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Filing # 195493718 E-Filed 04/04/2024 01:46:03 PM
IN THE CIRCUIT COURT FOR THE 20TH
JUDICIAL CIRCUIT IN AND FOR
LEE COUNTY, FLORIDA
ROBERT BALKUM and SALLIE BALKUM,
GENERAL JURISDICTION DIVISION
Plaintiffs,
CASE NO.:
vs.
EDISON INSURANCE COMPANY,
Defendant.
/
COMPLAINT
Plaintiffs, ROBERT BALKUM and SALLIE BALKUM (collectively referred to
hereafter as the “Insured”), hereby sue Defendant, EDISON INSURANCE COMPANY (the
“Insurance Company”), and allege as follows:
PARTIES, JURISDICTION AND VENUE
1. This is an action for damages that exceeds Fifty Thousand and 00/100 Dollars
($50,000.00) exclusive of interest, costs and attorney’s fees.
2. The Insured are individuals who at all times material hereto have resided in Lee
County, Florida.
3. The Insurance Company is a Florida corporation qualified to do business in
Florida and has, at all times material hereto, been conducting business in Lee County, Florida.
4. Venue is proper in Lee County, Florida because the contract, which forms the
subject matter of this lawsuit, was executed in Lee County, Florida.
5. All conditions precedent to the filing of this lawsuit have occurred, have been
waived or have been performed.
eFiled Lee County Clerk of Courts Page 1
GENERAL ALLEGATIONS
6. At all times material hereto, in consideration of a premium paid by the Insured, there
was in full force and effect a certain homeowners insurance policy issued by the Insurance Company
with a policy number of EDH5339089-01 (the “Policy”).
7. The Insured after diligent search and expending all efforts to locate a copy of the
Policy have not been able to do so. However, the Insurance Company must have a copy of said
Policy in its possession; as such the Insured will file a copy of the Policy after the same is provided
by the Insurance Company.
8. Accordingly, under the terms of the Policy, the Insurance Company agreed to provide
coverage to the Insured’s property against certain losses. The damaged property is located at 17696
Southwind Breeze Ct., Fort Myers, Florida 33908 (the “Property”).
9. On or about September 28, 2022, while the Policy was in full force and effect, the
Property sustained a covered loss as a result of Hurricane Ian (the “Loss”).
10. The Insurance Company assigned claim number EDI949972 to the Loss.
11. The Insurance Company acknowledged that the Property sustained a covered Loss
and offered payment. However, after diligent inspection of the Loss, it was obvious that the
Property sustained covered damages greater than the damages acknowledged by the Insurance
Company.
12. The Insurance Company’s finalization of its duty to adjust the loss with the insurance
is a condition precedent for the Insured to receive the insurance benefits that they are entitled to
under the terms of the Policy.
13. On August 25, 2023, pursuant to Florida Statute Section 627.70152, the Insured filed
a Notice of Intent to Initiate Litigation (the “Notice”) with the Florida Department of Financial
Services. A true and correct copy of the Notice is attached hereto as Exhibit A.
eFiled Lee County Clerk of Courts Page 2
14. On September 8, 2023, the Insurance Company responded to the Notice by offering
to engage in settlement talks. However, the parties were unable to reach an agreement.
15. As of the date of the filing of this lawsuit, the Insurance Company has failed to
acknowledge that additional payment would be forthcoming and it has failed to adequately provide
coverage under the terms of the Policy. As a result of the foregoing, the Insurance Company has
breached the Policy.
16. The Insured have suffered and continue to suffer damages resulting from the
Insurance Company’s breach of the Policy.
17. The Insured have been obligated to retain the undersigned attorneys for the
prosecution of this action and are entitled to a reasonable attorney’s fee pursuant to Florida Statute
Section 627.428.
COUNT I
BREACH OF CONTRACT
18. The Insured reincorporate paragraphs 1 through 17 as if fully set forth herein.
19. It is undisputed that the Insured and the Insurance Company entered into a written
contract, the Policy, wherein the Insured agreed to pay a premium and the Insurance Company
agreed to insure the Insured’s Property.
20. The Insured have paid all premiums due and owing as contemplated by the Policy;
thus, fully performing their obligations under the Policy.
21. The Insured’s Property sustained damage which the Insurance Company agreed to
provide coverage for under the terms of the Policy.
22. Furthermore, at all times material hereto, the Insured have satisfied all post-loss
obligations accorded in the Policy, including but not limited to: (i) protecting the Property from
further loss; (ii) making reasonable and necessary repairs to protect the Property; and (iii) keeping an
eFiled Lee County Clerk of Courts Page 3
accurate record of the repairs expenses. Accordingly, the Insured have made diligent effort to
complete reasonable repairs to the Property and have mitigated the damages sustained.
23. In contrast, the Insurance Company has failed to: (i) provide coverage for the Loss
under the terms of the Policy; and/or (ii) acknowledge that payment would be forthcoming; and/or
(iii) make adequate payment of insurance proceeds to the Insured. As a result of the foregoing, the
Insurance Company has breached the Policy.
