Civil Remedy Notice of Insurer Violations
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Filing Number:     278078
Filing Accepted:  1/30/2015
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Complainant
Last/Business Name *  
JORJA CLARK   First Name   PAT FOURNIER AND
Street Address * 601 SHREVE ST. UNIT 26A
City, State Zip * PUNTA GORDA, FL 33950
Email Address *
Complainant Type: * Insured
Insured
Last/Business Name*   JORJA CLARK   First Name   PAT FOURNIER
Policy # * 1503-1300-2468 Claim #* FL14-0111700
Attorney
Attorney is Applicable
Last Name* KUBIAK First Name * KELLY Initial L
Street Address* 777 S. HARBOUR ISLAND BLVD. SUITE 950
City, State Zip* TAMPA , FLORIDA 33602
Email Address * KKUBIAK@MERLINLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* RYAN PACIFIC, RICHARD COLLINS, TERRY BUCK, SABRINA ABREU, ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNIVERSAL PROPERTY AND CASUALTY INSURANCE COMPANY IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Failure to Acknowledge and Act Promptly to Communications Regarding Claim
Other : Failure to Properly Investigage Claim and with Due Regard to Insured's Interests
Claim Denial
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting 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.
624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
624.155(1)(b)(3) 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.
626.9541(1)(i)(1) Attempting to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

FLORIDA STATUTES VIOLATED (continued) FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED 69B-220.201(3) – Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: 69B-220.201(3)(a) – An adjuster shall: not directly or indirectly refer or steer any claimant needing repairs or other services in connection with a loss to any person with whom the adjuster has an undisclosed financial interest, or who will or is reasonably anticipated to provide the adjuster any direct or indirect compensation for the referral or for any resulting business. 69B-220.201(3)(b) – An adjuster shall treat all claimants equally. 69B-220.201(3)(b)1. – An adjuster shall not provide favored treatment to any claimant. 69B-220.201(3)(b)2. – An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(c) – An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(d) – An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(e) – An adjuster shall handle every adjustment and settlement with honesty, integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. 69B-220.201(3)(f) – An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(g) – An adjuster shall promptly report to the Department any conduct by an unlicensed insurance representative of this state which violates any provision of the Insurance Code or Department rule or order. 69B-220.201(3)(h) – An adjuster shall exercise extraordinary care when dealing with elderly clients to assure that they are not disadvantaged in their claims transactions by failing memory or impaired cognitive processes. 69B-220.201(3)(i) – An adjuster shall not negotiate or effect settlement directly or indirectly with any third-party claimant represented by an attorney, if the adjuster has knowledge of such representation, except with the consent of the attorney. For purposes of this subsection, the term “third-party claimant” does not include the insured or the insured’s resident relatives. 69B-220.201(3)(j) – An adjuster is permitted to interview any witness, or perspective witness, without the consent of opposing counsel or party. In doing so, however, the adjuster shall scrupulously avoid any suggestion calculated to induce a witness to suppress or deviate from the truth, or in any degree affect the witness’s appearance or testimony during deposition or at the trial. If any witness making or giving a signed or recorded statement so requests, the witness hall be given a copy of the statement. 69B-220.201(3)(k) – An adjuster shall not advise a claimant to refrain from seeking legal advice, nor advise against the retention of counsel to protect the claimant’s interest. 69B-220.201(3)(l) – An adjuster shall not attempt to negotiate with or obtain any statement from a claimant or witness at a time that the claimant or witness is, or would reasonably be expected to be, in shock or serious mental or emotional distress as a result of physical, mental, or emotional trauma associated with a loss. The adjuster shall not conclude a settlement when the settlement would be disadvantageous to, or to the detriment of, a claimant who is in the traumatic or distressed state described above. 69B-220.201(3)(m) – An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. An adjuster shall exercise care not to engage in the unlicensed practice of law as prescribed by the Florida Bar. 69B-220.201(3)(n) – A company or independent adjuster shall not draft special releases called for by unusual circumstances of any settlement or otherwise draft any form of release, unless advance written approval by the insurer can be demonstrated to the Department. Except as provided above, a company or independent adjuster is permitted only to fill in the blanks in a release form approved by the insurer they represent. 