Civil Remedy Notice of Insurer Violations
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Filing Number:     677050
Filing Accepted:  2/22/2023
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Complainant
Last/Business Name *  
MARIE COSBY­YOUNGS   First Name   LASHELL
Street Address * 12100 SW 270TH ST
City, State Zip * HOMESTEAD, FL 33032
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   MARIE COSBY­YOUNGS   First Name   LASHELL
Policy # * 1501­1706­3215 Claim #* FL22­0116940
Attorney
Attorney is Applicable
Last Name* PARDO First Name * ERIKA Initial
Street Address* 7700 N KENDALL DRIVE, SUITE 802
City, State Zip* MIAMI , FLORIDA 33156
Email Address * ERIKA@THEPARDOLAWFIRM.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):* ERIKA
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
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.
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)(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)(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)(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 Admin Code: 69B-220.201(3)(b): An adjuster shall treat all claimants equally. 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)(e): An adjuster shall handle every adjustment and settlement with honesty and 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)(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)(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. 69J-166.031: Selectively and detrimentally choosing which alternative dispute resolution to utilize. Governed by the cited authorities, the subject policy provides coverage for sudden and accidental losses and damages arising from water losses. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages. Furthermore, the policy provides coverage for assessments in relation to remediation, as well as the amount necessary to perform remediation.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Complainant and Insured, Lashell Marie Cosby- Youngs (“Complainant”), maintained a homeowner’s policy of insurance (“Policy”) with Universal Property & Casualty Insurance Company (Insurer), bearing policy number 1501¬1706¬3215, which provided coverage for sudden and accidental damages and losses arising from water loss (“Loss”) in exchange for premiums. A claim was timely made to the Insurer and it has failed to meet its contractual obligations pursuant to the terms of the Policy. Insurer has failed to properly address and evaluate covered damages that were caused by this loss and has failed to issue full payment and otherwise restore the property to its pre-loss condition. The Loss caused substantial, direct and consequential damages, and Insurer’s general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claims has caused the Complainant to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue. The stated misconduct is collectively referred to as “Bad Faith,” and the specific factual and/or legal considerations in relation thereto are further outlined below for its consideration in accordance with Fla. Stat. Sec. 624.155 and the cited legal authorities associated therewith. 1.) Insurer insures thousands of homes throughout the South Florida area wherein the Complainant’s residence is located. Even though Insurer knows that it has a fiduciary duty to its insureds, it failed to institute the necessary policies, procedures, guidelines, protocol, personnel and contingencies in relation to fully, promptly and equitably indemnifying its insureds. Consequently, insureds such as the Complainant was forced to: fend for themselves to mitigate damages arising from Insurer’s Bad Faith; incur out of pocket expenses that Insurer was required to afford pursuant to the Policy; absorb the burden, expense, inconvenience and delay associated with an insurer who was not equipped (because it didn’t want to incur the expense associated therewith) to meet its contractual obligations; risk health hazards associated with the presence of moisture, toxic conditions and/or mold due to Insurer’s failure to perform pursuant to the Policy; be placed in situation where they have to incur the costs associated with hiring experts/professionals/counsel to force Insurer to abide by its fiduciary duty and avoid the consequential damages associated with Insurer’s failure to perform pursuant to its fiduciary duty; etc. 2.) Insurer knew that water losses such as the one at issue in this claim are of a nature that a thorough and specialized investigation or adjustment of the claim needs to be promptly performed by qualified and prepared personnel to protect its insureds, satisfy its fiduciary duties, and otherwise not engage in the Bad Faith claim handling practices at issue. That said, to the detriment of its insureds and to maximize its financial interests, Insurer disregarded the obvious and known obligations by way of the following: (a.) Not developing, maintaining and/or instituting policies, procedures, protocol or guidelines to determine whether adjusters, personnel, and/or vendors utilized to protect its insureds were qualified to duly assess the scope and/or value of the loss or damages. (b.) By way of the cited legal authorities and considerations, Insurer knew that it would have to promptly hire a significant volume of contractors, uniquely qualified adjusters, and/or engineers, to fully, equitably and honestly assess the scope and/or value of the loss or damages suffered by its insureds. Although Insurer will hire such experts to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (c.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel or vendors to perform moisture meter assessments throughout the insured property to honestly assess the full extent of damages and losses suffered by its insureds. Such practice is a basic, inexpensive, efficient and industry-wide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (d.