Hurricane and wind: the denial record

The insureds utilized the services of a licensed public adjuster who inspected the insureds' property and determined that the loss was a covered loss and had caused $ $18,250,563.43 in damages before the deductible.

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.

Per the attached (2) estimates as outlined by Storm Force Roofing, a supplemental check in the amount of $590,574.51 will be sent under separate cover.

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

THE ESTIMATED COST OF REPAIRS TO THE INSURED PROPERTY CURRENTLY STANDS AT APPROXIMATELY $ 8,638,026.43.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

To cure the circumstances giving rise to the violations described in this notice, the Insurers must promptly tender $8,069,040.94 to [name redacted] minus the applicable deductible and prior payments.

The Policy provides coverage on a replacement cost basis with a limit of liability in the amount of $6,328,000 for building, $72,[address redacted]ructures, $345,000 for contents and $1,200,000 for business income coverage, subject to a 3% deductible ($238,250).

The Insured's total damage is estimated by Strategic Claims Consultants at $5,584,523.87 ACV / $5,693,298.15 RCV.

Cypress performed an initial evaluation of the claim and on December 19, 2022, issued an initial payment for undisputed damages for $57,331.85 ($453,802.85 minus deductible and depreciation).

The hurricane caused catastrophic damages to the roofs, windows, doors, exteriors, interiors, and numerous other building components and structures throughout the Property, resulting in more than $40,000,000 in damages.

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

Insurers must also tender the full remaining contractual amount owed based on Foundations' estimate of $4,242,292.00, less any prior payments and applicable deductibles, subject to the terms of the policy.

After drafting two estimates, the larger of which totaling $1,511,123.24 and deducting the deductible and depreciation, Insurers have paid a total of $926,483.26 for the substantial loss.

On or about May 3rd, 2023 Insurer respond to the notice and provided Association a Statement of Loss, Loss Letter, and Building estimates in a letter for an amount of $4,193,153 before considering recoverable, non-recoverable, and deductible amounts.

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

The insurer failed to make a claims determination within the prescribed statutory deadline and when the carrier did make payment, the claim payment was woefully deficient.

Based on its field adjuster's estimate, FRONTLINE issued payment totaling $89,978.19, after the application of the deductible and recoverable depreciation.

Having conducted thorough investigations and analysis, DAC prepared an estimate of costs to repair the damaged property in the amount of RCV $3,664,392.86.

Having conducted thorough investigations and analysis, DAC prepared an estimate of costs to repair the damaged property in the amount of RCV $3,664,392.86.

The Policy provides coverage on a replacement cost basis, subject to a 3% hurricane deductible, with a limit of liability in the amount of $770,000 for each building identified as Location # 1- Structure # 1-3, 7-8, 12, 13, and 16-18; and $376,000 for each building identified as Location # 1- Struct

The insured demands the full value of the covered loss as detailed in the sworn statement in proof of loss: $3,429,926.88.

Finally, on October 15, 2025 Centauri was forced to issue payment to Insured in the amount of $2,582,294,48 after application of the deductible and withholding recoverable depreciation.

Subsequently, the insureds prepared a loss package in the amount of $3,300,237.50 needed to restore the property back to its pre-loss condition.

Our email included supporting claim documentation for several necessary incurred mitigation and clean up expenses totaling $138,950.33, along with GlobalPro's estimate totaling $3,045,606.

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.

After its initial inspection, Frontline issued payments of only $688,920.51 for the main building, which failed to include any interior damage, and $61,445.16 for building 2.

The insurer failed to make a claims determination within the prescribed statutory deadline and when the carrier did make payment.

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] .

Specifically, the Association through its adjuster has submitted a detailed damage analysis and photos establishing damage in the amount of $1,832,803.26 ACV/ $2,062,162.29 RCV and Heritage refused to tender payment beyond the initial payment of $29,515.15.

Despite receiving detailed reports from ESi, photographs, and a repair estimate of $1,039,854.66 in July 2023 for Coverage A (dwelling), which included the full replacement of the windows, the Insurer failed to properly reinspect the Property.

An estimate for repair of all damages with respect to [name redacted] 's claim was prepared on their behalf for $1,954,972.53 was sent to Chubb.

The Insured's damages are calculated as follows: $1,864,378.87 ACV for Building damage, less prior payments of $1,184,146.06, less the deductible of $60,000.00, for a total of $620,232.81 ACV due under building coverage.

The Policy has an "All Other Perils Deductible" in the amount of $2,500.00 per building.

FRONTLINE has accepted coverage for this loss and has issued 16 checks to the Insured totaling $1,490,363.92.

On March 22, 2023, a partial denial letter was issued by FRONTLINE and advising of the payments made on the claim, specifically, a net amount of $164,203.79 (ACV), after the deductible of $19,140.00 and the prior payment of $4,842.35 was applied.

As is set forth hereafter, among other wrongs, considering the vicissitudes experienced by the Insured, this carrier has failed and refused to thoroughly, accurately, and completely investigate, evaluate, and adjust the Insured's insurance claims for damages in good faith.

Limit of Insurance 1 1 $835,000 1 2 $830,000 1 3 $835,000 These coverages are subject to a 5% windstorm or hail deductible.

Baran's damage estimate grossly undervalued the total damages to the Insured's Building and carports and amounted to only $579,313.02 for the Building and $68,227.75 for the Carport damage.

On that same day, May 15, 2023, the Insured timely submitted the requested SPOL to Frontline claiming Building Damages in the amount of the Mrozek estimate (i.e., $1,418,171.28) before application of the deductible.

The insurer declined to issue payment on the claim, based on the Insurers' determination that the repair costs were in the amount of $3,438.57, which was less than the policy deductible.

On July 1, 2024, the Insurer sent a letter to the Insureds advising that the damages to the Property totaled $133,799.43 RCV/$122,242.66 ACV for roof repairs, exterior repairs, interior repairs, and replacement of some windows.

After withholding "non-recoverable depreciation" in the amount of $76,581.53 and the Hurricane deductible of $114,124.20, Sedgwick issued what it claimed to be an actual cash value ("ACV") payment for the building damage in the amount of $57,944.40.

In an estimate dated January 5, 2023, Frontline concluded that dwelling damages total $167,742.28 (RCV).

On December 6, 2022, the carrier made the unilateral determinations that the damages were covered would total to the amount of $860,887.44 for full repairs to the [name redacted] after to the application of the deductible and once the recoverable depreciation was fully recovered.

On 04/12/2022, the Insured's appraiser and the Umpire executed an Appraisal Award in the total amount of $1,192,839.23 RCV/$952,976.68 ACV in relation to the Claim, based on the Umpire's estimate.

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

James' damage estimate of $1,131,064.66, plus interest, less the applicable deductible.

On October 8, 2022, [name redacted] of Deft Claims inspected the [name redacted] issued an Xactimate report finding that the cost to repair the [name redacted] $158,835.78, less the $24,551.00 deductible, for a total net claim of $134,284.78.

Griffey's damage estimate of $1,056,871.13 RCV, plus interest, less the applicable deductible.

To date, Scottsdale has tendered $454,806.96 for the Insured's covered loss.

Marshall provided the Insured with a damage estimate in the sum of $873,057.59 RCV and $821.201.88 ACV.