69B-220.201(3)(o) – An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. 69B-220.201(3)(p) – No person shall, as a public adjuster, represent any person or entity whose claim the adjuster has previously adjusted while acting as an adjuster representing any insurer or independent adjusting firm. No person shall, as a company or independent adjuster, represent him – or herself or any insurer or independent adjusting firm against any person or entity that the adjuster previously represented as a public adjuster. 69B-220.201(3)(q) – A public adjuster shall not represent or imply to any client or potential client that insurers, company adjusters, or independent adjusters routinely attempt to, or do in fact, deprive claimants of their full rights under an insurance policy. No insurer, independent adjuster, or company adjuster shall represent or imply to any claimant that public adjusters are unscrupulous, or that engaging a public adjuster will delay or have other adverse effect upon settlement of a claim. 69B-220.201(3)(r) – No public adjuster, while so licensed in the Department’s records, may represent or act as a company adjuster, independent adjuster, or general lines agent. 69B-220.201(3)(s) – A company adjuster, independent adjuster, attorney, investigator, or other person acting on behalf of an insurer that needs access to an insured or claimant or to the insured property that is the subject of a claim shall provide at least 48 hours notice to the insured or claimant prior to scheduling a meeting with the claimant or an on-site inspection of the insured property. The insured or claimant may deny access to the property if this notice has not been provided. RELEVANT POLICY LANGUAGE Specific policy language that is relevant to the violations include, but are not limited to, the following: See Subject Policy: UNIVERSAL PROPERTY AND CASUALTY INSURANCE COMPANY Policy No: 1503-1300-2468 Section I- Property Coverage - Coverage A – Dwelling Section I- Property Coverage - Coverage C – Personal Property Section I- Property Coverage – Coverage D – Loss of Use Section I- Perils Insured Against Unit-Owners Coverage A – Special Coverage Form All Additional Coverage provisions All Coverage(s) provided by Endorsement or Rider The Declarations Page Loss Payment or Settlement provision Personal Property Replacement Cost – Section I Duties in Event of Loss Policy provision The insurance policy's definition section The insurance policy's exclusion of coverage provisions All insurance policy provisions that provide coverage to the insured property All policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

1) failure to pay claim in full; 2) failure to promptly investigate claim; 3) failure to properly investigate claim; 4) failure to adjust loss; 5) failure to act in due diligence and good faith to resolve claim; 6) placing financial interest of insurer before that of policy holders and claimants; 7) failure to properly train, evaluate and manage adjusters; 8) looking for ways to deny coverage, pay less, delay payment and otherwise “low ball” or “stone wall” claim; 9) the reasons for this may be attributed to improper training, supervision, and/or motivation of adjusters and claims supervisors to promptly and fairly investigate, adjust and pay full benefits available to all beneficiaries. the insurer may have failed to adopt proper standards of investigation and adjustment of losses, or is otherwise not implementing those standards because full payment and prompt payment for the loss is not occurring. In Florida, the work of adjusting insurance claims engages the Public Trust. UNIVERSAL PROPERTY AND CASUALTY INSURANCE COMPANY (“UNIVERSAL”) has breached this duty by its adjustment of the Insureds’ claim of loss. UNIVERSAL has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations as set forth above. UNIVERSAL has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s insurance claim for damages. To date, notwithstanding the Insured’s pleas for assistance, UNIVERSAL has refused to acknowledge and pay the full amount of its Insured’s claim. This complaint is made on behalf of PAT FOURNIER AND JORJA CLARK (“THE INSUREDS”). In consideration of the premium paid to it by THE INSUREDS, UNIVERSAL issued a Homeowner’s Insurance Policy, Policy No. 1503-1300-2468 (“the Policy”). On or around August 8, 2014, while the Policy was in full force and effect, THE INSUREDS suffered a water loss at their insured property located at 601 SHREVE ST. BLDG. 2 UNIT 2A PUNTA GORDA, FL 33950 (“the Property”). The direct physical loss and ensuing loss to the INSUREDS’ Property and personal property caused by the subject water loss was sudden and accidental, and