Civil Remedy Notice of Insurer Violations
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Filing Number:     785637
Filing Accepted:  10/3/2024
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Complainant
Last/Business Name *  
OVIGOT   First Name   ORNIEL
Street Address * 327 FERRARA CT.
City, State Zip * POINCIANA, FL 34758
Email Address * ORNIELOVIGOT56@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   OVIGOT   First Name   ORNIEL
Policy # * OIC30090889-02 Claim #* 24FLHOV0015143
Attorney
Attorney is Applicable
Last Name* SINCLAIR First Name * GAL Initial
Street Address* 7950 W. FLAGLER STREET, SUITE 107
City, State Zip* MIAMI , FLORIDA 33144
Email Address * GAL@GALSINCLAIRLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLYMPUS INSURANCE COMPANY
NAIC Company Code 12954
 
Name of individual responsible for violation (if any):* JOHN HILL, SENIOR CLAIMS ADJUSTER II
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
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)(1) Attempting to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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.

THE POLICY PROVIDES COVERAGE FOR DIRECT PHYSICAL LOSS TO PROPERTY. THE POLICY CONTAINS A LOSS PAYMENT PROVISION. THE POLICY PROVIDES THAT THE INSURANCE COMPANY WILL ADJUST ALL LOSSES WITH THE INSURED. ALL APPLICABLE COVERAGES UNDER COVERAGE A, COVERAGE B, COVERAGE C, AND COVERAGE D, APPLICABLE ENDORSEMENTS, TERMS, CONDITIONS, AND DEFINITIONS. VIOLATION OF FLORIDA STATUTE 627.7015, WHICH IS INCORPORATED INTO THE POLICY
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE INSURED, ORINEL OVIGOT DAMAGES AS A RESULT OF A COVERED WATER DAMAGE LOSS. THE INSURED TIMELY NOTIFIED THE CARRIER OF THE LOSS. THE INSURED COMPLIED WITH ALL POLICY CONDITIONS. THE INSURANCE COMPANY FAILED TO PERFORM A PROPER INVESTIGATION AND EVALUATION OF THE CLAIM AND THEREFORE, IMPROPERLY UNDER ESTIMATE FOR PLAINTIFF’S LOSS AND DAMAGES. THE CARRIER HAS BREACHED THIS DUTY IN THE ADJUSTMENT OF THE INSURED’S CLAIM. THE CARRIER HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR PROPER INVESTIGATION OF CLAIMS HANDLING AND FOR TRAINING AND SUPERVISION OF EMPLOYEES RESULTING IN STATUTORY VIOLATIONS SET FORTH ABOVE. 1. THE CARRIER HAS FAILED AND/OR REFUSED TO THOROUGHLY, ACCURATELY, AND COMPLETELY INVESTIGATE, EVALUATE, AND PAY THE INSURED’S INSURANCE CLAIM FOR DAMAGES. THE CARRIER’S WRONGFUL CONDUCT AND OMISSIONS INCLUDE BUT ARE NOT LIMITED TO. 2. NOT CONDUCTING FULL AND PROMPT INVESTIGATION. 3. INSURANCE CREATED FACT THAT DO NOT EXIST BY DISHONESTLY MISREPRESENTATION FACTS TO FRAME ELDERLY INSURED AS A DISHONEST PERSON. 4. NOT TREATING THE POLICYHOLDERS WITH GOOD FAITH CLAIMS CONDUCT. 5. LOOKING FOR WAYS TO DENY RECOVERY TO THE INSURED. 6. NOT ADJUSTING THE CLAIM AND EVALUATING THE LOSS PROPERLY, PROMPTLY AND FAIRLY TO PROVIDE FULL AND PROMPT INDEMNITY TO THE INSURED. 7. FAILING TO IMPLEMENT PROPER STANDARDS FOR THE ADJUSTMENT AND INVESTIGATION OF CLAIMS. 8. NOT TRAINING, SUPERVISING OR MANAGING ADJUSTERS PROPERLY SO THAT PROMPT AND FULL PAYMENTS ARE MADE, BUT RATHER PLACING THE COMPANY’S INTERESTS BEFORE THE POLICYHOLDER’S INTERESTS. 9. INSURANCE COMPANY REFUSED TO PROVIDE AND/OR FAIL TO PROVIDE AND/OR FAIL TO PROVIDE CERTIFIED COPY OF THE SUBJECT POLICY. THE INSURANCE COMPANY WROTE TWO LETTERS THAT INDICATED DIFFERENT POLICY LANGUAGE. THE INSURED IS UNABLE TO EVALUATE HIS RIGHTS WITHOUT CERTIFIED COPY OF POLICY. 10. ESTABLISHING SEVERITY CONTROL INITIATIVES AND OTHERWISE ESTABLISHING A CULTURE OF NOT FULLY AND PROMPTLY PAYING CLAIMS FOLLOWING LOSSES; AND. 11. FAILING TO PAY THE INSURED’S DAMAGES DESPITE KNOWING IT MUST DO SO. THE CARRIER’S ACTIONS HINDER THE PROPERTY TO BE LIVABLE, CONSEQUENTELY, TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, THE CARRIER MUST, 12. TENDER PAYMENT FOR THE LEGITIMATE CLAIM ALREADY SUBMITTED IT TO DEFENDANT. 13. CEASE AND DESIST ALL PRESENT AND FUTURE BAD FAITH ACTIONS WITH REGARD TO THE INSURED’ POLICY. 14. THE CARRIER HAS ACCEPTED COVERAGE. 15. THE INSURED REQUEST THE CARRIER TO RE-EVLAUTE THE CLAIM AND MAKE A REASONABLE OFFER TO SETTLE THE CASE.
