Civil Remedy Notice of Insurer Violations
Login

Filing Number:     782757
Filing Accepted:  9/13/2024
         Print Filing
Complainant
Last/Business Name *  
COACH HOMES V AT MOODY RIVER CONDOMINIUM ASSOC.   First Name  
Street Address * 3001 EXECUTIVE DRIVE SUITE
City, State Zip * CLEARWATER, FL 33762
Email Address * LRMS7210@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   COACH HOMES V AT MOODY RIVER CONDOMINIUM ASSOC.   First Name  
Policy # * ECL 0886283 00 Claim #* 5630106102
Attorney
Attorney is Applicable
Last Name* PIMENTEL First Name * LUIS Initial
Street Address* 9000 SHERIDAN ST. SUITE 106
City, State Zip* PEMBROKE PINES , FLORIDA 33024
Email Address * LUIS@PIMENTELAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STEADFAST INSURANCE COMPANY
NAIC Company Code 26387
 
Name of individual responsible for violation (if any):* JENNIFER ODOM
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
* 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

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

The carrier was immediately put on notice of the insureds’ Hurricane Ian claim. Subsequently, the insureds prepared a loss package in the amount of $3,300,237.50 needed to restore the property back to its pre-loss condition. Whereas, the carrier has failed to prudently inspect the insureds’ property, come to a fair coverage determination and promptly pay the claim. In turn, the insureds have complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. The insured has fully cooperated with the carrier’s investigation of the claim including facilitating access to all requested and affected units, providing extensive documents reflecting repairs, board meetings etc. This claim is going on 7 months without a Coverage Determination despite all inspections being completed months ago in violation of Florida Statute. This intentional delay with the claim has led to direct prejudice of the insureds. About one hundred and eighty-two days have passed since the claim was reported to the carrier. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of the damage sustained by the insured’s property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f and 626.9541(1)(i)(4) as well as Condominium Association Coverage Form subsection A, providing coverage for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss as well as Section titled Florida Changes subsection 3 Loss Payment provision which requires payment for the claim within 90 days of receiving notice of an initial, reopened or supplemental claim. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $3,300,237.50, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned (786)-288-1681 if you have any questions or concerns. Sincerely, Luis Pimentel , esq.
Comments
User Id Date Added Comment
jmohammed@butler.legal 11-12-2024 Dear Sir/Madam; This firm represents Steadfast Insurance Company (“Steadfast”) in the above matter. This responds to Civil Remedy Notice of Insurer Violations number 782757 (“Notice”) filed by Coach Homes V at Moody River Condominium Association (“Insured”) against Steadfast on September 13, 2024. This response is timely. The Notice is invalid, and the allegations are meritless. Steadfast denies the allegations in the Notice. Steadfast acted in good faith toward the Insured. Steadfast is confident that the following summary of the efforts in the underlying claim will satisfy any inquiry by Florida’s Department of Financial Services and show that Steadfast acted in good faith. The Insured failed to report this claim until a year and five months after Hurricane Ian. Contrary to the Insured’s contention in the first sentence of the Notice that Steadfast “was immediately put on notice” of the claim, the Insured did not report anything to Steadfast until March 15, 2024. Due to the significant reporting delay the Insured, Steadfast issued a reservation of rights letter to the Insured at the outset of the claim. Steadfast hired JS Held and SEA Ltd. They inspected the property with the assigned Steadfast adjuster in April and May of 2024. The Insured’s significant reporting delay prejudiced Steadfast, and it could not verify that any of the claimed damages were caused by a covered cause of loss. The Insured further prejudiced Steadfast because it never produced critical documents including board meeting records and roof replacement quotes from 2020 and 2022, inspection reports and repair invoices for affected units. Steadfast denied coverage for this claim. It could not verify that any of the claimed damages were caused by a covered cause of loss, and the insurance policy bars coverage for some of the claimed damages. Moreover, the entire Notice is invalid under Florida law because it is defective. The filing of a valid Notice is a required condition precedent to an action under section 624.155, Florida Statutes. See Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1278, 1282 (Fla. 2000). Because the bad faith statute is in derogation of the common law, it must be strictly construed. Id. at 1283. The Notice is defective because it does not include specific language from the Policy relevant to the alleged violations. It vaguely refers to a “loss settlement provision” by title. This is insufficient and does not meet the requirements of the statute. Steadfast denies the allegation that it violated sections 624.155 or 626.9541, Florida Statutes. Steadfast denies all the alleged factual violations and purported reasons for the Notice, too. Steadfast denies that it violated section 624.155(1)(b)(1), Florida Statutes, by not attempting in good faith to settle this claim when, under all circumstances, it could and should have done so. Despite the significant reporting delay, Steadfast began investigating the claim and inspecting the property immediately. Steadfast requested critical documents from the Insured and its representatives several times. Steadfast denies that it violated section 624.155(1)(b)(3), Florida Statutes, by failing to promptly settle this claim, when the obligation to settle the claim has become reasonably clear, under one portion of the insurance policy coverage to influence settlements under other portions of the insurance policy coverage. Steadfast denies that it violated section 626.9541(1)(i)(3)(a), Florida Statutes, by failing to adopt and implement standards for the proper investigation of claims. Steadfast has proper standards for investigating claims. But the Insured refused to cooperate with the investigation as required by the policy. Steadfast denies that it violated section 626.9541(1)(i)(3)(c), Florida Statutes, by failing to acknowledge and act promptly upon communications with respect to claims. Steadfast acknowledged and communicated with the Insured and its representatives promptly throughout this claim. Steadfast denies the that it violated section 626.9541(1)(i)(4), Florida Statutes, by failing to pay undisputed amounts of partial or full benefits owed under a first-party property insurance policies within 60 days after receiving notice of a residential property insurance claim, determining the amounts of partial or full benefits, and agreeing to provide coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in section 627.70131(5), Florida Statutes. Steadfast denies the false claims that it did not inspect the property, that the Insured reported the loss immediately, and that the Insured cooperated with Steadfast during its investigation. These claims are not true. The Insured’s late reporting of this claim prejudiced Steadfast’ s ability to verify that any of the claimed damages were caused by a covered cause of loss. To the extent the Insured alleges Steadfast has not determined coverage in this claim, Steadfast has cured any such allegation. The Notice is invalid and Steadfast denies all allegations. Steadfast reserves the right to assert any defense regarding proper service of the Notice or the sufficiency or validity of the Notice. No part of this response shall be construed as a waiver of rights or defenses available to Steadfast under the policy or Florida law. Please contact us if there are any questions regarding this response. Sincerely, Paul Hudson Jones II
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