Civil Remedy Notice of Insurer Violations
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Filing Number:     785885
Filing Accepted:  10/4/2024
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Complainant
Last/Business Name *  
LEE   First Name   PAMELA
Street Address * 605 QUAIL AVE
City, State Zip * LONGWOOD, FL 32750
Email Address * GKIMMEL@FORTHEPEOPLE.COM
Complainant Type: * Insured
Insured
Last/Business Name*   LEE   First Name   PAMELA
Policy # * 80T205996 Claim #* 59-05X0-39N
Attorney
Attorney is Applicable
Last Name* GINA First Name * KIMMEL Initial
Street Address* 20 NORTH ORANGE AVE. SUITE 1600
City, State Zip* ORLANDO , FLORIDA 32801
Email Address * GKIMMEL@FORTHEPEOPLE.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FIRE AND CASUALTY COMPANY
NAIC Company Code 25143
 
Name of individual responsible for violation (if any):* N/A
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.
 
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGES SECTION I - LOSSES INSURED COVERAGE A- DWELLING We will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I - LOSSES NOT INSURED or otherwise excluded or limited in this policy. However, loss does not include and we will not pay for , any diminution in value. COVERAGE C- LOSS OF USE The most we will pay for the sum of all losses combined under Additional Living Expense, Fair Rental Value, and Prohibited Use is the limit of liability show in the Declarations for Coverage C- Loss of Use. 1. Additional Living Expense. When a loss is caused by a peril described in SECTION I - LOSSES INSURED causes the residence premises to become uninhabitable, we will pay the reasonable and necessary increase in cost incurred by an insured to maintain their normal standard of living for up to 24 months. Our payment is limited to incurred costs for the shortest of: a. the time required to repair or replace the premises; b. the time required for your household to settle elsewhere; or c. 24 months. This period of time is not limited by the expiration of this policy. We will not pay more than the limit of liability shown in the Declarations for Coverage C- Loss of Use. If any normal expenses were reduced or discontinued due to a loss insured, we will subtract the amount by which the expenses were reduced from any amount owed. 2. Fair Rental Value. When a loss insured causes that part of the residence premises rented to others or held for rental by you to become uninhabitable, we will pay its fair rental value. Payment will be for the shortest time required to repair or replace the part of the premises rented or held for rental, but not to exceed 12 months. This period of time is not limited by the expiration of this policy. Fair rental value will not include any expenses that does not continue while that part of the residence premises rented or held for rental is uninhabitable.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about April 11, 2020, Pamela Lee (“Insured”) had a pipe break in her home, which created substantial water damage. Insured reported the loss that same day and was assigned to desk adjuster Matthew Christopher Henderson. State Farm (“Insurer”) sent out their preferred contractor ServePro that same day to begin extracting the water damage. ServePro of Altamonte Springs/Longwood created an estimate for their mitigation and extraction services totaling $5,625.35. The estimate did not include mention of any dwelling repair damages that would fall under Coverage A of the policy, post remediation and water extraction. On December 5, 2020, an Xactimate estimate was completed by Insurer for contents, meal reimbursement, U-Haul fees, pack out and packing services. The estimate did not include mention of any dwelling damages that would fall under Coverage A of the policy. On July 11, 2020, Insured contacted ServePro regarding their estimate; however, she was informed on July 13, 2020, at 8:36 AM, by Frank Barclay at ServePro that State Farm told them they were “not welcome back” at the Insured’s home. On August 4, 2020, Insured advised Ms. Brooks that the estimates she had received from the vendors were incomplete and did not encompass the totality of the loss. On August 5, 2020, insured followed-up with Ms. Brooks to advise her that she was told by ServePro, that State Farm told them, they were not welcome in her home. Ms. Brooks never responded to this communication. On August 11, 2020, Insured sent several photos via email and advised Ms. Brooks stating that the, “living room wall is beginning to soften (only the outside walls were approved for flood cuts but the water traveled through the dining room/bedroom/living room walls and flooded the rooms behind them. I have included a picture of an internet connection now pulling away from the wall because the material around it is softening and I believe Andrew sent you a pic of the baseboard