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Filing # 188989460 E-Filed 01/03/2024 11:47:45 AM
IN THE CIRCUIT COURT OF THE 20th
JUDICIAL CIRCUIT IN AND FOR
LEE COUNTY, FLORIDA
JOANNE A. HENRY INDIVIDUALLY
AND AS A TRUSTEE OF THE SECOND
RESTATED AND AMENDED TRUST
AGREEMENT OF JOANNE A. HENRY, CASE NO.:
Plaintiff,
v.
EDISON INSURANCE COMPANY,
Defendant.
______________________________________/
PLAINTIFF’S COMPLAINT FOR BREACH OF CONTRACT & DEMAND FOR JURY
TRIAL
COMES NOW, Plaintiff, JOANNE A. HENRY INDIVIDUALLY AND AS A TRUSTEE
OF THE SECOND RESTATED AND AMENDED TRUST AGREEMENT OF JOANNE A.
HENRY, through the undersigned counsel, and hereby files this Complaint against Defendant,
EDISON INSURANCE COMPANY, and as grounds therefore states as follows:
1. This is an action for damages in excess of FIFTY THOUSAND DOLLARS
($50,000.00), exclusive of interest, attorneys’ fees and costs, and is otherwise within the
jurisdictional limits of this Court.
2. At all times material hereto, Defendant was an insurance company authorized to do
business in the State of Florida and doing business in Lee County, Florida.
3. At all times material hereto, the damaged property is located in Lee County,
Florida.
4. Prior to the direct physical damage sustained during the policy period, Plaintiff
sought and purchased homeowner’s insurance from Defendant to cover the property located at
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6435 Royal Woods Drive, Fort Myers, FL 33908 (hereinafter “Insured Property”). Said policy of
insurance, which is believed to be policy number EDH5383334-00, was issued by Defendant to
Plaintiff to provide property insurance coverage for the Insured Property.
5. At all times material hereto, Plaintiff and Defendant had a policy of insurance,
Policy No. EDH5383334-00 (hereinafter “Contract”). A copy of the Contract is attached hereto
and incorporated herein by reference as “Exhibit A”.
6. Plaintiff has paid the premiums for the Contract prior to the direct physical damage
sustained during the policy period.
7. During the policy period, the Insured Property sustained direct physical damage as
a result of Hurricane Ian.
8. The Contract described in Paragraph 5 above was in full force and effect during the
policy period in which the direct physical damage occurred.
9. Defendant received timely notice of the loss.
10. Defendant assigned the loss reported by Plaintiff and described in paragraph 7
above a claim number believed to be EDI954465.
11. Defendant and its agents requested and were given access and the opportunity to
inspect the Insured Property and the reported damage arising from the loss described in paragraph
7 above.
12. This is an action relating to Defendant’s breach of Contract for its failure to
properly pay the full amount of insurance proceeds owed to Plaintiff.
13. Plaintiff has complied with section 627.70152, Florida Statute.
14. Jurisdiction and venue of this matter are proper in the Circuit Court for Lee County,
Florida.
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COUNT I – BREACH OF CONTRACT
15. Plaintiff realleges and reincorporates paragraphs 1-14 as if fully stated herein, and
further alleges as follows:
16. During the above Contract period the Insured Property sustained direct physical
damages.
17. Plaintiff provided timely notice of the loss, described in paragraph 7, above to the
Defendant.
18. Plaintiff has complied with all obligations and conditions precedent to this lawsuit
and which would entitle Plaintiff to recover benefits under the Contract, or such conditions have
been waived.
19. Defendant has failed to provide complete coverage for the physical damages that
occurred during the Contract period.
20. This failure is contrary to the terms of the Contract and constitutes a breach of the
Contract.
21. Plaintiff has been damaged by this breach in the form of unpaid insurance proceeds
needed to restore the Insured Property to its pre-loss condition as a result of the Defendant refusing
to pay the full amount owed under the Contract.
22. As a direct and proximate result of Defendant’s breach of Contract, Plaintiff has
been required to retain the services of the undersigned attorneys to represent and protect the
interests of Plaintiff and Plaintiff has become obligated to pay them a reasonable fee for their
services in bringing this action.
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23. In the event that Plaintiff prevails in this action, Plaintiff is entitled to an award of
attorneys’ fees and costs pursuant to section 627.70152, 627.428, 626.9373 and 57.041, Florida
Statutes and/or other Florida Law.
WHEREFORE, Plaintiff demands judgment against Defendant for damages, including but
not limited to damages owed under the Contract, attorneys’ fees and costs.
DEMAND FOR JURY TRIAL
Plaintiff further demand a trial by jury of all issues so triable as a matter of right.
[Certificate of Service on Following Page]
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CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a certified copy of the foregoing has been served on Defendant.
KANNER & PINTALUGA, P.A.
Attorneys for Plaintiff
2020 Ponce De Leon, PH2
Coral Gables, FL 33134
Phone: (561) 424-0032
Fax: (866) 641-4690
Court Phone Number: (1-888) 824-7834
Email: sgibbons@kpattorney.com
mbatista@kpattorney.com
FirstPartyEService@kpattorney.com
By:_/s/ Shawn R. Gibbons .
SHAWN R. GIBBONS, ESQ.
Florida Bar No.: 118217
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EXHIBIT “A”
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HOMEOWNERS DECLARATION 01:35:58.949 PM
POLICY PERIOD
POLICY NUMBER From To
EDH5383334-00 02/03/2022 02/03/2023
P.O. Box 21957 Lehigh Valley, PA 18002-1957
12:01 A.M. Standard Time at the described location
For Customer Service and Claims Call 1-866-568-8922 or visit www.edisoninsurance.com
AMENDED DECLARATION Policy Form:HO3 Effective:02/16/2022 Date Issued:02/21/2022
INSURED: AGENCY:
JOANNE HENRY WAY BETTER INS INC
6435 ROYAL WOODS DR 4978 ROYAL GULF CIR
FORT MYERS, FL 33908 FORT MYERS, FL 33966
Agency ID: 0042006
Phone: 952-239-9513 Phone: 239-210-7720
The residence premises covered by this policy is located at the address listed below.
6435 ROYAL WOODS DR, FORT MYERS, FL 33908
Coverage is provided where premium and limit of liability is shown, subject to terms and conditions of the policy.
