Civil Remedy Notice of Insurer Violations
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Filing Number:     672089
Filing Accepted:  2/3/2023
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Complainant
Last/Business Name *  
PLUMMER   First Name   SHARON AND TERRELL
Street Address * 538 BRENTFORD COURT
City, State Zip * KISSIMMEE, FL 34758
Email Address * JWELLS@FLORIDAINSLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PLUMMER   First Name   SHARON AND TERRELL
Policy # * 09 0016018233 0 02 Claim #* 1 22 0002590
Attorney
Attorney is Applicable
Last Name* CIOCCHETTI First Name * MICHAEL Initial
Street Address* 125 N. RIDGEWOOD AVENUE, SUITE 100
City, State Zip* DAYTONA BEACH , FLORIDA 32114
Email Address * JWELLS@FLORIDAINSLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST COMMUNITY INSURANCE COMPANY
NAIC Company Code 13990
 
Name of individual responsible for violation (if any):* BRYAN FEIDT AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT, AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY FIRST COMMUNITY RELATED TO THIS CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Unfair Trade Practice
* 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)(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)(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)(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.

The limit of coverage portion of the policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of the insureds, SHARON PLUMMER and TERRELL PLUMMER. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155. In consideration of the premium paid to it, FIRST COMMUNITY INSURANCE COMPANY (“Carrier”), issued a policy, Policy No. 09 0016018233 0 02 (“Policy”), to the Insureds where the Policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 538 Brentford Ct, Kissimmee, Florida 34758 (“Insured Property”). The policy was in full force and effect at the time the damage occurred from Hurricane Ian, and the ensuing damages as a direct result thereof, to the Insured Property, on or about September 29, 2022. Thereafter, the Carrier was timely notified of the Loss. In particular, the Carrier was put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policy. Claim number 1 22 0002590 (“Claim”) was assigned to the Loss. The Carrier sent an adjuster to the Insured Property to perform an inspection. The Carrier performed a cursory inspection of the Insured Property and failed to retain unbiased experts necessary to trigger the cause of the Loss and covered repairs necessary to restore the Insured Property to its pre-loss condition. The Carrier deliberately denied the claim. The Carrier knows its aforementioned investigation is insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition. This inspection placed The Carrier on notice of the severity of the Loss. The Carrier subsequently denied the Insureds’ claim and issued no payment for the Loss. Thereafter, the insureds sought the assistance of a public adjuster who ensured the proper estimating of the loss and compliance with all Policy conditions. The public adjuster submitted a comprehensive estimate to the Carrier for the full scope of damages to the Insured Property. The Carrier disregarded this comprehensive estimate and, instead, denied the Claim. The Carrier has refused to reassess its denial of benefits and the basis of the denial and has refused to properly adjust and settle the Claim. The Carrier violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insureds with a due regard for their interest. When the Carrier was confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier chose to deny the Insureds’ valid Claim. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insureds that Policy coverage was unavailable for the Insureds’ Claim and Loss to the Insured Property. This misrepresentation was made in an attempt to deny the Insureds’ Claim and escape without paying for the full extent of substantial damage. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier apparently had no system or standards prepared or implemented which would allow it to evaluate the Claim as submitted by its Insureds. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or Policy provisions relating to the coverage at issue. This has been discussed fully hereinabove. The Carrier violated the provisions of Florida Statute 626.9541(1)(i)(3)(d) by denying the Insureds’ Claim without conducting reasonable investigation into the basis for the Claim. The Carrier violated the provisions of Florida Statute 626.9541 (1)(i)(3)(f) by failing to promptly provide a reasonable explanation in writing to the Insureds of the basis in the Policy, in relation to the facts or applicable law, for denial of the Claim. The Carrier has refused to properly assess its payment of benefits and the basis of payment and has refused to properly adjust and settle the claim constituting unfair claim settlement practices under Florida Statute §626.9541(1)(i)(3)(i). The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.