now pulling away from the same wall. If the living room wall is doing this then I know the dining room wall is as well, they are connected. The baseboards were also not removed at the time that they were drying the house out so any moisture that soaked up into the walls is still there. This was also not approved by insurance at the time.” On August 13, 2020, Insured was informed that ServePro was waiting on the desk adjuster’s directive on how to proceed forward with their repair services. That same day Insured informed Ms. Brooks that it was her understanding that construction would have begun earlier that week, but that ServePro was still waiting on State Farm’s approval. During June of 2020, Insurer issued several payments to Insured for ALE, but still had not approved any repair estimate or pay for any repair damage. On June 16, 2020, Insurer acknowledged receipt of Insured’s Sown Statement Proof of Loss and estimation of damages via a supplement claim, noting Insured’s disagreement with Insurer’s evaluation of the claimed loss. The estimate of damages provided exceeded State Farm’s future repair estimates. Finally on June 26, 2020 (about 76 days after the loss was reported) Insurer created an estimate of Coverage A damages totaling $16,193.87. Payment was issued on July 2, 2020, for $13,671.87. Later a second estimate was created by Insurer on July 7, 2020, for Coverage A damages totaling $18,243.84. A third estimate was created by Insurer on July 7, 2020, for Coverage A damages totaling $18, 720.42. An additional payment was issued in the amount $2,049.97 per the revised estimates. On March 16, 2022, Insurer invoked appraisal forcing Insured to incur costs towards appraisal and attorney fees. These additional expenses were all because of State Farm’s material misrepresentations and failure to properly evaluate the claim throughout the entire course of the claims handling process. Insured’s property was in good condition and performing adequately prior to the loss with no known issues. Insurer’s actions and failures to act constituted unnecessary and unreasonable delays and unnecessary expenses. It is believed that future bad faith discovery may reveal an extensive history of underpayments of claims similar to that of the insureds and other insureds across the state of Florida, as this conduct may be a business practice of this insurer. To cure this violation, Insurer can issue payment for the Insured’s additional living expenses, and any claims for attorney’s fees and costs under Fla. Stat. §627.428 and §57.041, and all other claims allowed to insureds under Florida law, not referenced herein. On April 14, 2020, Insured was advised by Mr. Henderson that field adjuster Clinton Bolton was assigned to the claim; and on April 16, 2020, five days after the loss occurred, Mr. Bolton contacted the Insured. On April 15, 2020, Insured was advised by Mr. Russell Branam that, “It was questionable whether there has been a loss caused by a peril insured against.” Later on April 20, 2020, Insured was advised by Mr. Henderson that, “Since fungus is listed as a loss not insured, we are unable to cover that portion of your claim. Coverage for the remainder of your claim will be determined upon completion of our investigation.” That same day, Mr. Russell Branam notified Insured that, “the coverage question mentioned in our April 16th, 2020 letter has been resolved and we are extending partial coverage.” Mr. Branam did not specifically indicate what was being covered or paid for regarding the loss. On April 21, 2020, ServePro of Apopka-Wekiva created an Xactimate estimate of dwelling damages totaling $12,813.25. This estimate was provided to Insurer by Frank Barclay at ServePro on April 22, 2020, stating, “Per the assigned assignment please review the attached rebuild repair estimate and photo sheet. Please provide email with approval when reviewed.” Insured requested that repairs begin; however, ServePro advised Insured that the estimate had not yet been approved by Alacrity, a third-party vendor retained by Insurer. Repairs remained on hold until final approval from the Insurer. On April 23, 2020, Scott Tracy from ServePro Apopka-Wekiva created an estimate for contents totaling $7,540.50 stating, “Extensive amount of Contents in rooms that need repairs. There is no extra space in home to move these contents to. Insured has already gotten one POD in driveway. No room for additional POD’s.” On April 27, 2020, Insured was advised by Mr. Henderson payment was issued directly to ServePro for their work performed. On April 29, 2020, Insurer prepared a Summary of Loss listing payments made for lodging, food, U-Haul fees, and mitigation services perform by ServePro. To date, no payment had been issued for the water damage, tear out costs, or put pack of the property to bring t back to its pre-loss condition.