COVERAGES LIMIT OF LIABILITY PREMIUM
SECTION I COVERAGE
A. DWELLING $ 211,000 $ 1,674.18
B. OTHER STRUCTURES $ 4,220 Included
C. PERSONAL PROPERTY $ 52,750 Included
D. LOSS OF USE $ 21,100 Included
SECTION II COVERAGE
E. PERSONAL LIABILITY $ 300,000 $ 15.00
F. MEDICAL PAYMENTS $ 5,000 $ 5.00
OPTIONAL COVERAGES $ -216.05
See FORMS SCHEDULE on page 2 for details
Total Policy Premium: $ 1,478.13
EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE TRUST FUND: $ 2.00
FLORIDA INSURANCE GUARANTY ASSOCIATION 2022 REGULAR ASSESSMENT: $ 10.35
MANAGING GENERAL AGENCY FEE: $ 25.00
TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $ 1,515.48
Note: The portion of your premium for Hurricane Coverage is: $ 849.54
Non-hurricane Premium: $ 628.59
Change in Policy Premium: $ -191.63
DEDUCTIBLES
All Other Perils Deductible: $5,000 Sinkhole Deductible: N/A
HURRICANE DEDUCTIBLE: 2% of Coverage A = $4,220
Law and Ordinance Coverage: 10%
MORTGAGEE COMPANY
NA
02/21/2022
COUNTERSIGNED BY AUTHORIZED REPRESENTATIVE COUNTERSIGNED DATE
EDI HO DEC FL 05 19 INSURED COPY Page 1 of 4
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POLICY PERIOD
POLICY NUMBER From To
EDH5383334-00 02/03/2022 02/03/2023
P.O. Box 21957 Lehigh Valley, PA 18002-1957
12:01 A.M. Standard Time at the described location
FORMS SCHEDULE
This policy is subject to the following Forms, Endorsements, Credits and Surcharges
Main Policy Forms
Form # Description
OIR-B1-1670 01 06 CHECKLIST OF COVERAGE
EDI HO3 OC 05 19 OUTLINE OF HOMEOWNERS POLICY
EDI PRI 06 14 PRIVACY NOTICE
EDI HOJ 01 20 POLICY JACKET
EDI HO 03 07 21 HOMEOWNERS 3 – SPECIAL FORM
OIR-B1-1655 02 10 NOTICE OF PREMIUM DISCOUNTS FOR HURRICANE LOSS MITIGATION
EDI HO CDE 05 21 COMMUNICABLE DISEASE EXCLUSION
EDI HO ELE 06 21 EXCESSIVE OR UNUSUAL LIABILITY EXPOSURE
EDI 24 06 14 CALENDAR YEAR HURRICANE DEDUCTIBLE WITH SUPPLEMENTAL REPORTING REQUIREMENT – FLORIDA
EDI 23 70 06 14 WINDSTORM EXTERIOR PAINT OF WATERPROOFING EXCLUSION
EDI HO LO 06 14 IMPORTANT INFORMATION REGARDING LAW AND ORDINANCE COVERAGE
EDI GC 01 06 14 GOLF CART OR OTHER MOTORIZED LAND CONVEYANCE PROPERTY DAMAGE AND LIABILITY LIMITATION
EDI HO 04 96 06 14 COVERAGE FOR HOME DAY CARE BUSINESS
EDI HO 04 01 09 16 FLOOD AFFIRMATION
Endorsements
Form # Description Limit Premium
EDI HO 04 95 08 15 WATER BACK-UP $ 5,000 $ 25.00
EDI HO LWD 02 19 LIMITED WATER DAMAGE COVERAGE $ 10,000 $ -241.05
LOSS ASSESSMENT $ 1,000 Included
SINKHOLE LOSS COVERAGE Excluded
EDI HO DEC FL 05 19 INSURED COPY Page 2 of 4
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POLICY PERIOD
POLICY NUMBER From To
EDH5383334-00 02/03/2022 02/03/2023
P.O. Box 21957 Lehigh Valley, PA 18002-1957
12:01 A.M. Standard Time at the described location
DISCOUNTS
These adjustments have already been applied to your premium.
Deductible -$197.33
Age of Roof -$65.78
Secured Community/Building -$62.75
Financial Responsibility -$274.63
Wind Mitigation -$2,184.53
Total Discounts: ($ -2,785.02)
RATING INFORMATION
Year Built 1983 Occupancy Owner Roof Year Replaced 2018
Construction Type Masonry Primary/Seasonal Primary Roof Shape Other
Dwelling Type Single Family House Number of Families 1 Roof Cover FBC Equivalent
Number of Stories 1 Protection Class 02 Roof Deck 8d @ 6"/6"
Number of Units 1 BCEG Class 99 Roof Wall Clips
Units in Firewall 1 Terrain B Open Protection Unknown
SWR Yes
Your windstorm loss mitigation credit is $2,184.53. A rate adjustment of 72% credit is included to reflect the Windstorm Mitigation Device
credit.
This credit applies only to the wind portion of your premium. Adjustments range from 0% to 92% credit.
A rate adjustment of -1% is included to reflect the Building Code Effectiveness Grade for your area.
Adjustments range from 1% surcharge to 12% credit.
You may be eligible for other programs in Florida Peninsula Holdings, LLC and should discuss with your agent.
THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR
HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-
POCKET EXPENSES TO YOU.
YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC
GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY
BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR
POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE
LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR
SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.
EDI HO DEC FL 05 19 INSURED COPY Page 3 of 4
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POLICY PERIOD
POLICY NUMBER From To
EDH5383334-00 02/03/2022 02/03/2023
P.O. Box 21957 Lehigh Valley, PA 18002-1957
12:01 A.M. Standard Time at the described location
DEDUCTIBLE OPTIONS NOTICE
This policy contains a separate deductible for Hurricane Losses and for All Other Perils. The deductibles shown in your
policy declaration page(s) are the deductibles that will apply as described in your policy in the event of a covered loss. If
you fail to select a deductible at the time of your application submission, $1,000 All Other Perils and 2% Hurricane
deductibles will apply. If you do not choose an All Other Perils or Hurricane Deductible at renewal, your previously
selected deductibles will apply.
You have the option to buy lower deductibles for an additional premium, or select higher deductibles for a premium credit.
For HO3 policies, All Other Peril deductible options are $500, $1,000, $2,500, $5,000 and $10,000. For HO6 policies, All
Other Peril deductible options are $500, $1,000, $2,500 and $5,000. Hurricane deductible options are $500, 2% (minimum
$500), 5% or 10%. Percentage deductibles apply to Coverage A in Form HO3 and Coverage C in Form HO6. In the event
you select a lower hurricane deductible and have suffered a hurricane loss under this policy or under one issued by a
member of our company group during the calendar year, such lower selected deductible will not take effect until January 1
of the following calendar year. If your policy does not exclude coverage for the peril of Windstorm or Hail, there are various
combinations of All Other Peril and Hurricane deductibles available. Not all of these deductible options may be available to
you due to the value of your dwelling. If your policy excludes coverage for the peril of Windstorm or Hail, a Hurricane
Deductible would not apply.
You have the option to buy Flood Coverage for an additional premium. Flood Coverage has a separate deductible with the
following options: $500, $1,000, $2,500, $5,000, $7,500 and $10,000. If you do not choose a Flood Deductible at renewal,
your previously selected deductible will apply.
For HO3 policies, you have the option to buy Sinkhole Coverage for an additional premium. Sinkhole Coverage has a
separate deductible of 10% of Coverage A in HO3. For HO6 policies, sinkhole coverage is included. It has a separate
deductible equal to the All Other Perils deductible.
Please contact your agent if you have any questions, concerns or wish to change your deductible options.
LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS
AN IMPORTANT COVERAGE THAT YOU MAY WISH TO
PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT.
YOUR POLICY PROVIDES LAW AND ORDINANCE COVERAGE OF
10% OF THE COVERAGE A LIMIT. LAW AND ORDINANCE
COVERAGE OF 25% OR 50% OF THE COVERAGE A LIMIT IS
AVAILABLE FOR AN ADDITIONAL PREMIUM.
FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE
PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER’S
INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR
DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS
AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT
SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE
UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS
THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE
COVERAGE WITH YOUR INSURANCE AGENT.
EDI HO DEC FL 05 19 INSURED COPY Page 4 of 4
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Checklist of Coverage
Policy Type: Homeowner's
(Indicate: Homeowner's, Condominium Unit Owner's, Tenant's, Dwelling, or Mobile Home Owner's)
The following checklist is for informational purposes only. Florida law prohibits this checklist from changing any of the
provisions of the insurance contract which is the subject of this checklist. Any endorsement regarding changes in types of coverage,
exclusions, limitations, reductions, deductibles, coinsurance, renewal provisions, cancellation provisions, surcharges, or credits will
be sent separately.
Reviewing this checklist together with your policy can help you gain a better understanding of your policy's actual coverages and
limitations, and may even generate questions. By addressing any questions now, you will be more prepared later in the event of a
claim. Experience has shown that many questions tend to arise regarding the coverage of attached or detached screened pool
enclosures, screened porches, and other types of enclosures. Likewise, if your policy insures a condominium unit, questions may
arise regarding the coverage of certain items, such as individual heating and air conditioning units; individual water heaters; floor,
wall, and ceiling coverings; built-in cabinets and counter tops; appliances; window treatments and hardware; and electrical fixtures.
A clear understanding of your policy's coverages and limitations will reduce confusion that may arise during claims settlement.
Please refer to the policy for details and any exceptions to the coverages listed in this checklist. All coverages are subject to the
provisions and conditions of the policy and any endorsements. If you have questions regarding your policy, please contact your
agent or company. Consumer assistance is available from the Department of Financial Services, Division of Consumer Services'
Helpline at (800) 342-2762 or www.fldfs.com.
This form was adopted by the Florida Financial Services Commission.
Dwelling Structure Coverage (Place of Residence)
Limit of Insurance: $211,000 Loss Settlement Basis: Replacement Cost
(i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.)
