Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 690366

Filing Accepted: 4/27/2023

Print Filing

Complainant

Last/Business Name *

GOTHAM

First Name

ROBERT AND DONNA

Street Address *

101 BAY MAR DRIVE

City, State Zip *

FORT MYERS BEACH, FL 33931

Email Address *

WITHHELD

Complainant Type: *

Insured

Last/Business Name*		GOTHAM		First Name		ROBERT AND DONNA
Policy # *		HCPC440805-9		Claim #*		926942

Attorney

Attorney is Applicable

Last Name*	NEMEROF First Name * MICHAEL Initial
Street Address*		4000 HOLLYWOOD BOULEVARD, SUITE 685-S
City, State Zip*		HOLLYWOOD , FLORIDA 33021
Email Address *		MNEMEROF@CASSEL.LAW

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 12944

Name of individual responsible for violation (if any):* PARESH PATEL, MARK HARMSWORTH, ANDREW GRAHAM, ANTHONY SARAVANOS, KARIN COLEMAN, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC. INVOLVED IN
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Claim Delay
	Unfair Trade Practice
	Other : Violation of Adjusters' Ethical Requirements

* Statutory provision(s) which the insurer allegedly violated.

	624.155(1)(b)(1)		Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(b)		Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.

* 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 violations asserted herein regarding Homeowners Choice Property & Casualty Insurance Company, Inc.'s bad faith actions are based heavily on the facts and circumstances asserted in the below section designated for same as well as violations of the portions of Florida Insurance Code and Florida Administrative Code upon which the bad faith statutes contained within Sections 624.155 & 626.9541, Florida Statutes, are based. With that said, the following policy language is relevant to Homeowners Choice Property & Casualty Insurance Company, Inc.'s statutory violations and bad faith conduct: SECTION I – CONDITIONS I. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Any loss payment will be paid to you and them, as each interest appears. Loss will be payable: 1. 20 days after we receive your proof of loss and reach written agreement with you; or 2. 60 days after we receive your proof of loss and: a. There is an entry of a final judgment; or b. There is a filing of an appraisal award or a mediation settlement with us. 3. Within 90 days after we receive notice of an initial, reopened, or supplemental property insurance claim from you, where for each initial, reopened, or supplemental property insurance claim, we shall pay or deny such claim or portion of such claim, unless there are circumstances beyond our control which reasonably prevent such payment. Paragraph 3. above does not form the sole basis for a private cause of action against us.