Comments
User Id Date Added Comment
gthomas@forthepeople.com 12-16-2024 Insureds hereby notify the Department and all interested parties that the issues presented in the Civil Remedy Notice of Insurer Violations have been resolved. Insureds hereby request the Department to take no further action other than to mark the file as resolved and close it.
sdornstein@kelleykronenberg.com 11-20-2024 Complainants: Pamela Lee Insured: Pamela Lee Insurer: State Farm Florida Insurance Company DFS File No.: 785885 Claim No.: 59-05X0-39N Policy No.: 80-T2-0599-6 Date of Loss: April 11, 2020 Dear Pamela Lee: Please accept this correspondence as State Farm Florida Insurance Company’s (“State Farm”) response to Civil Remedy Notice (“CRN”) Filing Number 785885 filed by you, on behalf of Pamela Lee (“Complainant”), dated October 4, 2024. At the outset, State Farm denies that any of its actions taken with regards to this claim have resulted in a violation of Florida’s bad faith laws as alleged in the CRN. Rather, State Farm has acted in good faith at all times in its investigation and handling of the above-claim and with regards to the best interest of our Insured. While State Farm welcomes the opportunity to respond to this CRN, and specifically denies each and every allegation contained in the CRN referenced above, State Farm requests the CRN be rejected as it fails to comply with several of the requirements of the Civil Remedy Notice of Insurer Violation documents provisions as set forth in Florida Statutes § 624.155, § 626.9541, and Florida case law. THE CRN ALLEGATIONS The CRN asserts the following reasons for the notice: • Claim Denial • Unsatisfactory Settlement Offer • Unfair Trade Practice In the CRN, the Insureds allege that State Farm violated the following statutes and applicable language (as taken from the Notice of Insurer Violations): 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. On April 11, 2020, the reported date of loss, the Insured reported damage to the Insured Property due to a pipe burst in the walls in the attic that damaged approximately 9 rooms. The rooms reportedly damaged were the kitchen, back room, living room, office, garage, and laundry room. This also reportedly included the carpet and tile underneath. Insured had an inspection done on April 14, 2020 and the faulty pipe was removed. There was reportedly flooding of over an inch of water. There was also reportedly mold growth found. Based upon the reporting of mold present at the property immediately after the reported date of loss, State Farm prepared a letter to the Insured informing her that there was a question about whether there was a loss caused by a covered peril. Ultimately, it was determined that the claim was partially covered, as the mold was not a covered loss. On April 11, 2020, the Insured opted to hire ServPro of Altamonte Springs to perform water mitigation at the property. ServPro of Altamonte Springs was part of a service provider referral program called the Premier Service Program offered by State Farm to assist homeowners in finding vendors to perform services such as emergency water mitigation at properties after a loss, but participation in the program is completely voluntary. State Farm has no control over the work provided by vendors engaged through the program and cannot instruct those vendors what services they can and cannot offer to policyholders. ServPro of Altamonte Springs was not an agent of State Farm, and State Farm is not a guarantor of the work performed by ServPro of Altamonte Springs. Photographs taken by ServPro of Altamonte Springs on April 11 and April 12, 2020 show that there was already evidence of mold on the walls and floors of the property, including but not limited to the kitchen. Contrary to allegations contained in the civil remedy notices filed by the Insured regarding this claim, of which this is the third, the mold does not appear to have resulted from the improper water mitigation performed by ServPro of Altamonte Springs, but was already in existence at the time they arrived to the property around the reported date of loss. The Insured claims that ServPro was informed by State Farm that they were no longer allowed in the home. State Farm offered to Insured the option to enroll in the State Farm Premier Service Program, which Insured elected to participate in. The State Farm Premier Service Program allows Insureds to choose any participating independent contractor or independent service provider(s) she wishes to repair her property. The Insured selected ServPro of Apopka-Wekiva for her mitigation needs. ServPro, during their inspection of the home, found mold which would need to be mitigated before their services could be completed. As mold is not covered under the policy, the mold remediation would need to be completed by the Insured out of pocket. Prior to performing the services in the estimate, ServPro has a review and approval process. Before this was completed by ServPro, the Insured contacted State Farm and informed that they took issue with the ServPro employee Frank Barclay, and requested a new contractor provide the mitigation services. The Insured requested a new contractor come to the Insured Property to finish the services. State Farm did not inform ServPro that they were no longer allowed in the home, but instead State Farm cancelled their assignment as requested by the Insured and reassigned the assignment to Quality First Builders. This was done at the behest of the Insured. These delays were caused by the actions of the Insured. Even so, State Farm had made several payments for building repairs to the Insured prior to litigation, starting in July 2, 2020, and the insured opted not to perform mold remediation or begin repairs at the property until September 2021. The delays in repairs to the property were caused by the Insured’s independent decision to disallow