Other Structures Coverage (Detached from Dwelling)
Limit of Insurance: $4,220 Loss Settlement Basis: Replacement Cost
(i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.)
Personal Property Coverage
Limit of Insurance: $52,750 Loss Settlement Basis: Actual Cash Value
(i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.)
Deductibles
Annual Hurricane: $4,220 All Perils (Other Than Hurricane): $5,000
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Checklist of Coverage (continued)
The above Limit of Insurance, Deductibles, and Loss Settlement Basis apply to the following perils insured against:
(Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is NOT included)
Y Fire or Lightning
Y Hurricane
N Flood (Including storm surge)
Y Windstorm or Hail (other than hurricane)
Y Explosion
Y Riot or Civil Commotion
Y Aircraft
Y Vehicles
Y Smoke
Y Vandalism or Malicious Mischief
Y Theft
Y Falling Objects
Y Weight of Ice, Snow or Sleet
N Accidental Discharge or Overflow of Water or Steam $10,000
Y Sudden and Accidental Tearing Apart, Cracking, Burning or Bulging
Y Freezing
Y Sudden and Accidental Damage from Artificially Generated Electrical Current
Y Volcanic Eruption
Y Catastrophic Ground Cover Collapse
N Sinkhole
Y Any Other Peril Not Specifically Excluded (dwelling and other structures only)
Special limits and loss settlement exceptions may apply to certain items. Refer to your policy for details.
Loss of Use Coverage
Coverage Limit of Insurance Time Limit
(Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is NOT included)
Y Additional Living Expense $21,100 See Policy
Y Fair Rental Value $21,100 See Policy
Y Civil Authority Prohibits Use $21,100 See Policy
Property - Additional/Other Coverages
(Items below marked Y (Yes) indicate coverage IS Limit of Insurance Amount of insurance is an additional amount of
included, those marked N (No) indicate coverage is NOT coverage or is included within the policy limit.
included) Included Additional
Y Debris Removal See Policy Y
Y Reasonable Repairs See Policy Y
Y Property Removed See Policy Y
Credit Card, Electronic Fund Transfer Card, or
Y $500 Y
Access Device, Forgery and Counterfeit Money
Y Loss Assessment $1,000 Y
Y Collapse See Policy Y
Y Glass or Safety Glazing Material See Policy Y
Y Landlord's Furnishings $2,500 Y
Y Law and Ordinance $21,100 Y
N Grave Markers
Y Mold / Fungi $10,000 Y
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Checklist of Coverage (continued)
Discounts
Dollar ($) Amount of Discount
(Items below marked Y (Yes) indicate discount IS applied, those marked N
(No) indicate discount is NOT applied)
N Multiple Policy
N Burglar Alarm
N Fire Alarm / Smoke Alarm / Sprinkler Alarm
Y Windstorm Loss Reduction -$2,184.53
N Building Code Effectiveness Grading Schedule
N Other
Insurer May Insert Any Other Property Coverage Below
Limit of Insurance Loss Settlement Basis:
(Items below marked Y (Yes) indicate coverage IS (i.e.: Replacement Cost, Actual Cash Value, Stated
included, those marked N (No) indicate coverage is NOT Value, etc.)
included)
Personal Liability Coverage
Limit of Insurance: $300,000
Medical Payments to Others Coverage
Limit of Insurance: $5,000
Liability - Additional/Other Coverages
Limit of Insurance Amount of insurance is an additional amount of
(Items below marked Y (Yes) indicate coverage IS
coverage or is included within the policy limit.
included, those marked N (No) indicate coverage is NOT
included) Included Additional
Y Claim Expenses See Policy Y
Y First Aid Expenses See Policy Y
Y Damage to Property of Others $500 Y
Y Loss Assessment $1,000 Y
Insurer May Insert Any Other Liability Coverage Below
(Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is Limit of Insurance
NOT included)
Y Mold/Fungi Section II $50,000
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EDISON INSURANCE COMPANY HOMEOWNERS
EDI HO3 OC 05 19
OUTLINE OF YOUR EDISON INSURANCE
COMPANY HO-3 HOMEOWNERS POLICY
This Outline is being provided to help you more easily understand your Edison Insurance Company HO-3
Homeowners Policy. It highlights the major coverages, exclusions, limitations and deductibles of your policy and
provides information on discounts, cancellation and nonrenewal. However, this is just a guide and not a legal
contract. Please read your HO-3 Homeowners policy carefully for complete descriptions and details.
The following Outline is for informational purposes only. Florida law prohibits this Outline from changing any of
the provisions of the insurance contract, which is the subject of this Outline. Any endorsement regarding
changes in types of coverage, coverage limits, exclusions, deductibles, renewal or cancellation provisions,
surcharges, credits, or any other changes will be sent separately.
SECTION I – PROPERTY COVERAGE
Coverage A - Dwelling
Protects against covered loss to your dwelling and structures attached to your dwelling. It also protects against
covered loss to building materials located on your residence, which are being used in connection with your
residence premises.
This coverage does not apply to land, including land on which the dwelling is located.
Coverage B - Other Structures
Protects against covered loss to structures on your residence premises not physically attached to the dwelling.
This coverage does not apply to land, including land on which other structures are located.
Coverage C - Personal Property
Protects against covered loss to your personal property such as clothing and furniture.
Special limits apply to some types of personal property including but not limited to:
• Money
• Securities
• Watercraft
• Theft of Jewelry
• Firearms
• Silverware
There are some items not covered under Coverage "C." Some examples are:
• Animals
• Motorized Vehicles
• Property of roomers or boarders and other tenants
Please review your policy for a complete list of items that have special limits or are excluded.
Coverage D - Loss Of Use
Provides for the additional living expenses you incur while you are temporarily unable to live at your home
because of a covered loss.
Payment would include such items as temporary lodging and increased costs for food. Coverage is limited to 24
consecutive months from the date of loss.
Pre-event evacuation expenses are not covered under the policy.
ADDITIONAL COVERAGES
These additional coverages include limitations and may not completely protect you against loss:
• Debris Removal
• Reasonable Repairs
• Trees, Shrubs and Other Plants
• Fire Department Service Charge
• Property Removed
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EDISON INSURANCE COMPANY HOMEOWNERS
EDI HO3 OC 05 19
• Credit Card, Fund Transfer Card, Forgery and Counterfeit Money
• Loss Assessment
• Collapse
• Glass or Safety Glazing Material
• Landlords Furnishings
• "Fungi," Wet or Dry Rot, Yeast or Bacteria
• Law and Ordinance
PERILS INSURED AGAINST
Coverage A – Dwelling and Coverage B – Other Structures
This policy insures under Coverages "A" and "B" unless not covered or excluded from coverage as described
elsewhere in the policy.
There are some perils not covered under Coverage "A" or "B." Some examples are:
• Freezing
• Wear and Tear
• Pollutants
• Corrosion
• Inherent Vice, Decay, Latent Defect and Mechanical Breakdown
• Vandalism (if vacant more than 30 consecutive days)
Additionally, there are exclusions and other property not covered. Please review your policy for a complete list
of items that have special limits or are excluded.
Coverage C – Personal Property
• Fire or Lightning
• Windstorm or Hail
• Explosion
• Riot or Civil Commotion
• Aircraft
• Vehicles
• Smoke
• Vandalism or Malicious Mischief
• Theft (including off-premise theft)
• Falling Objects
• Weight of ice, snow or sleet
• Accidental discharge or overflow of water or steam
• Sudden and accidental tearing apart, cracking, burning or bulging
• Freezing of plumbing or household appliances
• Sudden and accidental damage from artificially generated electrical current
• Volcanic eruption
• Catastrophic Ground Cover Collapse
PROPERTY EXCLUSIONS
This policy does not provide protection under Coverages "A," "B" and "C" for losses resulting in any manner
from:
• Sinkhole Loss Coverage
• Law and Ordinance
• Earth Movement and Settlement
• Flood and Other Water Damage
• Off-Premises Power Failure
• Neglect
• War or Nuclear Hazard
• Intentional Acts
• Existing Damage
• Constant or Repeated Seepage or Leakage of Water or Steam
There are other exclusions. Please refer to your policy for complete details regarding exclusions.
