Civil Remedy Notice of Insurer Violations
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Filing Number:     657083
Filing Accepted:  11/15/2022
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Complainant
Last/Business Name *  
GIANNINI   First Name   LEO AND STEPHANIE
Street Address * 391 OCEAN FOREST DRIVE
City, State Zip * SAINT AUGUSTINE, FL 32080
Email Address * STEPHEN@DIFATOLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GIANNINI   First Name   LEO AND STEPHANIE
Policy # * EDH5329209-00 Claim #* EDI944604
Attorney
Attorney is Applicable
Last Name* DIFATO First Name * STEPHEN Initial
Street Address* 164 PINEHURST POINTE DRIVE
City, State Zip* ST. AUGUSTINE , FLORIDA 32092
Email Address * STEPHEN@DIFATOLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   EDISON INSURANCE COMPANY
NAIC Company Code 12482
 
Name of individual responsible for violation (if any):* EDISON CLAIMS DEPARTMENT, SUPERVISORS, MANAGEMENT, AGENTS, AND ADJUSTERS, INCLUDING ANY AND ALL REPRESENTATIVES.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
* 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.
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)(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)(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.

Coverage A – Dwelling: Insurer is required to cover damage incurred by an insured event to the Insured’s dwelling. Insured is required to cover damage that Insured has claim coverage for. ***ADDITIONAL STATUTORY PROVISIONS ALLEGED TO HAVE BEEN VIOLATED ARE AS FOLLOWS:*** §624.155(1)(B)(1) Any person may bring a civil action against an insurer when such person is damaged: By the commission of any of the following acts by the insurer: 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 towards its insured and with due regard for his interests; 2. Making claims payments to insures or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made; or 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. §624.155 (5) No punitive damages shall be awarded under this section unless the acts giving rise to the violation occur with such frequency as to indicate a general business practice and these acts are: (a) Willful, wanton, and malicious; (b) In reckless disregard for the rights of any insured; or (c) In reckless disregard for the rights of a beneficiary under a life insurance contract; (8) The damages recoverable pursuant to this section shall include those damages which are a reasonably foreseeable result of a specified violation of this section by the authorized insurer and may include an award or judgment in an amount that exceeds the policy limits. §627.70131 Insurer’s duty to acknowledge communications regarding claims; investigation (1)(a) Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgement. If the acknowledgement is not in writing, a notification indicating acknowledgement shall be made in the insurer’s claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. (b) As used in this subsection, the term “agent” means any person to whom an insurer has granted authority or responsibility to receive or make such communications with respect to claims on behalf of the insurer. (c) This subsection shall not apply to claimants represented by counsel beyond those communications necessary to provide forms and instructions. (2) Such acknowledgement shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgement reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgement shall provide necessary claim forms, and instructions, including an appropriate telephone number. (3) Unless otherwise provided by the policy of insurance or by law, within 10 working days after an insurer receives proof of loss statements, the insurer shall begin such investigation as is reasonably necessary unless the failure to begin such investigation is caused by factors beyond the control of the insurer which reasonably prevent the commencement of such investigation. (4) For purposes of this section, the term “insurer” means any residential property insurer. (5) Within 90 days after an insurer receives notice of a property insurance claim from a policyholder, the insurer shall pay or deny such claim unless the failure to pay such claim is caused by factors beyond the control of the insurer which reasonably prevent such payment. Failure to comply with this subsection constitutes a violation of this code §626.9541(i) Unfair Claim Settlement Practices Reference policy language that is relevant to violation: the insuring agreement in the Policy, which provides coverage to the insured dwelling for damage that occurred during the Policy period and there are no applicable exclusions that would preclude coverage, despite the insurer’s potential position to the contrary. Without a full copy of the subject Policy, we have been forced to base our assessment on the information provided under the Declaration Pages and claim decision documents that happened to be in the possession of the Insured.