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

Form DFS-10-363, Rev. 10/14/2008, contains a field for the insureds to include their email addresses. Prior to filing the CRN, said form contains an instruction that, in the event the insureds do not with for certain information to become part of the public record, the insureds must simply include the term “WITHHELD” to satisfy the filing requirement. This is further established through the following statement with appears on Civil Remedy Notices which have been filed: Warning! Information submitted as part of this civil remedy notice is a public record. Data entered into this form will be displayed on the DFS website for public review. Please DO NOT enter Social Security Numbers, personal medical information, personal financial information or any other information you do not want available for public review. As any information contained herein becomes part of the public record, the insureds have withheld their email addresses so as not to make same available for public review and indicated same accordingly. Furthermore, as the insureds are represented by counsel, it would be improper for any representative of Homeowners Choice Property & Casualty Insurance Company, Inc. to contact the insureds directly for any reason utilizing their email addresses and, as such, the information is neither material to Homeowners Choice Property & Casualty Insurance Company, Inc.’s ability to correct the violations contained herein nor required by the Department of Financial Services. Homeowners Choice Property & Casualty Insurance Company, Inc. should direct all follow-up correspondences to the attorney listed above. Furthermore, as the above section requesting people with knowledge as to the allegations in the instant CRN often gets cut off, the following are those responsible for the violations alleged herein: Paresh Patel, Mark Harmsworth, Andrew Graham, Anthony Saravanos, Karin Coleman, and all other adjusters, supervisors, management and individuals associated with or retained by Homeowners Choice Property & Casualty Insurance Company, Inc. involved in this claim. The facts and circumstances giving rise to the insurer's violation as the insureds understand them at this time: Robert Gotham and Donna Gotham (hereinafter the “insureds”) purchased an all-risk property insurance policy, policy number HCPC440805-9 (hereinafter the “Subject Policy”) from Homeowners Choice Property & Casualty Insurance Company, Inc. (hereinafter “Homeowners Choice”) which, at all times material hereto, provided property insurance for the property located at 101 Bay Mar Drive, Fort Myers Beach, FL 33931 (hereinafter the “Subject Property”). On or about September 28, 2022, Hurricane Ian, one of the most destructive storms to hit Florida, caused direct physical loss and resultant ensuing damages to the Subject Property. The insureds timely notified Homeowners Choice of the loss. Homeowners Choice assigned claim number 926942 to the loss (hereinafter the "claim") and performed an inspection of the Subject Property. After the loss, the insureds sought assistance from Mark Dorsten of Dorsten Claims LLC for assistance with their claim against the carrier. On December 2, 2022, the public adjuster inspected the property. On December 12, 2022, the public adjuster sent a letter of representation to the carrier. On December 15, 2022, the carrier denied coverage for the loss. On December 22, 2022, the public adjuster wrote an estimate for the loss. The net dwelling claim totaled $530,000.00 for the destruction. The bad faith behavior complained of herein includes all claims with Homeowners Choice Property & Casualty Insurance Company as well as TypTap Insurance Company as both companies are fully intertwined and integrated through similar staff, adjusters, corporate officers, and addresses for their administration. As such, all bad faith behavior attributable to either TypTap or Homeowners Choice is attributable to both. Based on counsel's own files, the bad faith behavior perpetrated by Homeowners Choice occurs so frequently as to indicate a general business practice. The bad faith behavior complained of has occurred in the following claims: 1. Bendayan – TypTap Claim No.: 12-3002131-20 2. Beshears – Homeowners Choice Claim No.: 887269 3. Carroll - Homeowners Choice Claim No.: 8715494 4. Darone - Homeowners Choice Claim No.: 8710786 5. Eisler - Homeowners Choice Claim No.: 884092 6. Dash - Homeowners Choice Claim No.: 914334 7. Diaz & Jugo - Homeowners Choice Claim No.: 8712535 8. Dinius - Homeowners Choice Claim No.: 923492 9. Elias – Homeowners Choice Claim No.: 8722205 10. Espinosa - Homeowners Choice Claim No.: 878449 11. Gramc – Homeowners Choice Claim No.: 8719381 12. Greene – TypTap Claim No.: 12-3000259-19 13. Greenberg - Homeowners Choice Claim No.: 921099 14. Hood - Homeowners Choice Claim No.: 8718958 15. Johnson - Homeowners Choice Claim No.: 8721928 16. Lewis – Homeowners Choice Claim No.: 886660 17. Mammarella – Homeowners Choice Claim No.: 885061 18. Melamed & Belilty - Homeowners Choice Claim No.: 8712535 19. Milian & Galindo – TypTap Claim No.: 12-3000351-19 20. Navarro - Homeowners Choice Claim No.: 886230 21. Oberlander – TypTap Claim No.: 12-3000532-20 22. Poore - Homeowners Choice Claim No.: 8711439 23. Popescu - Homeowners Choice Claim No.: 8720612 24. Price - Homeowners Choice Claim No.: 880162 25. Salzstein - Homeowners Choice Claim No.: 887271 26. Sanders & San Lorenzo – Homeowners Choice Claim No.: 8717462 27. Santillan – TypTap Claim No.: 12-3001510-20 28. Schermer - Homeowners Choice Claim No.: 8722512 29. Seidamn – TypTap Claim No.: 12-3001498-20 30. Sosa – TypTap Claim No.: 12-3000557-20 31. Sullivan - Homeowners Choice Claim No.: 8723230 32. Turner - Homeowners Choice Claim No.: 8717442 These files all contain a common modus operandi: Homeowners Choice drastically under covers a claim, either through a minimal payment or a below deductible letter, along with, on many occasions, a partial denial of coverage. Once its insured submits documentation which evidences a discrepancy in the adjustment of the claim, Homeowners Choice piecemeals further adjustment, to wit, it will ask for a sworn proof of loss in one letter and then a reinspection only after it has received the sworn proof of loss despite having all of the necessary information to warrant further adjustment. It must be noted that, as the request for a sworn proof of loss comes only once an estimate has been submitted, the proof of loss request does nothing to further the adjustment of the claim. Once the proof of loss or reinspection has been requested, Homeowners Choice will find other reasons to delay additional coverage and/or payments. Furthermore, despite each Homeowners Choice adjuster possessing an email address and accepting correspondences via email, Homeowners Choice refuses to provide courtesy copies of correspondences via email, an instantaneous method of communication, and, instead, opts to send all correspondence via US mail so as to even further delay the claim. Finally, Homeowners Choice may request mediation through the department of financial services and send an adjuster who either refuses to offer any new money above what was previously offered or has been directed to act in that manner. There is no purpose to these mediations other than to simply delay the claim further. Homeowners Choice also routinely ignores the required payment for statutory interest despite issuing delayed payments which would otherwise require same. As the bad faith business practices outlined above are so rampant in the small sample size of counsel's own files, it is anticipated that there same practices are generally utilized throughout the litany of claims adjusted by Homeowners Choice and, as such, constitute willful, wanton, and malicious actions in reckless disregard for the rights of its insureds. As such, it is clear that the repeated and generally utilized business practices of both Homeowners Choice and TypTap violate Florida Statutes 624 and 626, as well as the Florida Administrative Code governing adjusters' ethical requirements, and the pattern and practice of de facto bad faith adjustment tactics can be established without the need for any further investigation of Homeowners Choice’s claim files or file management system. The carrier has since refused to reconsider their denial. Homeowners Choice in not paying the full policy limits has violated Florida’s Valued Policy Law (hereinafter "VPL"). Florida’s VPL, which has been in existence since 1899, provides, in pertinent part: In the event of the total loss of any building… located in this state and insured by any insurer as to a covered peril, in the absence of any change increasing the risk without the insurer’s consent and in the absence of fraudulent or criminal fault on the part of the insured or one acting in her or his behalf, the insurer’s liability under the policy for such total loss, if caused by a covered peril, shall be in the amount of money for which such property was so insured as specified in the policy and for which a premium has been charged and paid. Fla. Stat. § 627.702(1)(a) (2022). Furthermore, “if the covered perils alone would have caused the total loss,” coverage shall be afforded in the amount of the applicable policy limits. Id. at (b). The VPL requires an insurance company to set its maximum liability, for which it sets an appropriate premium, in order to eliminate any dispute over the amount of loss payable where the insured loss is total. The Valued Policy Law... sets the amount payable when there is a total loss. ‘Its principle object and purpose is to fix the measure of damages in case of loss total, or partial; and, to this end, it requires the insurer to ascertain the insurable value at the time of writing the policy, and to write it therein.’***Undoubtedly an important object of the statute is also to simplify and facilitate prompt settlement of insurance claims when a total loss occurs… Thus vexatious contest on this [value of the property] issue would persist when the best interests of all demanded prompt settlement and relief from the loss. A solution to this is found in the statute which in effect requires the parties to ascertain and agree in advance what the value is and in the case of total loss by the insured peril this amount shall be paid as liquidated damages. This is not an unfair scheme, as the insured is stating the limits of his recovery and at the same time the insurer is basing his premium charges on his maximum exposure. When the total loss occurs neither can contend the value of the destroyed property is any different from what they had previously specified. Springfield Fire and Marine Ins. Co. v. Boswell, 167 So.2d 780, 783-84 (1st DCA 1964); see also Ceballo v. Citizens Prop. Ins. Corp., 967 So.2d 811, 813 (2007)(“Florida’s VPL was originally enacted in 1899 to promote clarity and predictability for property insurers and insureds alike by predetermining the value of insured real property and having that value set out in the policy of insurance.”); Citizens Prop. Ins. Corp. v. Hamilton, 43 So.3d 746, 756 (1st DCA 2010)(“Once the jury found a total loss caused by wind, damages were fixed by statute.”). Hurricane Ian made landfall as a Category 4 storm whose maximum sustained winds were 150 mph with recorded gusts measured up to 170 mph, per NOAA records. With Hurricane