ServPro of Apopka-Wekiva to perform repairs at the property, and the failure of the Insured to remove the mold which was not covered under the Policy and was not the result of the alleged incomplete mitigation of water damage by ServPro of Altamonte Springs or any alleged action by State Farm which the Insured alleges caused delays to the repair of covered damage. State Farm made extensive payments for additional living expenses to the Insured despite the delays caused by the Insured’s own decision and directions. The Insured admitted at her deposition that there were no invoices for hotel lodging or food which were submitted to State Farm prior to suit which remained unpaid prior to suit. State Farm also paid for nursing home housing costs for the Insured’s mother, to the extent such costs were not paid by Medicare. However, the Insured has sought additional living expense payments which are not reasonable and are not covered under the terms of the Policy. These costs include the purchase price of a recreational vehicle in lieu of hotel lodging or other temporary housing, and requests for payment of lost rent based on the representation that the Insured collected rent from her elderly mother, which is not documented by a written lease agreement. The representation that the Insured’s mother was both a dependent relative of the named insured (and thus an additional insured) entitled to costly housing in a nursing home at State Farm’s expense, as well as a tenant for which the Insured can claim lost income at State Farm’s expense, is contrary to the language and intent of the Policy and constitutes double-dipping. The Policy states in pertinent part: COVERAGE C – LOSS OF USE The most we will pay for the sum of all losses combined under Additional Living Expense, Fair Rental Value, and Prohibited Use is the limit of liability shown in the Declarations for Coverage C – Loss of Use. 1. Additional Living Expense. When a loss caused by a peril described in SECTION I – LOSSES INSURED causes the residence premises to become uninhabitable, we will pay the reasonable and necessary increase in cost incurred by an insured to maintain their normal standard of living for up to 24 months. Our payment is limited to incurred costs for the shortest of: a. the time required to repair or replace the premises; b. the time required for your household to settle elsewhere; or c. 24 months. *** 2. Fair Rental Value. When a loss insured causes that part of the residence premises rented to others or held for rental by you to become uninhabitable, we will pay its fair rental value. Payment will be for the shortest time required to repair or replace the part of the premises rented or held for rental, but not to exceed 12 months. This period of time is not limited by the expiration of this policy. Fair rental value will not include any expense that does not continue while that part of the residence premises rented or held for rental is uninhabitable. The Insured has testified at deposition that she collected what she characterized as rental from her mother from the proceeds of her mother’s social security benefits. The payments did not entitle her mother to exclusive use of any portion of the house; her mother had a bedroom at the house and shared costs for groceries and utilities. There is no indication that the Insured has ever rented that portion of the property to any other tenant or intends to offer that portion of the property to any other prospective tenant, or that $1300 was the fair market value for allowing her mother to live at her house. There is also no indication that this arrangement constituted anything other than her mother contributing to the cost of utilities, groceries, and other necessities as an immediate family member living at the property. The “time required to repair or replace the premises” is a central issue to the civil remedy notice and ongoing litigation over this claim. The Insured has taken the position that her inability to live at the property was caused by the alleged delays and bad faith of State Farm. However, when asked at deposition about repairs ultimately performed at the property, the Insured indicated that the repairs at her property were done by various contractors between September 2021 and “the beginning of 2022”, indicating that the repairs could be performed in four months, possibly less. Despite this, the Insured is seeking additional living expenses (and lost rental income) for a period from the date of loss in April 2020 until completion of repairs in early 2022, almost two years. These costs are not “reasonable and necessary” and extend well beyond the “time required to repair or replace the premises.” Despite this, State Farm made payments to the Insured for months beyond the four months that it actually took to perform repairs, in good faith, and with the Insured’s (and her mother’s) best interests in mind. After reviewing the CRN, State Farm denies all allegations contained in the Complainant’s CRN. State Farm conducted a thorough review of its handling of the Complainant’s claim, Subject Claim No.: 59-05X0-39N. State Farm denies that it has violated any of the statutes as alleged in the CRN. At all times, State Farm acted in good faith, fairly, and honestly toward the Complainant and with due regard for their interests. State Farm also argues that the CRN fails to adequately describe the alleged violations and fails to provide sufficient information to allow it to correct the alleged violations. The CRN includes statutory provisions that could be claimed against an insurance company regardless of whether they are relevant or applicable to the alleged facts contained in the Notice. Because the CRN fails to identify the specific facts applicable to the listed statutes that were allegedly violated with respect to the subject claim, State Farm is unable to properly respond and