Civil Remedy Notice of Insurer Violations
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Filing Number:     782932
Filing Accepted:  9/16/2024
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Complainant
Last/Business Name *  
VANDERBILT BAY CONDOMINIUM ASSOCIATION, INC.   First Name  
Street Address * 10420 & 10482 GULF SHORE DRIVE
City, State Zip * NAPLES, FL 34108
Email Address * WMAXW5923@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   VANDERBILT BAY CONDOMINIUM ASSOCIATION, INC.   First Name  
Policy # * AMC-3258-07 Claim #* 4199742
Attorney
Attorney is Applicable
Last Name* KELLY First Name * FANTETTI Initial
Street Address* 109 S. EDISON AVENUE
City, State Zip* TAMPA , FLORIDA 33606
Email Address * KFANTETTI@STOCKHAMLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN COASTAL INSURANCE COMPANY
NAIC Company Code 12968
 
Name of individual responsible for violation (if any):* ZAMAL DWARKA, MICHAEL EVANS, DAN-YON WHITAKER, SYLVIA BOLAR, KATHLEEN BYERS
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

A. Coverage We will pay 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 The Loss Payment Condition dealing with the number of days within which we must pay for covered loss or damage is replaced by the following: Provided you have complied with all the terms of this Coverage Part, we will pay for covered loss or damage upon the earliest of the following: (1) Within 20 days after we receive the sworn proof of loss and reach written agreement with you; (2) Within 30 days after we receive the sworn proof of loss and: a. There is an entry of final judgment or b. There is a filing of an appraisal aware with us; or (3) Within 90 days of receiving notice of an initial, reopened, or supplemental claim, unless we deny the claim during that time or factors beyond our control reasonably prevent such payment. If a portion of the claim is denied, then the 90-day time period for payment of claim relates to the portion of the claim that is not denied. Ordinance or Law Coverage Endorsement (AC 04 05 07 18) (e) Increased Cost of Construction (2) In the event of damage by a Covered Cause of Loss to a building that is Covered Property, we will pay the increased costs incurred to comply with enforcement of an ordinance or law in the course of repair, rebuilding, or replacement of damaged parts of that property . . . . G. Optional Coverages If shown as applicable in the Declarations, the following Optional Coverages apply separately to each item. 3. Replacement Cost a. Replacement Cost (without deduction for depreciation) replaces Actual Cash Value in the Loss Condition, Valuation, of this Coverage Form. c. You may make a claim for loss or damage covered by this insurance on an actual cash value basis instead of on a replacement cost basis. In the event you elect to have loss or damage settled on an actual cash value basis, you may still make a claim for the additional coverage this Optional Coverage provides if you notify us of your intent to do so within 180 days after the loss or damage.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. American Coastal Insurance Company (“Insurer” or “American Coastal”) has breached the public’s trust by its adjustment of Vanderbilt Bay Condominium Association Inc.’s (“Insured”) claim of loss. American Coastal’s mailing address is 800 2nd Avenue, St. Petersburg, FL 33701. American Coastal has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. American Coastal has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s insurance claim for damages. American Coastal has failed to promptly settle the Insured’s insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the Insured’s pleas otherwise, American Coastal has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its Insured under the policy. Vanderbilt Bay Condominium Association Inc’s policy provides coverage for the Association’s buildings located at 10420 Gulf Shore Drive, Naples, Florida 34108, 10482 Gulf Shore Drive, Naples, Florida 34108, and 10420 Gulf Shore Drive, Naples, Florida, 34108. The buildings sustained significant damage during Hurricane Ian. Hurricane force winds impacted the Insured Property during Hurricane Ian of sustained winds of at least 83 MPH and gusts up to 110 MPH. Since the beginning of the claim, the Insured has complied with all policy conditions, including multiple inspections, supplying pertinent documentation, and executing a proof of loss. Nevertheless, instead of resolving the claim, American Coastal continues to demand more and more documentation and recorded statements, without explanation as to the necessity for same. Throughout the claim, the Insurer has repeatedly undervalued the claim and has failed to properly assess the scope of covered damage and repairs necessary to return the property to its pre-loss condition. The Insurer has failed to acknowledge