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EDISON INSURANCE COMPANY HOMEOWNERS
EDI HO3 OC 05 19
OTHER LIMITATIONS
Deductibles
A calendar year hurricane deductible and an all other perils deductible, selected by you, are shown on your
Declarations page. This is the amount of the loss you must incur before this policy pays.
Flood
This policy does not protect you against loss due to flood or wave wash. A Flood Coverage endorsement may
be available in certain areas. Flood insurance is also available through the Federal government.
Windstorm
In some areas of the state, generally coastal areas, windstorm and hail coverage, including hurricane coverage,
is not provided in your policy. Be sure to contact your agent to obtain this important coverage if it has been
excluded from your policy.
Loss Settlement
For Coverage C - Personal Property, we will pay the actual cash value at the time of loss but not more than the
cost to repair or replace.
For Coverage A - Dwelling, we will initially pay at least the actual cash value of the insured loss, less any
applicable deductible. We shall pay any remaining amounts necessary to perform such repairs as work is
performed and expenses are incurred or we will pay a licensed contractor after the insured signs a contract and
as repairs are made to the covered property. If a total loss of the covered dwelling occurs, we shall pay the
replacement cost coverage without reservation of any depreciation in value, subject to policy limits.
Vacant Property
If a loss occurs and the dwelling has been vacant for 30 consecutive days prior to the date of loss, there is no
coverage for vandalism, sprinkler leakage, glass breakage, water damage, theft or attempted theft, even if they
are a covered cause of loss.
SECTION II – LIABILITY COVERAGE
Coverage E - Personal Liability
Provides coverage for bodily injury or property damage you or a person insured under your policy are legally
obligated to pay.
The bodily injury or property damage must arise from an occurrence covered under Section II of your policy.
Coverage F - Medical Payments To Others
Provides coverage for reasonable and necessary medical expenses if a guest is injured on your premises or off
the insured premises under certain circumstances.
The bodily injury must arise from an occurrence covered under Section II of your policy with limited exceptions.
Some liability and medical expenses are not covered under Section II.
For example, there is no coverage for bodily injury or property damage arising from:
• Animals
• Watercraft
• Motorized vehicles
• Radon
• Pollutants
• Ingestion or inhalation of lead in any form or substance
• Under certain conditions, home day care operations
NONRENEWAL AND CANCELLATION PROVISIONS
All cancellations are granted a pro-rata return of premium.
Your Right To Cancel
You may cancel the policy at any time, for any reason, by giving us advance written notice of the future
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EDISON INSURANCE COMPANY HOMEOWNERS
EDI HO3 OC 05 19
cancellation effective date.
Our Right To Cancel
If your policy has been in effect for 90 days or less and the insurance is cancelled for other than nonpayment of
premium we may cancel for any valid reason by giving you at least 20 days notice before the cancellation
effective date, except where there has been a material misstatement, misrepresentation, or failure to comply
with underwriting requirements established in the first 90 days, then we may cancel immediately.
If your policy has been in effect over 90 days, we may cancel your policy for only a limited number of reasons.
The reasons include, but are not limited to, material misstatement or substantial change of risk. We will cancel
by giving you advance written notice at least 120 days before the cancellation becomes effective.
If the cancellation is due to nonpayment of premium, we will give you at least 10 days advance written notice.
Nonrenewal
If we do not intend to renew your policy, we will mail written notice to you. We will do so at least 120 days
before the expiration date of the policy.
Renewal
The renewal premium payment must be received no later than the renewal date or the policy will terminate.
PREMIUM CREDITS
The following are brief descriptions of the premium credits available on your HO-3 Homeowners policy. Your
policy Declarations page will show which of these credits, if any, apply to your policy.
Protective Devices
If your home has a qualified central station burglar alarm, central station fire alarm or automatic fire sprinkler
system, you are eligible for premium credits.
Deductible Credits
Deductible options greater than the calendar year hurricane deductible of 2% and other perils deductible of
$1,000 are available at a premium credit.
Deductibles less than the standard deductibles may be available which will result in premium increase.
Windstorm Loss Mitigation Credits
Housing features such as roof covering, roof shape, roof deck attachments, secondary water resistance, roof to
wall connection and opening protection (qualifying storm shutters or other protective devices) may qualify for
premium credit.
Contact your agent for more information.
OPTIONAL COVERAGES AVAILABLE
• Personal Property Replacement Cost
• "Fungi," Wet or Dry Rot, Yeast or Bacteria Coverage – Increased Limits
• Law and Ordinance Coverage – Increased Limits
• Sinkhole Loss Coverage with a 10% Deductible
• Animal Liability Coverage
• Premium Packages
• Identity Theft
• Screened Enclosure Coverage
• Flood Coverage Endorsement (available in certain areas)
• Water Back Up Coverage
THIS OUTLINE IS FOR INFORMATIONAL PURPOSES ONLY. READ YOUR POLICY CAREFULLY.
YOUR AGENT WILL ASSIST YOU WITH ANY QUESTIONS ABOUT YOUR POLICY.
EDI HO3 OC 05 19 Page 4 of 4
eFiled Lee County Clerk of Courts Page 17
Insurance Information and the Use of Financial Responsibility Credit
Like most insurance companies, we use credit information as a factor in determining the cost of your
insurance. We do so because research studies have shown it to be an accurate predictor of the
probability of future insurance losses. Studies also show that a majority of customers benefit from the use
of credit information.
It’s important to understand that many factors are used to determine the cost of insurance such as the
year your home was built for home insurance, previous insurance and claims history, discounts, and
coverage limits. Your credit history is also part of the overall calculation that determines your premium.
We look at credit history very differently than a financial institution because we’re not evaluating your
credit-worthiness. We’re using credit-based information in combination with other factors to help us
properly price insurance risks.
FREQUENTLY ASKED QUESTIONS
Why do you use my credit information?
Insurance companies often use credit information because it is a predictor of the probability of future
losses. Its use is an objective way to assess and price potential risk and enables us to more accurately
price policies and equitably distribute insurance costs among our policyholders.
Is my credit history the only factor that determines my rate?
No. Many factors such as previous insurance, claims history, discounts and coverage limits go into
determining what you pay for your insurance. In addition, the information you provided when you
purchased your policy and the verification of that information is used to determine your rate.
How do I know if I’m getting the best possible rate?
One of the benefits of buying insurance through an independent agent is their ability to advise you on
your options and ways to save money. Between the guidance of your local independent agent and a vast
array of Edison Insurance options, you can be sure you’re getting the coverage you want at a competitive
rate. If you have any questions, we encourage you to contact your independent Edison Insurance agent
and ask for an insurance review.
How is credit information used in determining my rate?
Edison Insurance, like most insurance companies, calculates an insurance score based on information
from your credit report. Different values or weights are assigned to the information contained in your
credit report, such as payment history, amounts owed or the number of applications for new credit lines.
The total sum of these weights creates your insurance score. As a result, it is likely that some of your
credit information helped to improve your insurance score, and some lowered it. The calculation process
and weights used by each insurance company and/or its service providers are proprietary and
confidential. As a result, we do not disclose your specific score or the details of how it was calculated.
How did my credit information affect my rate?
Due in part to your credit information, you did not receive the lowest possible rate. The reasons for this
are explained in this document under “What factors affected my insurance score?"
What can I do to improve my insurance score?
Edison Insurance and independent insurance agents are not credit counselors or financial advisors, so
we are not in a position to provide specific advice on how to improve your credit or insurance score.
However, we can tell you that the areas that have the biggest impact on your credit report are: payment
Edison Insurance Company
eFiled Lee County Clerk of Courts Page 18
history, amounts owed, length of credit history, new credit applications and type of credit accounts. To get
a copy of your current credit report, contact LexisNexis and follow the instructions under "How do I get a
copy of my credit report?"
How do I get a copy of my credit report?
The Fair Credit Reporting Act allows you to request a free copy of your credit report within 60 days of
receipt of this notice. To get a copy of your report call LexisNexis at 1-866-897-8126 or write to
LexisNexis Consumer Service Center, PO Box 105108, Atlanta, GA 30348. You will need to reference
your NCF Reference #: 22033211501352. LexisNexis can give you information about your credit report.