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel or vendors to perform thermal imaging assessments throughout the insured property to honestly assess the full extent of damages and losses suffered by its insureds. Such practice is a basic, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (e.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel or vendors to perform detailed, thorough, reliable and qualified assessments of any structural component of the home in which moisture made entry. Such practice is a basic, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (f.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insureds’ interests and its obligation under the insurance policy to retain a licensed mold assessor to determine whether there were concealed conditions within the home which necessitated mold remediation and the need for its insureds to take precautionary measures to preserve their physical health and property interests. Such practice is a basic, inexpensive, efficient and industry-wide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (g.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to promptly issue payment for professional and qualified moisture assessments and remediation in order to, inter alia, avoid: the development of hazardous and toxic conditions within the residence; preclude the insured from suffering consequential and extra-contractual damages; the development of an uninhabitable residence and various risks that may develop; etc. Such practice is a basic, reasonable, necessary and industry-wide accepted means of protecting its insured, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. (h.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to promptly issue payment for mold assessments and mold remediation in order to, inter alia, avoid: the development of hazardous and toxic conditions within the residence; preclude the insured from suffering consequential and extra-contractual damages; the development of an uninhabitable residence and various risks that may develop; etc. Such practice is a basic, reasonable, necessary and industry-wide accepted means of protecting its insured, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. (i.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to utilize a licensed mold remediator to consider a licensed mold assessor’s assessments and protocol in order to honestly determine the true scope and value of damages and/or the loss. Such practice is a basic, inexpensive, efficient and industry-wide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (j.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to carefully consider all policy terms that afford coverage for a water loss, and thereafter utilize counsel when an adjuster is in doubt to advise them on a claim by claim basis whether, in fact, it is duly indemnifying its insureds as a matter of law. Such practice is a basic, inexpensive, efficient and industrywide accepted means of protecting its insureds, however, Insurer knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainant. Although Insurer will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, again, it chooses to avoid such expense for self-gain when it knows that a water loss such as the one at issue in this claim is undoubtedly covered under the policy. (k.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to carefully evaluate on a claim by claim basis whether any amounts appropriated for “depreciation” are based on sufficient facts and data, reliable principles and methods, and/or the application of reliable principles and methods. In reality, Insurer knows that it is arbitrarily, capriciously, deceptively, willfully and wantonly appropriating depreciation without any claim/item specific consideration to justify same. In the aggregate, and unbeknownst to its insureds, this sham practice allows Insurer to unjustly avoid millions of dollars in benefits owed to its insureds who are consequently placed in a position wherein they are financially coerced into choosing whether to leave its home in state of disrepair, or alternatively, searching for handyman and non-licensed vendors to perform makeshift repairs which create secondary risks and potential damages that Insurer will deny coverage for when they arise. (l.) By way of the cited legal authorities and considerations, Insurer knew that it would be in its insured’s interests and its obligation under the insurance policy to carefully evaluate on a claim by claim basis, and only after equitably and fully investigating and adjusting claim, the amounts owed to the insured for: overhead and profit associated with the insured’s reasonable need to utilize a general contractor; taxes associated with the repairs; permit costs associated with the repair; costs associated with various licensed trades that will be needed to effectuate the repairs; whether benefits are owed to the insured for loss of use and/or additional living expenses; personal property that may have been affected by any toxic, mold, and/or moisture conditions that developed in the home; costs associated with maintaining the continuity of the finish or appearance for pairs or sets such as cabinets, flooring, roof coverings, walls, ceilings, etc. (m.) By way of the cited legal authorities and considerations, Insurer knew that it had an obligation to ensure that software programs, data bases and adjusting practices utilized to estimate the scope and value of the Loss were being utilized in form that: honestly and fully delineated the line item repairs or costs that needed to be performed; pricing corresponded with licensed professionals - as opposed to handyman or non-licensed professionals; accounted for consideration of actual expenditures incurred by the insureds or otherwise compensable expenses on a repair cost basis; etc. Ultimately, Insurer knows that the adjusting practices are guided to unlawfully deprive its insureds of benefits owed under