the true extent of the damage sustained to the Insured Property during Hurricane Ian. Despite the evidence presented, the Insurer’s failure to properly consider the actual scope of damage and the evidence of damage submitted by the Insured has left the Insured with unresolved damage and the financial burden of having to replace the roofs of the property without adequate compensation. The claim was reported by the Insured’s public adjuster, Keys Claims Consulting on or about October 17, 2022. The Insurer advised that Don-Yon Whitaker was the assigned adjuster from Sedwick Delegated Authority. Thereafter, both the Insurer and the Insured conducted multiple inspections of the property to determine the full extent of the damages. Subsequently, on January 31, 2023, Zamal Dwarka was assigned as the new adjuster on behalf of Sedgwick, the claims administrator for the Insurer. Zamal Dwarka, on February 24, 2023, advised the Insurer had determined the damage to the Insured Property was under the applicable deductible based upon the inspection by the field adjuster, Michael Evans; Applied Engineering Technology; and JS Held. On August 24, 2023, Zamal Dwarka, again advised the claim did not exceed the deductible, and requested a Proof of Loss from the Insured and additional information. Despite being fully aware the Insured was represented by a public adjuster, the Insurer sent the request for the Proof of Loss to the Insured directly and the public adjuster was not notified of the request until the Insured forwarded the correspondence. The Insured, through its public adjuster, took every effort to comply with the information requested by the Insurer and submitted its Sworn Proof of Loss totaling $2,939,603.88 RCV / $2,357,059.78 ACV dated November 15, 2023. Due to the underlying damage to the roofs, the Insured’s public adjuster notified the Insurer on March 5, 2024, that the replacement of the roofs was scheduled for May 2024 and welcomed any necessary inspections to be completed before the replacement was scheduled. Again, on April 5, 2024, the Insured’s public adjuster notified the Insurer that the roof replacement by Green Coast Roofing was scheduled to commence on May 6, 2024. Nevertheless, American Coastal never responded to these correspondences and never reinspected the roofs. The roofs have since been replaced for a total of $471,100.06. Thereafter, the public adjuster and Mr. Dwarka spoke about possible resolution of the claim, including the option of appraisal. However, Mr. Dwarka later rejected the idea of appraisal. Instead, he threatened that the claim would be met with continued delay if the claim was not resolved to his liking. Thus, the Insurer has unilaterally blocked all attempts by the Insured to resolve the underlying differences in this claim and has forced the Insured to obtain legal counsel and move this claim towards litigation. On June 28, 2024, the public adjuster again wrote to the Insurer confirming that the prior negotiation efforts had failed, and the carrier had answered the property manager’s call while ignoring the public adjuster’s attempts to amicably resolve the claim. The Insurer has ignored the findings of Trillas Consulting Engineers and National Testing Services outlined below to the detriment of the Insured. Despite being put on notice of the Insured’s prior intention of replacing the roof in May 2024, Sylvia Bolar, on behalf of the Insurer, advised on July 1, 2024, that Compass Building would be willing to perform the repairs as outlined in its estimate; however, such a recommendation was improper and would not place the Insured back to the position it was in prior to the loss. Eric Trillas, P.E., S.I. of Trillas Consulting Engineers, LLC inspected the property on behalf of the Insured on March 1, 2023, and March 2, 2023. Mr. Trillas prepared a report totaling over 3,000 pages for the two seven-story buildings at the Insured Property. The report confirmed damage to the building components and envelope due to excessive and cyclical wind pressures causing uplift and fatigue failures. Damage included impact debris damage, evidence of lateral movement and uplift, damage to the roofing elements, and damage to the fenestration products causing moisture intrusion. Mr. Trillas opined that due to the widespread damage from windborne debris and interaction by the roofing systems with the winds from Hurricane Ian, the entire roofing system needs removed and replaced. A summary of Mr. Trillas’ observations are as follows: - Cracking was observed to the interior finishes due to lateral movement and uplift caused by the buildings’ interactions with the high winds. - Moisture damage was present at numerous areas of the buildings’ interiors caused by the failure of the fenestration products during the storm and ensuing interior damage due to the damage to the building envelope