therefore, a covered peril under the Policy. THE INSUREDS timely reported their loss to UNIVERSAL. UNIVERSAL had its Claims Department open a claim and assigned claim number FL14-0111700 to THE INSUREDS’ loss. THE INSUREDS did what they could to mitigate the damages to the Property, allowed UNIVERSAL to inspect the Property on multiple occasions and complied with all other applicable duties after loss as set forth in the Policy. THE INSUREDS retained The WrightWay/Reynolds Ventures, Inc. (“WrightWay”) to perform both Emergency Mitigation and Mold Mitigation Service at the Property. WrightWay provided a mold remediation estimate for a total amount of $9,856.36, $8,760.52 for the Dwelling and $1,095.84 for the Contents. WrightWay also provided a separate emergency water remediation estimate in the amount of $9,681.74 for the Dwelling and $2,261.22 for the Contents. In a letter dated September 2, 2014, UNIVERSAL advised THE INSUREDS that “the Mold Mitigation/Emergency Mitigation Service (EMS) estimates submitted by your contractor, The WrightWay/Reynolds Ventures Inc. revealed that the total charges of $19,011.08 are in excess of the policy mold sub-limit of $10,000.00. However, we are allocating a total of $10,000.00 to address the invoices for the services rendered in which the draft will need to be endorsed by both you and your contractor.” In a subsequent letter dated September 12, 2014, UNIVERSAL notified THE INSUREDS that it was issuing four drafts for the undisputed amounts of their claim: $17,429.47 (re-build), $2,261.22 (contents storage), $641.99 (damaged contents), and $367.16 (contents cleaning). The total amount equaled $20,699.84. UNIVERSAL’S payment for the undisputed damage to THE INSURED’S property was based on its adjuster’s repair estimate in the amount of $28,508.88 (less $2,068.33 in recoverable depreciation, $8,011.08 for “excess of policy limit/sub-limit,” and the Policy’s $1,000.00 deductible) for damage to the Dwelling under Coverage A of the Policy and $3,270.37 repair estimate for damage to the contents under Coverage C of the Policy. UNIVERSAL excluded from its adjuster’s repair estimate any damages to the Property’s drywall, concrete foundation, plumbing, HVAC system or anything within the wall cavity area and took the position that any such damage would have to be paid by THE INSURED’S Condominium Association. Subsequently, THE INSUREDS retained Advantage Public Adjustors, INC., (“Advantage”) to assist with the handling of their claim. Advantage performed an inspection of the property to determine the necessary repairs needed to place THE INSUREDS back to their pre-loss condition. In its initial estimate dated October 9, 2014, Advantage’s concluded THE INSUREDS’ dwelling sustained $41,661.41 in damage as a result of the covered loss. Advantage further provided UNIVERSAL with personal property inventory forms that estimated the damage to THE INSUREDS’ contents to initially total $10,980.42. Advantage had also asked UNIVERSAL to explain the reason it combined WrightWay’s charges for Emergency Mitigation Services/water extraction with WrightWay’s separate charges for Mold Mitigation and applied the entire amount to the Policy’s mold $10,000.00 sub-limit. As a result of the subject loss, THE INSUREDS have also incurred additional living expenses while trying to resolve their claim with UNIVERSAL. In a letter dated October 16, 2014, THE INSUREDS submitted to UNIVERSAL documentation to support their claim for reimbursement for additional living expenses. Such expenses include, but are not limited to: THE INSUREDS having to rent a house because their unit was unlivable, and the total for the rental was $1,375.00. THE INSUREDS have returned to Florida two different times since the subject loss and since their kitchen was completely removed they had to eat some meals away from the unit. The total for ALE meals is $494.12. There is also the extra cost to THE INSUREDS’ electric bill from all of the restoration/remediation work that was done by Wright Way, and the total for electric bill ALE is $ 148.41. The overall total for additional living expenses initially submitted to UNIVERSAL totaled $ 2,017.53. However, these additional living expenses have increased since October, and will likely continue to increase, and despite UNIVERSAL being provided with a breakdown of THE INSUREDS additional living expenses UNIVERSAL has failed to pay any expenses incurred by THE INSUREDS. UNIVERSAL has acknowledged that THE INSUREDS have sustained covered damages, but yet refuses to provide THE INSUREDS with all the insurance benefits due and owing, despite knowing that THE INSUREDS have damages that far exceed the insurance benefits paid to date. UNIVERSAL has failed to pay for the full amount due and owing to THE INSUREDS for their loss. THE INSUREDS have provided UNIVERSAL with an accurate repair estimate and emergency services estimate relating to the subject loss. The repair estimates