However, they did not make any decision about your insurance premium or how your policy was rated,
and they are unable to answer questions about those decisions.
What can
Preview
Filing # 188989460 E-Filed 01/03/2024 11:47:45 AM IN THE CIRCUIT COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR LEE COUNTY, FLORIDA JOANNE A. HENRY INDIVIDUALLY AND AS A TRUSTEE OF THE SECOND RESTATED AND AMENDED TRUST AGREEMENT OF JOANNE A. HENRY, CASE NO.: Plaintiff, v. EDISON INSURANCE COMPANY, Defendant. ______________________________________/ PLAINTIFF’S COMPLAINT FOR BREACH OF CONTRACT & DEMAND FOR JURY TRIAL COMES NOW, Plaintiff, JOANNE A. HENRY INDIVIDUALLY AND AS A TRUSTEE OF THE SECOND RESTATED AND AMENDED TRUST AGREEMENT OF JOANNE A. HENRY, through the undersigned counsel, and hereby files this Complaint against Defendant, EDISON INSURANCE COMPANY, and as grounds therefore states as follows: 1. This is an action for damages in excess of FIFTY THOUSAND DOLLARS ($50,000.00), exclusive of interest, attorneys’ fees and costs, and is otherwise within the jurisdictional limits of this Court. 2. At all times material hereto, Defendant was an insurance company authorized to do business in the State of Florida and doing business in Lee County, Florida. 3. At all times material hereto, the damaged property is located in Lee County, Florida. 4. Prior to the direct physical damage sustained during the policy period, Plaintiff sought and purchased homeowner’s insurance from Defendant to cover the property located at Page 1 of 6 eFiled Lee County Clerk of Courts Page 1 6435 Royal Woods Drive, Fort Myers, FL 33908 (hereinafter “Insured Property”). Said policy of insurance, which is believed to be policy number EDH5383334-00, was issued by Defendant to Plaintiff to provide property insurance coverage for the Insured Property. 5. At all times material hereto, Plaintiff and Defendant had a policy of insurance, Policy No. EDH5383334-00 (hereinafter “Contract”). A copy of the Contract is attached hereto and incorporated herein by reference as “Exhibit A”. 6. Plaintiff has paid the premiums for the Contract prior to the direct physical damage sustained during the policy period. 7. During the policy period, the Insured Property sustained direct physical damage as a result of Hurricane Ian. 8. The Contract described in Paragraph 5 above was in full force and effect during the policy period in which the direct physical damage occurred. 9. Defendant received timely notice of the loss. 10. Defendant assigned the loss reported by Plaintiff and described in paragraph 7 above a claim number believed to be EDI954465. 11. Defendant and its agents requested and were given access and the opportunity to inspect the Insured Property and the reported damage arising from the loss described in paragraph 7 above. 12. This is an action relating to Defendant’s breach of Contract for its failure to properly pay the full amount of insurance proceeds owed to Plaintiff. 13. Plaintiff has complied with section 627.70152, Florida Statute. 14. Jurisdiction and venue of this matter are proper in the Circuit Court for Lee County, Florida. Page 2 of 6 eFiled Lee County Clerk of Courts Page 2 COUNT I – BREACH OF CONTRACT 15. Plaintiff realleges and reincorporates paragraphs 1-14 as if fully stated herein, and further alleges as follows: 16. During the above Contract period the Insured Property sustained direct physical damages. 17. Plaintiff provided timely notice of the loss, described in paragraph 7, above to the Defendant. 18. Plaintiff has complied with all obligations and conditions precedent to this lawsuit and which would entitle Plaintiff to recover benefits under the Contract, or such conditions have been waived. 19. Defendant has failed to provide complete coverage for the physical damages that occurred during the Contract period. 20. This failure is contrary to the terms of the Contract and constitutes a breach of the Contract. 21. Plaintiff has been damaged by this breach in the form of unpaid insurance proceeds needed to restore the Insured Property to its pre-loss condition as a result of the Defendant refusing to pay the full amount owed under the Contract. 22. As a direct and proximate result of Defendant’s breach of Contract, Plaintiff has been required to retain the services of the undersigned attorneys to represent and protect the interests of Plaintiff and Plaintiff has become obligated to pay them a reasonable fee for their services in bringing this action. Page 3 of 6 eFiled Lee County Clerk of Courts Page 3 23. In the event that Plaintiff prevails in this action, Plaintiff is entitled to an award of attorneys’ fees and costs pursuant to section 627.70152, 627.428, 626.9373 and 57.041, Florida Statutes and/or other Florida Law. WHEREFORE, Plaintiff demands judgment against Defendant for damages, including but not limited to damages owed under the Contract, attorneys’ fees and costs. DEMAND FOR JURY TRIAL Plaintiff further demand a trial by jury of all issues so triable as a matter of right. [Certificate of Service on Following Page] Page 4 of 6 eFiled Lee County Clerk of Courts Page 4 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a certified copy of the foregoing has been served on Defendant. KANNER & PINTALUGA, P.A. Attorneys for Plaintiff 2020 Ponce De Leon, PH2 Coral Gables, FL 33134 Phone: (561) 424-0032 Fax: (866) 641-4690 Court Phone Number: (1-888) 824-7834 Email: sgibbons@kpattorney.com mbatista@kpattorney.com FirstPartyEService@kpattorney.com By:_/s/ Shawn R. Gibbons . SHAWN R. GIBBONS, ESQ. Florida Bar No.: 118217 Page 5 of 6 eFiled Lee County Clerk of Courts Page 5 EXHIBIT “A” Page 6 of 6 eFiled Lee County Clerk of Courts Page 6 HOMEOWNERS DECLARATION 01:35:58.949 PM POLICY PERIOD POLICY NUMBER From To EDH5383334-00 02/03/2022 02/03/2023 P.O. Box 21957 Lehigh Valley, PA 18002-1957 12:01 A.M. Standard Time at the described location For Customer Service and Claims Call 1-866-568-8922 or visit www.edisoninsurance.com AMENDED DECLARATION Policy Form:HO3 Effective:02/16/2022 Date Issued:02/21/2022 INSURED: AGENCY: JOANNE HENRY WAY BETTER INS INC 6435 ROYAL WOODS DR 4978 ROYAL GULF CIR FORT MYERS, FL 33908 FORT MYERS, FL 33966 Agency ID: 0042006 Phone: 952-239-9513 Phone: 239-210-7720 The residence premises covered by this policy is located at the address listed below. 6435 ROYAL WOODS DR, FORT MYERS, FL 33908 Coverage is provided where premium and limit of liability is shown, subject to terms and conditions of the policy. COVERAGES LIMIT OF LIABILITY PREMIUM SECTION I COVERAGE A. DWELLING $ 211,000 $ 1,674.18 B. OTHER STRUCTURES $ 4,220 Included C. PERSONAL PROPERTY $ 52,750 Included D. LOSS OF USE $ 21,100 Included SECTION II COVERAGE E. PERSONAL LIABILITY $ 300,000 $ 15.00 F. MEDICAL PAYMENTS $ 5,000 $ 5.00 OPTIONAL COVERAGES $ -216.05 See FORMS SCHEDULE on page 2 for details Total Policy Premium: $ 1,478.13 EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE TRUST FUND: $ 2.00 FLORIDA INSURANCE GUARANTY ASSOCIATION 2022 REGULAR ASSESSMENT: $ 10.35 MANAGING GENERAL AGENCY FEE: $ 25.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $ 1,515.48 Note: The portion of your premium for Hurricane Coverage is: $ 849.54 Non-hurricane Premium: $ 628.59 Change in Policy Premium: $ -191.63 DEDUCTIBLES All Other Perils Deductible: $5,000 Sinkhole Deductible: N/A HURRICANE DEDUCTIBLE: 2% of Coverage A = $4,220 Law and Ordinance Coverage: 10% MORTGAGEE COMPANY NA 02/21/2022 COUNTERSIGNED BY AUTHORIZED REPRESENTATIVE COUNTERSIGNED DATE EDI HO DEC FL 05 19 INSURED COPY Page 1 of 4 eFiled Lee County Clerk of Courts Page 7 POLICY PERIOD POLICY NUMBER From To EDH5383334-00 02/03/2022 02/03/2023 P.O. Box 21957 Lehigh Valley, PA 18002-1957 12:01 A.M. Standard Time at the described location FORMS SCHEDULE This policy is subject to the following Forms, Endorsements, Credits and Surcharges Main Policy Forms Form # Description OIR-B1-1670 01 06 CHECKLIST OF COVERAGE EDI HO3 OC 05 19 OUTLINE OF HOMEOWNERS POLICY EDI PRI 06 14 PRIVACY NOTICE EDI HOJ 01 20 POLICY JACKET EDI HO 03 07 21 HOMEOWNERS 3 – SPECIAL FORM OIR-B1-1655 02 10 NOTICE OF PREMIUM DISCOUNTS FOR HURRICANE LOSS MITIGATION EDI HO CDE 05 21 COMMUNICABLE DISEASE EXCLUSION EDI HO ELE 06 21 EXCESSIVE OR UNUSUAL LIABILITY EXPOSURE EDI 24 06 14 CALENDAR YEAR HURRICANE DEDUCTIBLE WITH SUPPLEMENTAL REPORTING REQUIREMENT – FLORIDA EDI 23 70 06 14 WINDSTORM EXTERIOR PAINT OF WATERPROOFING EXCLUSION EDI HO LO 06 14 IMPORTANT INFORMATION REGARDING LAW AND ORDINANCE COVERAGE EDI GC 01 06 14 GOLF CART OR OTHER MOTORIZED LAND CONVEYANCE