the insurance policy, which in the aggregate, serves to maximize its profits to the detriment of its insureds. (n.) By way of the cited legal authorities and considerations, Insurer knew that it had an obligation to honestly, promptly, in continuity, reliably and fairly communicate with its insured in relation to their rights and obligations under the policy, basis for payment and/or nonpayment, policy conditions and/or exclusions which are being considered in relation to payment and/or nonpayment; etc. Not only has Insurer disregarded said duty, it knows that it serves its financial interest by ultimately deterring a large volume of insureds from lawfully obtaining benefits. (o.) By way of the cited legal authorities and considerations, Insurer knew that it had an obligation to treat all insureds equally and honestly. However, and for its own financial interest, they will only start to fully consider its obligations as stated herein if the insured retains legal representation and pursues a legal action which exposes them to liabilities and costs associated with, inter alia, Fla. Stat. Secs. 627.428, 54.071 and 624.155. Even then, they will withhold monies owed in an unjust effort to limit/delay its liabilities in relation to the statutory considerations and otherwise. (p.) By way of the cited legal authorities and considerations, and even after litigation ensues, Insurer knows that it has a continuous and ongoing duty to not engage in the Bad Faith conduct that is the subject of this Complaint. However, to advance its own financial interest and avoid the liabilities pursuant to the above cited statutory authorities, it will direct and utilize nonqualified counsel (due to a high-volume case load, lack of expertise in the area of law, etc.) to delay the equitable and prompt payment of the claim via delay tactics and by otherwise not implementing policies, procedures and/or guidelines to ensure that its duties are fulfilled during the course of litigation. Moreover, it will insist upon the insureds to fulfill its own obligations by imposing upon them the burden to establish their full entitlement to benefits for which Insurer knows, or should know, are owed or subject to further assessments and considerations for the reasons set forth herein. (q.) By way of the cited legal authorities and considerations, Insurer knows that it has to assess the application of the policy deductible on a case by case basis and only after the claim is fully adjusted and investigated. This practice is necessary to protect the interests of insureds, since pursuant to binding precedent, the policy deductible is subject to being absorbed by losses and/or damages that, inter alia, exceed a limitation of coverage under a certain section of the policy, constitute the full amount of the damages or losses before the application of depreciation or other secondary considerations that serve to, in part, limit full payment from the onset. (r.) By way of the cited legal authorities and considerations, Insurer knows that it has a duty to duly assess whether benefits are owed to the insured in relation to the costs associated with removing and resetting personal property in relation to repairs and/or remediation work that needs to be performed. This duty is ignored by Insurer to maximize its own financial interests. Further, they have a duty to assess whether the personal property has been contaminated by way of toxic moisture conditions that developed due to the loss and consequential damages. (s.) By way of the cited legal authorities and considerations, Insurer knows that it has duty to issue payment for interest owed in relation to payments that were untimely issued per governing authorities. With that said, and to the detriment of its insureds, it foregoes and/or delays such considerations in order to maximize its financial interests. (t.) By way of the cited legal authorities and considerations, Insurer knows that it has a duty to consider the specific circumstances which served to create damages to the insured property. Such concealed conditions can slowly serve to destroy the residence, and/or are of a nature that, if claimed months or years later, the insurer will assert that they are not covered pursuant to certain policy conditions or exclusion. Thus, causing progressive, unknown and substantial injury/damages to its insureds and a potential inability to: insure the real property; sell the real property; reside in the real property; maintain a safe environment within the real property; assess the necessary scope of repair; etc. (u.) Although from the onset of the Loss, Insurer will have no good faith basis to deny coverage in part and/or in whole for a loss/damage, they will delay notifying insureds that coverage has been accepted, and/or otherwise delay performing, in order to: maximize its financial interests; unlawfully and deceptively withhold monies for its own use; utilize policy conditions as a shield in litigation; utilize policy conditions at later date to further delay payment when the insured demands performance under the policy; and/or so as to otherwise implement a deceptive and immoral scheme to deprive insureds of benefits owed under the policy. (v.) Although Insurer knows that it has a duty to treat all insureds and assignees equally, it will consistently act inconsistently in relation to: the application of policy limits; the manner in which valuations and/or the scope of repair is assessed; the manner in which an insured is required to comply with policy conditions; the application and/or consideration of policy conditions and/or exclusions to bar coverage; the timing and/or circumstances upon which undisputed payments will be made pre-suit and post-suit; etc. The lack of consistency and organization ultimately serves to deprive insureds of their rights under a policy and otherwise creates an inherently dishonest, immoral and unfair means of adjusting and