24. As a direct and proximate result of the Insurance Company’s breach of the Policy, the
Insured have sustained damages.
WHEREFORE, the Insured respectfully request that this Court, compel the Insurer to
Appraisal, or in the alternative enter judgment against the Insurance Company for damages, plus
interest, court costs and reasonable attorney’s fees pursuant to Section 627.428, Florida Statutes.
JURY TRIAL DEMAND
Plaintiffs hereby demand a trial by jury on all issues so triable.
Dated this 4th day of April, 2024.
Respectfully submitted,
The Law Offices of Grey & Mourin, P.A.
Counsel for the Insured
1400 NW 10th Avenue, Ste. RG6
Miami, Florida 33136
Telephone No. (305) 325-8119
Email: eservice@greyandmourin.com
Secondary Email: lourdes@greyandmourin.com
veronica@greyandmourin.com
By:/s/ Lourdes Rodriguez Brea
Lourdes Rodriguez Brea
Florida Bar No.: 104460
eFiled Lee County Clerk of Courts Page 4
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Preview
Filing # 195493718 E-Filed 04/04/2024 01:46:03 PM IN THE CIRCUIT COURT FOR THE 20TH JUDICIAL CIRCUIT IN AND FOR LEE COUNTY, FLORIDA ROBERT BALKUM and SALLIE BALKUM, GENERAL JURISDICTION DIVISION Plaintiffs, CASE NO.: vs. EDISON INSURANCE COMPANY, Defendant. / COMPLAINT Plaintiffs, ROBERT BALKUM and SALLIE BALKUM (collectively referred to hereafter as the “Insured”), hereby sue Defendant, EDISON INSURANCE COMPANY (the “Insurance Company”), and allege as follows: PARTIES, JURISDICTION AND VENUE 1. This is an action for damages that exceeds Fifty Thousand and 00/100 Dollars ($50,000.00) exclusive of interest, costs and attorney’s fees. 2. The Insured are individuals who at all times material hereto have resided in Lee County, Florida. 3. The Insurance Company is a Florida corporation qualified to do business in Florida and has, at all times material hereto, been conducting business in Lee County, Florida. 4. Venue is proper in Lee County, Florida because the contract, which forms the subject matter of this lawsuit, was executed in Lee County, Florida. 5. All conditions precedent to the filing of this lawsuit have occurred, have been waived or have been performed. eFiled Lee County Clerk of Courts Page 1 GENERAL ALLEGATIONS 6. At all times material hereto, in consideration of a premium paid by the Insured, there was in full force and effect a certain homeowners insurance policy issued by the Insurance Company with a policy number of EDH5339089-01 (the “Policy”). 7. The Insured after diligent search and expending all efforts to locate a copy of the Policy have not been able to do so. However, the Insurance Company must have a copy of said Policy in its possession; as such the Insured will file a copy of the Policy after the same is provided by the Insurance Company. 8. Accordingly, under the terms of the Policy, the Insurance Company agreed to provide coverage to the Insured’s property against certain losses. The damaged property is located at 17696 Southwind Breeze Ct., Fort Myers, Florida 33908 (the “Property”). 9. On or about September 28, 2022, while the Policy was in full force and effect, the Property sustained a covered loss as a result of Hurricane Ian (the “Loss”). 10. The Insurance Company assigned claim number EDI949972 to the Loss. 11. The Insurance Company acknowledged that the Property sustained a covered Loss and offered payment. However, after diligent inspection of the Loss, it was obvious that the Property sustained covered damages greater than the damages acknowledged by the Insurance Company. 12. The Insurance Company’s finalization of its duty to adjust the loss with the insurance is a condition precedent for the Insured to receive the insurance benefits that they are entitled to under the terms of the Policy. 13. On August 25, 2023, pursuant to Florida Statute Section 627.70152, the Insured filed a Notice of Intent to Initiate Litigation (the “Notice”) with the Florida Department of Financial Services. A true and correct copy of the Notice is attached hereto as Exhibit A. eFiled Lee County Clerk of Courts Page 2 14. On September 8, 2023, the Insurance Company responded to the Notice by offering to engage in settlement talks. However, the parties were unable to reach an agreement. 