during the storm. - Impact damage to the parapet wall systems and protective flashing systems caused by the buildings’ interactions with the high winds and windborne debris during the storm event - Screens of the balcony enclosures were observed to be torn or missing due to the interactions with the high winds during the storm - Areas of soft spots, impacted, and uplifted areas of the roofing membranes from the high wind event. - Indentations of the metal roofing panels are indicative of damage from high winds - HVAC units on the rooftops are indicative of damage from the high winds - Widespread damage to the drip edge flashing system and parapet protective walls observed at multiple locations due to wind suction causing uplift and flying debris - Deformation to the gutter systems were observed - Evidence of cyclical movement of fenestration products were apparent causing cracking to the exterior finishes. Additionally, misalignment, twisted, and/or bent frames were observed due to the high winds. - Separation and dislocation of the boards on the exterior staircases due to interaction with the high wind event - Balcony enclosures had missing screens and bent metal due to the high winds - Cracking to the exterior of the buildings was observed due to the lateral movement and uplift from the high wind event affecting the building envelope components A fenestration study was also conducted on behalf of the Insured by Moisture Intrusion Solutions d/b/a National Testing Services (NTS). A large number of the systems were observed with damage to the gaskets, wind damage, and joinery gaps from the stress of the extreme wind and/or differential pressure. Based upon the testing failures, the windows and sliding glass doors need replaced. Extensive testing, like that performed by NTS, was not performed by the Insurer’s retained experts. Despite the evidence presented, the Insurer has refused to acknowledge the need for the full roof replacements and replacement of the damaged windows and doors. The roof was unable to be repaired and full replacement was necessary and appropriate. Accordingly, as mentioned above, the Insured was forced to retain an attorney to continue pursuing this claim. Despite that the public adjuster had previously request a copy of the insurance policy on October 17, 2022, and again on September 5, 2023, the policy was not provided until the Stockham Law Group sent its letter of representation. In addition, on September 3, 2024, more than two years after the loss, and in response to receiving the letter of representation, American Coastal sent a lengthy request for documents and a recorded statement, despite the extensive information previously provided by the public adjuster. The request provided no explanation for why such information was necessary. Rather, it seems like American Coastal is making good on Mr. Dwarka’s threat to drag out the claim process if the Insured does not capitulate to his settlement demands. Nevertheless, the Insured has agreed to submit to the recorded statement and is in the process of gathering the requested documents in an effort to comply with the conditions of the insurance policy. The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the Insured may mitigate its damages and be put back into the position she was in prior to the loss as quickly as possible. The Insurer has breached this duty. The Insured was, and still is, forced to expend out of pocket monies to submit its insurance claim, e.g., retaining an attorney and other experts to force the Insurer to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to the Insured. The Insurer has refused and/or failed to tender all the insurance proceeds due and owing to the Insured. The Insurer’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the Insured is wrongful conduct. Furthermore, the Insured contends that the Insurer’s adjusters and/or representatives financially benefit from such wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, Insurer must (1) promptly tender all insurance proceeds due and owing to the Insured that would reasonably place the Insured back into the pre-loss condition, including the tender of accrued interest; and (2) timely communicate with the Insured and/or its representatives to complete the adjustment and investigation of the claim; and (3) participate in good faith negotiations to reach an agreement relating to the parties’ dispute over coverage and amount of damages. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
Comments
User Id Date Added Comment