Comments
User Id Date Added Comment
bkelley@wallenkelley.com 04-09-2025 April 9, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainant: Orniel Ovigot Address: 327 Ferrara Court, Poinciana, FL 34758 Email: OrnielOvigot56@gmail.com Insured: Orniel Ovigot Policy #: OIC30090889-02 Claim: 24FLHOV0015143 Attorney: Gal Sinclair Address: 7950 West Flagler Street, Suite 107, Miami, FL 33144 Email: Gal@Galsinclairlaw.com DOI File #: 785637 Date of Acceptance: October 3, 2024 To Whom It May Concern: Please accept this as the response of Olympus Insurance Company ("Olympus") to the Civil Remedy Notice filed by the Complainant. Olympus’ response is specifically in regards to Claim 24FLHOV0015526. The Insured’s property located at 327 Ferrara Court, Poinciana, FL 34758 was insured by Olympus under Policy # OIC30090889-03 (it appears that the Insureds’ Counsel has improperly cited to a prior policy with Olympus with the effective dates of that Policy being June 8, 2024 through June 8, 2025 and was in effect on the alleged date of loss, June 18, 2024. 1. Statement of Facts This matter arises from a denied claim at the Insured’s Poinciana, FL residence. For the convenience of the reader, I have broken down the Statement of Facts that will detail Olympus’ handling of the file. 2. Claim 24FLHOV0015143 The instant claim was reported to Olympus on or about June 25, 2024 with an alleged date of loss of June 18, 2024. After receipt of the claim, Olympus assigned a claim number, 24FLHOV0015143, and sent an acknowledgment letter to the Insured. In addition, Olympus provided a Homeowners Bill of Rights to inform them of their rights under the Policy. Olympus also sent correspondence requesting an executed sworn proof of loss in an effort to ascertain the amount of damages being claimed. That same day, Olympus’ Desk Adjuster sent an email to the Insured to provide his contact information and requested a telephone conference to discuss information about the claim, explain the claim process and answer questions about same. Later that day, Olympus received the Insured’s Public Adjuster’s (Global Public Adjusters) letter of representation, contract for the instant claim, and a request for the Insured’s Policy. Immediately thereafter, Olympus provided Global with a copy of the Insured’s Policy per their request. After multiple failed attempts to speak to the Insured and/or Global, Olympus sent a follow up letter on June 27, 2024 which specifically advised the Insured that, “We have attempted to reach you and your public adjuster by phone and email. We understand this is a challenging time, and we are here to help. However, we require further information from you to investigate your claim. Please contact me at your earliest opportunity between the hours of 8:00 AM and 5:00 PM, EST, Monday through Friday. Olympus Insurance Company (“Olympus”) notes your cooperation in the investigation of your claim is a condition under your policy and your failure to provide necessary information may prejudice our investigation into your claim and may jeopardize coverage under the policy. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the abovementioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. I look forward to speaking with you.” In an effort to obtain more information about the claim and to advise the Insured of their duties under the policy (specifically to assist in the adjustment of same) on June 28, 2024, Olympus’ Desk Adjuster sent a Reservation of Rights Letter to the Insured that noted as follows, “We received your claim on June 25 2024 for water damage to the kitchen that reportedly occurred on June 18 2024. We are issuing this Reservation of Rights letter to you because there may not be coverage under your policy for this claim. The rights of Olympus Insurance Company may have been prejudiced and/or policy exclusions may apply. Please refer to the pertinent parts of your Homeowner’s Policy, HO 00 03 10 00 Homeowners 3 – Special Form as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, which state as follows: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. The time limitations to provide notice are tolled during any term of deployment to a combat zone or combat support posting which materially affects the ability of a named insured who is a servicemember as defined in Florida Statute 250.01 to file a claim, “reopened claim”, or “supplemental claim”. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. … Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any questions, please contact me.” Once more on July 1, 2024, Olympus’ Desk Adjuster attempted to contact both the Insured and Public Adjuster and left voicemails for each requesting a call back to discuss the claim. Olympus then retained the services of a licensed leak detection company, Hydroscout, to perform an inspection of the Insured’s property. On July 8, 2024, Travis Van Etten’s inspection took place to determine the cause of reported damage in the kitchen (the Insured refused to allow access on July 5, 2024). During that inspection, he took photographs of the property, prepared a report containing his findings, and sent same to Olympus. During that inspection, the insured stated that the issue was noticed a couple of months prior to the inspection. The insured also stated that the right sink was leaking at the drain connection to the sink and he had it replaced. In their subsequent report to Olympus, Hydroscout specifically concluded that: “1. Our leak detection inspection revealed deficiencies in the sealant around the kitchen sink faucet that allows water to drip into the kitchen sink base cabinet below, resulting in this loss. 2. It was reported that the right kitchen sink drain previously leaked down into the sink base cabinet below. However, it appears the right kitchen sink drain was replaced prior to our inspection. 3. Testing revealed no evidence of leakage from the right kitchen sink or sink drain assembly. 4. Testing revealed no evidence of leakage from the left kitchen sink or sink drain assembly. 5. The dishwasher was inoperable at the time of our inspection, however no evidence of leakage from the dishwasher was observed. 6. The pressure test of the potable water system confirmed there were no active pressurized potable water leaks at the time of our inspection. 7. No other issues were found to be contributing to this loss.” In an effort to obtain more information about the claim, on July 9, 2024, Olympus’ Desk Adjuster sent a Request for Information letter to the Insured which specifically advised that, “Olympus Insurance Company (“Olympus”) is evaluating your above referenced claim. Olympus requests your assistance to complete our investigation. To assist in our investigation and evaluation of your claim, we request that you provide us with the following information/documentation: 1. Provide documentation to support the cause of loss. 2. Submit all photos and videos taken at the time of the loss of the claimed damages. 3. Allow us to obtain a Recorded Statement and/or Examination Under Oath at our request. 4. Provide any and all documentation for mitigation completed at the property including but not limited to signed contracts, dry logs, estimates, and photos. 5. Submit a Sworn Proof of Loss. This is not a new request. This was requested in our claim acknowledgement letter. Another form is enclosed for your convenience. Please provide us with the requested information within the next twenty days so that we can proceed with our investigation of your claim. The documentation can be submitted via email OlympusClaims@oigfl.com, faxed to 800-634-6892, or mailed to the address provided above. Please be sure to include your claim number on all correspondence submitted to our office. Please be advised that the insurance contract requires compliance with all applicable provisions including without limitation all post loss duties. Compliance with providing the requested information is material to the investigation and is a condition precedent to recovery under the insurance contract. Failure to supply the requested information constitutes a breach of the insurance contract and could jeopardize coverage for this loss. Please refer to the pertinent parts of your Homeowner’s Policy, HO 00 03 10 00 Homeowners 3 – Special Form as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, which state as follows: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. The time limitations to provide notice are tolled during any term of deployment to a combat zone or combat support posting which materially affects the ability of a named insured who is a servicemember as defined in Florida Statute 250.01 to file a claim, “reopened claim”, or “supplemental claim”. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any questions, please contact me.” On July 11, 2024, Olympus’ Desk took a statement of the Insured in the presence of his public adjuster. During that statement, Mr. Ovigot noted that he saw damages under the sink but that he could not identify the cause of loss or duration of same. After a review of all materials in its file and the terms of the Insured’s Policy, Olympus reached a coverage decision for the claim. On July 29, 2024, Olympus’ Desk Adjuster sent correspondence to the Insured which informed him that, “Olympus Insurance Company (“Olympus”) investigated the claim you reported on June 25th, 2024, for water damage to the kitchen resulting from a failure of the sealant at the base of the sinks faucet that reportedly occurred on June 18th, 2024. Olympus inspected the insured location with a third-party vendor, HydroScout, on July 8th, 2024. Their inspector observed the following: Water damage to the sink basin cabinet was noted during the inspection. HydroScout determined that failure of the sealant at the base of the sink faucet caused the loss. Their report indicates the damage is consistent with a leak occurring over a period of time. Based on our investigation of your claimed damage the failure of the sealant at the base of the sink faucet which caused the loss was determined to be the result of wear, tear, or deterioration and not the result of a Peril Insured Against. Furthermore, the ensuing water damage caused by the failed sealant was determined to be from repeated seepage or leakage. Be advised, your policy does not include coverage for damage caused by constant or repeated seepage or leakage occurring over a period of weeks, months, or years. Therefore, based on the terms and conditions of your policy, Olympus respectfully denies your claim for water damage to the kitchen. Your policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, states in relevant part: SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure for sudden and accidental direct physical loss to covered property described in Coverage A and Coverage B unless the loss is otherwise excluded or limited in this policy. However, loss does not include and we will not pay for any “diminution in value”. 2. We do not insure, however, for loss: a. Excluded under Section I – Exclusions; … c. Caused by: … (5) Constant or repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years, unless such seepage or leakage of water or the presence or condensation of humidity, moisture or vapor: (a) Results from the accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning, or automatic fire protective sprinkler system, or household appliance, on the “residence premises”; and (b) The resulting damage is: i. Unknown to all “insureds”; and ii. Is hidden within the walls or ceilings, or beneath the floors, or above the ceilings of a structure. However; there is no coverage for loss resulting from water or steam, or the presence or condensation of humidity, moisture, or vapor that seeps or leaks through showers, bath surrounds, and similar structures, as a result of grout failure which occurs over a period of weeks, months, or years, unless such grout failure is the direct result of a Peril Insured Against. For purposes of this provision, damage is not hidden if visible on the surface of the walls, ceilings, or floors, or located within cabinets or similar structures or would be visible on the surface of the walls, ceilings, or floors, or within cabinets or similar structures but for objects blocking visibility. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instance the constant or repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. In this peril, a plumbing system or household appliance does not include: (i) A sump, sump pump, irrigation system, or related equipment; or (ii) A roof drain, gutter, down spout, or similar fixtures or equipment. (6) Any of the following: … (a) Wear and tear, marring, deterioration; … … Our denial of your claim does not relieve you of the duty to maintain your property. You should move forward with any repairs necessary to remedy any defects and protect your property from further damage. If you have any additional information that may cause us to reconsider our position, we ask that you submit all such documentation to the undersigned for our review. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any further questions concerning your claim, please let me know.” Thereafter, Olympus’ Desk Adjuster contacted the Insured (leaving him a voicemail) to explain the rationale for Olympus’ coverage decision. Seemingly in response to same, on October 3, 2024, Olympus received the instant Civil Remedy Notice and a Notice of Intent to Initiate Litigation. In response to the Notice of Intent to Initiate Litigation, Olympus sent correspondence to the Insureds and their counsel on October 10, 2024, which noted that, “Olympus Insurance Company acknowledges receipt of the Property Notice of Intent to Initiate Litigation (Notice Number 212594) accepted by the Florida Department of Financial Services on October 3, 2024 (hereafter referred to as “the Notice”). The Notice was submitted on behalf of Orniel Ovigot (hereafter “the Insureds”) and Olympus Insurance Company received the notice on October 3, 2024. Please note that your Notice is defective as coverage for this claim has not been afforded or denied at this time. Moreover, please be advised that there is a question as to whether the Notice of Intention to Initiate Litigation document (“the Notice”) is compliant with the statutory requirements of F.S. 627.70152. First, it should be noted that the policy listed above, OIC3009088902, is incorrect. The Policy in place on the alleged date of loss was actually OIC30090889-03. Second, the allegations contained within this Notice are incomplete as they merely state, “THE CARRIER HAS FAILED AND/OR REFUSED TO THOROUGHLY, ACCURATELY, AND COMPLETELY INVESTIGATE, EVALUATE, AND PAY THE INSURED’S INSURANCE CLAIM FOR DAMAGES. THE CARRIER FAILED TO PAY THE UNDISPUTED AMOUNT. FAILURE TO ISSUE PAYMENT FOR THE COMPLETE COMPENSATION FOR CLAIMANT DAMAGES AND/OR EXPENSE.” Until and unless a more complete statement is provided, Olympus is left to surmise how it has failed to thoroughly, accurately, and completely failed to evaluate the Insured’s claim. Third, it appears that the only line item included is an estimate that has likely been calculated on a replacement cost basis. Replacement cost benefits are not due and owing until and unless the work necessary to repair or replace the covered property is performed and the expenses are incurred. To date, Olympus has not been notified that the work has commenced or been performed or that any expenses to make the necessary repairs have been incurred that would exceed the policy deductible. Accordingly, the claim should be limited to the actual cash value of the direct physical loss to covered property. Because the estimate is incomplete, the Notice does not place Olympus on sufficient notice of the specific damages in dispute. For these reasons, the Notice is noncompliant with § 627.70152(3) (a), Fla. Stat. The lack of specificity inhibits Olympus’ right to promptly investigate, review, and evaluate the “dispute” stated in the Notice. Olympus requests that a proper and statutorily compliant written notice of intent to initiate litigation be submitted before suit is filed under the policy. Finally, without waiving the deficiencies