15. As of the date of the filing of this lawsuit, the Insurance Company has failed to acknowledge that additional payment would be forthcoming and it has failed to adequately provide coverage under the terms of the Policy. As a result of the foregoing, the Insurance Company has breached the Policy. 16. The Insured have suffered and continue to suffer damages resulting from the Insurance Company’s breach of the Policy. 17. The Insured have been obligated to retain the undersigned attorneys for the prosecution of this action and are entitled to a reasonable attorney’s fee pursuant to Florida Statute Section 627.428. COUNT I BREACH OF CONTRACT 18. The Insured reincorporate paragraphs 1 through 17 as if fully set forth herein. 19. It is undisputed that the Insured and the Insurance Company entered into a written contract, the Policy, wherein the Insured agreed to pay a premium and the Insurance Company agreed to insure the Insured’s Property. 20. The Insured have paid all premiums due and owing as contemplated by the Policy; thus, fully performing their obligations under the Policy. 21. The Insured’s Property sustained damage which the Insurance Company agreed to provide coverage for under the terms of the Policy. 22. Furthermore, at all times material hereto, the Insured have satisfied all post-loss obligations accorded in the Policy, including but not limited to: (i) protecting the Property from further loss; (ii) making reasonable and necessary repairs to protect the Property; and (iii) keeping an eFiled Lee County Clerk of Courts Page 3 accurate record of the repairs expenses. Accordingly, the Insured have made diligent effort to complete reasonable repairs to the Property and have mitigated the damages sustained. 23. In contrast, the Insurance Company has failed to: (i) provide coverage for the Loss under the terms of the Policy; and/or (ii) acknowledge that payment would be forthcoming; and/or (iii) make adequate payment of insurance proceeds to the Insured. As a result of the foregoing, the Insurance Company has breached the Policy. 24. As a direct and proximate result of the Insurance Company’s breach of the Policy, the Insured have sustained damages. WHEREFORE, the Insured respectfully request that this Court, compel the Insurer to Appraisal, or in the alternative enter judgment against the Insurance Company for damages, plus interest, court costs and reasonable attorney’s fees pursuant to Section 627.428, Florida Statutes. JURY TRIAL DEMAND Plaintiffs hereby demand a trial by jury on all issues so triable. Dated this 4th day of April, 2024. Respectfully submitted, The Law Offices of Grey & Mourin, P.A. Counsel for the Insured 1400 NW 10th Avenue, Ste. RG6 Miami, Florida 33136 Telephone No. (305) 325-8119 Email: eservice@greyandmourin.com Secondary Email: lourdes@greyandmourin.com veronica@greyandmourin.com By:/s/ Lourdes Rodriguez Brea Lourdes Rodriguez Brea Florida Bar No.: 104460 eFiled Lee County Clerk of Courts Page 4 3URSHUW\,QVXUDQFH1RWLFHRI,QWHQWWR,QLWLDWH/LWLJDWLRQ 1RWLFH1XPEHU 1RWLFH$FFHSWHG 30 7KHVXEPLWWHUKHUHE\VWDWHVWKDW7KH3URSHUW\,QVXUDQFH,QWHQWWR,QLWLDWH/LWLJDWLRQ1RWLFHLVSURYLGHGSXUVXDQWWR 6HFWLRQ)ORULGD6WDWXWHV &ODLPDQW ,QVXUHGILOLQJVXLWXQGHUDUHVLGHQWLDORUFRPPHUFLDOLQVXUDQFHSROLF\ 1DPH 6DOOLH%DONXP 6WUHHW$GGUHVV 6RXWKZLQQG%UHH]H&7 &LW\6WDWH=LS )RUW0\HUV)/ (PDLO$GGUHVV \XPH#LFRQFODLPVFRP 3ROLF\1XPEHU ('+ &ODLP1XPEHU (', $WWRUQH\ 1DPH 6WUHHW$GGUHVV &LW\6WDWH=LS (PDLO$GGUHVV )ORULGD%DU )LUP1DPH 5ROHRQ&ODLP )RUP)LOLQJ2QO\ 3XUVXDQWWR6HFWLRQ)ORULGD6WDWXWHVWKH$WWRUQH\ILOLQJWKLV1RWLFHPXVWSURYLGHDFRS\RIWKLV1RWLFHWR WKH&ODLPDQW7KH&ODLPDQW¶VHPDLODGGUHVVLVDUHTXLUHGILHOGDVWKLV1RWLFHZLOOEHWUDQVPLWWHGWRWKH&ODLPDQWXSRQ VXEPLVVLRQ EXHIBIT A ')6 Page: 1 of 2 5HY eFiled Lee County Clerk of Courts Page 5 1RWLFH'HWDLOV ,QVXUHU1DPH (',621,1685$1&(&203$1< 0DNHVXUHWRUHIHUHQFHWKHGHFODUDWLRQVSDJHRQWKHLQVXUDQFHSROLF\WRFRQILUPWKHOHJDOQDPHRIWKHLQVXUDQFH FRPSDQ\,I\RXDUHXQVXUHDERXWWKHFRUUHFWOHJDOQDPHRIWKHXQGHUZULWLQJFRPSDQ\SOHDVHFKHFNZLWKWKH6HFUHWDU\ RI6WDWH'LYLVLRQRI&RUSRUDWLRQVDWZZZVXQEL]RUJRUWKH2IILFHRI,QVXUDQFH5HJXODWLRQZHEVLWHDW ZZZFRPSDQ\VHDUFKP\IORULGDFIRJRYWRVHDUFKIRUDQLQVXUHU¶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age: 2 of 2 5HY eFiled Lee County Clerk of Courts Page 6