Civil Remedy Notice of Insurer Violations
Login

Filing Number:     654871
Filing Accepted:  11/1/2022
         Print Filing
Complainant
Last/Business Name *  
GLOVER   First Name   BARBARA
Street Address * 3302 E. 26TH AVENUE
City, State Zip * TAMPA, FL 33605
Email Address * BARBARAGLOVER40@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GLOVER   First Name   BARBARA
Policy # * 1501-2008-4764 Claim #* FL22-0136274-A322
Attorney
Attorney is Applicable
Last Name* COTTEN First Name * ALEXIS Initial M
Street Address* 2132 CENTRAL AVE
City, State Zip* ST. PETE , FLORIDA 33712
Email Address * ALEXIS@JEEVESLAWGROUP.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):* JEEVES LAW GROUP
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
Unsatisfactory Settlement Offer
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.
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)(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)(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.

A. Loss By Windstorm During A Hurricane With respect to Paragraphs B. and C. below, coverage for loss caused by the peril of windstorm during a hurricane which occurs anywhere in the state of Florida includes loss to: 1. The inside of a building; or 2. The property contained in a building caused by: a. Rain; b. Snow; c. Sleet; d. Hail; e. Sand; or f. Dust; if the direct force of the windstorm damages the building, causing an opening in a roof or wall and the rain, snow, sleet, hail, sand or dust enters through this opening.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On September 28, 2022 a tree fell and crashed into the insured's home. To date the insurer has not tarped the hole in the roof thereby leaving all contents of her home open to the elements. An agent of Universal came out and informed insured the home is no longer safe to live in and has since sent multiple checks but refuses to send a report of their inspection. Universal keeps sending checks that are below her coverage and failing to provide the policy coverages that said checks are to cover.
Comments
User Id Date Added Comment
swhetstone@gspalaw.com 11-18-2022 November 18, 2022 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: Insured: Barbara Glover Claim No.: FL22-0136274-A322 Policy No.: 1501-2008-4764 DFS File No.: 654871 Dear Sir/Madam: Please accept this response to Civil Remedy Notice of Insurer Violations No. 654871 (the “Notice”) on behalf of Universal Property & Casualty Insurance Company (“Universal”). On November 1, 2022, upon information and belief, the Notice was filed by Alexis M. Cotten, Esq. on behalf of Barbara Glover (the “Insured”) against Universal alleging violations of Sections 624.155 and 626.9541, Florida Statutes. Universal denies any and all allegations of violations of Florida law or policy provisions regarding the claim adjudication of this matter. The Notice filed by the Insured generally alleges that Universal did not attempt to settle the claim in good faith and failed to acknowledge and act promptly with respect to the claim. Universal contends that the Notice filed by the Insureds is deficient as a matter of law as it fails to comply with Fla. Stat. §624.155. See 316, Inc. v. Maryland Cas. Ins. Co., 526 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to § 624.155(3)(b), Fla. Stat., the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language, 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 ; 5. a statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In addition to the criteria cited above, the Florida legislature created “Form DFS-10-363”, which is a Civil Remedy Notice form that lays out an additional fifteen (15) requirements: 1. Complainant’s Name; 2. Complainant’s Address; 3. Complainant’s email address; 4. Complainant type (Insured or otherwise) 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s email Address; 11. Type of Insurer (authorized or otherwise) 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & casualty or otherwise); and 15. Reason for Notice. Similar to the five (5) criteria specifically listed in Fla. Stat. § 624.155, the fifteen (15) additional items required by the Department of Financial Services must be correctly stated with specificity in order to satisfy a condition precedent to bringing an action under Fla. Stat. § 624.155. See, Pin-Pon Corp. v. Landmark Am. Ins. Co., 20-CV-14013, 2020 WL 3038576, at * 3-4 (holding that the plaintiff’s Civil Remedy Notice was deficient as a matter of law because the email address listed for the Complainant was the attorney’s email address); Mathurin v. State Farm Mut. Auto Ins, Co., 285 F. Supp. 3d 1311 (M.D. Fla. 2018) (holding that the correct policy number, one of the above listed requirements promulgated by the Florida Department of Financial Services, must be on a Civil Remedy Notice for it to be valid because Fla. Stat. § 624.155 requires a Civil Remedy Notice to have the information required by the Florida Department of Financial Services). To put it simply, a CRN is defective as a matter of law if any of the twenty (20) mandatory items cited above are missing or otherwise incorrect. The Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity, including failing to include the Insurer’s address. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. See Pin Pon, 2020 WL 6588379; Julien v. United Property & Casualty Ins. Co., 2021 WL 824438. With respect to the statutory requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notice generally alleges that Universal violated Fla. Stat. 626.9541(1)(i)(3)(b) by “Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.” However, the Notice does not identify the person or persons who made such misrepresentations. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. As a result, the Complainant failed to comply with the requirements provided in Section 624.155(3)(b)(2), Fla. Stat. Second, it fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. The Notice fails to reference a single individual and Universal is left to guess the individual(s) who are most responsible and/or knowledgeable of the facts giving rise to the allegations in the Notice. In order to comply with the requirements of Fla. Stat. § 624.155, the Insureds must name the individual(s) involved with specificity to allow Universal to properly investigate the allegations. The Notice, as filed, lacks the requisite specificity as provided in Fla. Stat. § 624.155. Thus, the Notice is insufficient as a matter of law. In addition, a demand for a cure is properly limited to the four corners of the policy and thus extra-contractual demands render a Notice insufficient on its face. In fact, the Florida Supreme Court has recognized that a Civil Remedy Notice is invalid if the curative action demands more than the payment of contractual benefits under the insurer’s policy. See, Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Subsequent to Talat, Florida courts, and federal courts applying Florida law, reaffirmed the rule articulated in Talat. See, Do v. Geico Gen. Ins. Co., 1:17-CV-23041-JLK, 2019 WL 331295, at *1 (S.D. Fla. Jan. 25, 2019) (finding that a plaintiff’s Civil Remedy Notice was invalid as a matter of law because the curative actions demanded did not concern payment of contractual benefits owned under the insurer’s policy). The subject policy of insurance, governing statutes, and case law only permit submission of a claim and payment for covered losses. While an insurance company is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. Florida law continually affirms the principle that an insurer has the right to investigate claims presented for payment. An insurance company is expressly afforded an opportunity to evaluate its rights and liabilities. Notwithstanding Universal remains committed to resolving this matter. Very truly yours, GROELLE & SALMON, P.A. /s/ Susan M. Whetstone, Esq. Susan M. Whetstone, Esq. For the Firm cc: Via email only Alexis M. Cotton, Esq. alexis@jeeveslawgroup.com
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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




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