with the Notice, and subject to a complete reservation of rights, Olympus Insurance Company asserts the right to reinspect the damaged property. By asserting the right to reinspect the damaged property, Olympus Insurance Company has fourteen business days after this response to perform the reinspection to accept or continue to deny coverage. As such, it is imperative that you make the property available for reinspection within the next fourteen calendar days for reinspection. Our counsel, Brian Kelley, Esq. (BKelley@wallenkelley.com) will contact you to coordinate a mutually convenience date at time for this to take place. This response is based on Olympus’ investigation, review, and evaluation of the claim and the information provided by the Insureds and their representatives to date. If there is additional information or documentation pertinent to the Insureds’ claim that has not previously been submitted, please submit it now for review and evaluation. By responding to the Notice, Olympus does not waive any rights under the policy or law, and nothing in this letter shall constitute a waiver of any right or an admission of any obligation under the policy. Nor shall any conduct of Olympus or its agents, attorneys, or employees be construed as an estoppel, waiver, modification, or surrender of the terms, limitations, exclusions, conditions, or agreements of the insurance policy. As such, Olympus reserves all its rights and defenses under the policy and Florida law, as well as the right to investigate, review, and evaluate any properly stated dispute in the event Olympus receives a statutorily compliant notice of intent or new or additional information. A copy of this response was sent to the Insured by the designated email contained within this Notice.” Thereafter, the parties coordinated a re-inspection of the property which is scheduled to take place on December 2, 2024. 3. Nature of the Insured's Civil Remedy Complaint In the Civil Remedy Notice, the Complainant alleges Olympus: (1) Failed to attempt 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, (2) Failed 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, (3) Attempted to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured, (4) Made material misrepresentations to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy, (5) Failed to adopt and implement standards for the proper investigation of claims, (6) Misrepresented pertinent facts or insurance policy provisions relating to coverages at issue, (7) Failed to acknowledge and act promptly upon communications with respect to claims, (8) Denied the claim without conducting reasonable investigations based upon available information, (9) Failed to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of loss statements have been completed, (10) Failed 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, (11) Failed to promptly notify the insured of any additional information necessary for the processing of a claim, and (12) Failed to clearly explain the nature of the requested information and the reasons why such information is necessary. These boilerplate accusations are misleading, inaccurate, and unfair given the nature of the facts and damages surrounding this claim. Here, the claim was thoroughly processed, the property inspected, Olympus took a statement of the Insured, a request for information was sent, a coverage decision was conveyed, and Olympus has asked for additional information to consider without receiving any notable response. Beyond Olympus’ adamant belief that it acted with the utmost good faith, the CRN is deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. Florida Statute § 624.155 requires a complainant to file with the Department of Financial Services a Civil Remedy Notice which shall be “on a form provided by the [Department] and shall state with specificity…such other information as the Department may require.” The Department created a CRN form: Form DFS-10-363 which lays out 15 requirements, including in part, the Complainants E-mail address, Complainant Type, Attorney’s Name, Attorney’s Address, Attorney’s Email Address, Type of Insurer, Address of Insurer, Type of Insurance, Reason for Notice. As these requirements are required by the Department, according to § 624.155, they must be stated with specificity. The instant CRN fails to provide the Address of the insurer. Due to the improper completion of the mandated information, the CRN fails to comply with the form requirements set forth in Florida Statute § 624.155, fails to comply with 624.155(3)(b) (3), and is facially deficient. See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). The CRN also does not refer to any specific policy language pertinent to the allegations of bad faith. The CRN expressly and intentionally fails to notify Olympus of the totality of the “specific policy language that is relevant to the violation.” “Courts have found that listing whole sections of the insurance policy constitutes insufficient specificity.” See Fox v. Starr Indem. & Liab. Co., No. 8:16CV-3254-T-23MAP, 2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294 at *2; see also Julien v. Olympus Property & Casualty Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021) (“Here, Julien did not substantially comply with the specificity standard, and this was more than a mere technical defect.”). The failure to provide a specific reference to policy language is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155. The CRN requires that Olympus speculate as to the policy provisions at issue, which is the opposite of putting Olympus on notice. Therefore, failure to include specific policy language renders the CRN deficient in form and substance. For these reasons, the CRN fails on its face. Failure to provide specific reference to any relevant policy language is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155, and therefore renders the CRN deficient on its face, as to form and substance. For these reasons alone, the CRN fails at its inception. The CRN fails to provide any description relating to any acts, facts, or circumstances which give rise to the alleged statutory violations, thus, prejudicing Olympus from providing any meaningful or complete response. The CRN is hardly more than a recitation of several Florida statutory provisions, with minimal factual allegations supporting the conclusory statutory recitations. In this particular instance, the conclusory allegations are fatal to the Insured's bad faith claim as Olympus is without knowledge of the purported bad faith conduct supposedly alleged based on the face of the CRN itself. A CRN must state the facts and circumstances that give rise to an alleged violation with sufficient specificity to allow an insurer to cure the alleged violation within the sixty-day statutory period. Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). Moreover, the CRN fails to apprise Olympus of any actions that rise to the level of a statutory violation, and the facts contained therein are disingenuous, misleading, and incomplete. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith required as a condition precedent to any civil claim for bad faith pursuant to Fla. Stat. §624.155. For these reasons alone, the CRN fails at its inception. In short, and contrary to the unsupported conclusory statements contained in the Complainant/Insured’s CRN, the actual facts of this case are far different from the unsupported and conclusory statements alleged in the CRN. Olympus, at all times, conducted its investigation in good faith and complied with all of its obligations under the Policy and Florida Law. Not only did Olympus perform its duties under the subject policy of insurance and applicable Florida law, but it also did not at any time whatsoever act in bad faith towards the Insured or the Insured’s representatives in the handling of the subject claim. Moreover, the failure to identify policy language, the failure to include specific allegations, and the inadequate cure all render the CRN deficient on its face. Further, the CRN contains “cures” that are unavailable under the insurance policy or applicable law, as well as being vague and unascertainable. The Complainant provided a deficient cure and essentially demands that Olympus “pay [them] everything [they have] asked for.” Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, *5 (S.D. Fla. 2010). However, “[i]nsurers are not required to pay any amount demanded by their Insured [or other beneficiaries] to avoid a bad-faith claim.” Id. Therefore, Olympus is left entirely without the opportunity to “cure” the alleged violations in the absence of further information. The only cures listed are nonmonetary. It is important to note that there is varying case law regarding whether and what type of cure is required. In Hunt v. State Farm Fla. Ins. Co., 112 So. 3d 547, 548 (Fla. 2d DCA 2013), the appellate court found that the trial court erred in ruling that the CRN in that case was invalid under Florida Statute § 624.155 (2006) for failure to include a definite cure amount. The appellate court noted that Section 624.155(3)(b) did not require a CRN to allege a specific cure amount. That being said, if it is absolutely impossible for the carrier to ascertain a demand, an argument can be made that the CRN fails to provide a true and feasible cure method. Here, the cure’s non-monetary conditions are entirely illusory and unascertainable due to the lack of specificity contained in the CRN making it impossible for Olympus to ascertain a cure for the alleged violations. By making these demands the sole “opportunity” to cure the CRN, the Insured have failed to preserve a bad faith claim by failing to strictly comply with the statutory requirements. This is because “the CRN is designed to prevent insurers from playing a ‘guessing game’ as to what, and how, to cure within the sixty-day window.” King v. Gov’t Emp’ees Ins. Co., 2012 U.S. Dist. LEXIS 130662, 2012 WL 4052271, *7 (M.D. Fla. 2012); see also Heritage Corp. of S. Fla. v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008) (“The CRN is vague and ‘shotgun’ in nature—hardly the type of specific notice required by the statute that would allow National Union an opportunity to cure.”). As such, the CRN is insufficient for failing to provide Olympus with an opportunity to cure. To the extent that the instant CRN is intended to address any other facts or circumstances which purport to establish additional coverage for the reported losses, the CRN provides insufficient identification of any such facts or circumstances and therefore prevents Olympus from addressing any other aspect herein. Notwithstanding, Olympus believes that the above facts demonstrate beyond dispute that it has at all times acted in good faith with regard to its investigation of the subject claim, and further believes that the facts provided to date fail to establish that it has not adjusted the reported loss in accordance with the express terms, provisions, limitations and exclusions contained within the policy. 4. Settlement Following the cure period for the instant Civil Remedy Notice, the parties agreed to settlement of the instant matter and counsel sent and subsequently received a general release that included the allegations of this Civil Remedy Notice. Moreover, in this release, Olympus specifically did not admit any liability, bad faith, or the allegations contained within this CRN. The Insureds, via their counsel, confirmed receipt of the settlement checks and confirmed this matter to be resolved. 5. Conclusion Olympus would note that the claim was properly adjusted, thoroughly processed, and a coverage letter outlining the pertinent facts was mailed to the Insured. Furthermore, Olympus believes that the Complainant’s position is untenable due to the facts surrounding the claim. Olympus spent considerable time and resources in the investigation of this matter and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Complainant's claim and unfairly paints Olympus in a negative light. Moreover, the Civil Remedy Notice is deficient in that it fails to specifically identify specific policy language and fails to list a specific cure amount. Finally, pursuant to the settlement of this matter, all allegations contained within this Civil Remedy Notice are now moot. Sincerely, Brian Kelley, Esq. On behalf of Olympus Insurance Company
bkelley@wallenkelley.com 11-27-2024 November 27, 2024 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainant: Orniel Ovigot Address: 327 Ferrara Court, Poinciana, FL 34758 Email: OrnielOvigot56@gmail.com Insured: Orniel Ovigot Policy #: OIC30090889-02 Claim: 24FLHOV0015143 Attorney: Gal Sinclair Address: 7950 West Flagler Street, Suite 107, Miami, FL 33144 Email: Gal@Galsinclairlaw.com DOI File #: 785637 Date of Acceptance: October 3, 2024 To Whom It May Concern: Please accept this as the response of Olympus Insurance Company ("Olympus") to the Civil Remedy Notice filed by the Complainant. Olympus’ response is specifically in regards to Claim 24FLHOV0015526. The Insured’s property located at 327 Ferrara Court, Poinciana, FL 34758 was insured by Olympus under Policy # OIC30090889-03 (it appears that the Insureds’ Counsel has improperly cited to a prior policy with Olympus with the effective dates of that Policy being June 8, 2024 through June 8, 2025 and was in effect on the alleged date of loss, June 18, 2024. 1. Statement of Facts This matter arises from a denied claim at the Insured’s Poinciana, FL residence. For the convenience of the reader, I have broken down the Statement of Facts that will detail Olympus’ handling of the file. 2. Claim 24FLHOV0015143 The instant claim was reported to Olympus on or about June 25, 2024 with an alleged date of loss of June 18, 2024. After receipt of the claim, Olympus assigned a claim number, 24FLHOV0015143, and sent an acknowledgment letter to the Insured. In addition, Olympus provided a Homeowners Bill of Rights to inform them of their rights under the Policy. Olympus also sent correspondence requesting an executed sworn proof of loss in an effort to ascertain the amount of damages being claimed. That same day, Olympus’ Desk Adjuster sent an email to the Insured to provide his contact information and requested a telephone conference to discuss information about the claim, explain the claim process and answer questions about same. Later that day, Olympus received the Insured’s Public Adjuster’s (Global Public Adjusters) letter of representation, contract for the instant claim, and a request for the Insured’s Policy. Immediately thereafter, Olympus provided Global with a copy of the Insured’s Policy per their request. After multiple failed attempts to speak to the Insured and/or Global, Olympus sent a follow up letter on June 27, 2024 which specifically advised the Insured that, “We have attempted to reach you and your public adjuster by phone and email. We understand this is a challenging time, and we are here to help. However, we require further information from you to investigate your claim. Please contact me at your earliest opportunity between the hours of 8:00 AM and 5:00 PM, EST, Monday through Friday. Olympus Insurance Company (“Olympus”) notes your cooperation in the investigation of your claim is a condition under your policy and your failure to provide necessary information may prejudice our investigation into your claim and may jeopardize coverage under the policy. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the abovementioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. I look forward to speaking with you.” In an effort to obtain more information about the claim and to advise the Insured of their duties under the policy (specifically to assist in the adjustment of same) on June 28, 2024, Olympus’ Desk Adjuster sent a Reservation of Rights Letter to the Insured that noted as follows, “We received your claim on June 25 2024 for water damage to the kitchen that reportedly occurred on June 18 2024. We are issuing this Reservation of Rights letter to you because there may not be coverage under your policy for this claim. The rights of Olympus Insurance Company may have been prejudiced and/or policy exclusions may apply. Please refer to the pertinent parts of your Homeowner’s Policy, HO 00 03 10 00 Homeowners 3 – Special Form as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, which state as follows: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. The time limitations to provide notice are tolled during any term of deployment to a combat zone or combat support posting which materially affects the ability of a named insured who is a servicemember as defined in Florida Statute 250.01 to file a claim, “reopened claim”, or “supplemental claim”. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. … Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any questions, please contact me.” Once more on July 1, 2024, Olympus’ Desk Adjuster attempted to contact both the Insured and Public Adjuster and left voicemails for each requesting a call back to discuss the claim. Olympus then retained the services of a licensed leak detection company, Hydroscout, to perform an inspection of the Insured’s property. On July 8, 2024, Travis Van Etten’s inspection took place to determine the cause of reported damage in the kitchen (the Insured refused to allow access on July 5, 2024). During that inspection, he took photographs of the property, prepared a report containing his findings, and sent same to Olympus. During that inspection, the insured stated that the issue was noticed a couple of months prior to the inspection. The insured also stated that the right sink was leaking at the drain connection to the sink and he had it replaced. In their subsequent report to Olympus, Hydroscout specifically concluded that: “1. Our leak detection inspection revealed deficiencies in the sealant around the kitchen sink faucet that allows water to drip into the kitchen sink base cabinet below, resulting in this loss. 2. It was reported that the right kitchen sink drain previously leaked down into the sink base cabinet below. However, it appears the right kitchen sink drain was replaced prior to our inspection. 3. Testing revealed no evidence of leakage from the right kitchen sink or sink drain assembly. 4. Testing revealed no evidence of leakage from the left kitchen sink or sink drain assembly. 5. The dishwasher was inoperable at the time of our inspection, however no evidence of leakage from the dishwasher was observed. 6. The pressure test of the potable water system confirmed there were no active pressurized potable water leaks at the time of our inspection. 7. No other issues were found to be contributing to this loss.” In an effort to obtain more information about the claim, on July 9, 2024, Olympus’ Desk Adjuster sent a Request for Information letter to the Insured which specifically advised that, “Olympus Insurance Company (“Olympus”) is evaluating your above referenced claim. Olympus requests your assistance to complete our investigation. To assist in our investigation and evaluation of your claim, we request that you provide us with the following information/documentation: 1. Provide documentation to support the cause of loss. 2. Submit all photos and videos taken at the time of the loss of the claimed damages. 3. Allow us to obtain a Recorded Statement and/or Examination Under Oath at our request. 4. Provide any and all documentation for mitigation completed at the property including but not limited to signed contracts, dry logs, estimates, and photos. 5. Submit a Sworn Proof of Loss. This is not a new request. This was requested in our claim acknowledgement letter. Another form is enclosed for your convenience. Please provide us with the requested information within the next twenty days so that we can proceed with our investigation of your claim. The documentation can be submitted via email OlympusClaims@oigfl.com, faxed to 800-634-6892, or mailed to the address provided above. Please be sure to include your claim number on all correspondence submitted to our office. Please be advised that the insurance contract requires compliance with all applicable provisions including without limitation all post-loss duties. Compliance with providing the requested information is material to the investigation and is a condition precedent to recovery under the insurance contract. Failure to supply the requested information constitutes a breach of the insurance contract and could jeopardize coverage for this loss. Please refer to the pertinent parts of your Homeowner’s Policy, HO 00 03 10 00 Homeowners 3 – Special Form as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, which state as follows: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. The time limitations to provide notice are tolled during any term of deployment to a combat zone or combat support posting which materially affects the ability of a named insured who is a servicemember as defined in Florida Statute 250.01 to file a claim, “reopened claim”, or “supplemental claim”. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any questions, please contact me.” On July 11, 2024, Olympus’ Desk took a statement of the Insured in the presence of his public adjuster. During that statement, Mr. Ovigot noted that he saw damages under the sink but that he could not identify the cause of loss or duration of same. After a review of all materials in its file and the terms of the Insured’s Policy, Olympus reached a coverage decision for the claim. On July 29, 2024, Olympus’ Desk Adjuster sent correspondence to the Insured which informed him that, “Olympus Insurance Company (“Olympus”) investigated the claim you reported on June 25th, 2024, for water damage to the kitchen resulting from a failure of the sealant at the base of the sinks faucet that reportedly occurred on June 18th, 2024. Olympus inspected the insured location with a third-party vendor, HydroScout, on July 8th, 2024. Their inspector observed the following: Water damage to the sink basin cabinet was noted during the inspection. HydroScout determined that failure of the sealant at the base of the sink faucet caused the loss. Their report indicates the damage is consistent with a leak occurring over a period of time. Based on our investigation of your claimed damage the failure of the sealant at the base of the sink faucet which caused the loss was determined to be the result of wear, tear, or deterioration and not the result of a Peril Insured Against. Furthermore, the ensuing water damage caused by the failed sealant was determined to be from repeated seepage or leakage. Be advised, your policy does not include coverage for damage caused by constant or repeated seepage or leakage occurring over a period of weeks, months, or years. Therefore, based on the terms and conditions of your policy, Olympus respectfully denies your claim for water damage to the kitchen. Your policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 09 23 Special Provisions – Florida endorsement, states in relevant part: SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure for sudden and accidental direct physical loss to covered property described in Coverage A and Coverage B unless the loss is otherwise excluded or limited in this policy. However, loss does not include and we will not pay for any “diminution in value”. 2. We do not insure, however, for loss: a. Excluded under Section I – Exclusions; … c. Caused by: … (5) Constant or repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years, unless such seepage or leakage of water or the presence or condensation of humidity, moisture or vapor: (a) Results from the accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning, or automatic fire protective sprinkler system, or household appliance, on the “residence premises”; and (b) The resulting damage is: i. Unknown to all “insureds”; and ii. Is hidden within the walls or ceilings, or beneath the floors, or above the ceilings of a structure. However; there is no coverage for loss resulting from water or steam, or the presence or condensation of humidity, moisture, or vapor that seeps or leaks through showers, bath surrounds, and similar structures, as a result of grout failure which occurs over a period of weeks, months, or years, unless such grout failure is the direct result of a Peril Insured Against. For purposes of this provision, damage is not hidden if visible on the surface of the walls, ceilings, or floors, or located within cabinets or similar structures or would be visible on the surface of the walls, ceilings, or floors, or within cabinets or similar structures but for objects blocking visibility. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instance the constant or repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. In this peril, a plumbing system or household appliance does not include: (i) A sump, sump pump, irrigation system, or related equipment; or (ii) A roof drain, gutter, down spout, or similar fixtures or equipment. (6) Any of the following: … (a) Wear and tear, marring, deterioration; … … Our denial of your claim does not relieve you of the duty to maintain your property. You should move forward with any repairs necessary to remedy any defects and protect your property from further damage. If you have any additional information that may cause us to reconsider our position, we ask that you submit all such documentation to the undersigned for our review. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any further questions concerning your claim, please let me know.” Thereafter, Olympus’ Desk Adjuster contacted the Insured (leaving him a voicemail) to explain the rationale for Olympus’ coverage decision. Seemingly in response to same, on October 3, 2024, Olympus received the instant Civil Remedy Notice and a Notice of Intent to Initiate Litigation. In response to the Notice of Intent to Initiate Litigation, Olympus sent correspondence to the Insureds and their counsel on October 10, 2024, which noted that, “Olympus Insurance Company acknowledges receipt of the Property Notice of Intent to Initiate Litigation (Notice Number 212594) accepted by the Florida Department of Financial Services on October 3, 2024 (hereafter referred to as “the Notice”). The Notice was submitted on behalf of Orniel Ovigot (hereafter “the Insureds”) and Olympus Insurance Company received the notice on October 3, 2024. Please note that your Notice is defective as coverage for this claim has not been afforded or denied at this time. Moreover, please be advised that there is a question as to whether the Notice of Intention to Initiate Litigation document (“the Notice”) is compliant with the statutory requirements of F.S. 627.70152. First, it should be noted that the policy listed above, OIC3009088902, is incorrect. The Policy in place on the alleged date of loss was actually OIC30090889-03. Second, the allegations contained within this Notice are incomplete as they merely state, “THE CARRIER HAS FAILED AND/OR REFUSED TO THOROUGHLY, ACCURATELY, AND COMPLETELY INVESTIGATE, EVALUATE, AND PAY THE INSURED’S INSURANCE CLAIM FOR DAMAGES. THE CARRIER FAILED TO PAY THE UNDISPUTED AMOUNT. FAILURE TO ISSUE PAYMENT FOR THE COMPLETE COMPENSATION FOR CLAIMANT DAMAGES AND/OR EXPENSE.” Until and unless a more complete statement is provided, Olympus is left to surmise how it has failed to thoroughly, accurately, and completely failed to evaluate the Insured’s claim. Third, it appears that the only line item included is an estimate that has likely been calculated on a replacement cost basis. Replacement cost benefits are not due and owing until and unless the work necessary to repair or replace the covered property is performed and the expenses are incurred. To date, Olympus has not been notified that the work has commenced or been performed or that any expenses to make the necessary repairs have been incurred that would exceed the policy deductible. Accordingly, the claim should be limited to the actual cash value of the direct physical loss to covered property. Because the estimate is incomplete, the Notice does not place Olympus on sufficient notice of the specific damages in dispute. For these reasons, the Notice is noncompliant with § 627.70152(3)(a), Fla. Stat. The lack of specificity inhibits Olympus’ right to promptly investigate, review, and evaluate the “dispute” stated in the Notice. Olympus requests that a proper and statutorily compliant written notice of intent to initiate litigation be submitted before suit is filed under the policy. Finally, without waiving the deficiencies with the Notice, and subject to a complete reservation of rights, Olympus Insurance Company asserts the right to reinspect the damaged property. By asserting the right to reinspect the damaged property, Olympus Insurance Company has fourteen business days after this response to perform the reinspection to accept or continue to deny coverage. As such, it is imperative that you make the property available for reinspection within the next fourteen calendar days for reinspection. Our counsel, Brian Kelley, Esq. (BKelley@wallenkelley.com) will contact you to coordinate a mutually convenience date at time for this to take place. This response is based on Olympus’ investigation, review, and evaluation of the claim and the information provided by the Insureds and their representatives to date. If there is additional information or documentation pertinent to the Insureds’ claim that has not previously been submitted, please submit it now for review and evaluation. By responding to the Notice, Olympus does not waive any rights under the policy or law, and nothing in this letter shall constitute a waiver of any right or an admission of any obligation under the policy. Nor shall any conduct of Olympus or its agents, attorneys, or employees be construed as an estoppel, waiver, modification, or surrender of the terms, limitations, exclusions, conditions, or agreements of the insurance policy. As such, Olympus reserves all its rights and defenses under the policy and Florida law, as well as the right to investigate, review, and evaluate any properly stated dispute in the event Olympus receives a statutorily compliant notice of intent or new or additional information. A copy of this response was sent to the Insured by the designated email contained within this Notice.” Thereafter, the parties coordinated a re-inspection of the property which is scheduled to take place on December 2, 2024. To date, no “new” information has been provided to Olympus or the undersigned by the Insured or his counsel. 3. Nature of the Insured's Civil Remedy Complaint In the Civil Remedy Notice, the Complainant alleges Olympus: (1) Failed to attempt 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, (2) Failed 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, (3) Attempted to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured, (4) Made material misrepresentations to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy, (5) Failed to adopt and implement standards for the proper investigation of claims, (6) Misrepresented pertinent facts or insurance policy provisions relating to coverages at issue, (7) Failed to acknowledge and act promptly upon communications with respect to claims, (8) Denied the claim without conducting reasonable investigations based upon available information, (9) Failed to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed, (10) Failed 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, (11) Failed to promptly notify the insured of any additional information necessary for the processing of a claim, and (12) Failed to clearly explain the nature of the requested information and the reasons why such information is necessary. These boilerplate accusations are misleading, inaccurate, and unfair given the nature of the facts and damages surrounding this claim. Here, the claim was thoroughly processed, the property inspected, Olympus took a statement of the Insured, a request for information was sent, a coverage decision was conveyed, and Olympus has asked for additional information to consider without receiving any notable response. Beyond Olympus’ adamant belief that it acted with the utmost good faith, the CRN is deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. Florida Statute § 624.155 requires a complainant to file with the Department