investigating claims. (w.) Insurer knows that once the claim is fully and fairly investigated and adjusted, it then has to determine whether certain benefits are owed to insureds for the cost of insurance in relation to the construction and repairs that need to be performed. These costs are avoided by Insurer by engaging in the Bad Faith conduct described herein. (x.) Insurer knows that once the claim is fully and fairly investigated and adjusted, it then has to determine whether certain benefits are owed to insureds for the cost of engineering fees in relation to the construction and repairs that need to be performed. These costs are avoided by Insurer by engaging in the Bad Faith conduct described herein. (y.) Insurer’s Bad Faith conduct as described places the insured in a position that it has to unnecessarily incur expert fees to secure judicial relief by way of a legal action. Moreover, and as part of the Bad Faith practice, Insurer will await the insured’s post-suit retention of an expert to retain a designated and predisposed (due to financial biases) expert to further delay its obligations to its insured and the consequential liabilities that the legislature has imposed to deter Insurer from engaging in the Bad Faith practice. Insurer’s bad faith claims handling practices as described above leaves insureds, the insured’s counsel, the insurer’s counsel and even the judiciary guessing as to when and how Insurer will duly perform. This described Bad Faith conduct not only serves to maximize Insurer’s prospective financial gains by being able to avoid paying benefits, it also serves to minimize Insurer’s loss adjusting expense as it sees fit to the invariable detriment of its insureds, the Complainant, and ultimately the tax paying citizens of this State that bear the expense of the judicial system, which needs to unravel the tangled web created by Insurer. To cure the above stated immoral, deceptive, unlawful and collectively defined general business practice of Bad Faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the insured’s interests being implemented, Insurer must perform as follows within 60 days of receiving this Complaint: 1. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainant; 2. Confessing judgment in relation to any pending breach of contract action brought forth by the Complainant and/or confessing judgment in relation to any pending declaratory action brought forth by the Complainant; 3. To the extent verified after duly performing under the policy pursuant to citied authorities and considerations, issuing any and all payments owed to the Complainant for interest on benefits that were untimely paid 4. Stipulate to the Complainant’s and/or its counsel’s entitlement to attorney’s fees and costs pursuant to Fla. Stat. Secs. 627.428 and 57.041; 5. After exercising good faith efforts to resolve the claim, issuing payment to the Complainant’s counsel for any attorney’s fees and/or costs that it cannot dispute are due and owing; 6. As it relates to any claims benefits that may remain in dispute or undetermined, fairly, honestly, specifically, meaningfully and substantively disclosing to the Complainant’s counsel the basis therefor and the means to promptly reach resolution; 7. And otherwise fulfilling any and all obligations under the policy that it knows, or should know, remain to be performed.
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User Id Date Added Comment
oc1102@universalproperty.com 04-06-2023 April 6, 2023 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 676161 Filing Date: 2/17/2023 Complainant(s): Lashell Marie Cosby --Youngs Insured(s): Lashell Marie Cosby --Youngs Policy No.: 1501-¬1706¬-3215 Claim No.: FL22-0116938 Re: DFS File No.: 677050 Filing Date: 2/22/2023 Complainant(s): Lashell Marie Cosby-Youngs Insured(s): Lashell Marie Cosby-Youngs Policy No.: 1501¬-1706¬-3215 Claim No.: FL22-¬0116940 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, Erika Pardo, on behalf of Complainant, Lashell Marie Cosby-Youngs (also referenced as the “Insured.”) The Notices allege violations of Sections 624.155 and 626.9541, Florida Statutes, and Florida Administrative Code 69B-220-201 and 69J-166.031. Universal specifically denies each and every allegation contained in the Notices. Additionally, Universal denies that it violated these or any statutes, Administrative Code, Florida law or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notices fail to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notices are deficient as a matter of law as they fail to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 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 Section 624.155(3)(b), Florida Statutes 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. Moreover, the Department of Financial Services (“DFS”), created form DFS-10-363, which lays out 15 requirements that the Complainant must respond to with specificity. The Florida Supreme Court holds that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant has specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). To begin, the Notices fail to meet the requirement of Section 624.155, Florida Statutes, on several grounds. First, the Notices fail to provide a separate email address for the Complainant and instead states, “WITHHELD.” The failure to properly respond to each field set forth on the DFS form with specificity is one of the reasons why the Notices are deficient and do not comply with Section 624.155, Florida Statutes. Second, the Notices fail 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. In order to comply with the requirements of Section 624.155, Florida Statutes, the Complainant must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to properly investigate the allegations. The Notices lack the requisite specificity as required by Section 624.155, Florida Statutes. Here, Notice No. 676161 states, “DEBRA FINKELSTEIN,” without more, and Notice No. 677050 simply states, “ERIKA,” with no last name. However, the Notices do not state what knowledge the named individuals have or what they did or failed to do. Therefore, the Notices do not have the requisite specificity as to whom the Complainant is asserting has knowledge as to each specific allegation contained in the Notices. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainant alleged that Universal “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to coverages at issue.” The Notices fail to include any specificity as to whom made any misrepresentations, what was misrepresented, or when any of these misrepresentations were made. Accordingly, Complainant’s Notices are insufficient as a matter of law. Third, the Civil Remedy Notice requires the Complainant “pursuant to section 624.155, Florida Statutes, please indicate all statutory provisions alleged to have been violated.” The Notices filed by the Complainant in this matter includes almost every statutory provision that could be claimed against an insurance company, without the requisite specificity as to how, if at all, they are relevant or applicable to any facts alleged in the Notices. Because the Notices fail to identify any specific statutes, Universal is unable to properly respond and the Notices do not comply with Section 624.155, Florida Statutes. Fourth, the Notices fail to satisfy Section 624.155(3)(b)(4), Florida Statutes, in that they fail to reference any specific policy language relevant to any alleged violation(s). Instead, the Notices improperly cite sections of the Florida Admin Code: 69B-220.201 and 69J-166.031, however, these sections are not contained within the Policy and moreover, there are no facts specified to place Universal on notice of how it allegedly violated these codes. In addition, the Florida Administrative Code provisions are not part of the civil remedy notice statute and are improperly included in the Notices. Furthermore, the Notices do not reference any specific policy language but instead state in pertinent part the following: “Governed by the cited authorities, the subject policy provides coverage for sudden and accidental losses and damages arising from water losses. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages. Furthermore, the policy provides coverage for assessments in relation to remediation, as well as the amount necessary to perform remediation.” General, vague, and overbroad references to possible or potential policy provisions does not satisfy the specificity required by Section 624.155(3)(b)(4), Florida Statutes. As such, the Notices are deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Fifth, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notices fail to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Complainant provides three (3) reasons for submitting the Notices, “Unsatisfactory Settlement Offer,” “Claim Delay,” “Unfair Trade Practice.” The Complainant’s allegations have no specific factual support specified in the Notices and therefore are insufficient to meet the threshold notice requirement of the Florida Civil Remedy Statute under Section 624.155, Florida Statutes. The Notices assert general allegations consisting of conclusory and inaccurate statements rather than specific allegations of fact regarding any alleged misconduct or statutory violations. As an example, Notice No. 676161 generally alleges that the claim was “timely” reported to Universal. To the contrary, the Insured provided Universal with untimely notice of the loss, and consequently, Universal advised the Insured it would be reserving its rights under the policy for the late reporting of the claim. As an additional example, the Notices state, “[t]he Loss caused substantial, direct and consequential damages, and Insurer’s general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claims has caused the Complainant to suffer further harm… The stated misconduct is collectively referred to as “Bad Faith…” The Notices fail to provide any specific facts to support the above referenced inflammatory conclusory statements which appear to only be utilized to color or taint the reasonable actions of Universal. As will be discussed below, Universal promptly investigated the Insured’s losses and timely issued payment to the Insured, for each respective loss, pursuant to the terms in the Policy. Additionally, the Notices generally state in part: “Even though Insurer knows that it has a fiduciary duty to its insureds, it failed to institute the necessary policies, procedures, guidelines, protocol, personnel and contingencies in relation to fully, promptly and equitably indemnifying its insureds. Consequently, insureds such as the Complainant was forced to: fend for themselves to mitigate damages arising from Insurer’s Bad Faith…” However, there are no specific facts to support the allegations above or any allegations contained within the Notices. In fact, there is not a single specific fact related specifically to the instant claims in the conclusory statements made in subsections 1 and 2 (a-y) in the “facts and circumstances” section in the Notices. Instead, the Notices merely set forth the generalized requirements of the cited statutes and codes. The Notices do not specify any facts to support any of the above referenced conclusions or alleged violations which could enable Universal to investigate and if necessary, cure Complainant’s allegations. Moreover, the Complainant alleges that Universal is “[m]isrepresenting pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Notices do not set forth any facts regarding any misrepresentations made by Universal and do not identify the person or persons who made such misrepresentations. The Notices do not state any facts to support the Complainant’s misrepresentation allegations or any of the allegations contained therein. It is evident that the statement of facts falls short of