Ian, wind and wind-driven debris occurred first. This wind damage would have caused a total loss on its own. As such, Florida’s VPL is triggered and policy limits are owed. The Subject Policy provides $530,000.00 in Coverage A - Dwelling, $10,600.00 in Coverage B – Other Structure, $132,500.00 in Coverage C - Personal Property, and $53,000.00 in Coverage D – Loss of Use. Thus, the insureds have been left with no choice but to hire an attorney in order to file a notice of intent to initiate litigation subject to Fla. Stat. § 627.70152. Based on the documentation previously submitted, Homeowners Choice could have reversed its coverage position and afforded coverage in line with the terms and conditions of the Subject Policy and governing Florida law or, at a minimum, requested a further inspection in order to attempt to find coverage by viewing the circumstances in the light most favorable to the insureds; instead, Homeowners Choice chose to sit back and wait before Homeowners Choice ever thought to act in a manner inconsistent with their own self-interest, forcing the insureds into hiring an attorney, thereby coming further out of pocket and leaving less of the outstanding due and owing insurance proceeds for actual repairs. This delay in claims adjustment constitutes a pattern of de facto bad faith conduct. Through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Homeowners Choice has violated the following sections of Florida Statutes: §624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insured and with due regard; §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)(c) Failing to acknowledge and act promptly upon communications with respect to claims; and §626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Additionally, through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Homeowners Choice has failed to comply with the following sections of Florida Administrative Code: 69B-220.201(3)(b) An adjuster shall treat all claimants equally; 69B-220.201(3)(b)(1) An adjuster shall not provide favored treatment to any claimant; 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)(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation; 69B-220.201(3)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim; and 69B-220.201(3)(k) 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. As a direct result of Homeowners Choice's actions, the insureds have sustained irreparable harm. Upon information and belief, the aforementioned actions complained of herein, among others, are effectuated by Homeowners Choice so often as to constitute a general business practice evidencing a motive to enhance Homeowners Choice's profits and cause a detrimental effect to its policyholders. Homeowners Choice clearly failed to adopt and implement standards for the proper investigations of claims. As a direct and proximate result of Homeowners Choice's handling of the claim, the insureds sustained extra-contractual damages, including, but not limited to, a public adjuster's fee. Homeowners Choice's implemented claims programs and practices that were improper which directly resulted in additional losses to its insureds. Homeowners Choice, as part of its routine business pattern and practices, employs outcome-oriented adjusters/vendors/experts who purposely looked for ways to minimize coverage instead of affording coverage to its policyholders. In contrast to the legislative intent which motivated the enumeration of an insurance adjuster’s responsibilities outlined in the Florida Administrative Code, the insureds were not afforded the professional duties entrusted and imposed on Homeowners Choice by the Public Trust. The outcome-oriented claim adjustment practices undertaken by Homeowners Choice led to Homeowners Choice's failure to adequately adjust the Claim. Based on the above, it is clear that Homeowners Choice must have a reason to act with such blatant disregard to policy, statute, rules, code, and procedure. The only possible motive an insurance company could have to act in such an egregious manner is that Homeowners Choice is somehow benefiting financially through its bad faith actions. If a financial motive for acting in bad faith proves to be true, Homeowners Choice, and, through the piercing of Homeowners Choice's corporate veil, its officers individually, should be monetarily sanctioned by all entities governing insurance in the State of Florida but also its license to write new insurance policies should be suspended until such a time as it has indemnified all outstanding claims. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Homeowners Choice fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. In order to cure the defects outlined in this Civil Remedy Notice, Homeowners Choice must act as follows: immediately deliver payment of all insurance proceeds due and owing to the insureds which would reasonably place the Subject Property back in its pre-loss condition or, alternatively, if appraisal is or has been requested, complete the appraisal process and deliver payment of the executed award; deliver payment for policy limits of additional living expenses due to the foreseeable requirement that same will be incurred; and keep the claim open for the adjustment of any supplemental claim and payment of any as of yet unincurred costs. If Homeowners Choice disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, Homeowners Choice should cure to the extent it believes it must under the Subject Policy and governing laws to correct the allegations of bad faith contained herein. While it is not being requested as a cure for the bad faith alleged herein, the insureds remain willing to entertain any reasonable counteroffer of settlement.