PROPERTY DAMAGE AND LIABILITY LIMITATION EDI HO 04 96 06 14 COVERAGE FOR HOME DAY CARE BUSINESS EDI HO 04 01 09 16 FLOOD AFFIRMATION Endorsements Form # Description Limit Premium EDI HO 04 95 08 15 WATER BACK-UP $ 5,000 $ 25.00 EDI HO LWD 02 19 LIMITED WATER DAMAGE COVERAGE $ 10,000 $ -241.05 LOSS ASSESSMENT $ 1,000 Included SINKHOLE LOSS COVERAGE Excluded EDI HO DEC FL 05 19 INSURED COPY Page 2 of 4 eFiled Lee County Clerk of Courts Page 8 POLICY PERIOD POLICY NUMBER From To EDH5383334-00 02/03/2022 02/03/2023 P.O. Box 21957 Lehigh Valley, PA 18002-1957 12:01 A.M. Standard Time at the described location DISCOUNTS These adjustments have already been applied to your premium. Deductible -$197.33 Age of Roof -$65.78 Secured Community/Building -$62.75 Financial Responsibility -$274.63 Wind Mitigation -$2,184.53 Total Discounts: ($ -2,785.02) RATING INFORMATION Year Built 1983 Occupancy Owner Roof Year Replaced 2018 Construction Type Masonry Primary/Seasonal Primary Roof Shape Other Dwelling Type Single Family House Number of Families 1 Roof Cover FBC Equivalent Number of Stories 1 Protection Class 02 Roof Deck 8d @ 6"/6" Number of Units 1 BCEG Class 99 Roof Wall Clips Units in Firewall 1 Terrain B Open Protection Unknown SWR Yes Your windstorm loss mitigation credit is $2,184.53. A rate adjustment of 72% credit is included to reflect the Windstorm Mitigation Device credit. This credit applies only to the wind portion of your premium. Adjustments range from 0% to 92% credit. A rate adjustment of -1% is included to reflect the Building Code Effectiveness Grade for your area. Adjustments range from 1% surcharge to 12% credit. You may be eligible for other programs in Florida Peninsula Holdings, LLC and should discuss with your agent. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. EDI HO DEC FL 05 19 INSURED COPY Page 3 of 4 eFiled Lee County Clerk of Courts Page 9 POLICY PERIOD POLICY NUMBER From To EDH5383334-00 02/03/2022 02/03/2023 P.O. Box 21957 Lehigh Valley, PA 18002-1957 12:01 A.M. Standard Time at the described location DEDUCTIBLE OPTIONS NOTICE This policy contains a separate deductible for Hurricane Losses and for All Other Perils. The deductibles shown in your policy declaration page(s) are the deductibles that will apply as described in your policy in the event of a covered loss. If you fail to select a deductible at the time of your application submission, $1,000 All Other Perils and 2% Hurricane deductibles will apply. If you do not choose an All Other Perils or Hurricane Deductible at renewal, your previously selected deductibles will apply. You have the option to buy lower deductibles for an additional premium, or select higher deductibles for a premium credit. For HO3 policies, All Other Peril deductible options are $500, $1,000, $2,500, $5,000 and $10,000. For HO6 policies, All Other Peril deductible options are $500, $1,000, $2,500 and $5,000. Hurricane deductible options are $500, 2% (minimum $500), 5% or 10%. Percentage deductibles apply to Coverage A in Form HO3 and Coverage C in Form HO6. In the event you select a lower hurricane deductible and have suffered a hurricane loss under this policy or under one issued by a member of our company group during the calendar year, such lower selected deductible will not take effect until January 1 of the following calendar year. If your policy does not exclude coverage for the peril of Windstorm or Hail, there are various combinations of All Other Peril and Hurricane deductibles available. Not all of these deductible options may be available to you due to the value of your dwelling. If your policy excludes coverage for the peril of Windstorm or Hail, a Hurricane Deductible would not apply. You have the option to buy Flood Coverage for an additional premium. Flood Coverage has a separate deductible with the following options: $500, $1,000, $2,500, $5,000, $7,500 and $10,000. If you do not choose a Flood Deductible at renewal, your previously selected deductible will apply. For HO3 policies, you have the option to buy Sinkhole Coverage for an additional premium. Sinkhole Coverage has a separate deductible of 10% of Coverage A in HO3. For HO6 policies, sinkhole coverage is included. It has a separate deductible equal to the All Other Perils deductible. Please contact your agent if you have any questions, concerns or wish to change your deductible options. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. YOUR POLICY PROVIDES LAW AND ORDINANCE COVERAGE OF 10% OF THE COVERAGE A LIMIT. LAW AND ORDINANCE COVERAGE OF 25% OR 50% OF THE COVERAGE A LIMIT IS AVAILABLE FOR AN ADDITIONAL PREMIUM. FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER’S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. EDI HO DEC FL 05 19 INSURED COPY Page 4 of 4 eFiled Lee County Clerk of Courts Page 10 Checklist of Coverage Policy Type: Homeowner's (Indicate: Homeowner's, Condominium Unit Owner's, Tenant's, Dwelling, or Mobile Home Owner's) The following checklist is for informational purposes only. Florida law prohibits this checklist from changing any of the provisions of the insurance contract which is the subject of this checklist. Any endorsement regarding changes in types of coverage, exclusions, limitations, reductions, deductibles, coinsurance, renewal provisions, cancellation provisions, surcharges, or credits will be sent separately. Reviewing this checklist together with your policy can help you gain a better understanding of your policy's actual coverages and limitations, and may even generate questions. By addressing any questions now, you will be more prepared later in the event of a claim. Experience has shown that many questions tend to arise regarding the coverage of attached or detached screened pool enclosures, screened porches, and other types of enclosures. Likewise, if your policy insures a condominium unit, questions may arise regarding the coverage of certain items, such as individual heating and air conditioning units; individual water heaters; floor, wall, and ceiling coverings; built-in cabinets and counter tops; appliances; window treatments and hardware; and electrical fixtures. A clear understanding of your policy's coverages and limitations will reduce confusion that may arise during claims settlement. Please refer to the policy for details and any exceptions to the coverages listed in this checklist. All coverages are subject to the provisions and conditions of the policy and any endorsements. If you have questions regarding your policy, please contact your agent or company. Consumer assistance is available from the Department of Financial Services, Division of Consumer Services' Helpline at (800) 342-2762 or www.fldfs.com. This form was adopted by the Florida Financial Services Commission. Dwelling Structure Coverage (Place of Residence) Limit of Insurance: $211,000 Loss Settlement Basis: Replacement Cost (i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.) Other Structures Coverage (Detached from Dwelling) Limit of Insurance: $4,220 Loss Settlement Basis: Replacement Cost (i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.) Personal Property Coverage Limit of Insurance: $52,750 Loss Settlement Basis: Actual Cash Value (i.e.: Replacement Cost, Actual Cash Value, Stated Value, etc.) Deductibles Annual Hurricane: $4,220 All Perils (Other Than Hurricane): $5,000 OIR-B1-1670 (1-1-06) 1 of 3 eFiled Lee County Clerk of Courts Page 11 Checklist of Coverage (continued) The above Limit of Insurance, Deductibles, and Loss Settlement Basis apply to the following perils insured against: (Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is NOT included) Y Fire or Lightning Y Hurricane N Flood (Including storm surge) Y Windstorm or Hail (other than hurricane) Y Explosion Y Riot or Civil Commotion Y Aircraft Y Vehicles Y Smoke Y Vandalism or Malicious Mischief Y Theft Y Falling Objects Y Weight of Ice, Snow or Sleet N Accidental Discharge or Overflow of Water or Steam $10,000 Y Sudden and Accidental Tearing Apart, Cracking, Burning or Bulging Y Freezing Y Sudden and Accidental Damage from Artificially Generated Electrical Current Y Volcanic Eruption Y Catastrophic Ground Cover Collapse N Sinkhole Y Any Other Peril Not Specifically Excluded (dwelling and other structures only) Special limits and loss settlement exceptions may apply to certain items. Refer to your policy for details. Loss of Use Coverage Coverage Limit of Insurance Time Limit (Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is NOT included) Y Additional Living Expense $21,100 See Policy Y Fair Rental