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insurer issued an insurance policy (the “Policy”) to the Insured protecting the Insured’s property listed in this Civil Remedy Notice (the “Property”). When an insurance company in Florida issues an insurance policy, it promises to provide financial security and public trust in the event of covered damages, in this case the Insured’s Dwelling under the Policy. When a covered loss occurs, the insurance company’s obligation under its promise to pay is triggered. The policyholder is completely dependent on performance by the insurance company when they are at their most vulnerable position. Therefore, the insurance company’s chief task should be to seek and find coverage, not to seek and find coverage controversies or to delay, deny, dispute or underpay claims. Trusting that the Insurer would act in good faith under their promise to pay, the Insured submitted a claim for damage due to a storm that hit the Insured’s Property. The Insured submitted claim for damage to Insured’s roof due to wind damage. The Insurer conducted an investigation of the loss and has wrongfully accounted for all of the damages to the Property, thus partially denying the claim. The Insurer’s report stated there was damage to the roof but it was repairable. The Insurer’s duty is to place the Insured in a pre-loss condition. In this case the Insurer is attempting to repair the roof when it’s not repairable. The Insurer is attempting to repair the roof but the Insurer is unable to match new shingles to the current roof, the roof is brittle and unrepairable, and attempting to repair the roof will cause more damage that benefit. The standard for a brittle test is that the shingle must be able to be lifted ninety degrees in order for a nail gun to nail in the new, replacement, shingle. That is impossible here as the shingles, and roof as a whole, have failed the brittle test. Due to a brittle test failure, a repair would create a ripple effect, destroying the whole roof. Further, by mismatching the shingles, the Insurer will not be placed at pre-loss condition but rather in a condition that makes the Insured’s roof look like a spotted dog – spots and repairs all over creating creases surrounding the shingles. That’s at the very least three shingles damaged per repair. That’s three shingles damaged with a mis-colored shingle at the center – sticking out like a sore thumb. The Insured would then have to fix those newly damaged shingles; thus the Insurer is placing the Insured in a very tough position because the Insurer is requiring a repair that will destroy the entirety of the roof. The Insurer has tried to defer damages to “wear and tear” but the reality is that the damages are due to a covered loss. On top of that, even if some damage were due to “wear and tear” it is of no consequence due to the court ruling in Sebo v. American Home Assurance Co. In the Sebo v. American Home Assurance Co. case the court ruled that when there are covered damages, it does not matter that there are also “wear and tear” damages. The coinciding damages, covered or not, under the policy are both covered in their entirety. It is clear that the Insurer has failed to adopt and implement proper standards for investigation, evaluation, and adjustment of claims; has failed to properly train, manage, supervise and promote claims adjusters so that the policyholder receives good faith, fair, prompt adjustment of claim, service and indemnity; has failed to conduct a full and fair investigation of the claim and has failed to provide full reasons and facts to the claimant for partial denial of the claim resulting in statutory violations as set forth in this notice. Moreover, the Insurer has engaged in unfair claim partial denial; has used business or outcome oriented investigations and experts to determine the outcome of the claim; has looked for ways to partially deny coverage and otherwise “stonewall” the claim; and has used secret claims practices to reduce claim severity and profit from wrongful claims practices. Clearly the Insurer has failed to perform an adequate investigation of the claim that would provide an accurate assessment of the total damages suffered by the Insured in relation to the reported loss. Rather than issuing the proper payments, the Insurer has wrongfully provided insufficient payment for the claim, failed to account for all damages, failed to assess the damage correctly or fairly, and failed to extend monies on coverages that are owed. These tactics are believed to be a business practice of this Insurer. To cure the defects outlined in the Civil Remedy Notice, the Insurer must admit full coverage for the loss which include the full replacement and repair of the Insured’s roof, tender payment for all contractual damages owed, interest on the delayed payment, and attorneys’ fees. The Insurer has wrongfully provided insufficient payment for the Insured’s entire claim without a reasonable explanation for doing so. Consequently, the amount of money provided to the Insured was insufficient to restore the property to its pre-loss condition while making the necessary repairs covered under the policy.