provided to UNIVERSAL and the facts that have been made known to UNIVERSAL since the date of the subject loss clearly demonstrate that UNIVERSAL has grossly undervalued the cost to repair THE INSUREDS’ Property. UNIVERSAL has not been working with THE INSUREDS to timely resolve their claim, and this is evidenced by UNIVERSAL’S delay in paying the claim. In addition, there are several instances where THE INSUREDS and Advantage have attempted to contact UNIVERSAL to find out the status of the claim but many of their calls were not returned or it took several attempts to reach someone at UNIVERSAL. To date, despite THE INSUREDS’ repeated pleas, UNIVERSAL has not tendered the full amount needed to repair the Property. As UNIVERSAL must admit, it is implied within every insurance policy a duty of good faith and fair dealings. In an insurance contract, each party is prevented from interfering with the other’s right to benefit from the contract. The obligations of good faith and fair dealings encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. UNIVERSAL is bound to conduct itself with the utmost good faith for the benefit of THE INSUREDS. However, UNIVERSAL has failed to comply with the obligations in connection with this claim and has never looked at the claim or the contract for insurance with good faith and fair dealing. Instead, UNIVERSAL has looked for ways not to pay the claim in full and these actions have been to the detriment of THE INSUREDS. The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of UNIVERSAL have approached this investigation in a manner prejudicial to its Insureds. UNIVERSAL is using either untrained or improperly trained adjusters in connection with this claim. UNIVERSAL should have been adjusting the loss with its Insureds but instead, it was looking for ways not to pay the claim at all or pay the claim in full. If UNIVERSAL handles all the claims in the manner in which THE INSUREDS’ claim was adjusted then it is improperly handling all claims. UNIVERSAL’S conduct has been reckless and unfair to THE INSUREDS, and has caused and continues to cause additional damages throughout the property. This is evidenced by the delay in paying the claim and the failure of UNIVERSAL to evaluate the claim in total. UNIVERSAL has refused and/or failed to cooperate and/or “Adjust the Loss” by cooperating with THE INSUREDS during the claims adjustment process in compliance with The Policy’s “Loss Payment” provision. This is a breach of The Policy. UNIVERSAL has a contractual obligation to make a perfunctory investigation, not ignoring evidence that would support THE INSUREDS’ claim. This is a breach of The Policy. UNIVERSAL has a contractual obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. This is a breach of The Policy. The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the Insureds may mitigate their damages and to put them back into the position they were in prior to the loss as quickly as possible. UNIVERSAL has breached this duty. UNIVERSAL has refused and/or failed to tender all insurance proceeds to THE INSUREDS upon demand. UNIVERSAL’S refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the Insured is wrongful conduct. Furthermore, THE INSUREDS contend that UNIVERSAL’S adjusters and/or representatives financially benefit by such wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, UNIVERSAL must: Create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and to avoid this from occurring in the future; UNIVERSAL must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims, and for the training and supervision of employees with regard to these types of claims to ensure UNIVERSAL’S claims handling procedures with regard to these types of losses are adequate to stop further Insureds from being treated unfairly and wrongfully; UNIVERSAL must assist THE INSUREDS in mitigating their damages; UNIVERSAL must pay THE INSUREDS the full amount of the additional living expenses submitted by the INSUREDS pursuant to the relevant policy provisions and coverage provided therein; UNIVERSAL must agree to pay THE INSUREDS the full amount of any subsequent additional living expenses incurred by the INSUREDS to date pursuant to the relevant policy provisions and coverage provided therein; UNIVERSAL must act fairly and honestly towards the Insured and with due regard for their interests in attempting to settle THE INSUREDS’ claim; UNIVERSAL must immediately tender all insurance monies due and owing to THE INSUREDS that would reasonably place THE INSUREDS back to their pre-loss condition pursuant to the relevant policy provisions and coverage provided therein; and UNIVERSAL must pay THE INSUREDS the fair value of their insurance claim, including, but not limited to – any repair costs incurred by the insured; any emergency remediation expenses incurred by the insured; and the full amount of THE INSUREDS repair estimate(s) provided to UNIVERSAL with respect to the loss.
