Civil Remedy Notice of Insurer Violations
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Filing Number:     686362
Filing Accepted:  4/3/2023
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Complainant
Last/Business Name *  
KENNEDY   First Name   TRAVIS AND BELINDA
Street Address * 4554 CENTRAL AVENUE
City, State Zip * ST. PETERSBURG, FL 33711
Email Address * BOGGS-PLEADINGS@BOGGSLAWGROUP.COM
Complainant Type: * Insured
Insured
Last/Business Name*   KENNEDY   First Name   TRAVIS AND BELINDA
Policy # * 1503-2201-4005 Claim #* FL22-0151377-A322
Attorney
Attorney is Applicable
Last Name* CONGERO First Name * NICHOLAS Initial
Street Address* 4554 CENTRAL AVENUE
City, State Zip* ST. PETERSBURG , FLORIDA 33711
Email Address * BOGGS-PLEADINGS@BOGGSLAWGROUP.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):* N/A
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(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)(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.
* 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 1. We cover: a. The alterations, appliances, fixtures and improvements which are part of the building contained within the "residence premises"; b. Items of real property which pertain exclusively to the "residence premises"; c. Property which is your insurance responsibility under a corporation or association of property owners agreement; or d. Structures owned solely by you, other than the "residence premises", at the location of the "residence premises".
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Travis and Belinda Kennedy (the “Insureds”) own the property at 32700 Ocean Shore Blvd. #508, Ormond Beach, FL 32176 (the “Property”). The Property was significantly damaged when Hurricane Ian pummeled Florida on September 28-29, 2022. The Property was insured by Universal Property & Casualty Insurance Company (“UPCIC”) under Policy No. 1503-2201-4005 (the “Policy”) at the time of loss. The Insureds duly reported the loss to UPCIC following the hurricane and UPCIC inspected the Property. UPCIC denied the claim and took the position that the damage at the Property fell under the Policy exclusions for Fungi, Wet or Dry Rot, or Bacteria, and Assignees or Third Parties. Despite the significant damage to the Property, UPCIC has refused to issue any payment owed under the Policy. The Insureds retained contractors, United Water Restoration, Maselli Home Repairs, and Total Comfort, to perform necessary repairs to the Property. In total, the Insured spent $8,925.15 to complete the extensive repairs to the Property. Additionally, the Insured incurred $5,541.50 in related maintenance and travel expenses during the repairs. The failure of UPCIC to accept coverage for the damage to the Property despite substantial damage to the interior and the roof and shingles constitutes a bad faith effort to avoid full payment for the covered losses. On information and belief, UPCIC has engaged in the following behaviors with such frequency that the conduct is a pattern and practice of UPCIC: delay, improper adjustment of claims, under-valuation of claims, failure to communicate with insureds, and failure to tender undisputed amounts due in a timely manner. This Notice is sent to perfect the Insured’s rights under Florida Statute section 624155. In order to cure the defects identified in this Civil Remedy Notice of Insurer Violation, UPCIC must tender the full amount to repair the Property pursuant to the contractor invoices submitted by the Insured – or explain why some or part of the damage is not covered; and must tender the full amount due for the loss of use.
Comments
User Id Date Added Comment
sm1102@universalproperty.com 05-23-2023 May 23, 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.: 686362 Filing Date: 4/3/2023 Complainant(s): Travis and Belinda Kennedy Insured(s): Travis and Belinda Kennedy Policy No.: 1503-2201-4005 Claim No.: FL22-0151377-A322 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by attorney, Nicholas Congero, on behalf of Complainants, Travis and Belinda Kennedy (also referenced as the “Insureds”). The Notice alleges violations of Sections 624.155 and 626.9541, Florida Statutes. Universal specifically denies each allegation contained in the Notice. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the adjustment of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Sec. 624.155, Fla. Stat. and Florida law. The Notice is deficient as a matter of law as it fails to comply with Sec. 624.155, Fla. Stat. 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 Sec. 624.155(3)(b), Fla. Stat., the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language which the authorized insurer allegedly violated; 2. the facts and circumstances giving rise to the violation; 3. the name of any individual involved in the violation; 4. reference to specific policy language that is relevant to the violation, if any...; and 5. a statement that the Notice is given to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Florida Department of Financial Services (“DFS”) created form DFS-10-363, which sets out fifteen (15) requirements that the Complainant(s) must respond to with specificity. The Florida Supreme Court holds that Sec. 624.155, Fla. Stat. "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(s) 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). The Notice fails to meet the requirements of Sec. 624.155, Fla. Stat., on several grounds. First, concerning the requirement to set forth with specificity the "facts and circumstances giving rise to the violation," the Notice fails to specify any facts that would put Universal on notice that it violated any policy provision or statute. The Complainants list one (1) reason for filing the Notice: “Claim Denial.” However, the Complainants’ allegations regarding this Reason for Notice are unsupported by actual facts and therefore are unfounded and insufficient to meet the threshold notice requirement of the Florida Civil Remedy Statute under Section 624.155, Florida Statutes. The Notice asserts general allegations of conclusory and inaccurate statements without the requisite specificity. For example, the Notice alleges “[t]he failure of UPCIC to accept coverage for the damage…constitutes a bad faith effort to avoid full payment for the covered losses.” However, the Complainants fail to specify any facts or circumstances that support this conclusion. Furthermore, the Notice asserts general allegations consisting of speculative and boilerplate language rather than providing specific facts to support any allegation. For