kferry@camboferry.com 11-12-2024 November 12, 2024 VIA EMAIL ONLY Vanderbilt Bay Condominium Association Stockham Law Group Attn: Kelly Fantetti, Esq. 109 S. Edison Ave Tampa, FL 33606 kfantetti@stockhamlawgroup.com RE: Date of Loss: 09/28/2024 Insured's name: Vanderbilt Bay Condominium Association Carrier Name: American Coastal Insurance Company Claim Number: 4199742 Policy Number: AMC-3258-07 CRN Filing Number: 782932 Dear Ms. Fantetti: As you know, my firm represents American Coastal Insurance Company (“AmCoastal”) with respect to the above matter. This correspondence constitutes AmCoastal’s response to the Civil Remedy Notice of Insurer Violation (“CRN”) with filing number 782932 you filed on behalf of Vanderbilt Bay Condominium Association. The Notice is void because it is legally invalid. Beyond that, the allegations in the Notice have no merit. I. The Civil Remedy Notice is legally invalid. The filing of a valid Civil Remedy Notice is a condition precedent to an action brought pursuant to section 624.155, Florida Statutes. Talat Enter., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Because the statute is in derogation of the common law, it must be strictly construed. Id. “[A]ny statute in derogation of the common law requires strict compliance with its provisions by one seeking to avail himself of its benefits.” Florida Steel Corp. v. Adaptable Devs., Inc., 503 So. 2d 1232, 1234 (Fla. 1986). Section 624.155, Florida Statutes, requires a civil remedy notice to provide specific information to put the AmCoastal on notice of the alleged violation. Additionally, a civil remedy notice must be “specific enough to provide Insurer notice of the wrongdoing so the Insurer can cure the same within sixty days.” Valenti v. Unum Life Ins. Co. of Am., 8:04CV1615T-30TGW, 2006 WL 1627276, at *2 (M.D. Fla. 2006). Here, the Notice is invalid because it does not contain all of the information required by section 624.155. Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Also, it is invalid because it lacks sufficient specificity to provide notice to AmCoastal of the alleged wrongdoing, as discussed below. First, the Notice is invalid because it does not list a specific cure for the alleged violations. In Talat, the Florida Supreme Court said that to “cure” a Notice, an Insurer must pay the amount owed pursuant to the express terms and conditions of the policy.” However, no cure amount of any kind is provided and AmCoastal is left to guess what would be required to “cure” the alleged violations. It is improper for a civil remedy notice to not contain a cure, therefore the CRN is invalid. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002). Second, the Notice is invalid because it conditions AmCoastal’s ability to “cure” by requiring AmCoastal to pay for things and do things that are not required under Talat. In Talat, the Florida Supreme Court said that to “cure” a Notice, an Insurer must pay the amount owed pursuant to the express terms and conditions of the policy.” However, the Notice here demands payment of money that is not owed pursuant to the policy, such as interest. It is improper to demand such items as a cure for a civil remedy notice. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002) (discussing whether a demand of attorneys’ fees in a civil remedy notice is proper). Third, the boilerplate CRN lacks sufficient specificity to provide notice of the alleged bad-faith conduct. The CRN lists 5 different statutes which AmCoastal allegedly violated. However, the CRN fails to provide any relevant facts supporting the alleged violations or relating these alleged violations to the 5 cited statutes. Because the Civil Remedy Notice fails to identify any specific statutes or any facts to support why the Insured believes AmCoastal violated the statutes, AmCoastal is unable to properly respond, and the Notice is invalid and should be rejected and returned. Because the CRN fails to comply with the information requirements promulgated by the Department of Financial Services, it is legally invalid. See Pin-Pon Corp. v. Landmark Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Prop. & Cas. Ins. Co., 4D19-2763 (September 23, 2020); Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Again, in serving this response, AmCoastal reserves all rights under Florida law to be served with a properly completed and statutorily compliant CRN. As the CRN fails to strictly comply with the requirements of section 624.155, Florida Statutes, it is legally insufficient and should be rejected. II. The Civil Remedy Notice Lacks Merit The Notice also lacks merit. AmCoastal issued a commercial policy to the Insured, insuring the property located at 10482 Gulf Shore Drive, 10420 Gulf Shore Drive, Naples, FL 34108 for a policy period from May 13, 2022 through May 13, 2023. The insured property is two seven story commercial condominium buildings that are insured as following subject to a 5% Hurricane Deductible: The Insured’s public adjuster (“PA”), Keys Claims Consultants, reported a claim on October 18, 2022 for damage allegedly occurring a the subject property on September 28, 2022 as a result of Hurricane Ian. On October 18, 