Civil Remedy Notice of Insurer Violations
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Filing Number:     785417
Filing Accepted:  10/2/2024
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Complainant
Last/Business Name *  
JOHN M. O'MALLEY AND STACEY LYN BAKEN-NARZEM   First Name  
Street Address * 10488 NW 1ST CT
City, State Zip * CORAL SPRINGS, FL 33071
Email Address * JOHN@JOHNOMALLEYLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JOHN M. O'MALLEY AND STACEY LYN BAKEN-NARZEM   First Name  
Policy # * FHPL191406 Claim #* CLM00629409
Attorney
Attorney is Applicable
Last Name* BLACKMAN First Name * MAX Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MBLACKMAN@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AUTO CLUB INSURANCE COMPANY OF FLORIDA
NAIC Company Code 12813
 
Name of individual responsible for violation (if any):* ERENESTO TAMAYO
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.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the insured’s windstorm claim. The carrier initially attempted to low-ball the claim. Subsequently, the insured prepared a loss package in the amount of $90,788.04 needed to restore the property back to its pre-loss condition. Whereas, the carrier wrongfully represented the damages to the insured’s property to be below the policy deductible. Additionally, the carrier did not appropriately address the need for the replacement of the insured’s roof due to the tiles being discontinued, allegedly relying on the wrongful findings of a representative who it is believed was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of wind damage to the roof for the purpose of wrongfully low-balling the claim as a whole. The insured has 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 insured. About five hundred ten 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 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)(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 $90,788.04, 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 Chabeli Montas at (561)-892-9826 if you have any questions or concerns. Sincerely, Max Blackman Attorney at Law
Comments
User Id Date Added Comment
dtotten@gspalaw.com 11-05-2024 November 5, 2024 Via Online Submission Department of Financial Services Division of Legal Services Service of Process Section 200 East Gaines Street South Tallahassee, FL 32399 RE: Insured: John M. O'Malley & Stacey Lyn Baken-Narzem Claim No.: CLM00629409 Policy No.: FHP1191406 Date of Loss: May 18, 2023 Our File No.: AAA.48334-AO DFS File No.: 785417 DFS Filing Date: October 2, 2024 Insurer: AUTO CLUB INSURANCE COMPANY OF FLORIDA Dear Sir / Madam: Please be advised that the undersigned has been retained to represent the interests of Auto Club Insurance Company of Florida (“Auto Club”), in the above-referenced matter. Auto Club has sent us a copy of a Civil Remedy Notice of Insurer Violation (“CRN”), prepared by Max Blackman, Esq., on behalf of Insureds, John O’Malley and Stacey Lyn Baken-Narzem (“the Complainants”). The Florida Department of Financial Services assigned this CRN an acceptance date of October 2, 2024, DFS File No. 785417. Auto Club does not consider there to have been any manner of violation, and questions the validity of the CRN. Although Auto Club expressly denies the allegations included in the CRN, these issues have now been fully resolved to Complainants’ satisfaction. As part of the terms of settlement, Counsel for Complainants will be filing a withdrawal of the CRN. In the withdrawal of the CRN, Counsel for Complainants would attest that Complainants are withdrawing the CRN since this matter has been resolved. Although Complainants have indicated the desire to withdraw the CRN, Auto Club submits this brief reply in an abundance of caution, and in order to document the record. Auto Club is of course able to provide a more detailed and substantive response to each of the specific allegations in the CRN, if the Florida Department of Financial Services so requests. Auto Club conducted a thorough review of the allegations in the CRN, as well as of its claims handling, and determined that the allegations in the CRN are without merit. Auto Club asserts that it would be difficult to meaningfully respond to the allegations in the CRN as it lacks sufficient information and factual allegations, and does not specify policy language relevant to the alleged violations. Auto Club generally and specifically denies all allegations in the CRN that it in any way violated any provision of the Florida Statutes, as well as all allegations that it in any way acted improperly or in bad faith. At all times, Auto Club acted in good faith, fairly, and honestly towards its insureds, with due regard for the Complainants’ interests. In conclusion, Auto Club adamantly denies that there is any merit to the allegations in the CRN that it in anyway violated Florida Statutes, or in any way improperly adjusted the claim at issue, or engaged in any wrongdoing. We trust this correspondence will serve as an adequate response to the CRN. If you have any questions regarding this claim or require any additional information, please do not hesitate to contact the undersigned. Very truly yours, GROELLE & SALMON, P.A. /s/ Diva N. Totten Diva N. Totten For the Firm DNT/cs cc: Client Max Blackman, Esq. (via email only to mblackman@kpattorney.com) 48334 CRN Response
ebrooksherproperty@kpattorney.com 10-03-2024 This filed Civil Remedy Notice is hereby withdrawn due to a filing error.
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