Comments

User Id		Date Added		Comment
hwood@wood-bronstein.com		06-20-2023		Bureau of Consumer Assistance Civil Remedy Section Florida Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-0322 Re: Civil Remedy Notice of Insurer Violation Complainants: Robert Gotham and Donna Gotham Insureds: Robert Gotham and Donna Gotham DFS File No.: 690366 Acceptance Date: 4/27/2023 Claim No.: 926942 Dear Bureau of Consumer Assistance: Please be advised that we are in receipt of a Civil Remedy Notice of Insurer Violation, which was accepted on or about April 27, 2023, regarding the above referenced claim. The following is our response on behalf of Homeowners Choice Property & Casualty Insurance Company, Inc., (hereinafter “Homeowners Choice”). At the outset, Florida Statute §624.155 requires the insured to set forth sufficient factual allegations to state a prima facie case of an insurer violation, so as to put the insurer on notice and be afforded the opportunity to cure the deficiency. Here, the Complainant and/or the Complainant’s attorney failed to do so. Nevertheless, and in an abundance of caution, we provide a response on behalf of Homeowners Choice. A review of our file indicates that Homeowners Choice has acted appropriately in the handling of this claim. Robert Gotham and Donna Gotham, (hereinafter “Complainants”) through their attorney, Michael Nemerof, list the reasons for the Civil Remedy Notice as, “Claim Denial”, “Claim Delay”, “Unfair Trade Practice” and “Violation of Adjusters’ Ethical Requirements. It is then claimed that Homeowners Choice violated Florida Statute §§ 624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests; 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims; 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims; and 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. None of these allegations are accurate, nor do the facts of this claim justify the filing of a Civil Remedy Notice of Insurer Violation. This loss allegedly occurred on September 27, 2022 as a result of Hurricane Ian. This claim was reported to Homeowners Choice on October 4, 2022 by the insured, Robert Gotham. Mr. Gotham advised that on September 27, 2022 his home suffered a total loss. While he was not able to get onto the island, he had seen pictures leading him to believe there was nothing left of his house. A claim number was assigned. The claim was then assigned to a field adjuster who promptly scheduled an inspection of the residence. He inspected the risk on October 23, 2022 and found the risk to be a total loss. No structure remained on the site. Homeowners Choice retained Independent Forensics Group, LLC) to determine the cause of loss. Independent Forensics Group, LLC inspected the risk on October 26, 2022. Based upon the investigation conducted and findings obtained, the carrier made its coverage determination, in a letter dated December 1, 2022, sent directly to the insureds. The coverage determination letter explained that “We have completed our investigation of your claim. Based on our field adjuster’s inspection on October 23, 2022 and the engineering inspection conducted on October 26, 2022, it was determined the dwelling was completely washed by storm surge. Unfortunately, your policy does not afford coverage for this type of loss. Please refer to your policy, HOMEOWNERS 2 – HO 02 11 14 WIND ONLY Homeowners Policy, it states in part: … PERIL INSURED AGAINST 1. We insure for direct physical loss to the property described in Coverages A, B and C caused only by the peril of windstorm or hail unless the loss is excluded in EXCLUSIONS. 2. With respect to paragraph 1. above, coverage for loss caused by a Peril Insured Against includes loss to … b. The inside of a building or the property we cover contained in a building caused by: (1)Rain; (2)Snow; (3)Sleet; (4)Hail; (5)Sand; or (6)Dust; if the direct force of the windstorm or hail first damages the building, causing an opening through which the rain, snow, sleet, hail, sand or dust enters and causes damage. … EXCLUSIONS We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. … 3. Water Damage Water Damage means: a. Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water, storm surge, wave wash, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge; b. Water which: (1) Backs up or overflows through sewers or drains. (2)Backs up, overflows or is otherwise discharged from a septic system or drain field, or related equipment or similar systems; or (3) Overflows, backs up or is otherwise discharged from: (a) A sump, sump pump, irrigation system, or related equipment; or (b) A roof drain, gutter, down spout, or similar fixtures or equipment; … 11.Wear, Tear, Marring and Deterioration This policy does not include loss caused by wear, tear, marring and deterioration. 