2022, Sedgwick Delegated Authority (“SDA”), on behalf of AmCoastal, acknowledged the claim, assigned a claim number, and provided the account manager/adjuster’s information. Based on the extent of the claimed loss and damage, as well as the severe flooding at the subject property, AmCoastal retained an engineer to inspect the subject property and to determine the cause and extent of the claimed damage. On November 7, 2022 and November 8, 2022, Applied Engineering & Technology inspected the subject property and concluded the following: 1. Hurricane Ian struck Florida in late September of 2022. The storm’s eyewall passed within about 40 miles of the Vanderbilt Bay Condominium property. Although the Vanderbilt Beach area was subjected to severe storm surge that resulted in significant flood damage, this area was not exposed to hurricane force winds to the same degree as areas that were closer to the storm’s eyewall. 2. During Hurricane Ian, the heaviest winds at Vanderbilt Bay Condominium were blowing from the south and west, with the available weather data indicating that maximum wind gust speeds were likely between 88 mph and 99 mph. The hurricane produced wind pressures only about 82 percent of the pressures that the property structures were designed to resist. 3. AET’s moisture survey of the main roofs indicated that the roofs are dry with the exception of some localized areas of pre-existing age-related deficiencies in the roof membrane. None of the localized areas of elevated moisture appear to be the result of wind damage or a one-time weather event such as Hurricane Ian. 4. A few minor roof damage items on the main roofs of Buildings 1 and 2 are attributable to the strong winds of Hurricane Ian. Such wind damages include dislodged/deformed flashings and detachment of lightning protection elements. 5. AET also observed a location of minor impact damage at the standing seam metal roof at the front (west) side of Building 2. It is possible that this impact, which also affected the adjacent gutter, is the result of windborne debris carried by the hurricane winds. 6. AET observed no hurricane damage to the condo unit sliding glass doors or windows throughout Buildings 1 and 2. AET did observe minor manufacturing deficiencies in many of the sliding glass door/window units throughout the buildings that are unrelated to Hurricane Ian. In addition, many of the original sliding glass door/window units throughout the building have been affected significantly by long-term wear-and-tear deterioration because they are nearly 40 years old and should have already been replaced. 7. The condo unit balconies did not suffer damage due to Hurricane Ian, with the exception of the floor-to-ceiling insect screening that has been installed along the perimeter of the balconies, which suffered some localized wind damage. 8. At Unit 141 a bent baluster at the balcony guardrail indicates possible impact damage that occurred during Hurricane Ian. It is possible that an item stored on the balcony may have been blown into the guardrail baluster at this location. Otherwise, the storm did not cause damage to the balcony guardrails. 9. Two locations were noted where dislodged lights were observed at the ceilings of condo balconies. It appears that these lights were dislodged by the hurricane wind. 10. The common areas and stairs of Buildings 1 and 2 were not affected by Hurricane Ian, with the exception of some exterior exit lights that are missing components. It is possible that the exit lights were damaged by the hurricane wind. 11. AET observed no indications of hurricane damage at the elevated tennis court or the parking area directly beneath the court. 12. The storm surge from Hurricane Ian caused water from the ocean and channel to rise to an elevation of nearly six feet above the ground floors in Buildings 1 and 2. The moving water produced by the storm surge came into contact with the building perimeters and was able to inundate the ground floor levels after infiltrating through the building envelopes. AET has noted where the storm surge flood water caused damage to building elements at the ground floors of Buildings 1 and 2, and also to the swimming pool area. 13. AET has provided a list of hurricane-related repairs that are required at the property based on its field evaluation (excluding damages caused by storm surge flooding). On January 31, 2023, SDA emailed the PA with its new account manager information. Further, the field adjuster emailed the PA requesting the following information to complete the claim investigation: 1. Name and contact information for each unit with reported damage 2. Contractor repair estimates for damaged claimed- Interior and exterior. Estimate needs to be itemized. 