Comments
User Id Date Added Comment
ksanchez@waltonlantaff.com 03-30-2015 WALTON LANTAFF SCHROEDER & CARSON LLP ATTORNEYS AT LAW (A LIMITED LIABILITY PARTNERSHIP INCLUDING PROFESSIONAL ASSOCIATIONS) MIAMI ? FORT LAUDERDALE ? WEST PALM BEACH ? TAMPA TALLAHASSEE ? ORLANDO ? PENSACOLA -ESTABLISHED 1934- 9350 FINANCIAL CENTRE, 10TH FLOOR 9350 SOUTH DIXIE HIGHWAY MIAMI, FLORIDA 33156 _________________ TELEPHONE: 305-671-1300 FACSIMILE: 305-670-7065 DIRECT LINE: (305) 671-1341 E-MAIL ADDRESS: sdevendorf@waltonlantaff.com March 30, 2015 ***VIA E- FILE*** Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, FL 32399-0322 RE: Insureds : Pat Fournier & Jorja Clark Date of Loss : 08/08/14 Policy No. : 1503-1300-2468 Claim No. : FL14-0111700 DFS File No. : 278078 Our File No. : 0316-01081 Dear Sir/Madam: This office has been retained by Universal Property & Casualty Insurance Company (hereinafter “Universal”) to file a response to the above captioned Civil Remedy Notice (CRN) filed by Pat Fournier and Jorja Clark (hereinafter “Insureds”) on January 30, 2015. The CRN filed by the Insureds generally alleges that Universal did not attempt to settle the claim in good faith, and it engaged in unfair claim settlement practices. In addition, the CRN alleges that Universal violated essentially every provision of Fla. Admin. Code 69B-220.201(3) which addresses the ethical requirements of adjusters. Please refer to the CRN for a more detailed recitation of the specific statutory provisions cited in the CRN. The Insureds state that the reason for the CRN is due to the following: claim delay; unsatisfactory settlement offer; unfair trade practices; failure to acknowledge and act promptly to communications regarding claim; failure to properly investigate claim and with due regard to the Insureds’ interests; and claim denial. However, the allegations contained in the CRN do little to place Universal on notice of the alleged violations. Notwithstanding the failure to provide sufficient information to properly place Universal on notice of the alleged violations, Universal denies any and all allegations of violations of Florida law or policy provisions regarding the claim adjustment of this matter. It is Universal’s position that the CRN filed by the Insureds is deficient as a matter of law as it fails to comply with § 624.155, Fla. Stat. Section 624.155(3)(b), Fla. Stat., provides in pertinent part: The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. 2. The facts and circumstances giving rise to the violation. 3. The name of any individual involved in the violation. 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. § 624.155(3)(b), Fla. Stat. The CRN does not contain the information as required by statute (specifically sections 2, 3, and 4 above). First and foremost, the Notice fails with respect to the Insureds’ obligation to set forth with specificity the “facts and circumstances giving rise to the violation.” The Notice asserts general allegations consisting of little more than conclusory statements and complaints that the Insureds have not been paid all of the monies they are seeking. The statement of facts falls short of the specificity required by Fla. Stat. § 624.155. The CRN did not explain how Universal violated the statutory provisions. It also did not specify the amount of damages at issue. A written notice which is vague and “shotgun” in nature or is written in general terms fails the specificity requirement of the statute. See Heritage Corp. of South Fla. v. National Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008); 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193; Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. 2010); Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). Thus, the Notice is insufficient as a matter of law. Second, the Notice fails to satisfy § 624.155(3)(b)(3) in that it fails to state what violations were committed by the individuals allegedly involved in the violations. Simply listing the names of individuals with out more does nothing to place Universal on notice of any alleged violations. Third, the Notice fails to satisfy Fla. Stat. § 624.155(3)(b)(4) with respect to the requirement to reference the specific policy language that is relevant to the violation. The Notice filed by the Insureds does not reference any specific policy language. It merely makes vague references to various headings of different sections of the