12. Inherent Vice, Latent Defect and Mechanical Breakdown This policy does not include loss caused by inherent vice, latent defect or mechanical breakdown. This policy does not include loss caused by inherent vice, latent defect or mechanical breakdown. … CONDITIONS … B. Duties After Loss You must see that the following are done in the event of loss or damage to covered property: 1. Give prompt notice to us or our agent. 2. Protect the property from further damage. If repairs to the property are required, you must: a. Make reasonable and necessary temporary repairs to protect the property; and b. Keep an accurate record of repair expenses. 3. Cooperate with us in the investigation of a claim. … By stating the above reason for the denial of the claim, Homeowners Choice Property & Casualty Insurance Company (“HCPCI”) does not intend to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert such policy defenses at any time. HCPCI does not intend this letter to be a full disclosure of all policy coverages, conditions and exclusions, neither is it our intent to waive any of the rights and privileges afforded to us under the policy in question. HCPCI hereby continues to reserve those rights and privileges.” The letter, as mentioned above, referenced pertinent portions of the policy and in particular the exclusions – “We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. … 3. Water Damage … Water Damage means: a. Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water, storm surge, wave wash, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge…”. (emphasis added) Based on the field adjuster’s inspection on October 23, 2022 and the engineer’s inspection on October 26, 2022, it was determined the dwelling was completely washed away by storm surge. Unfortunately, the policy does not afford coverage for this type of loss, as it is specifically excluded in the language above. Consequently, Homeowners Choice was unable to provide coverage for this claim. The contention that Homeowners Choice did not address this claim fairly and promptly is without merit. To the contrary, the field adjuster and the engineer promptly inspected the property and provided their opinions to Homeowners Choice. The attorney for the insureds provides a time line of the events in support of their position listing 12/2/22 as the date the PA inspected the property, 12/12/22 as the date the PA sent a letter of representation to the carrier and 12/15/22 as the date the carrier denied coverage for the loss. This timeline leaves out 10/4/2022 as the First Notice of Loss, 10/23/2022 as the date the FA inspected, 10/26/2022 the date the Professional Engineer inspected and 12/1/2022 as the actual date the carrier denied coverage for the loss. The facts of this matter clearly indicate that Homeowners Choice acted fairly towards its insureds at all times with regards to this claim. Homeowners Choice was notified of this claim on October 4, 2022. An adjuster was assigned to the claim and promptly contacted the insureds to schedule an inspection of the insured residence. Thereafter, on October 26, 2022, a Professional Engineer inspected the property. Homeowners Choice reached its coverage determination and timely provided the insureds with a detailed explanation, in writing, of the coverage determination for the insurance claim. In conclusion, none of the allegations of insurer misconduct, contained in this Civil Remedy Notice of Insurer Violation, are accurate. An objective review indicates Homeowners Choice has acted appropriately in the handling of this claim. In addition, Homeowners Choice has at all times, acted fairly and properly towards Complainants with full regard for their interests and has complied with its obligations to its insureds, Homeowners Choice’s other insureds, and the citizens of the State of Florida. We trust that we have adequately responded to the Civil Remedy Notice. However, should you have any questions or comments concerning this matter, please do not hesitate to contact the undersigned. Thank you for your attention. Very truly yours, E-Mailed Hayes G. Wood For the Firm

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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008