3. Insurance information for each unit with damage. Information should contain Insurance Company, Claim number, adjuster contact information and estimate from insurance carrier. A Copy of the insurance company estimate should contain all of his information. 4. Roof & elevations repair estimate for your reported damage. 5. Copy of Association Bi laws. 6. Documented Lien holders for COA Additionally, based on the engineering inspection, a building consultant prepared an estimate of the claimed damage caused by Hurricane Ian. After applying the 5% Hurricane deductible, the loss was below the deductible. Accordingly, on February 24, 2023, AmCoastal issued its coverage determination, opening coverage for the covered Hurricane Ian damage, which fell below the applicable Hurricane Deductible, and denying coverage for the flood related damage as described by the engineer. AmCoastal explained its coverage position in this correspondence. Following discussions with the SDA adjuster and the PA who claimed that the elevators in each building were damaged because of wind rather than flood, AmCoastal retained an engineer to opine on the cause of loss of the elevators. On May 23, 2023, Rimkus Engineering inspected the subject property and concluded the following: 1. There was evidence that wind-driven rain had collected around the hoistway doors in Vanderbilt Bay Tower 2 and encroached into the hoistway by running under and around the hoistway doors, damaging some of the elevator equipment. 2. There was no evidence that the winds from Hurricane Ian had damaged the ventilation louver at the top of the hoistway or that the damaged screen had contributed in any way to water damage from wind-driven rain. 3. The three items on the Water Damage Work Order from TK Elevator that had reportedly been damaged by the wind-driven rain could reasonably have been damaged when the wind-driven rain encroached into the hoistway and should be replaced. 4. The total costs to replace the three items damaged by the wind-driven rain of $37,350.34 was reasonable in cost and in the scope of work. SDA received this report on August 26, 2023. Accordingly, on September 14, 2023, SDA on behalf of AmCoastal, issued a supplemental claim determination letter opening coverage for the wind-driven rain covered elevator damage, but explaining that the loss was still below the Hurricane deductible. Further, as AmCoastal had not received all the requested information in its prior request for information, it requested the following information: 1. Any engineering or expert reports which address the nature or cause of damage being claimed under American Coastal’s policy, and any photographs taken by the engineer or expert. 2. Any and all Association Meeting Minutes, agendas, notes, records, logs for the last (10) years. 3. Any and all Association internal incident reports, maintenance records, vendor agreements, repair contracts, and repair records for the last (10) years. 4. Signed Proof of Loss (copy enclosed), including all estimates, proposals, invoices, receipts, permits and contracts, and correspondence for work performed or to be performed in related to the damage reported for this claim. 5. A copy of the Insured’s articles of incorporation, bylaws, declaration of condominium, and other documents creating any association(s), as well as all amendments to these items. 6. List of interior units with reported damage from this claim. 7. Any reports, including appraisals, prepared by or on behalf of the Association which speak to the condition of the property prior to the date of loss. 8. Any photographs, videos or otherwise which depict the condition of the property at any time, both before and after the date of the loss. 9. Any other documentation which supports the Association’s contention that the claimed damage was due to a covered cause of loss, including contractor estimate, signed contract and permits etc. 10. Any documentation regarding mitigation services performed at the subject property. 11. Any documentation related to the flood damages, including but not limited to the flood policy, claim settlement letter and estimate etc. 12. Any and all documentation related to the roof history from 2012 to present, including but not limited to maintenance records, bids, repairs, prior insurance claim documentation, estimate, settlement letter etc. Contrary to the allegations that the PA was unaware that AmCoastal requested a Sworn Proof of Loss, on October 2, 2023, the PA requested an extension to submit the sworn proof of loss to which AmCoastal agreed. On November 20, 2023, AmCoastal received the Insured’s Sworn Proof of Loss in the amount of $2,357,059.78. AmCoastal accepted the Sworn Proof of Loss in form only, as it disputed the scope and amount of loss as claimed by the Insured. Given the Insured’s supplemental claim, which included a claim for replacement of all doors, windows, sliders, roofs, and elevations, AmCoastal retained a general contractor to provide a