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When a Civil Remedy Notice Isn't Enough to Get Your Claim Met

Posted by Christopher Keller | Sep 15, 2020 | 0 Comments

Dealing with an insurance claim can be one of the most stressful experiences in life. As a responsible adult, you take out insurance policies and pay into them monthly. You continue to follow this pattern, trusting that the insurance company will one day have your back in return if you ever need it. But, what happens when the insurance company fails to meet your claim?

Fortune and Domin v. First Protective Insurance Company

When homeowners Patti Fortune and Jeremy Domin agreed to an insurance policy with First Protective Insurance Company, they trusted the company would save the day in the event of a disaster. Unfortunately, that disaster arrived in 2017 with Hurricane Irma. The infamous hurricane claimed the lives of 129 people, directly and indirectly, and cost the United States about $50 billion in damages. The extensive destruction forced six million Florida residents to evacuate. 

After the hurricane touched down in September of that year, the homeowners from this case filed a timely claim with their insurance company. The insurer came out to inspect the losses, and determined that the total loss would amount to $3,013.20 after applying the deductible from the policy and after taking depreciation into consideration. However, this amount did not come close to what the homeowners' public adjuster's estimate claimed. Instead of meeting their estimate, the insurance company stuck with their initial offer. 

The homeowners became outraged at what they considered to be a lowball offer. For both Fortune and Domin, the insurance company did not attempt to settle the claim in good faith. Ultimately, this is what led them to file a bad faith action pursuant to Florida Statute 624.155 against First Protective Insurance Company. 

What Does Florida Statute Section 624.155 State? 

Florida State Statute 624.155 states, “bad faith is when the insurer does not attempt in good faith to settle claims 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 her or his interests; making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made; or except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.”

Was This Enough to Get Their Claim Met? 

When the homeowners realized the insurer was not going to meet their claim, they got a Civil Remedy Notice of Insurer's Violations (CRN). However, by the time it reached a final summary judgement, the decision was in favor of the insurer because the insurance company had supposedly “cured” the CRN by citing the appraisal process before the CRN was created in January and by paying the appraisal amount more than sixty days after the CRN. However, the homeowners insist that the insurance company refused to reconsider its payment of benefits. Instead of explaining the reason for low payment, the insurer refused to adequately adjust the total and failed to identify the necessary repairs for the damage.

The insurance company denied all allegations and made it clear that it did not owe anything to the homeowners because all requirements had been met for the policy as it was at that time. The company also denied any acts of bad faith because it had upheld the policy, sought appraisal to alleviate the dispute, and paid for damages after sixty days following the CRN. In June of the following year, the appraisal award was set at $121,516.55, and the insurance company paid $110,067.35 the following month. Later, in October of 2018, the homeowners filed a complaint of bad faith because the insurance company had failed to pay the appraisal award in full within sixty days of the CRN receipt. When the insurer countered that it had fully cured the issue of bad faith in June with a pending appraisal and subsequent payment, the homeowners pointed out that the waiting period for an eventual appraisal does not affect how the company should have responded. Based on the law, the insurance company's excuse of appraisal as a cure is not an acceptable cure. Moving forward, the homeowners have every right to pursue their claim of bad faith. 

What To Do If Your Claim Has Been Denied

In this case, you have a catch-22 situation. Due to timing restrictions and loopholes in cures, an insurance company has the opportunity to act in bad faith without any sort of consequence as long as it pays the appraisal award within a certain time frame. As you can see, there are plenty of different scenarios that can play out when seeking compensation for an insurance claim denial. Do not make your life any more complicated by trying to sort out the legal process on your own. Give yourself a break and contact a trusted lawyer at Keller Melchiorre & Walsh today to get exactly what you are owed. 

About the Author

Christopher Keller

Christopher J. Keller is an experienced plaintiff's personal injury attorney.  He concentrates his practice in the areas of Wrongful Death, Auto, Truck, Train & Motorcycle Accidents and Premises Liability.  Before founding Keller, Melchiorre & Walsh, PLLC, Mr. Keller practiced personal injury ...

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