Value $21,100 See Policy Y Civil Authority Prohibits Use $21,100 See Policy Property - Additional/Other Coverages (Items below marked Y (Yes) indicate coverage IS Limit of Insurance Amount of insurance is an additional amount of included, those marked N (No) indicate coverage is NOT coverage or is included within the policy limit. included) Included Additional Y Debris Removal See Policy Y Y Reasonable Repairs See Policy Y Y Property Removed See Policy Y Credit Card, Electronic Fund Transfer Card, or Y $500 Y Access Device, Forgery and Counterfeit Money Y Loss Assessment $1,000 Y Y Collapse See Policy Y Y Glass or Safety Glazing Material See Policy Y Y Landlord's Furnishings $2,500 Y Y Law and Ordinance $21,100 Y N Grave Markers Y Mold / Fungi $10,000 Y OIR-B1-1670 (1-1-06) 2 of 3 eFiled Lee County Clerk of Courts Page 12 Checklist of Coverage (continued) Discounts Dollar ($) Amount of Discount (Items below marked Y (Yes) indicate discount IS applied, those marked N (No) indicate discount is NOT applied) N Multiple Policy N Burglar Alarm N Fire Alarm / Smoke Alarm / Sprinkler Alarm Y Windstorm Loss Reduction -$2,184.53 N Building Code Effectiveness Grading Schedule N Other Insurer May Insert Any Other Property Coverage Below Limit of Insurance Loss Settlement Basis: (Items below marked Y (Yes) indicate coverage IS (i.e.: Replacement Cost, Actual Cash Value, Stated included, those marked N (No) indicate coverage is NOT Value, etc.) included) Personal Liability Coverage Limit of Insurance: $300,000 Medical Payments to Others Coverage Limit of Insurance: $5,000 Liability - Additional/Other Coverages Limit of Insurance Amount of insurance is an additional amount of (Items below marked Y (Yes) indicate coverage IS coverage or is included within the policy limit. included, those marked N (No) indicate coverage is NOT included) Included Additional Y Claim Expenses See Policy Y Y First Aid Expenses See Policy Y Y Damage to Property of Others $500 Y Y Loss Assessment $1,000 Y Insurer May Insert Any Other Liability Coverage Below (Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is Limit of Insurance NOT included) Y Mold/Fungi Section II $50,000 OIR-B1-1670 (1-1-06) 3 of 3 eFiled Lee County Clerk of Courts Page 13 EDISON INSURANCE COMPANY HOMEOWNERS EDI HO3 OC 05 19 OUTLINE OF YOUR EDISON INSURANCE COMPANY HO-3 HOMEOWNERS POLICY This Outline is being provided to help you more easily understand your Edison Insurance Company HO-3 Homeowners Policy. It highlights the major coverages, exclusions, limitations and deductibles of your policy and provides information on discounts, cancellation and nonrenewal. However, this is just a guide and not a legal contract. Please read your HO-3 Homeowners policy carefully for complete descriptions and details. The following Outline is for informational purposes only. Florida law prohibits this Outline from changing any of the provisions of the insurance contract, which is the subject of this Outline. Any endorsement regarding changes in types of coverage, coverage limits, exclusions, deductibles, renewal or cancellation provisions, surcharges, credits, or any other changes will be sent separately. SECTION I – PROPERTY COVERAGE Coverage A - Dwelling Protects against covered loss to your dwelling and structures attached to your dwelling. It also protects against covered loss to building materials located on your residence, which are being used in connection with your residence premises. This coverage does not apply to land, including land on which the dwelling is located. Coverage B - Other Structures Protects against covered loss to structures on your residence premises not physically attached to the dwelling. This coverage does not apply to land, including land on which other structures are located. Coverage C - Personal Property Protects against covered loss to your personal property such as clothing and furniture. Special limits apply to some types of personal property including but not limited to: • Money • Securities • Watercraft • Theft of Jewelry • Firearms • Silverware There are some items not covered under Coverage "C." Some examples are: • Animals • Motorized Vehicles • Property of roomers or boarders and other tenants Please review your policy for a complete list of items that have special limits or are excluded. Coverage D - Loss Of Use Provides for the additional living expenses you incur while you are temporarily unable to live at your home because of a covered loss. Payment would include such items as temporary lodging and increased costs for food. Coverage is limited to 24 consecutive months from the date of loss. Pre-event evacuation expenses are not covered under the policy. ADDITIONAL COVERAGES These additional coverages include limitations and may not completely protect you against loss: • Debris Removal • Reasonable Repairs • Trees, Shrubs and Other Plants • Fire Department Service Charge • Property Removed EDI HO3 OC 05 19 Page 1 of 4 eFiled Lee County Clerk of Courts Page 14 EDISON INSURANCE COMPANY HOMEOWNERS EDI HO3 OC 05 19 • Credit Card, Fund Transfer Card, Forgery and Counterfeit Money • Loss Assessment • Collapse • Glass or Safety Glazing Material • Landlords Furnishings • "Fungi," Wet or Dry Rot, Yeast or Bacteria • Law and Ordinance PERILS INSURED AGAINST Coverage A – Dwelling and Coverage B – Other Structures This policy insures under Coverages "A" and "B" unless not covered or excluded from coverage as described elsewhere in the policy. There are some perils not covered under Coverage "A" or "B." Some examples are: • Freezing • Wear and Tear • Pollutants • Corrosion • Inherent Vice, Decay, Latent Defect and Mechanical Breakdown • Vandalism (if vacant more than 30 consecutive days) Additionally, there are exclusions and other property not covered. Please review your policy for a complete list of items that have special limits or are excluded. Coverage C – Personal Property • Fire or Lightning • Windstorm or Hail • Explosion • Riot or Civil Commotion • Aircraft • Vehicles • Smoke • Vandalism or Malicious Mischief • Theft (including off-premise theft) • Falling Objects • Weight of ice, snow or sleet • Accidental discharge or overflow of water or steam • Sudden and accidental tearing apart, cracking, burning or bulging • Freezing of plumbing or household appliances • Sudden and accidental damage from artificially generated electrical current • Volcanic eruption • Catastrophic Ground Cover Collapse PROPERTY EXCLUSIONS This policy does not provide protection under Coverages "A," "B" and "C" for losses resulting in any manner from: • Sinkhole Loss Coverage • Law and Ordinance • Earth Movement and Settlement • Flood and Other Water Damage • Off-Premises Power Failure • Neglect • War or Nuclear Hazard • Intentional Acts • Existing Damage • Constant or Repeated Seepage or Leakage of Water or Steam There are other exclusions. Please refer to your policy for complete details regarding exclusions. EDI HO3 OC 05 19 Page 2 of 4 eFiled Lee County Clerk of Courts Page 15 EDISON INSURANCE COMPANY HOMEOWNERS EDI HO3 OC 05 19 OTHER LIMITATIONS Deductibles A calendar year hurricane deductible and an all other perils deductible, selected by you, are shown on your Declarations page. This is the amount of the loss you must incur before this policy pays. Flood This policy does not protect you against loss due to flood or wave wash. A Flood Coverage endorsement may be available in certain areas. Flood insurance is also available through the Federal government. Windstorm In some areas of the state, generally coastal areas, windstorm and hail coverage, including hurricane coverage, is not provided in your policy. Be sure to contact your agent to obtain this important coverage if it has been excluded from your policy. Loss Settlement For Coverage C - Personal Property, we will pay the actual cash value at the time of loss but not more than the cost to repair or replace. For Coverage A - Dwelling, we will initially pay at least the actual cash value of the insured loss, less any applicable deductible. We shall pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred or we will pay a licensed contractor after the insured signs a contract and as repairs are made to the covered property. If a total loss of the covered dwelling occurs, we shall pay the replacement cost coverage without reservation of any depreciation in value, subject to policy limits. Vacant Property If a loss occurs and the dwelling has been vacant for 30 consecutive days prior to the date of loss, there is no coverage for vandalism, sprinkler