comparative estimate of covered damage. On March 4, 2024 and March 5, 2024, the general contractor inspected the subject property. On March 14, 2024, the general contractor provided his report and estimate to AmCoastal. Based on the estimate, the claim was still below the Insured’s Hurricane deductible. Accordingly, on April 5, 2024, AmCoastal sent another coverage determination letter as to the Insured’s supplemental claim, opening coverage for the line items provided in the general contractor’s estimate, but explaining that the loss still fell below the Insured’s Hurricane deductible. Subsequently, the PA submitted correspondence from Green Coast Solar & Roofing explaining that it could not repair the roofs per the Florida Building Code due to the previous repair attempts and the number of layers of roofing materials. On July 1, 2024, AmCoastal sent correspondence to the PA requesting that the PA provide the documents requested in its September 14, 2023 and April 4, 2024 requests for information. The correspondence also explained that AmCoastal would close the claim should it not receive the responsive documents. This is contrary to the allegations that Mr. Dwarka would delay the claim if it was not resolved to his liking—rather, the Insured did not respond to the multiple requests for information with information that would change AmCoastal’s coverage determination. Further, while the Insured claims that AmCoastal ignored the Trillias Consulting Engineers, LLC’s report, as explained above, AmCoastal retained two separate engineers to inspect and determine the cause of loss, and it opened coverage consistent with their scientific findings. On August 26, 2024, rather than providing the requested documents, AmCoastal received a Letter of Representation from the Insured’s counsel. On September 6, 2024, AmCoastal acknowledged the Letter of Representation and reiterated its prior requests for information. Again, rather than providing the responsive information, which was requested nearly a year prior, on September 16, 2024, the Insured’s counsel filed this CRN claiming that AmCoastal delayed the claim. However, to the contrary, the Insured’s claim is—and always has been—a moving target, requiring AmCoastal to continuously retain vendors to address each of the Insured’s additional claims. Further, the CRN improperly states that on September 3, 2024, AmCoastal sent a lengthy request for documents without providing any explanation for the necessity of the documents while completely ignoring AmCoastal prior requests for these exact same documents requested nearly a year prior. Again, on September 23, 2024, AmCoastal, through counsel, sent its fourth request for information to the Insured. AmCoastal also requested that the parties participate in mediation pursuant to the policy to resolve the dispute over the amount of loss. Mediation is currently scheduled to occur on December 17, 2024 and the parties are working towards amicably resolving this claim. It was not until October 14, 2024, over a year after its initial request, that the Insured provided documents responsive to AmCoastal’s request for information. Included in these documents were invoices from Green Coast Solar & Roofing and roofing permits showing the roof replacements and the amount of such. Following receipt of these documents, on October 29, 2024, AmCoastal issued another supplemental coverage determination letter, opening coverage for the roof replacement per the Green Coast Solar & Roofing invoices, which resulted in a net payment to the Insured in the amount of $89,227.99. On November 7, 2024, the Insured’s counsel provided additional documents of work completed and stated the following in email correspondence: “I appreciate your patience and understanding. The Association has a new property manager, and he is still getting up to speed with some of these things. I hope it goes without saying that if American Coastal issues payment for these invoices outside of the CRN cure period, we would waive any alleged bad faith with regard to those payments.” As such, AmCoastal agrees that it will continue evaluating this claim and issue any payments for which coverage is confirmed, denies any wrongdoing, yet considers this CRN “cured” based on the allegations raised in the CRN. In light of AmCoastal’s investigation, coverage was properly accepted and payment was issued for covered damages in the amount of $89,227.99 under the subject claim, pursuant to the terms, conditions, exclusions, limits and deductible of the subject policy. Accordingly, AmCoastal denies any and all allegations of bad faith in connection with the claim submitted by the Insured. If you have any questions, please do not hesitate to contact me. Warmest regards, CAMBO FERRY, PLLC Katelyn Mae Ferry, Esq. kferry@camboferry.com
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