example, the Notice states “[o]n information and belief, UPCIC has engaged in the following behaviors with such frequency that the conduct is a pattern and practice of UPCIC: delay, improper adjustment of claims, under-valuation of claims, failure to communicate with insureds, and failure to tender undisputed amounts due in a timely manner.” However, Complainants fail to specify any facts or examples that support the above referenced allegations. The Complainants are required to provide with specificity the facts and circumstances giving rise to the alleged violation strictly related to the Complainants’ allegations, not conjecture or speculation of what may be a business practice by the carrier. In addition, the Notice generally alleges that Universal violated Fla. Stat. 626.9541(1)(i)(3)(b) by “[m]isrepresenting pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Notice does not set forth any facts regarding any misrepresentations made by Universal and does not identify the person or persons who made such misrepresentations. The Notice does not state any facts to support the Complainants’ misrepresentation allegations. Therefore, it is evident that the statement of facts falls short of the specificity required by Sec. 624.155, Fla. Stat. As a result, the Complainants fail to comply with Sec. 624.155(3)(b)(2), Fla. Stat. Second, the Notice fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of Fla. Stat. § 624.155, the Complainants must name the individual(s) involved with specificity as it relates to the purported violation to allow Universal to properly investigate the allegations. The Notice lacks the requisite specificity as required by Fla. Stat. § 624.155. Here, the Complainants do not identify the person or persons at Universal with the most knowledge of the facts regarding any alleged violation(s), but instead state “N/A.” The Notice does not have the requisite specificity as to whom the Complainants are asserting has knowledge as to each specific allegation contained in the Notice. This failure to inform Universal of the identity of any specific person(s) who may have knowledge precludes Universal from investigating the alleged violations and potentially cure them. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainants allege Universal has “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to coverages at issue.” The Notice fails to include sufficient specificity as to whom made any misrepresentations, what was misrepresented, and when any of these misrepresentations were made. Accordingly, Complainants’ Notice is insufficient as a matter of law. Third, the Notice fails to satisfy Fla. Statute § 624.155(3)(b)(4) in that it fails to reference any specific policy language relevant to any alleged violation. Instead, the Complainants reference a category of coverage but fail to identify how the referenced language relates to any alleged violation. The cited policy sections and provisions provide no guidance or explanation, such that Universal is left to wonder what specific policy language Complainants believe were allegedly violated or breached and why. It is therefore unclear what if any policy language pertains to any allegation or how and if the language is relevant to the subject claim. General, vague, and overbroad references to a category of coverage does not satisfy the specificity required by Section 624.155(3)(b)(4), Fla. Stat. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Fourth, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects. A Civil Remedy Notice aims 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 Statute, does not impose on an insurer the obligation to pay whatever amount its insureds demand. Talat, 753 So. 2d at 1282. On 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 insureds. See Talat, 753 So. 2d at 1281. Notably, Universal asserts that by the Complainants initiating litigation prior to the expiration of the cure period, prejudiced Universal’s ability to cure any purported allegation in the Notice as there is no actual cure period wherein Universal could cure without paying extra-contractual damages. See id. at 1278. In summary, the Complainants failed to respond to each of the fields set forth on the DFS Form with the requisite specificity as stated herein including, but not limited to, failing to provide a separate email address for the Complainants and instead using the attorney’s same email address, boggs-pleadings@boggslawgroup.com, in place of the Complainants’; failing to identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notice; failing to sufficiently allege facts and circumstances giving rise to the violation; failing to reference specific policy language relevant to any alleged violation; and failing to provide a proper means whereby Universal can “cure” the alleged defects including but not limited to, not requiring it to pay extra-contractual damages which are not due and owing. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. See Julien, 311 So. 3d 875 (Fla. 4th DCA 2021). Accordingly, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notice. On October 17, 2022, Universal received notice from the Insured, Travis Kennedy, that the insured location was damaged on September 29, 2022. On November 4, 2022, Universal was permitted to inspect the interior of the insured property and document any visible damage. On November 7, 2022, Universal advised the Insureds there was no available coverage for the claim pursuant to the terms of the Policy. Thereafter, on April 18, 2023, the Insureds initiated litigation against Universal in County Court in and for Duval County under Case No. 162023CC006294XXXXMA. Thus, at the time of the instant Notice, the parties were and continue to litigate their disputes to determine what, if any, available coverage exists under the terms of the Policy. Universal did not breach any duty to its Insureds. An insurer is not required to pay whatever amount its insureds demand. As outlined above, the alleged statutory violations set forth in the Notice lack specific factual support and are without merit. Universal complied with all policy provisions and applicable Florida law regarding the evaluation of this claim. We trust that the preceding is sufficient to advise you of Universal's position regarding this matter and fully responds to the alleged violations in the Notice filed by the Complainants. Sincerely, /s/ Rose Y. Valentine Rose Y. Valentine, Esq. Senior Associate General Counsel cc: Nicholas Congero, Esq., boggs-pleadings@boggslawgroup.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