policy. In light of its failure to reference specific policy language relevant to the alleged violation, the Notice lacks the specificity required by 624.155(3)(b)(4) and is insufficient as a matter of law. Nonetheless, Universal Property and Casualty Insurance Company denies any bad faith claims handling in connection with the above referenced matter. Furthermore, Universal denies that it violated any of the terms and conditions of the policy, including but not limited to, those identified by the Insureds in the CRN section titled Reason for Notice, and denies any other allegations, acts, omissions, or statutory or ethical violations as may be set forth in the CRN. Universal rejects the Insureds’ assertions that it acted in bad faith or otherwise failed to act properly in the manner in which it has adjusted this claim. The following discussion of the claim will provide you with the accurate facts and circumstances regarding this matter and shall demonstrate that Universal has not violated any Policy or statutory provisions. Universal issued policy number 1503-1300-2468 with a policy period of January 29, 2014 through January 29, 2014 to the Insureds for the property located at 601 Shreve Street, Apt. 26A, Punta Gorda, Florida 33950, subject to all terms, conditions, limitations, and exclusions, and applicable Florida law. On August 8, 2014, the Insureds’ agent reported a water loss at the insured risk that occurred on August 8, 2014. The source of the water was unknown. Universal retained Coastal Adjustment Services, Inc. to adjust the claim, and Richard Collins was assigned as the adjuster. Mr. Collins inspected the risk on August 12, 2014. Mr. Collins spoke with a representative of the Banyan Point Condominium Association and was advised that the water loss was caused by a backup of sewage from a common drain line shared by three units. The association hired a plumber who discovered a large deposit of grease in a common drain line. During his inspection, Mr. Collins observed water damage in the kitchen, living room, entry, entry closet, and the master bathroom. Mr. Collins noted that the Insured had hired Henry Plumbing for emergency services to prevent further damage, and he had hired The Wright Way/Reynolds Ventures, Inc. (Wright Way) to perform emergency mitigation services related to mold. He also noted that Wright Way had hired a mold testing company, which prepared a mold report. Mr. Collins also documented damages to the contents inside the risk. He noted water damage to a wood buffet table in the dining room, and he was given a personal property inventory form which included various contents. On August 29, 2014, Mr. Collins issued a report to Universal estimating net damages of $20,699.84, after taking deductions for the deductible, recoverable depreciation, and mold limits. Mr. Collins prepared an estimate of the damages which included, but was not limited to, the following: general: payment of EMS invoice from Wright Way; payment of mold remediation invoice from Wright Way; trash removal; and cleaning; living/dining room: remove and replace textured wall surface and re-paint; and remove and replace base molding; kitchen: remove and replace select cabinets; re-facing select cabinets; remove and replace textured wall surface and re-paint; remove and replace base molding; and remove and reset appliances; entry hall: remove and replace base molding; and paint doors; master bath: remove and replace wall paper; remove and replace base molding; paint doors; and reset fixtures; entry closet: remove and replace base molding; remove and replace texture walls and re-paint; and paint doors; and contents: CRDN invoice; contents storage; and replacement of wood buffet. On September 2, 2014, Universal sent the Insureds a letter indicating that the mold mitigation/emergency mitigation services were in excess of the policy’s mold sub-limit of $10,000.00, but Universal would be allocating the $10,000.00 to address the invoices for the services that had been rendered by Wright Way. The letter also advised the Insureds that there were certain areas of the condominium unit, such as drywall, the concrete foundation, plumbing, the HVAC system, and the areas inside the wall cavity that were the responsibility of the condominium association. On September 3, 2014, Universal sent the Insureds a letter enclosing a sworn statement of proof of loss in the amount of $20,699.84. Universal