly reported a claim for damage to Insurer.

IUIC has failed to create and implement adequate guidelines for proper investigation and evaluation of claims and for training and supervision of employees resulting in statutory violations as set forth herein.

From the outset of this claim, Nova has ignored or wrongfully dismissed evidence showing the full scope of covered damage caused by a lightning strike to the property and attempted to deny the damage and/or point to causes of loss that are excluded so Nova can avoid its obligation to pay this claim

PRINCETON has failed to create and implement adequate guidelines for proper investigation and evaluation of claims and for training and supervision of employees resulting in statutory violations as set forth herein.

State Farm Florida Insurance Company has delayed a valid claim due to its failure to properly investigate and estimate the claim and have failed to act with due diligence and good faith to resolve this claim.

Tender the full policy limits of $100,000 for the fire damage sustained. 2.

On September 27, 2022, USIC denied the claim (apparently without any investigation).

To date, USIC has failed to provide [name redacted] with a defense in the Lawsuit.

Nonetheless, USIC has failed to respond to [name redacted] 's tenders of defense.

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

THE INSURED HAS MADE AN APPLICATION FOR INSURANCE BENEFITS UNDER THE POLICY BUT THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSURED IS ENTITLED FOR THE LOSS.

Upon learning of the damage, Insureds promptly reported the claim for damage to Insurer.