of Financial Services a Civil Remedy Notice which shall be “on a form provided by the [Department] and shall state with specificity…such other information as the Department may require.” The Department created a CRN form: Form DFS-10-363 which lays out 15 requirements, including in part, the Complainants E-mail address, Complainant Type, Attorney’s Name, Attorney’s Address, Attorney’s Email Address, Type of Insurer, Address of Insurer, Type of Insurance, Reason for Notice. As these requirements are required by the Department, according to § 624.155, they must be stated with specificity. The instant CRN fails to provide the Address of the insurer. Due to the improper completion of the mandated information, the CRN fails to comply with the form requirements set forth in Florida Statute § 624.155, fails to comply with 624.155(3)(b) (3), and is facially deficient. See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). The CRN also does not refer to any specific policy language pertinent to the allegations of bad faith. The CRN expressly and intentionally fails to notify Olympus of the totality of the “specific policy language that is relevant to the violation.” “Courts have found that listing whole sections of the insurance policy constitutes insufficient specificity.” See Fox v. Starr Indem. & Liab. Co., No. 8:16CV-3254-T-23MAP, 2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294 at *2; see also Julien v. Olympus Property & Casualty Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021) (“Here, Julien did not substantially comply with the specificity standard, and this was more than a mere technical defect.”). The failure to provide a specific reference to policy language is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155. The CRN requires that Olympus speculate as to the policy provisions at issue, which is the opposite of putting Olympus on notice. Therefore, failure to include specific policy language renders the CRN deficient in form and substance. For these reasons, the CRN fails on its face. Failure to provide specific reference to any relevant policy language is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155, and therefore renders the CRN deficient on its face, as to form and substance. For these reasons alone, the CRN fails at its inception. The CRN fails to provide any description relating to any acts, facts, or circumstances which give rise to the alleged statutory violations, thus, prejudicing Olympus from providing any meaningful or complete response. The CRN is hardly more than a recitation of several Florida statutory provisions, with minimal factual allegations supporting the conclusory statutory recitations. In this particular instance, the conclusory allegations are fatal to the Insured's bad faith claim as Olympus is without knowledge of the purported bad faith conduct supposedly alleged based on the face of the CRN itself. A CRN must state the facts and circumstances that give rise to an alleged violation with sufficient specificity to allow an insurer to cure the alleged violation within the sixty-day statutory period. Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). Moreover, the CRN fails to apprise Olympus of any actions that rise to the level of a statutory violation, and the facts contained therein are disingenuous, misleading, and incomplete. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith required as a condition precedent to any civil claim for bad faith pursuant to Fla. Stat. §624.155. For these reasons alone, the CRN fails at its inception. In short, and contrary to the unsupported conclusory statements contained in the Complainant/Insured’s CRN, the actual facts of this case are far different from the unsupported and conclusory statements alleged in the CRN. Olympus, at all times, conducted its investigation in good faith and complied with all of its obligations under the Policy and Florida Law. Not only did Olympus perform its duties under the subject policy of insurance and applicable Florida law, but it also did not at any time whatsoever act in bad faith towards the Insured or the Insured’s representatives in the handling of the subject claim. Moreover, the failure to identify policy language, the failure to include specific allegations, and the inadequate cure all render the CRN deficient on its face. Further, the CRN contains “cures” that are unavailable under the insurance policy or applicable law, as well as being vague and unascertainable. The Complainant provided a deficient cure and essentially demands that Olympus “pay [them] everything [they have] asked for.” Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, *5 (S.D. Fla. 2010). However, “[i]nsurers are not required to pay any amount demanded by their Insured [or other beneficiaries] to avoid a bad-faith claim.” Id. Therefore, Olympus is left entirely without the opportunity to “cure” the alleged violations in the absence of further information. The only cures listed are nonmonetary. It is important to note that there is varying case law regarding whether and what type of cure is required. In Hunt v. State Farm Fla. Ins. Co., 112 So. 3d 547, 548 (Fla. 2d DCA 2013), the appellate court found that the trial court erred in ruling that the CRN in that case was invalid under Florida Statute § 624.155 (2006) for failure to include a definite cure amount. The appellate court noted that Section 624.155(3)(b) did not require a CRN to allege a specific cure amount. That being said, if it is absolutely impossible for the carrier to ascertain a demand, an argument can be made that the CRN fails to provide a true and feasible cure method. Here, the cure’s non-monetary conditions are entirely illusory and unascertainable due to the lack of specificity contained in the CRN making it impossible for Olympus to ascertain a cure for the alleged violations. By making these demands the sole “opportunity” to cure the CRN, the Insured have failed to preserve a bad faith claim by failing to strictly comply with the statutory requirements. This is because “the CRN is designed to prevent insurers from playing a ‘guessing game’ as to what, and how, to cure within the sixty-day window.” King v. Gov’t Emp’ees Ins. Co., 2012 U.S. Dist. LEXIS 130662, 2012 WL 4052271, *7 (M.D. Fla. 2012); see also Heritage Corp. of S. Fla. v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008) (“The CRN is vague and ‘shotgun’ in nature—hardly the type of specific notice required by the statute that would allow National Union an opportunity to cure.”). As such, the CRN is insufficient for failing to provide Olympus with an opportunity to cure. To the extent that the instant CRN is intended to address any other facts or circumstances which purport to establish additional coverage for the reported losses, the CRN provides insufficient identification of any such facts or circumstances and therefore prevents Olympus from addressing any other aspect herein. Notwithstanding, Olympus believes that the above facts demonstrate beyond dispute that it has at all times acted in good faith with regard to its investigation of the subject claim, and further believes that the facts provided to date fail to establish that it has not adjusted the reported loss in accordance with the express terms, provisions, limitations and exclusions contained within the policy. 4. Conclusion Olympus would note that the claim was properly adjusted, thoroughly processed, and a coverage letter outlining the pertinent facts was mailed to the Insured. Furthermore, Olympus believes that the Complainant’s position is untenable due to the facts surrounding the claim. Olympus spent considerable time and resources in the investigation of this matter and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Complainant's claim and unfairly paints Olympus in a negative light. Moreover, the Civil Remedy Notice is deficient in that it fails to specifically identify specific policy language and fails to list a specific cure amount. Sincerely, Brian Kelley, Esq. On Behalf of Olympus Insurance Company
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