advised that payment would be issued within 10 business days of the receipt of the executed proof of loss. On September 8, 2014, the Insureds retained Paul J. Konigs, a public adjuster with Advantage Public Adjusters, Inc. On September 12, 2014, Universal sent Mr. Konigs a letter enclosing four separate payment drafts for the undisputed amount. The drafts included $17,429.47 for re-building, $2,261.22 for contents, $641.99 for damaged contents, and $367.16 for cleaning the contents. On September 15, 2014, Mr. Collins conducted an inspection of the contents located at The Wright Way drying warehouse with the Insureds. His inspection revealed the following: no signs of water damage to the microwave; no signs of damage to the refrigerator, or range that were attributable to the loss; crack in Corian counter-top back splash, which was repairable; broken seam in counter top; possible rust damage to legs of screen; damage to veneer of wood chest; bottom of dishwasher showed signs of possible contact with black water; no damage to metal or upholstery of reclining couch, but light rust noted on one corner, and small stain on another section; and long term rust on stove not attributable to loss. On October 2, 2014, Mr. Collins sent a 10-day letter to Mr. Konigs requesting that a written estimate, and a personal property inventory form regarding the claimed water damaged contents be provided within 10 days. On October 9, 2014, Mr. Konigs submitted an estimate of the damages to Mr. Collins in the amount of $41,061.72 for damages under Coverage A and $599.69 for damages under Coverage C. The estimate included, but was not limited to, the following: entry/hallway: application of textured drywall; remove and replace base boards; painting; and related costs associated with repairs; kitchen: application of textured drywall; remove and replace base boards; remove and replace upper and lower cabinets; remove and replace countertop and backsplash; remove and replace dishwasher due to blackwater contamination; remove and replace range due to blackwater contamination; remove and replace garbage disposal; painting; and related costs associated with repairs; living room/dining room: application of textured drywall; remove and replace base boards; painting; and related costs associated with repairs; guest bedroom: remove and replace carpet; paint baseboards; and related costs associated with repairs; master bedroom: remove and replace carpet; paint baseboards; and related costs associated with repairs; master bath: remove and replace baseboards; painting; and related costs associated with repairs; miscellaneous: permits and fees; trash removal; and revised mold remediation invoices. On October 13, 2014, Mr. Konigs submitted the Insureds’ personal property inventory form. The form listed $10,980.42 in contents. The contents list included many items that could be cleaned, such as metal utensils, as well as items that were improperly discarded by Wright Way. On October 29, 2014, Mr. Konigs submitted receipts to Mr. Collins in support the Insureds’ claim for additional living expenses. The total claim was $2,017.53. The claim included $1,275.00 for a short term rental unit from August 8, 2014 to August 15, 2014; $125.00 cleaning fee for rental; $494.12 for meals; and $148.41 for an increase in his electrical bill for the billing period from August 12, 2014 to September 11, 2014 due to the restoration/remediation work being done at the risk by Wright Way. Mr. Collins noted that the short term rental was a four bedroom house, which was an upgrade from the risk, which was a two bedroom, two bath condominium. On October 29, 2014, Mr. Collins prepared a supplemental report to Universal. Mr. Collins indicated that Wright Way had provided him with a revised emergency mitigation services invoice for services at the risk related to mold in the amount of $7,572.32. The invoice included, but was not limited to, the following: removal of base moldings in kitchen, living/dining room, and entry closet; removal of countertops, and base cabinets; and setting up dehumidifiers and fans/air scrubbers. Wright Way had also provided a revised mold remediation estimate in the amount of $11,003.60. The estimate included, but was not limited to, the following: cleaning ceilings, walls, and floors; cleaning ductwork; and setting up dehumidifiers and fans/air scrubbers. The total of the two estimates was $18,575.92. In addition, Mr. Collins reviewed the estimate submitted by Mr. Konigs. He noted that the estimate included several items that should have not been included. These items included, but were not limited to, the following: removal of base moldings that had already been included in the EMS estimate; removal and replacement of undamaged upper cabinets that can be refaced to match new base cabinets; replacement of water filter system, and garbage disposal that were not damaged in the loss; removal and replacement of base cabinets and countertops that had been included in the revised EMS estimate; removal and replacement of carpet in guest bedroom and master bedroom, although there was no documented damage in those areas; and cleaning of tile flooring that was included in the mold remediation process. He also noted that the Insureds had not returned the signed and dated additional living expenses form. Mr. Collins prepared a supplemental estimate for damages under Coverage A in the net amount of $1,189.74. The supplemental estimate included re-grouting in the entry, living/dining room, guest bathroom, master bathroom, and kitchen. His supplemental estimate for damages under Coverage C was in the net amount of $818.22. He noted that the area rugs could not be inspected because they were not at the storage facility. He also noted that the Insureds had claimed many items on the personal property inventory form that could be cleaned and there were other contents that were not directly damaged by sewage or water. He also noted that the Insureds had submitted a reimbursement request for a screen that was much nicer that the one that had been damaged. On October 30, 2014, Universal sent a letter to the Insureds acknowledging receipt of the estimate that was submitted on their behalf. The letter noted that the claim was under review. On December 11, 2014, Universal issued payment of $7,572.32 for the Wright Way EMS invoice, and $8,760.52 for the Wright Way mold remediation estimate. On February 2, 2015, Universal received the CRN, and on February 3, 2015, it was served with a one count Complaint for breach of contract. For the reasons set forth above, the allegations contained in the Insureds’ CRN are wholly without merit. Universal promptly paid all covered damages sustained by the Insureds. Upon the Insureds’ request for a re-assessment of the claim, the Insurer promptly proceeded to re-assess the claim, and upon re-assessment, issued supplemental payments for additional damages under Coverage A, and Coverage C. Moreover, upon further investigation of the revised EMS invoice, and the revised mold remediation estimate from Wright Way, and negotiating the EMS invoice, Universal issued full payment to Wright Way for the invoices. The Insurer paid for the vast majority of work claimed by the Insureds’ public adjuster. Universal reiterates that it specifically denies any bad faith claims in the handling of this matter. To the contrary, Universal has properly and promptly investigated the claim, assessed the Insureds’ covered damages, and otherwise complied with all applicable policy provisions and Florida law. This matter appears to have been a bona fide dispute between Universal and the Insureds regarding coverage and the extent and value of the related damages. Universal is of the position that it promptly and timely provided the Insureds with multiple inspections of the property, conducted a thorough investigation, and acted in good faith in the adjustment of the claim. Universal was promptly willing to re-assess prior decisions on the claim numerous times and, upon learning of additional damages, promptly paid the same. Furthermore, Universal is of the position that the issues contained within the CRN are cured as a result of Universal’s actions as described herein. Universal Property and Casualty Insurance Company does not intend, by this response or any aspect of the investigation of this claim, to waive any defenses, rights or terms and conditions of the dwelling policy and/or the Florida Statutes. We trust that this correspondence will serve as a suitable response to the Civil Remedy Notice. If, however, you need additional information or require an additional response, please do not hesitate to contact the undersigned. Very truly yours, / S / Shawn E. Devendorf SED/kms cc: Kelly Kubiak, Esq. Todd Brant, Esq.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008