the specificity required by Section 624.155, Florida Statutes. As a result, the Complainant fails to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. Lastly, the Notices do not provide a proper means whereby Universal can “cure” the alleged defects, without paying benefits which are not due and owing to the Insured. The purpose of a Civil Remedy Notice 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, Section 624.155, Florida Statutes, does not impose on an insurer the obligation to pay whatever an insured demands. Talat, 753 So. 2d at 1282. To the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. Complainant demands extra-contractual damages including, but not limited to requiring Universal to “[s]tipulate to the Complainant’s and/or its counsel’s entitlement to attorney’s fees and costs….” The Notices fail to provide Universal an opportunity to “cure” the alleged violations without paying extra-contractual damages. Additionally, Complainant demands “cures” which are not available under the policy of insurance or the Civil Remedy Statute including, but not limited to, requiring Universal to “[confess] judgment in relation to any pending breach of contract action brought forth by the Complainant and/or [confess] judgment in relation to any pending declaratory action brought forth by the Complainant,” which is improper and not the appropriate venue for such a request. As such, the Notices are deficient. Notably, Universal asserts that when the Complainant initiated litigation before the expiration of the cure period of Notice No. 676161, it prejudiced Universal's ability to cure any purported allegation in that Notice as there is no actual cure period wherein Universal could cure without paying extra-contractual damages. Universal is only obligated to pay contractual amounts owed to cure a civil remedy. See id. at 1278. In summary, as outlined above, the Complainant fails to respond to each of the fields set forth on the DFS Form with the requisite specificity, including but not limited to the failure to list an email address for Complainant, the failure 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 failure to reference specific policy language relevant to the alleged violation, the failure to allege any specific conduct on the part of Universal that would violate any policy provision or statute, and the failure to provide a proper means whereby Universal can “cure” the alleged defects. Therefore, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notices are deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with the facts and circumstances regarding these claims, which shall demonstrate that Universal has not violated any Policy terms or statutory provisions. On May 31, 2022, Universal received notice from a representative of the Insured the insured location had damage which occurred on May 19, 2022, to which Universal assigned claim number FL22-0116938; and damage which occurred on May 26, 2022, to which Universal assigned claim number FL22-0116940. On June 3, 2022, Universal advised the Insured it would be reserving its rights under the policy for the late reporting of claim number FL22-0116938. Further, Universal requested material documents and information, for both claims, including, but not limited to, a date and time to inspect the property, a signed sworn Proof of Loss and detailed estimate, any and all receipts for repairs completed or commenced, emergency mitigation invoices/documents, and water usage records. On June 13, 2022, Universal was finally permitted to inspect the property and documented any visible damage. Universal sent follow-up correspondences dated June 27, 2022, and July 18, 2022, advising the Insured Universal again was requesting material documents and information, including those listed above. Universal received some, but not all, requested material documents and information. On August 10, 2022, Universal issued an undisputed payment to the Insured, for claim no. FL22-0116940, in the full amount of its estimate less the applicable deductible and recoverable depreciation, pursuant to the terms of the Policy. On August 15, 2022, Universal issued an undisputed payment to the Insured, for claim no. FL22-0116938, in the full amount of its estimate less the applicable deductible and recoverable depreciation, pursuant to the terms of the Policy. Under the terms of the Policy, Universal will initially pay at least the actual cash value of the insured loss, less any applicable deductible. It will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. Universal has not received any documentation from the Insured showing the amount necessary to perform such repairs or that expenses have been incurred in excess of the payment issued by Universal to the Insured. On February 21, 2023, the Insured initiated litigation against Universal, for claim FL22-0116938, in the Circuit Court of Miami-Dade County under Case No. 2023-004590-CC-26. Thus, at this time, the parties continue to litigate their disputes to determine what, if any, additional coverage exists under the Policy. At no time has Universal breached any duty to its Insured. An Insurer is not required to pay whatever amount the Insured demands. While an insurance company is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. As outlined above, the alleged statutory violations set forth in the Notices are devoid of factual support and without merit. Universal has complied with all policy provisions and applicable Florida law regarding the evaluation of these claims. We trust that the foregoing is sufficient to advise you of Universal’s position regarding these matters and fully responds to the alleged violations in the Notices filed by the Complainant. Sincerely, /s/ Osnelicia Cudila Osnelicia Cudila, Esq. Associate General Counsel cc: Erika Pardo, Esq., ERIKA@THEPARDOLAWFIRM.COM (via email only)
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