Comments
User Id Date Added Comment
jbosch@qpwblaw.com 01-11-2023 VIA ELECTRONIC SUBMISSION: civilremedy@myfloridacfo.com Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Leo and Stephanie Giannini (“Complainant[s]” or “Insured[s]”) Claim No: EDI944604 (“Subject Claim”) Policy No: EDH5329209-00 (“Policy”) Loss Location: 391 Ocean Forest Dr, St Augustine, FL 32080 (“Property”) CRN Filing No: 657083 CRN Acceptance Date: 11/15/2022 RE: CIVIL REMEDY NOTICE - DFS FILING NUMBER 657083 Dear Sir or Madam: The undersigned counsel represents Edison Insurance Company (“Edison”) in regard to the alleged dispute as to Subject Claim number EDI944604 involving a plumbing leak with a date of loss of July 14, 2021, made under the Policy of insurance Edison issued the Insureds bearing the number EDH5329209-00. This correspondence constitutes Edison Insurance Company’s response to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) filed on behalf of Leo and Stephanie Giannini regarding the claim listed above. This Civil Remedy Notice should be rejected and returned by the Department of Financial Services as it completely misstates the facts surrounding this claim. The Complainants have alleged violations of various statutory provisions in CRN filing number 657083. Specifically, the Complainants allege violations of the following statutory provisions: ALLEGED STATUTORY VIOLATIONS 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. Edison specifically denies the Insureds’ allegation that it has violated the above referenced statute. Edison did not violate these provisions. Edison conducted a thorough investigation in good faith and found that the loss was under the deductible. There was no obligation to issue payment under any policy provision. However, the parties attended mediation and Edison later sent correspondence with a good faith attempt to settle. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. Edison consistently communicated with the Insureds and their representatives via phone, email and formal correspondence. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. Edison conducted a thorough, complete, comprehensive investigation. 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the Insureds 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. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. Edison sent detailed correspondence as outlined below. 626.9541(1)(i)(3)(g): Failing to promptly notify the Insureds of any additional information necessary for the processing of a claim. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. 626.9541(1)(i)(3)(i): Unfair claim settlement practices. Edison specifically denies the Complainants’ allegation that it has violated the above referenced statute. In addition to the allegations specifically denied above, Edison generally denies all allegations presented in this CRN, as Edison has not violated any statute, Code or Rule. SPECIFICITY REQUIREMENTS Florida Statute requires that a CRN state the facts and circumstances giving rise to the alleged violations with specificity sufficient to allow an insurer to “cure” the alleged violations within the sixty-day statutory period. See Fla. Stat. § 624. 155(3)(b)(2). See also Lane v. Westfield Ins. Co., 862 So. 2d 774, 777 (Fla. 5th DCA 2003), Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). However, here, the CRN is deficient and defective in that it fails to state with sufficient specificity the necessary facts in support of the Insureds’ contentions, including but not limited to, those that would be necessary for Edison to “cure” the alleged violations. Further, the subject CRN provides what appears to be several boilerplate and conclusory statements, which fail to describe any accurate facts constituting violations of the statutes cited therein. Thus, because the allegations in the CRN are incomplete and incorrect, they fail to provide actual notice of the specific allegations and the actions that Edison could undertake to cure any alleged violations. 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193 (N. D. Fla. 2008). Blanket references to policy provisions and statutes without specification deems the Civil Remedy Notice deficient. Julien v. United Property and Casualty Insurance Co., (Fla. 4th DCA 2020). For the reasons set forth herein, Edison hereby objects to the subject CRN and states it does not intend to waive, ratify or otherwise accept the deficiencies in the CRN, and reserves the right to contest the legal adequacy of the CRN hereinafter as appropriate. As to the contents of the CRN here, it is important to note that said CRN is a nullity and should be rejected because the CRN fails to comply with the specific requirements mandated by Florida Statutes §624.155. Specifically, Fla. Stat. § 624.155(3)(b)(2) requires the Complainant to set forth with specificity, sufficient factual allegations to state a prima facie case of an insurer violation, so as to put the insurer on notice and be afforded the opportunity to cure the deficiency. However, the Insured failed to do so in the subject CRN and instead only included conclusory statements, which lack even minimal specificity and/or lack the underlying factual basis to support them. The Insureds’ failure to describe any actual facts or circumstances to support the alleged statutory violations in the CRN precludes Edison from evaluating what error, if any, allegedly occurred during the claim process. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported and incorrect allegations with no basis in fact or circumstances. Consequently, the CRN lacks the requisite minimal specificity and Edison is unable to determine what specifically the Complainants are claiming was done by or on behalf of Edison that constitutes the bad faith alleged. Due to the absence of specific and accurate information regarding the alleged acts or omissions by Edison which allegedly give rise to any violation of the Civil Remedy Statute, Edison is limited in its ability to set forth specific facts to address and/or refute these unsubstantiated assertions. Notwithstanding, Edison explicitly denies violations of any applicable Florida Statute in the adjustment of the Subject Claim and realleges and re-asserts its specific denials to the alleged violations in the subject CRN as set forth above, including but not limited to its specific denials of the allegations that it has not attempted in good faith to settle the Insureds’ claim and that it failed to acknowledge and act promptly upon communications related to the Subject Claim. Moreover, Edison specifically denies that it denied the Subject Claim without conducting a reasonable investigation, that it failed to implement standards for the proper investigation of claims, and that it misrepresented pertinent facts relating to coverages at issue. Accordingly, without waiver of its objections, rights and defenses, Edison maintains that it has acted and continues at all times to act in good faith during the investigation and adjustment of the Insureds’ claim. Further, Edison wishes to dispel even the inference of any statutory violation and reiterates below the various reasons which clearly show the proper handling of the Subject Claim by Edison. Moreover, as stated in Demase v. State Farm Florida Insurance Company (Fla. 5th DCA November 14, 2022), as a condition precedent to bringing a first-party bad faith case, an insured must provide timely notice of the alleged violation to the authorized insurer and to the DFS. BACKGROUND FACTS Aside from the fact that the allegations contained in the subject CRN lack specific facts, the tenor and inferences of statutory violations are wholly without merit and Edison denies each and every one. Below are some of the relevant facts regarding the Subject Claim that the Insureds failed to include in the CRN. On July 15, 2021, the Insured, Leo Giannini reported a water leak that took place the day before, on July 14, 2021. Specifically, the water leaked from the second-floor bathroom causing damage to the tile flooring and leaked into the first-floor ceiling in the family room below. It also allegedly caused damage to an area rug on the floor. At the time, the Insureds were out of town but were returning home on July 19, 2021. The Insured stated a friend who was checking on the home discovered the damage and immediately shut off the water. The Insured hired Paul Davis Restoration for mitigation purposes and had a contractor friend cut out the drywall in the ceiling to prevent mold and in an attempt to salvage the rug. Edison immediately sent correspondence acknowledging receipt of the claim. This correspondence included information on mediation and claims handling and the Florida homeowner claim bill of rights. Soon after, on July 19, 2021, Edison’s field adjuster inspected the subject property. The inspection revealed interior damage due to a leak in the second-floor water supply line. In order to further investigate the claim, Edison obtained the recorded statement of the Insured, Leo Giannini. On August 4, 2021, Edison contacted the Insured to request a copy of the inspection report from his original purchase of the home. The Insured stated he was not sure if he had it and would look for same. He also advised he has additional documentation to submit regarding the rug, invoices, and other estimates for repair. On October 8, 2021, Edison received an email from Paul Davis with an estimate for $1,211.50 for water restoration. On October 11, 2021, Edison issued its coverage determination letter stating the damage to the property was less than the policy deductible. Therefore, Edison was unable to make a payment for the claim. The letter further explains in detail, “The repair of the plumbing and/or appliance is not covered under the policy. The subject policy, under which you are seeking insurance benefits, does not afford coverage for wear and tear, deterioration, or loss to the system or appliance from which the water escaped. The conditions of the subject policy of insurance stipulate that you must show us the damaged property and the cause of loss and the condition it was in at the time of loss and allow us to inspect all damaged property prior to its removal from the “residence premises”. Your failure to adhere to these policy duties prejudiced the investigation of a portion of your claim.” On October 12, 2021, the handling adjuster spoke to the Insured and discussed the file in detail. On the next day, the Insured called again stating he was unhappy with the coverage determination. On October 14, 2021, the adjuster sent correspondence to the Insureds stating, “We have received your claim inquiry. As previously reviewed with you, we firmly maintain our decisions made on this claim and stand by our coverage determination. Pursuant to Florida Statute, Section 627.7015, you may request mediation as a method of alternative dispute resolution.” Almost three months later, on January 6, 2022, Edison received an email from a public adjuster attaching a signed contract and letter of representation seeking claim documents and claim material. On the very next day, January 7, 2022, Edison promptly sent correspondence to the public adjuster providing