leakage, glass breakage, water damage, theft or attempted theft, even if they are a covered cause of loss. SECTION II – LIABILITY COVERAGE Coverage E - Personal Liability Provides coverage for bodily injury or property damage you or a person insured under your policy are legally obligated to pay. The bodily injury or property damage must arise from an occurrence covered under Section II of your policy. Coverage F - Medical Payments To Others Provides coverage for reasonable and necessary medical expenses if a guest is injured on your premises or off the insured premises under certain circumstances. The bodily injury must arise from an occurrence covered under Section II of your policy with limited exceptions. Some liability and medical expenses are not covered under Section II. For example, there is no coverage for bodily injury or property damage arising from: • Animals • Watercraft • Motorized vehicles • Radon • Pollutants • Ingestion or inhalation of lead in any form or substance • Under certain conditions, home day care operations NONRENEWAL AND CANCELLATION PROVISIONS All cancellations are granted a pro-rata return of premium. Your Right To Cancel You may cancel the policy at any time, for any reason, by giving us advance written notice of the future EDI HO3 OC 05 19 Page 3 of 4 eFiled Lee County Clerk of Courts Page 16 EDISON INSURANCE COMPANY HOMEOWNERS EDI HO3 OC 05 19 cancellation effective date. Our Right To Cancel If your policy has been in effect for 90 days or less and the insurance is cancelled for other than nonpayment of premium we may cancel for any valid reason by giving you at least 20 days notice before the cancellation effective date, except where there has been a material misstatement, misrepresentation, or failure to comply with underwriting requirements established in the first 90 days, then we may cancel immediately. If your policy has been in effect over 90 days, we may cancel your policy for only a limited number of reasons. The reasons include, but are not limited to, material misstatement or substantial change of risk. We will cancel by giving you advance written notice at least 120 days before the cancellation becomes effective. If the cancellation is due to nonpayment of premium, we will give you at least 10 days advance written notice. Nonrenewal If we do not intend to renew your policy, we will mail written notice to you. We will do so at least 120 days before the expiration date of the policy. Renewal The renewal premium payment must be received no later than the renewal date or the policy will terminate. PREMIUM CREDITS The following are brief descriptions of the premium credits available on your HO-3 Homeowners policy. Your policy Declarations page will show which of these credits, if any, apply to your policy. Protective Devices If your home has a qualified central station burglar alarm, central station fire alarm or automatic fire sprinkler system, you are eligible for premium credits. Deductible Credits Deductible options greater than the calendar year hurricane deductible of 2% and other perils deductible of $1,000 are available at a premium credit. Deductibles less than the standard deductibles may be available which will result in premium increase. Windstorm Loss Mitigation Credits Housing features such as roof covering, roof shape, roof deck attachments, secondary water resistance, roof to wall connection and opening protection (qualifying storm shutters or other protective devices) may qualify for premium credit. Contact your agent for more information. OPTIONAL COVERAGES AVAILABLE • Personal Property Replacement Cost • "Fungi," Wet or Dry Rot, Yeast or Bacteria Coverage – Increased Limits • Law and Ordinance Coverage – Increased Limits • Sinkhole Loss Coverage with a 10% Deductible • Animal Liability Coverage • Premium Packages • Identity Theft • Screened Enclosure Coverage • Flood Coverage Endorsement (available in certain areas) • Water Back Up Coverage THIS OUTLINE IS FOR INFORMATIONAL PURPOSES ONLY. READ YOUR POLICY CAREFULLY. YOUR AGENT WILL ASSIST YOU WITH ANY QUESTIONS ABOUT YOUR POLICY. EDI HO3 OC 05 19 Page 4 of 4 eFiled Lee County Clerk of Courts Page 17 Insurance Information and the Use of Financial Responsibility Credit Like most insurance companies, we use credit information as a factor in determining the cost of your insurance. We do so because research studies have shown it to be an accurate predictor of the probability of future insurance losses. Studies also show that a majority of customers benefit from the use of credit information. It’s important to understand that many factors are used to determine the cost of insurance such as the year your home was built for home insurance, previous insurance and claims history, discounts, and coverage limits. Your credit history is also part of the overall calculation that determines your premium. We look at credit history very differently than a financial institution because we’re not evaluating your credit-worthiness. We’re using credit-based information in combination with other factors to help us properly price insurance risks. FREQUENTLY ASKED QUESTIONS Why do you use my credit information? Insurance companies often use credit information because it is a predictor of the probability of future losses. Its use is an objective way to assess and price potential risk and enables us to more accurately price policies and equitably distribute insurance costs among our policyholders. Is my credit history the only factor that determines my rate? No. Many factors such as previous insurance, claims history, discounts and coverage limits go into determining what you pay for your insurance. In addition, the information you provided when you purchased your policy and the verification of that information is used to determine your rate. How do I know if I’m getting the best possible rate? One of the benefits of buying insurance through an independent agent is their ability to advise you on your options and ways to save money. Between the guidance of your local independent agent and a vast array of Edison Insurance options, you can be sure you’re getting the coverage you want at a competitive rate. If you have any questions, we encourage you to contact your independent Edison Insurance agent and ask for an insurance review. How is credit information used in determining my rate? Edison Insurance, like most insurance companies, calculates an insurance score based on information from your credit report. Different values or weights are assigned to the information contained in your credit report, such as payment history, amounts owed or the number of applications for new credit lines. The total sum of these weights creates your insurance score. As a result, it is likely that some of your credit information helped to improve your insurance score, and some lowered it. The calculation process and weights used by each insurance company and/or its service providers are proprietary and confidential. As a result, we do not disclose your specific score or the details of how it was calculated. How did my credit information affect my rate? Due in part to your credit information, you did not receive the lowest possible rate. The reasons for this are explained in this document under “What factors affected my insurance score?" What can I do to improve my insurance score? Edison Insurance and independent insurance agents are not credit counselors or financial advisors, so we are not in a position to provide specific advice on how to improve your credit or insurance score. However, we can tell you that the areas that have the biggest impact on your credit report are: payment Edison Insurance Company eFiled Lee County Clerk of Courts Page 18 history, amounts owed, length of credit history, new credit applications and type of credit accounts. To get a copy of your current credit report, contact LexisNexis and follow the instructions under "How do I get a copy of my credit report?" How do I get a copy of my credit report? The Fair Credit Reporting Act allows you to request a free copy of your credit report within 60 days of receipt of this notice. To get a copy of your report call LexisNexis at 1-866-897-8126 or write to LexisNexis Consumer Service Center, PO Box 105108, Atlanta, GA 30348. You will need to reference your NCF Reference #: 22033211501352. LexisNexis can give you information about your credit report. However, they did not make any decision about your insurance premium or how your policy was rated, and they are unable to answer questions about those decisions. What can