Civil Remedy Notice of Insurer Violations
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Filing Number:     785113
Filing Accepted:  10/1/2024
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Complainant
Last/Business Name *  
JAVIER MEDINA AND LAURA RIVERA   First Name  
Street Address * 3731 SW 131 STREET
City, State Zip * PLACE ROAD, FL 34473
Email Address * JAVIERPEROL021@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JAVIER MEDINA AND LAURA RIVERA   First Name  
Policy # * SJ31087283 Claim #* SL23208307
Attorney
Attorney is Applicable
Last Name* SANCHEZ First Name * MARIA Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MSANCHEZ@KPATTORNEY.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):* CLAIMS DEPARTMENT
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(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)(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.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
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The carrier was put on notice of the insureds’ hail damage claim. Subsequently, the insured prepared a loss package in the amount of $42,481.60 needed to restore the property back to its pre-loss condition. The insureds have attempted to follow-up with the carrier multiple times regarding the status of the claim and have been ignored by the carrier. 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. This intentional delay with the claim has led to direct prejudice of the insureds. More than five hundred and twenty-five days have passed since the original date of loss. 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 insureds’ 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)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. 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 $42,481.60, 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 or Lizzette Hernandez at (561)-892-9959 if you have any questions or concerns. Sincerely, Maria Sanchez Attorney at Law
Comments
User Id Date Added Comment
mthornton@slideinsurance.com 11-27-2024 Via E-mail & Posting on DFS Website Maria Sanchez, Esq. The Law Office of Kanner & Pintaluga 925 S Federal Hwy Boca Raton, FL 33432 msanchez@kpattorney.com Complainant: Javier Medina and Laura Rivera Insured: Javier Medina and Laura Rivera Claim No: SL23208307 Policy No: SJ31087283 CRN Filing No.: 785113 Dear Maria Sanchez: Please allow this correspondence to serve as Slide Insurance Company’s (“Slide”)’s response to the Civil Remedy Notice (“CRN”) filed on behalf of Javier Medina and Laura Rivera (“Insured”). The CRN was accepted by the Department on October 1, 2024. Without waiving any objections to the sufficiency of the CRN, and specifically subject to a reservation of all rights and defenses herein, Slide denies all allegations that it violated Florida Statutes or other codes, regulations, and/or rules in this matter. Slide challenges the validity of the CRN as it fails to identify the specific policy terms the Insured claims Slide failed to follow and does not provide factual support for their allegations; in fact, the CRN does not have any details regarding the purported date of loss, the alleged damages, conduct underlying the raised violations, or individuals who would have knowledge of same. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, 879 (Fla. 4th DCA 2021); Demase v. State Farm Florida Insurance Company, 351 So.3d 136, 138-39 (Fla. 5th DCA 2022) (holding the trial court properly determined a civil remedy notice that failed to state with specificity the relevant policy language was legally insufficient). Thus, the CRN is deficient and should be returned by the Department. CLAIM FACTS Slide issued a homeowners’ insurance policy to the Insured covering property located at 3731 SW 131st Place Road, Ocala, Florida, in effect for the period of May 16, 2022 to May 16, 2023 (the “Policy”). On April 5, 2024, a representative from The Law Office of Kanner & Pintaluga (“Insured’s Attorney”), filed a claim on the Insured’s behalf for hail damage to their property. The date of loss was reported as April 23, 2023 – approximately 11 months prior. Slide acknowledged receipt of the claim and assigned a licensed field adjuster to inspect the loss. Due to the significant delay in reporting the claim, Slide also sent the Insured via their Attorney a written request on April 8, 2024, for information material to the claim investigation, including but not limited to, repair records, photographs of the alleged damage, mitigation records, and the Insured’s recorded statement. The Insured provided access for inspection of the property on April 16, 2024. At the inspection, the Insured told the field adjuster they were solicited by Apex Roofing & Restoration, who said there was wind and hail damage on the roof. The Insured stated that Apex Roofing & Restoration supplied the reported date of loss of April 23, 2023. During