the coverage determination package as well as the recorded statement as requested. Then, on January 12, 2022, Edison sent an email to public adjuster attaching a certified copy of the policy. A month later, on February 14, 2022, Edison received an email from the public adjuster attaching photos and an estimate dated January 26, 2022 for $122,570.76. Please note, this estimate was for specific areas of damage on the first floor and on the second floor. Notably, it is not for the exterior or the roof. Upon receipt of this estimate, Edison swiftly reopened the claim and contacted the public adjuster to schedule a reinspection. The reinspection was initially scheduled for March 7, 2022 but the public adjuster cancelled this inspection and refused to reschedule same despite many attempts on the part of the field adjuster. On February 17, 2022, Edison received an email from the Department of Financial Services requesting a mediation and on March 11, 2022, Edison received another email from the Department of Financial Services assigning a mediator to this file. Accordingly, the parties attended Mediation which resulted in an impasse despite Edison’s good faith settlement offer. Please note, Edison continued to seek a reinspection with the public adjuster multiple times from February through April. On November 15, 2022, Edison received a letter of representation from Campione Law, P.A. On the same day counsel filed a notice of intent to litigate stating their presuit demand is $142,571.00 attaching the previously provided estimate for the interior of the home. On the same day, counsel filed the subject Civil Remedy Notice. Both of these Notices are erroneously for a wind claim requiring a roof replacement despite the fact that this claim is an interior plumbing loss. This colossal difference shows this Civil Remedy Notice is completely baseless, unjustified, and filed in bad faith. Despite this significant error, on November 28, 2022, Edison sent correspondence in response to the notice of intent to litigate making a good faith offer to fully resolve the claim. On November 28, 2022, Edison sent a copy of the subject policy to counsel listed on the letter of representation. Then, after a discussion with counsel who filed this CRN, on January 4, 2023, Edison received a release of representation from Campione Law. INACCURACY OF ALLEGATIONS IN THE SUBJECT CRN The case specific facts related to Edison’s handling of the Subject Claim provided above implicitly address many of the vague allegations contained within the Insureds’ CRN and further establish that Edison undertook a thorough investigation in accordance with applicable statutory requirements and professional standards of care. It is important to note that the Insureds have not provided even one shred of factual support for any of the above allegations. Instead, the facts support that Edison promptly contacted the Insureds, inspected the claim shortly after it was reported, conducted a recorded statement, and issued a coverage determination based on a thorough investigation. When additional information was provided in the form of the public adjuster estimate, Edison made many attempts to reinspect the claim. Edison also made a good faith attempt to settle at mediation and again after receipt of the notice of intent to litigate. The circumstances support that Edison conducted a thorough, prompt investigation with the information provided. The Insureds accuse Edison of misrepresenting pertinent facts and delaying the claim without any basis. The reality is that the Insureds failed to comply with Edison’s request to reinspect the claim. The Insureds simply disagree with the findings of the investigation and appear to fraudulently be seeking a new roof on a plumbing claim. Insureds’ counsel is alleging bad faith in a scenario where Edison conducted a comprehensive, prompt investigation in good faith. Also, the Notice fails to set forth any specific policy language alleged to have been violated. Instead, the notice simply states, “Coverage A – Dwelling: Insurer is required to cover damage incurred by an Insured event to the Insured’s dwelling. Insured is required to cover damage that Insureds has claim coverage for.” It is this failure to identify the specific policy provision that is allegedly relevant to the alleged violations that prevents Edison from addressing any issues regarding the policy. Furthermore, in this section seeking pertinent policy language, the Insureds’ counsel copied and pasted portions of Florida Statue §624.155 without any explanation or correlation to the facts of the subject claim. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time”, the purpose of which is “to enable the insurer to investigate and resolve [the] claim”, the Civil Remedy Notice itself only provides completely false allegations with no basis in fact or circumstances. For example, the Civil Remedy Notice discuses roof damage based on a wind claim but the subject claim was based on an interior plumbing leak. Furthermore, the tenor and inferences of the allegations are without merit and Edison denies each and every one. Some of the relevant facts that Insureds’ counsel failed to include in the notice have been set out above. Here, the loss was not greater than the deductible after a full investigation. Simply reporting a claim does not automatically entitle the Insureds to payment and the lack of payment does not trigger bad faith. In their Notice, the Insureds make multiple blanket statements that appear to just be copied and pasted and not based on any facts. Edison did not fail to adopt and