Civil Remedy Notice of Insurer Violations
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Filing Number:     663463
Filing Accepted:  12/20/2022
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Complainant
Last/Business Name *  
PULIZZI   First Name   DESIRAYE LYNN
Street Address * 231 DAVID AVE
City, State Zip * LEHIGH ACRES, FL 33936
Email Address * N/A
Complainant Type: * Insured
Insured
Last/Business Name*   PULIZZI   First Name   DESIRAYE LYNN
Policy # * FPH1078743-12 Claim #* FPI231408
Attorney
Attorney is Applicable
Last Name* KUNZ First Name * PAUL Initial K
Street Address* 1998 JUANA ROAD
City, State Zip* BOCA RATON , FL 33486
Email Address * PMKUNZ@GMAIL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FLORIDA PENINSULA INSURANCE COMPANY
NAIC Company Code 10132
 
Name of individual responsible for violation (if any):* FIELD ADJUSTER (NAME UNKOWN)
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.
* 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: Loss Settlement Provisions
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Insured's property was damaged by Hurricane Ian. Florida Peninsula Insurance Company ("FPIC") admitted coverage; however, it vastly undervalued the claim and failed to include storm damage. More specifically, FPIC authorized only repair to one elevation of the roof. The storm damage and Florida law requires that the entire roof be replaced. To cure this CRN, FPIC must admit coverage for replacement of the roof.
Comments
User Id Date Added Comment
jbosch@qpwblaw.com 02-15-2023 VIA DFS WEBSITE Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant/Insured: Desiraye Lynn Pulizzi Claim No: FPI231408 (“Subject claim”) Policy No: FPH1078743-12 (“Policy”) Loss Location: 231 DAVID AVE , LEHIGH ACRES, FL 33936 (“Property”) CRN Filing No: 663463 CRN Acceptance Date: 12/20/2022 RE: CIVIL REMEDY NOTICE - DFS FILING NUMBER 663463 Dear Sir or Madam: The undersigned counsel represents Florida Peninsula Insurance Company (“Florida Peninsula”) regarding the alleged dispute as to the subject claim number listed above involving a Hurricane Ian claim with a date of loss of September 28, 2022, made under the Policy of insurance Florida Peninsula issued to the Insured listed above. This correspondence constitutes Florida Peninsula Insurance Company’s response to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) filed on behalf of Desiraye Lynn Pulizzi (referenced herein as “Insured” or “Complainant”) regarding the claim listed above. Based on the below response, the Civil Remedy Notice should be rejected and returned by the Department of Financial Services as it is substantively defective and objectionable for the reasons stated herein, and, without waiving objections, as it completely misstates the facts surrounding this claim. 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. Florida Peninsula specifically denies the Complainant’s allegation that it has violated the above referenced statute. Florida Peninsula did not violate these provisions. The CRN does not include any facts to support this allegation. Florida Peninsula conducted a thorough investigation in good faith and issued payment accordingly. Florida Peninsula proceeded to make multiple additional good faith attempts to resolve this matter which resulted in the parties entering into a settlement agreement. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Florida Peninsula specifically denies the Complainant’s allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Florida Peninsula did not fail to adopt and implement standards for the proper investigation of claims. In addition to the allegations specifically denied above, Florida Peninsula generally denies all allegations presented in this CRN, as Florida Peninsula 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 Florida Peninsula 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 Florida Peninsula 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, Florida Peninsula 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 content 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 Insureds 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 Florida Peninsula 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 Florida Peninsula is unable to determine what specifically the Complainants are claiming was done by or on behalf of Florida Peninsula that constitutes the bad faith alleged. Due to the absence of specific and accurate information regarding the alleged acts or omissions by Florida Peninsula which allegedly give rise to any violation of the Civil Remedy Statute, Florida Peninsula is limited in its ability to set forth specific facts to address and/or refute these unsubstantiated assertions. Notwithstanding, Florida Peninsula 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. In addition, Florida Peninsula denies that it has conducted the practices listed under the “reasons for notice” portion of the Notice. Accordingly, without waiver of its objections, rights and defenses, Florida Peninsula 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, Florida Peninsula 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 Florida Peninsula. Moreover, as stated in Demase v. State Farm Florida Insurance Company (Fla. 5th DCA November 14, 2022), and 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. The Insured has failed to provide such timely notice to Florida Peninsula. 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 Florida Peninsula 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 October 3, 2022, the Insured reported damage to her home from strong winds and heavy rain from Hurricane Ian, which took place on September 28, 2022. She said she was able to see missing shingles scattered across the yard. She stated there was no damage to the interior of the home. On the very same day, Florida Peninsula immediately sent correspondence acknowledging receipt of the claim. This correspondence included the Florida homeowner claim bill of rights as well as information on mediation and claims handling. On the day after it was reported, a field adjuster inspected the loss on behalf of Florida Peninsula. The field adjuster observed damage to the roof, and based on this inspection, on October 11, 2022, Florida Peninsula sent a coverage determination letter to the insured, along with an estimate and payment in the amount of $3,912.47. On November 2, 2022, Florida Peninsula received an email from the Landau Group attaching a letter of representation and seeking a copy of the policy. In