Comments
User Id Date Added Comment
taylor@floridainslaw.com 05-20-2024 The Carrier has resolved the CRN to the satisfaction of the Insured, and the Insured hereby withdraws the instant CRN.
cpc@bolin-law.com 03-21-2023 March 21, 2023 VIA E-MAIL AND UPLOAD TO DFS Sharon and Terrell Plummer c/o Michael Ciocchetti, Esq. Florida Insurance Lawyer 125 N Ridgewood Ave, Suite 100, Daytona Beach, Florida, 32114 JWELLS@FLORIDAINSLAW.COM Re: Matter: Sharon Plummer and Terrell Plummer v. First Community Insurance Company Date(s) of Loss: September 28, 2022 Claim Number(s): 1-22-0002590 Policy Number: 09 0016018233 0 02 DFS Filing Number: 672089 Dear Mr. Ciocchetti: My firm represents First Community Insurance Company (“FCIC”) with respect to the above matter. This letter is in response to the Civil Remedy Notice of Insurer Violation (“CRN”) with filing number 672089 you filed on behalf of Sharon Plummer and Terrell Plummer. The Notice is void because it is legally invalid. Beyond that, the allegations in the Notice have no merit. I. The Civil Remedy Notice is legally invalid. The filing of a valid Civil Remedy Notice is a condition precedent to an action brought pursuant to section 624.155, Florida Statutes. Talat Enter., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Because the statute is in derogation of the common law, it must be strictly construed. Id. “[A]ny statute in derogation of the common law requires strict compliance with its provisions by one seeking to avail himself of its benefits.” Florida Steel Corp. v. Adaptable Devs., Inc., 503 So. 2d 1232, 1234 (Fla. 1986). Section 624.155 requires a civil remedy notice to provide specific information to put the insurer on notice of the alleged violation. Additionally, a civil remedy notice must be “specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days.” Valenti v. Unum Life Ins. Co. of Am., 8:04CV1615T-30TGW, 2006 WL 1627276, at *2 (M.D. Fla. 2006). Here, the Notice is invalid because it does not contain all of the information required by section 624.155. Also, it is invalid because it lacks sufficient specificity to provide notice to FCIC of the alleged wrongdoing, as discussed below. First, the CRN fails to reference the specific policy language relevant to the alleged violation as required by Fla. Stat. §624.155(3)(b)4. Pursuant to Fla. Stat. §624.155(3)(b)4, the CRN must cite to the specific policy language that is relevant to the alleged violations. The CRN simply states, “the limit of coverage portion of the policy” without any specific reference to the specific policy language relevant to the alleged violations. The CRN does not in any way reference the specific policy language alleged to have been violated. In turn, this prevents FCIC from addressing any issues regarding the policy the Complainant alleges to have been violated which is the underlying purpose of Fla. Stat. §624.155(3)(b)4. The CRN, therefore, is statutorily deficient because it does not comply with the requirements set forth in Fla. Stat. §624.155(3)(b)4. Second, the CRN does not provide any specific supporting facts and merely makes conclusory statements. No specific facts identifying what, if anything, FCIC did or failed to do with regard to the claim were provided. Instead, the allegations are mere self-serving and conclusory statements without substance or relation to any alleged violation. This undermines the purpose of the CRN requirement preventing FCIC from investigating and resolving any of the alleged violations. The failure to provide any specific supporting facts for the allegations renders the CRN invalid. Third, the Notice is invalid because it does not list a specific cure for the alleged violations. In Talat, the Florida Supreme Court said that to “cure” a Notice, an insurer must pay the amount owed pursuant to the express terms and conditions of the policy. However, the Notice here states, “The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.” No specific cure amount of any kind is provided and FCIC is left to guess what would be required to “cure” the alleged violations. It is improper for a civil remedy notice to not contain a cure, therefore the CRN is invalid. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002). Moreover, the CRN does not list the Complainant’s e-mail address instead it provides the email of Jonathan Wells of Michael Ciocchetti, PLLC. See Pin-Pon Corp., 2020 U.S. Dist. LEXIS 100072, *7 (S.D. Fla., June 5, 2020). Finally, the boilerplate CRN lacks sufficient specificity to provide notice of the alleged bad-faith conduct. The CRN lists seven (7) different statutes which FCIC allegedly violated. However, the CRN fails to provide any relevant facts supporting each of the alleged violations or relating these alleged violations to the seven (7) different statutes. Instead, the facts section merely makes conclusory and self-serving statements regarding the claim without relating these facts or statements to the cited statutes. To be clear, counsel for the Insureds has filed more than 1700 civil remedy notices against numerous insurance companies. Moreover, the majority of the allegations in each of those notices filed on behalf of his clients appear to be very similar in both form and content. This conduct appears to be a business practice designed to force insurance carriers into settlement without regard to the underlying facts, policy, and