implement proper standards for investigation, evaluation, and adjustment of claims; did not fail to properly train, manage, supervise and promote claims adjusters so that the policyholder receives good faith, fair, prompt adjustment of claim, service and indemnity. Edison conducted a full and fair investigation of the claim and provided full reasons and facts to the claimant for partial denial of the claim. Moreover, Edison has not engaged in unfair claim partial denial; has not used business or outcome oriented investigations and experts to determine the outcome of the claim; has not looked for ways to partially deny coverage and otherwise “stonewall” the claim; and has not used secret claims practices to reduce claim severity and profit from wrongful claims practices. As clearly set forth above and contrary to the allegations set forth in the Notice, Edison’s investigation and adjusting of its Insureds’ claim was prompt, thorough, and complete. Furthermore, the Insureds have included absolutely no facts or evidence to support any claims in the Notice. They simply state baseless allegations in order to get a new roof on a plumbing claim. As mentioned above, the Civil Remedy Notice is based on roof damage from a wind claim but the subject claim was based on an interior plumbing leak as detailed in the public adjuster’s own estimate. In the Notice, counsel goes into detail about repairing or replacing the roof and the status of the shingles when in reality the loss is actually limited to the interior of the property. Among other thing, the Notice does not state anywhere what Edison should have done except pay for the roof which is not part of the subject claim. The Notice does not seem to actually be related to the loss. All of these baseless claims support Edison’s position that the claim was properly adjusted and the Insureds do not actually have any concrete facts to support a bad faith allegation The Civil Remedy Notice states that Edison can rectify these violations in the following ways: the Insurer must admit full coverage for the loss which include the full replacement and repair of the Insureds’ roof, and tender payment for all contractual damages owed, interest on the delayed payment, and attorneys’ fees. However, mere disagreement as to the amount of coverage does not equate to bad faith. The Civil Remedy Notice does not show how Edison has failed to comply with the statutory provisions alleged to have been violated. Evidently, this Civil Remedy Notice was filed in bad faith, as it is being used as an improper mechanism designed solely for the purpose of intimidating Edison into paying the Insureds for a loss that is not related to the subject claim. For the aforementioned reasons, Edison categorically denies that it has acted with bad faith in connection with this claim. CONCLUSION The purpose of a CRN is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000). However, the CRN here does not serve this purpose because it does not provide any means as to how Edison can “cure” the alleged defects. This failure to provide a proper opportunity to cure renders the CRN improper. Longpoint Condominium Associations v. Allstate Insurance Co. , 2005 WL 131580 (N. D. Fla. June 2, 2005). Moreover, the method for curing the violations alleged in a civil remedy notice are not determined by the insured. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: Section 624. 155 does not impose on an insurer the obligation to pay whatever the insured demands. . . . Section 624. 155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624. 155(2)(d). . . . To cure an alleged violation and to avoid a civil action, an insurer must pay the claim . . . before the sixty days expire. Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F. Supp. 773, 777-778 (M. D. Fla. 1996). Here, Edison properly adjusted the Subject Claim as it investigated the loss within the statutory time frame and the Insureds have produced no evidence that they are entitled to any additional damages. Edison denies all of the allegations contained in the subject CRN, which is defective and improper, as Edison has not violated any of the subject statutes. Edison further states that the accusations made against it in the subject CRN are patently false. In closing, Edison first believes that the Civil Remedy Notice should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Due to the lack of any factual and circumstantial basis to support the allegations therein, Edison respectfully requests, through this response, that the DFS return and reject the CRN for lack of specificity pursuant to Florida Statutes. Regardless of the rejection, Edison denies all allegations contained in the Civil Remedy Notice and submits there are no violations. While this response is meant to be comprehensive, Edison’s response above is based upon the limited information provided in the Civil Remedy Notice and the information we have to date. If the Insureds feel that we are not in possession of all the facts, please inform us immediately. Please note that Edison’s response is not necessarily exhaustive and does not preclude us from asserting any other valid reason for seeking rejection and return of the Civil Remedy Notice. Also, this letter or any act or failure to act on the part of Edison or any agent or representative of Edison should not be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation alleged in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very Truly Yours, QUINTAIROS, PRIETO, WOOD & BOYER, P.A. Maya Thomas, Esq. Jose Bosch, 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