Response, on November 12, 2022, Florida Peninsula sent the coverage determination letter previously issued. On December 5, 2022, Florida Peninsula received an email from Fortification Testing and Emergency Services, LLC, attaching an assignment of benefits and invoice for $3,000 for a tarp. On December 16, 2022, Florida Peninsula issued another payment in the amount of $920.42, to Fortification Testing for the undisputed amount of services. The letter explained, “The invoice submitted by FORTIFICATION TESTING & EMERGENCY SERVICES LLC, in the amount of $3,000.00, is not covered in its entirety. It was determined that the reasonable costs should be $920.42. This amount is based on a comparative estimate prepared after the review of FORTIFICATION TESTING & EMERGENCY SERVICES LLC dry out documents and reflects customary and reasonable charges for said services.” The subject Civil Remedy Notice was filed on December 20, 2022. Also on the same day, Counsel filed a Notice of Intent to Initial litigation stating, “Insured dramatically undervalued Hurricane Ian claim.” It further stated that the pre-suit demand was $65,432.00, and there were photos and an estimate for $73,520.78 from Worldwide Estimators. It is important to note that this was the first time the estimate was provided to Florida Peninsula. On December 29, 2022, Florida Peninsula sent correspondence to counsel in response to the Notice of Intent to Litigate advising that it was rejecting it, and informing Counsel that despite the dispute, Florida Peninsula was willing to discuss an offer to resolve the claim. On January 13, 2023, counsel and the handling claim adjuster discussed the claim and Florida Peninsula made another good faith offer to settle for $17,000. Accordingly, on January 31, 2023, the parties came to a settlement agreement to resolve this matter and Florida Peninsula sent a release to be executed the same day. The claim is pending receipt of the executed release but has been resolved for all intend and purposes. INACCURACY OF ALLEGATIONS IN THE SUBJECT CRN The case specific facts related to Florida Peninsula’s handling of the Subject claim provided above implicitly address many of the vague allegations contained within the Insured’s CRN and further establish that Florida Peninsula 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 any factual support for any of the above allegations. Instead, the facts support that Florida Peninsula promptly contacted the Insured, inspected the claim immediately after it was reported, and issued a coverage determination and payment based on a thorough investigation. When additional information was provided, Florida Peninsula made two good faith offers to settle and ultimately resolved the claim. The circumstances support that Florida Peninsula conducted a good faith, thorough, prompt investigation with the information provided. Insured’s counsel is alleging bad faith in a scenario where Florida Peninsula conducted a comprehensive, prompt investigation in good faith. Also, regarding specific policy language alleged to have been violated, the notice states “Coverage A-loss settlement provisions.” However, Florida Peninsula consistently acted in accordance with the terms and condition outlined in the policy including the loss settlement provision. 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 false allegations with no basis in fact or circumstances. For example, the Civil Remedy Notice suggests that Florida Peninsula undervalued the claim and failed to include storm damage. However, the payment made was for the damage to the home that was a direct result of the covered peril. The CRN further states that “storm damage” and Florida law requires that the entire roof be replaced but does not elaborate as to what law they are referring. The subject policy only provides payment to the areas of the property damaged by a covered peril and the parties agreed to a settlement of the damaged areas. Furthermore, the tenor and inferences of the allegations are without merit, and Florida Peninsula denies each and every one. Some of the relevant facts that Insured’s counsel failed to include in the notice have been set out above. As clearly set forth above and contrary to the allegations set forth in the Notice, Florida Peninsula’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. All of these baseless claims support Florida Peninsula’s position that the claim was properly adjusted, and the Insureds do not actually have any concrete facts to support a bad faith allegation. Mere disagreement as to the amount of coverage does not equate to bad faith. The Civil Remedy Notice does not show how Florida Peninsula 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 Florida Peninsula into potentially over paying the Insured. For the aforementioned reasons, Florida Peninsula 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 Florida Peninsula 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, Florida Peninsula properly adjusted the Subject claim as it investigated the loss within the statutory time frame and come to a settlement agreement with counsel. Florida Peninsula denies all of the allegations contained in the subject CRN, which is defective and improper, as Florida Peninsula has not violated any of the subject statutes. Florida Peninsula further states that the accusations made against it in the subject CRN are patently false. In closing, Florida Peninsula 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, Florida Peninsula 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, Florida Peninsula denies all allegations contained in the Civil Remedy Notice and submits there are no violations. While Florida Peninsula’s response herein is meant to address the allegations in the Insureds’ Notice, it is based upon the limited information provided in the Civil Remedy Notice and the information presented to date. If the Insureds feel that Florida Peninsula is not in possession of all the facts, please inform the undersigned immediately. Please note that Florida Peninsula’s response is not necessarily exhaustive and does not preclude Florida Peninsula or anyone on Florida Peninsula’s behalf 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 Florida Peninsula or any agent or representative of Florida Peninsula 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. On behalf of Florida Peninsula, we trust that this response addresses the allegations 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.
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