the inspection, the field adjuster did not observe any damage consistent with wind or hail. Rather, the 16-year-old shingle roof exhibited signs consistent with its age. Inside the property, the field adjuster noted discoloration on the master bathroom ceiling attributable to humidity build-up after shower use. No evidence of staining or roof leaks were found during inspection of the attic. No other damage was reported or observed. The desk adjuster assigned to the claim sent another letter to the Insured’s Attorney on May 24, 2024, reiterating the prior requests and asking for information to support the date of loss provided to the Insured by Apex Roofing & Restoration. Despite follow up emails to the Insured’s Attorney on July 23, 2024, again attaching the letters requesting information regarding the Insured’s claims, none of the requested records, information, or recorded statement were submitted by the Insured. Therefore, the Insured failed to comply with the unambiguous terms of the Policy; their actions prevented Slide from investigating material facts of the claimed loss. On September 16, 2024, the desk adjuster followed up with the Insured’s Attorney to schedule the Insured’s recorded statement. Before the recorded statement or any other requested information was received, Slide received a Property Insurance Notice of Intent to Initiate Litigation filed by the Law Office of Kanner & Pintaluga on the Insured’s behalf on September 26, 2024. In response, Slide again requested the recorded statement and documentation first requested months before on April 8, 2024. Instead, the Insured, through their Attorney, filed this Civil Remedy Notice. Therefore, any allegations that Slide breached the Policy are meritless. Rather, the Insured has repeatedly failed to comply with the Policy conditions, actively impeded Slide’s investigation of their purported damages, and has breached the Policy of insurance. To date, neither the Insured nor their representatives have submitted any information to support their claim or otherwise notify Slide of the basis of their allegations. Slide maintains that it has acted in accordance with the terms of the subject insurance policy and the law in its adjustment of the claim. The facts and circumstances set forth in the CRN are misleading, vague, and incomplete. The Insured has presented no evidence to support the allegations of claim delay or unfair trade practice. DENIAL OF ALL VIOLATIONS OF FLORIDA STATUTE The CRN asserts Slide violated §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), and 626.9541(1)(i)(3)(f), Fla. Stats. Notwithstanding any challenges to the CRN’s legal sufficiency, and specifically subject to a reservation of all defenses and/or rights, Slide categorically denies all violations of Florida Statutes or any other codes, regulations, and/or rules in its handling of the subject loss. The underlying claim was investigated and adjusted in as thorough and expedient a manner as possible. Following the evaluation of loss, including but not limited to an on-site inspection, the Insured was notified in writing of material information needed to complete the investigation of the loss, pursuant to the Policy’s terms, conditions, endorsements, limitations, and exclusions. Due to the Insured’s and/or their representatives’ refusal to comply with Slide’s requests, Slide was prevented any opportunity to verify the Insured’s claims. Thus, the documented facts of the claim show Slide has made repeated efforts to diligently investigate this claim, has been forthcoming and truthful regarding the pertinent claim facts and Policy provisions relating to the loss, and promptly responded to all communications from the Insured and/or their representatives. Correspondences to the Insured and their representatives proves there is no basis to the Insured’s allegations that Slide failed to promptly act on any communications received, provide an explanation of the coverage decision in writing, or otherwise adequately and diligently adjust the claim.?There is simply no support for the violations raised in this CRN and Slide asserts its full and strict compliance with the statutory requirements imposed upon it. The Insured has submitted absolutely no facts or circumstances to support their allegations. CONCLUSION In conclusion, the documented facts contradict all allegations that Slide has in any manner acted improperly or contrary to its contractual obligations to the Insured. In filing this response, Slide does not intend to waive any rights or defenses that it may have in law or the policy. Rather, Slide expressly reserves all such rights and defenses without exception or limitation. Should there be any questions or further inquiry with respect to this matter, please contact the undersigned at mthornton@slideinsurance.com. Sincerely, /s/ Marianne Thornton Marianne Thornton, 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