claims handling related to a specific claim. This conduct undermines the purpose of the CRN. Because the CRN fails to comply with the information requirements promulgated by the Department of Financial Services, it is legally invalid. See Pin-Pon Corp. v. Landmark Ins. Co., 2020 U.S. Dist. LEXIS 100072, *7 (S.D. Fla., June 5, 2020); Julien v. United Property and Casualty Insurance Company, 4D19-2763 (September 23, 2020). Again, in serving this response, FCIC reserves all rights under Florida law to be served with a properly completed and statutorily compliant CRN. As the CRN fails to strictly comply with the requirements of section 624.155, Florida Statutes, it is legally insufficient and should be rejected. II. The Civil Remedy Notice Lacks Merit The Notice also lacks merit. On September 29, 2022, the subject claim was reported as a Hurricane Ian loss with a reported date of loss of September 28, 2022. FCIC assigned claim number 1-22-0002590 to the Insureds’ claim. On October 7, 2022, FCIC, through an independent field adjuster, inspected the subject property. The inspecting adjuster documented their observations and took photos of the observable damages in the interior and exterior of the home. On November 8, 2022, FCIC received an email from AskanAdjuster (the insureds’ “Public Adjuster”) providing a Letter of Representation, W9, and Public Adjuster Contract executed by the insureds on November 1, 2022. On November 10, 2022, FCIC, through a desk adjuster, emailed the insureds providing a Reservation of Rights Letter. This correspondence noted the cause of loss is in question as to: (1) Whether the damages occurred as the result of a single event or multiple events (2) Whether the damages are the result of a sudden and accidental occurrence, long term exposure, or some other cause. (3) Whether the damages claimed are covered under the policy. This letter also requested coordination to schedule an engineering reinspection. On November 15, 2022, FCIC received an email from AskanAdjuster requesting a copy of the certified Policy of Insurance. On November 17, 2022, FCIC, through a desk adjuster, sent the insureds and their Public Adjuster a certified copy of the subject Policy of Insurance. On November 30, 2022, FCIC, through a desk adjuster, emailed the insureds and their Public Adjuster providing a Second Reservation of Rights Letter. On December 5, 2022, FCIC, through an independent engineering firm, EFI Global, reinspected the subject property. The inspecting engineer documented their observations, took photos of the observable damages in the interior and exterior of the home, and subsequently prepared a report regarding their findings and opinions. On December 5, 2022, FCIC received an email from AskanAdjuster noting the engineering inspection has been completed and requesting the engineering report. On December 7, 2022, FCIC, through a desk adjuster, emailed the insureds and their Public Adjuster providing an additional copy of the Second Reservation of Rights Letter and noting FCIC is still pending the engineering report. On January 12, 2023, FCIC received an email from AskanAdjuster providing an estimate for repairs dated November 14, 2022 totaling $133,281.24. On January 12, 2023, FCIC received an email from EFI Global providing the Engineering Report related to the December 5, 2022 reinspection. On January 19, 2023, FCIC, through a desk adjuster, sent the insureds and their Public Adjuster a Coverage Determination Letter noting FCIC was denying the subject claim. This letter also cited to conclusions of EFI Global’s engineering report, “1. Damage to the shingle roofing at the Plummer residence as a result of wind-related forces can be ruled out. 2. The shingle roofing at the Plummer residence is experiencing normal wear and tear. 3. The cause of damage to the exterior walls of the Plummer residence is from ground settlement. 4. The cause of interior water damages at the residence is from age-related deterioration of the roofing, lack of maintenance to the exterior walls, and wind driven rain. 5. The cause of damage to the wood flooring in the Plummer residence is from improper installation.” On January 27, 2023, FCIC received an email from the insureds’ counsel, Michael Ciocchetti, PLLC, providing a Letter of Representation for the insureds. On January 27, 2023, FCIC, through a desk adjuster, sent the insureds’ counsel an email acknowledging the LOR. On February 3, 2023, the insureds filed the subject Civil Remedy Notice with filing number 672089 with the Florida Department of Financial Services. Also, on February 3, 2023, the insureds filed a Property Insurance Notice of Intent to Initiate Litigation with filing number 81165 with the Florida Department of Financial Services. In light of FCIC’ investigation, coverage was properly denied for the subject claim, pursuant to the terms, conditions, exclusions, limits and deductible of the subject policy. As the claim was denied, Complainant’s claim is not covered for the same reasons set forth above and the relevant Coverage Determination Letter. Accordingly, FCIC denies any and all allegations of bad faith in connection with the claim submitted by Sharon Plummer and Terrell Plummer. If you have any questions, please do not hesitate to contact me. Sincerely, /s/ Michael J. Neusaenger, Esq. Michael J. Neusaenger, 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