Civil Remedy Notice of Insurer Violations
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Filing Number:     686492
Filing Accepted:  4/4/2023
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Complainant
Last/Business Name *  
NELSON   First Name   VICKI
Street Address * 4029 SW 10TH AVE
City, State Zip * CAPE CORAL, FL 33914
Email Address * VICKINELSON@ELCORREALTY.COM
Complainant Type: * Insured
Insured
Last/Business Name*   NELSON   First Name   VICKI
Policy # * SJ31162765 Claim #* SL22211150
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W
Street Address* 2790 SUNSET POINT RD
City, State Zip* CLEARWATER , FL 33759
Email Address * GRANT@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SLIDE INSURANCE COMPANY
NAIC Company Code 17227
 
Name of individual responsible for violation (if any):* DELMONTE MEGGS, AND ANY INDIVIDUAL FROM, OR AGENT OF, SLIDE INSURANCE COMPANY, WHO WAS INVOLVED IN THE CLAIM AND UNKNOWN TO THE CLAIMANT.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Not treating the policyholder with good faith claims conduct
Other : Placing the company’s financial interests before the policyholder’s interests
Other : Looking for ways to deny full recovery to the Claimant
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made
Other : Misrepresenting the terms of the insurance policy
* 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)(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)(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.

Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Slide Insurance Company (“Insurer”) has committed the following violations in handling the claim of its insured, Vicki Nelson (“Insured” or “Claimant”): 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the policy holders and claimants; 3) looking for ways to deny benefit payments and otherwise “low ball” or “stone wall” claims; 4) not attempting in good faith to settle claims; 5) looking for ways to delay benefit payments; 6) misrepresenting policy provisions to Claimant; and 7) conducting inadequate investigations. The Claimant timely submitted a claim to the Insurer for Hurricane Ian damage sustained to the insured property, which occurred on or about September 28, 2022. The Insurer responded with a coverage determination letter dated October 28, 2022, issuing payment in the net amount of $6,231.62. Of note, the only policy language this payment letter cites is the Loss Settlement provision. The payment letter does not cite any policy language in support of the carrier’s decision to afford only partial coverage for the roof rather than provide for a complete roof replacement. Clearly, the Insurer failed to provide a reasonable explanation in writing to the Claimant of the basis in the insurance policy for the offer of this compromised and insufficient settlement. Given the clear scope and nature of the damage, the Claimant retained JKS Construction and Engineering, which produced a report detailing the damage to the property in the amount of $284,365.49 due to the Claimant under the contract of insurance. The Insurer’s estimate of the insured property’s loss resembles that of a classic “low-ball” offer and would not restore the property to its pre-loss condition which is Insurer’s duty under the contract of insurance issued by it. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of the Insurer over those of the Claimant, to delay the Claimant’s claim, and to delay the Claimant in restoring the property to its pre-loss condition. In addition to the Insurer’s failure to estimate for a complete roof replacement despite the widespread damage, the estimate also fails to account for a roofing labor minimum. This is an underhanded attempt to place the financial interest of the Insurer over those of the Claimant, to delay the Claimant’s claim, and to delay the Claimant in restoring the property to its pre-loss condition. The initial investigation by the Insurer was inadequate. As a result of the inadequate investigation and surrounding circumstances, it is apparent that the Insurer significantly underestimated the scope of the loss to the Claimant’s property. The Insurer’s estimate of the insured property’s loss simply would not restore the property to its pre-loss condition, which is the Insurer’s duty under its own contract of insurance. The Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement cost of the damages. This is an underhanded attempt to place the financial interest of the Insurer over those of the Claimant, to delay the Claimant’s claim, and to delay the Claimant’s ability to restore the property to its pre-loss condition. In short, the Insurer is not acting with due regard for the Claimant’s interests. In Florida, the work of adjusting insurance claims engages the public trust. The Insurer has breached this duty. The Insurer has taken advantage of the knowledge imbalance between it and the Claimant to misrepresent policy provisions in an attempt to retain funds it knows should go to the Claimant to restore the property to its pre-loss condition. The Insurer’s actions amount to but are not limited to the following: 1. Claim delay; 2. Not treating the policyholder with good faith claims conduct; 3. Looking for ways to reduce recovery to the Claimant; 4. Looking for ways to deny recovery to the Claimant; 5. Failing to implement proper standards for the adjustment and investigation of claims; and 6. Misrepresenting the Claimant’s rights pursuant to the Insurance Policy issued by the Insurer. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: 1. Create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and to avoid this from occurring in the future. 2. Act fairly and honestly towards the Claimant with due regard for their best interests in attempting to settle the claim. 3. Admit full coverage for the Claimant’s loss. 4. Tender full benefits owed to the Claimant under the insurance contract, in the amount of $284,365.49 less the prior payment and applicable deductible. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via Electronic Mail: Slide Insurance Company P.O. Box 1779 Columbia, SC 29202-1779 slideclaims@seibels.com
Comments
User Id Date Added Comment
mnixon@slideinsurance.com 04-26-2023 April 26, 2023 Via E-mail & Posting on DFS Website Grant Krapf, Esq. Krapf Legal 2790 Sunset Point Road Clearwater, FL 33759 grant@krapflegal.com badfaith@krapflegal.com RE: Insured: Vicki Nelson Claim No: SL22211150 Policy No: SJ31162765 Date of loss: 09/28/2022 CRN Filing No.: 686492 Dear Mr. Krapf: Please allow this correspondence to serve as Slide Insurance Company’s (“Slide”)’s response to the Civil Remedy Notice (“CRN”) that was filed on behalf of Vicki Nelson (“Insured”). Herein, we include a brief factual history of the underlying claim and actions by Slide which reveals it has acted properly in responding to the underlying claim and in compliance with its contractual and legal obligations. Slide denies each and every allegation brought forth in the CRN and denies any wrongdoing in the handling of the underlying claim. Additionally, Slide denies violating any Florida Statute or Administrative Code as set forth more specifically herein. Moreover, Slide denies violating any provisions or duties set forth in the applicable policy of insurance. Slide further states that the facts and circumstances that are set forth in the CRN, while incomplete and misleading, do not give rise to any violation of any statute or policy provision referenced in the Notice. Furthermore, Slide challenges the validity of the CRN for not identifying the specific policy language they claim Slide failed to follow. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, 879 (Fla. 4th DCA 2021) (affirming dismissal for civil remedy notice’s failure to either strictly, or substantially, comply with statutory specificity requirement); Demase v. State Farm Florida Insurance Company, 351 So.3d 136, 138-39 (Fla. 5th DCA 2022) (holding that the trial court properly determined that a CRN that failed to state with specificity the relevant policy language was legally insufficient). Finally, the Notice is improper as the Insured failed to establish that Slide breached the policy of insurance, as required by Fla. Stat. § 624.1551. CLAIM FACTS The underlying claim was reported as a claim for damages from Hurricane Ian on October 4, 2022. On October 13, 2022, Slide sent Independent Adjuster Ben Perry to inspect the insured property. Based on Slide’s investigation and evaluation of the claim, on or about October 31, 2022, Slide issued its determination letter and undisputed payment(s) of approximately $6,231.62. Thus, Slide maintains that it has acted in accordance with the terms of the subject insurance policy, and the law, and has acted in good faith towards the Insured. Slide denies that it violated any statutes or committed the acts asserted in the CRN. Slide neither waives nor is estopped from asserting any and all rights that it may have in law or under the terms of the policy. Slide expressly reserves all such rights without exception or limitation. REASONS FOR THE NOTICE The CRN alleges multiple reasons for the filing of the Notice. However, no specific facts or circumstances are provided to support these allegations. Notwithstanding, Slide denies each and every allegation individually as follows: 1. Claim Delay: Slide denies any delay in the claims handling process of the underlying loss as is evident from the facts outlined above. Slide promptly acknowledged the claim and timely initiated its investigation of the loss including an inspection of the subject property. Slide acted in accordance with its duties and obligations pursuant to the policy of insurance and responded appropriately to information and documentation that was provided. Thus, Slide asserts that this allegation is without basis and therefore denied. 