said CRN should be rejected and returned. The CRN states that State Farm violated the following policy language: “SECTION I - PROPERTY COVERAGES SECTION I - LOSSES INSURED COVERAGE A - DWELLING We will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I - LOSSES NOT INSURED or otherwise excluded or limited in this policy. However, loss does not include and we will not pay for, any diminution in value. COVERAGE C - LOSS OF USE The most we will pay for the sum of all losses combined under Additional Living Expense, Fair Rental Value, and Prohibited Use is the limit of liability show in the Declarations for Coverage C- Loss of Use. 1. Additional Living Expense. When a loss is caused by a peril described in SECTION I - LOSSES INSURED causes the residence premises to become uninhabitable, we will pay the reasonable and necessary increase in cost incurred by an insured to maintain their normal standard of living for up to 24 months. Our payment is limited to incurred costs for the shortest of: a. the time required to repair or replace the premises; b. the time required for your household to settle elsewhere; or c. 24 months. This period of time is not limited by the expiration of this policy. We will not pay more than the limit of liability shown in the Declarations for Coverage C- Loss of Use. If any normal expenses were reduced or discontinued due to a loss insured, we will subtract the amount by which the expenses were reduced from any amount owed. 2. Fair Rental Value. When a loss insured causes that part of the residence premises rented to others or held for rental by you to become uninhabitable, we will pay its fair rental value. Payment will be for the shortest time required to repair or replace the part of the premises rented or held for rental, but not to exceed 12 months. This period of time is not limited by the expiration of this policy. Fair rental value will not include any expenses that does not continue while that part of the residence premises rented or held for rental is uninhabitable.” State Farm informed Insured in correspondence dated October 13, 2020, that: “There has been sufficient time to start the repairs at your home. We have had you in temporary housing since April 12, 2020 and the building repairs still have not started at your residence. Quality First Builders has estimated the time to complete the repairs at approximately 4 weeks once repairs begin. We will allow one additional week for repairs to begin and then an additional 4 weeks for the repairs to be completed. Therefore, the temporary housing will be extended until November 18, 2020 and will be the final extension. As previously advised, the total time for restoration is based on the reasonable time required to repair or replace the covered damages. The period of time for temporary housing does not include time spent for unnecessary or unreasonable delays in commencing repairs, suspensions of work, or additional construction time related to improvements, remodeling or other non-covered damages. Your policy includes a limit for Additional Living Expense coverage of $78,989.00 and to date we have been billed for your temporary housing through August 5, 2020. To date we have paid a total of $31,153.66 under the Additional Living Expense coverage of your policy for your temporary housing and increased meal expenses and the repairs to your home have not begun to date.” State Farm paid for ALE well beyond the policy time limit of “the time required to repair or replace the premises” which would be the shortest of the three time limits in which incurred costs is owed under the policy. Quality First Builders informed that it would take 4 weeks for repairs to be completed. ALE was extended due to COVID restrictions and as a courtesy due to the Insured’s and her mother’s health issues. Mold is not covered under the policy, including loss of use of the Insured Property or delay in rebuilding/repairing/replacing. The relevant policy language is below: “SECTION I - LOSSES NOT INSURED 2. We will not pay for, under any part of this policy, any loss that would not have occurred in the absence of one or more of the following excluded events. We will not pay for such loss regardless of (a) the cause of the excluded event, or (b) other causes of the loss; or (c) whether other causes acted concurrently or in any sequence with the excluded event to produce the loss; (d) whether the event occurs abruptly or gradually, involves isolated or widespread damage, occurs on or off the residence premises, arises from any natural or external forces, or occurs as a result of any combination of these: g. Fungus including: (1) any loss of use or delay in rebuilding, repairing, or replacing covered property, including any associated cost or expense, due to interference at the residence premises or location of the rebuilding, repair, or replacement, by fungus; (2) any remediation of fungus, including the cost to: (a) remove the fungus from covered property or to repair, restore, or replace that property; or (b) tear out and replace any part of the building structure or other property as needed to gain access to the fungus; or (3) the cost of any testing or monitoring of air or property to confirm the type, absence, presence, or level of fungus, whether performed prior to, during, or after removal, repair, restoration, or replacement of covered property. As detailed above, the CRN allegations are baseless and without merit and purposefully drafted in a manner that fails to provide State Farm with proper notice of the allegations or allow any meaningful opportunity to respond and/or evaluate the claims being asserted. Based upon the foregoing, the CRN is insufficient on its face and should be rejected. Talat Enterprises Inc. vs. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000); Lane v. Westfield Ins. Company, 862 So. 2d 744 (Fla. 5th DCA 2003). Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported, vague, ambiguous, and incorrect allegations with no basis in fact or circumstances. Aside from the fact that the allegations are devoid of any specific facts, the tenor and inferences of the allegations are wholly without merit and State Farm denies each and every one. Finally, the “cure” sought by the Complainant is to “issue payment for the Insureds’ loss, including additional living expenses, less their policy deductible, exclusive of any claims for attorney’s fees and costs under Fla. Stat. §627.428 and §57.041, and all other claims allowed to insureds under Florida law, not referenced herein,” notwithstanding State Farm’s right to investigate and adjust the loss. Despite no actual amount being provided by the Insured to cure the CRN, the method for curing the violations alleged in a CRN are not determined by the Complainant. Fla. Stat. § 624.155 does not impose on an insurer the obligation to pay whatever the Complainant demands. Fla. Stat. § 624.155(2)(d) would have no effect or purpose under such an interpretation. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: “Section 624.155 does not impose on an insurer the obligation to pay whatever the insured demands…. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624.155(2)(d)… [t]o cure an alleged violation and to avoid a civil action, an insurer must pay the claim…before the sixty days expire.” Talat, 753 So.2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F.Supp. 773, 777-778 (M.D. Fla. 1996). The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624.155(2)(d). Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F.Supp. 773, 777-778 (M.D. Fla. 1996). For the aforementioned reasons, the CRN is insufficient as a matter of law. The Insured provided items as ALE items but these expenses do not constitute the normal standard of living, additional coverage, or were already addressed. Items such as the insurance of the Recreational Vehicle are not related to normal standard of living and do not constitute as ALE and storage was previously addressed. State Farm denies the alleged violations set forth in the CRN and asserts that it has acted properly, fairly, and reasonable in its investigation of this claim. The CRN is deficient and does not provide sufficient facts and evidence to support any of the alleged statutory violations. The allegations included in the CRN are boilerplate and conclusory in nature. The CRN should be rejected as it is insufficient on its face and written contrary to the requirements of Section 624.155 and fails to specifically describe the facts or circumstances giving rise to each specific violation alleged against State Farm. State Farm acted in good faith, fairly and honestly toward the Complainants in the adjustment of the instant claim. State Farm was contacted on or about April 11, 2020 and was informed of a loss from April 11, 2020. After the loss was reported, State Farm promptly set up a date and time for an inspection by a licensed adjuster to examine and photograph the reported loss. After the investigation, State Farm partially opened coverage, denying coverage for the mold. State Farm provided ALE well beyond the policy time limits for ALE to allow ample time for repairs and replacements to the home. Insured consistently held up the repair and replacement process, which caused multiple delays. It is important to note that while an insurance company is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. Florida law continually affirms the principle that an insurer has the right to investigate claims presented for payment. An insurance company is expressly afforded an opportunity to evaluate its rights and liabilities. Neither the subject policy nor does Florida law provide that a carrier must accept whatever demand for repairs it is provided by its insureds as the amount necessary to repair a loss. In the instant case, the violations alleged by the Complainants all revolve around the contention that State Farm has not fully indemnified the claimed loss. Lastly, State Farm’s investigation and handling of the Insured’s claim was completed in good faith, thoroughly, and timely, and in accordance with the effective insurance policy and Florida law. There is no question that State Farm complied with its obligations under the effective policy of insurance and Florida Statutes. As detailed above, State Farm denies each and every allegation contained in the CRN. State Farm takes the position that the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Regardless of the rejection, State Farm denies all allegations contained in the CRN and submits there are no violations to the Complainants. While this response is meant to be comprehensive, State Farm’s response above is based upon the limited information provided in the CRN and the information State Farm has to date. If the Complainant or their counsel are in possession of information or facts of which State Farm is not in possession, State Farm requests all such information or facts be provided to it immediately. Please note that State Farm’s response is not necessarily exhaustive and does not preclude it from asserting any other valid reason for seeking rejection and return of the CRN. Also, this letter or any act or failure to act on the part of State Farm or any agent or representative of State Farm should not be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. Having responded to each and every violation alleged in the CRN, a copy of the response has also been submitted to the Florida Department of Financial Services on its portal. As always, should you have any questions regarding this response, or the matters referenced herein, please do not hesitate to contact the undersigned. Very truly yours, Michael O. Colgan Michael O. Colgan, Esq.
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