2. Unfair Trade Practice: There is no basis for this allegation, thus it is wholly denied. The Insured has submitted no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the expediency and timeliness allowed by the statutory requirements imposed upon Slide. At no time did Slide, its agents, or its employees delay the handling, administration, or disposition of this claim. The facts show that Slide acted promptly with respect to the investigation of the underlying claim and made communications as necessary to adjust the claim in a prompt and appropriate manner. Information necessary and relevant to the proceeding of the claim was communicated to the Insured or their representatives in an appropriate and timely manner. 3. Not treating the policyholder with good faith claims conduct: There is no basis for this allegation, thus it is wholly denied. Slide’s adjusters have at all times acted fairly and honestly and in good faith towards the Insured in the adjustment of the underlying claim, treating all insureds equally. Slide asserts its full and strict compliance with the requirements of Florida law and the policy of insurance. The Insured’s assertions to the contrary are unsupported by the facts. Thus, this allegation is without basis and therefore denied. 4. Placing the company’s financial interests before the policyholder’s interests: Slide denies that it placed its financial interests before the policyholder’s interests. Slide has at all times acted fairly and honestly and in good faith towards the Insured in the adjustment of the underlying claim, treating all insureds equally. Slide asserts its full and strict compliance with the requirements of Florida law and the policy of insurance. The Insured’s assertions to the contrary are unsupported by the facts. Thus, this allegation is without basis and therefore denied. 5. Looking for ways to deny full recovery to the Claimant: Slide denies that it denied full recovery to the Claimant as is evident from the facts outlined above. Slide promptly acknowledged the claim and timely initiated its investigation of the loss including an inspection of the subject property. Slide acted in accordance with its duties and obligations pursuant to the policy of insurance and Florida law, and responded appropriately to information and documentation that was provided. Thus, Slide asserts that this allegation is without basis and therefore denied. 6. Not training, supervising, or managing adjusters properly so that prompt and full payments are made: There is no basis for this allegation, thus it is wholly denied. The aforementioned facts demonstrate that Slide employed proper and customary claims practices in the investigation and adjustment of this claim including, but not limited to, an inspection of the insured property and communications with the Insured and their representatives. Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Additionally, the Insured has submitted no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the expediency and timeliness allowed by the statutory requirements imposed upon Slide. At no time did Slide, its agents, or its employees delay the handling, administration, or disposition of this claim. The facts show that Slide acted promptly with respect to the investigation of the underlying claim and made communications as necessary to adjust the claim in a prompt and appropriate manner. Information necessary and relevant to the proceeding of the claim, were communicated to the Insured or their representatives in an appropriate manner. Thus, this allegation is without basis and therefore denied. 7. Misrepresenting the terms of the insurance policy: There is no basis for this allegation, thus it is wholly denied. Slide has not misrepresented the terms of the insurance policy to the Insured or any other person having an interest in the proceeds payable under the subject policy for insurance. The underlying claim has been investigated and adjusted in as thorough and expedient a manner as possible. Slide routinely communicated relevant information to the Insured and her representatives. Thus, any such allegation is without merit and unsupported by the facts of the underlying claim. Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. ALLEGED STATUTORY VIOLATIONS The CRN alleges six (6) statutory violations. However, no specific facts or circumstances are provided to support these allegations. Notwithstanding, Slide denies each and every allegation of statutory violation individually as follows: 1. 624.155(1)(b)(1): Denied. The underlying claim was investigated and adjusted in as thorough and expedient a manner as possible. Following the investigation and evaluation of the underlying claim, payment(s) were tendered to the Insured. Moreover, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 2. 624.155(1)(b)(3): Denied. Slide has not failed to promptly settle the underlying claim. The underlying claim was investigated and adjusted in as thorough and expedient a manner as possible.?Following the investigation and evaluation of the underlying claim, payment(s) were tendered to the Insured. Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it.? Moreover, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 3. 626.9541(1)(i)(2): Denied. Slide has not made any material misrepresentations to the Insured or any other person having an interest in the proceeds payable under the subject policy for insurance. The underlying claim has been investigated and adjusted in as thorough and expedient a manner as possible. Slide routinely communicated relevant information to the Insured and/or their representatives. Thus, any such allegation is without merit and unsupported by the facts of the underlying claim. Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 4. 626.9541(1)(i)(3)(a): Denied. This allegation is without basis. Slide has adopted and implemented standards for the proper investigation of claims at all times during the investigation of the subject matter. The aforementioned facts demonstrate that Slide employed proper and customary claims practices in the investigation and adjustment of this claim including, but not limited to, a prompt inspection of the insured property and timely communications with the Insured and their representatives. Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 5. 26.9541(1)(i)(3)(b): Denied.? This allegation is without basis.? Slide has been forthcoming and truthful regarding the pertinent claim facts and/or insurance policy provisions relating to the reported loss. Slide’s correspondences and communications to the Insured and their representatives proves this fact.? Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it.? Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 6. 626.9541(1)(i)(3)(f): Denied. Slide did not fail to provide an explanation for its denial of the claim. Slide has conducted a reasonable investigation of the reported loss as referenced in the factual narrative above. Slide did not deny the underlying claim, but instead issued payment(s) to the Insured. Thus, there is simply no support for this allegation and Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. ALLEGED VIOLATIONS OF THE INSURANCE POLICY The CRN fails to allege specific violations of the insurance policy and provides no specific facts or circumstances of wrongdoing. The boilerplate CRN merely sets forth blanket allegations of wrongdoing, without further information. As such, the CRN is defective, as it failed to specifically identify the policy language that is the subject of the alleged violation, and further failed to include sufficient facts to put Slide on notice of the alleged violations. Notwithstanding, Slide denies any and all allegations of policy violations. All actions by Slide were done in compliance with the applicable Policy. As indicated above, Slide thoroughly investigated the reported loss including inspection of the Insured’s property. Thus, it is clear that Slide has acted in compliance with the Policy. Slide asserts that it has at all times complied with the terms of the Policy and has complied with all applicable provisions of the Policy and Florida Statutes in the handling of this matter. STATEMENTS AS TO CURING THE DEFECTS OUTLINED IN THE NOTICE The CRN asserts that Slide must tender all insurance benefits due and owing. Nevertheless, the method for curing violations alleged in a Civil Remedy Notice is not determined by the Insured. Talat Enterprises, Inc. v. Aetna Casualty Surety Co., 753 So. 2d So. 2d 1278 (Fla. 2000). Accordingly, Florida Statutes 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. Thus, Slide reasserts that it has acted in good faith towards its Insured at all times. Slide references to all the facts herein, which unequivocally demonstrate Slide’s expedient and timely administration of the Insured’s claim. Slide further asserts its full and strict compliance with the Policy and reiterates that it has acted properly in responding to the underlying claim in compliance with its contractual and legal obligations. Slide denies any wrongdoing in the handling of the underlying claim. Additionally, Slide denies violating any Florida Statute, Administrative Code, or code of ethics. CONCLUSION In conclusion, the documented facts of this claim establish that Slide acted diligently in its claims response and adequately performed its obligations under the policy of insurance and Florida law. Thus, the facts contradict all allegations that Slide has in any manner acted improperly or contrary to its contractual obligations to the Insured in this claim. Herein, Slide has attempted to fully and adequately respond to the allegations the Insured allege in the Civil Remedy Notice of Insurer Violation filed with the Department. Should there be any questions or further inquiry with respect to this matter, please contact the undersigned at (813) 761-1866 or at mnixon@slideinsurance.com. Sincerely, /s/ Michael Nixon Michael Nixon, Esq. Staff Counsel
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