Civil Remedy Notice of Insurer Violations
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Filing Number:     785990
Filing Accepted:  10/7/2024
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Complainant
Last/Business Name *  
HUYNH/LE   First Name   TUAN/NGUYEN
Street Address * 16884 NW 2ND RD
City, State Zip * NEWBERRY, FL 32669
Email Address * HAPPY_LENGUYEN@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   HUYNH/LE   First Name   TUAN/NGUYEN
Policy # * K515985A1359A Claim #* 5967SO41R
Attorney
Attorney is Applicable
Last Name* HUFFMAN First Name * SAMANTHA Initial M
Street Address* 2300 MAITLAND CENTER PARKWAY SUITE 106
City, State Zip* MAITLAND , FL 32751
Email Address * SHUFFMAN@SERRANOCAGAN.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* UNKNOWN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(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.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* 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 COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section)
 
* 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 06/14/2023, ("Insured"), sustained a covered direct physical loss to Insured's property due to a weather-related incident. Insured reported the loss thereafter to STATE FARM FLORIDA INSURANCE COMPANY ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # K515985A1359A which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # 5967SO41R. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $0.00 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about 09/05/2024, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice are done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests; 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims; 626.9541(1)(i)(3)(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. 626.9541(1)(i)(3)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $63,122.63, less any applicable deductible and prior payment to the Insured, to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.
Comments
User Id Date Added Comment
SHUFFMAN@SERRANOCAGAN.COM 06-21-2025 THE COMPLAINTANT HEREBY WITHDRAWS THIS CRN.
njacobs@simonreedlaw.com 12-06-2024 On behalf of State Farm Florida Insurance Company (“State Farm®”), we respond as follows: State Farm denies the allegations contained within the CRN filed in this matter and finds them to be without merit. The CRN sets forth insufficient facts to support that a violation has occurred. The Civil Remedy Statute requires that a civil remedy notice provide the insurer with notice of the circumstances giving rise to the violation so that the insurer has an opportunity to cure any deficiencies during the 60-day cure period. Talat Enterprises Inc. v. Aetna Casualty & Surety Co., 753 So. 2d 1278 (Fla. 2000). The CRN contains boilerplate, conclusory accusations and minimal, generic facts of this claim which do not support the accusations. The CRN contains only general unspecific and unsupported allegations of violations, and deliberately misstates and omits the material facts of this claim of which the Complainants and their representatives are aware and as a result, the notice does not comply with the specificity requirement under the statute. Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). The CRN further fails to cite to any specific policy language relevant to the violation and instead lists SECTION I- Property Coverage and all sections of Coverage A, B, C and D, which is essentially the entire policy as it pertains to property damage and thus renders this CRN insufficient to put the carrier on notice of any alleged violation. See Demase v. State Farm Florida Ins. Co., 351 So.3d 136 (Fla. 5th DCA 2022). The Complainants’ limited, generic, and vague allegations are all contested. The CRN states that in order for State Farm to “remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $63,122.63, less any applicable deductible and prior payment to the Insured, to complete the repairs for the Insured property.” However, the CRN neglects to provide any specific factual information supporting the violations claimed and absolutely no information as to how to cure any alleged violations other than to generally and vaguely admit and “tender payment” for an arbitrary amount which was demanded for the first time when this CRN was filed. State Farm has acted and continues at all times to act in good faith. Without waiving its objections to the deficiencies of the instant CRN, State Farm provides herein a brief summary in response to the CRN setting forth facts which specifically contradict the allegations contained in the CRN and show that a CRN is unwarranted. Complainants failed to report this alleged loss for roof damage until May 17, 2024, nearly one year after they alleged the damage occurred as the result of a storm on June 14, 2023. No interior damage was reported, only that a roofer inspected their property and claimed that there was wind damage to the roof thereby recommending a replacement of the Complainants’ roof. The roofer marked the roof with chalk, but by the time State Farm’s inspector was allowed to inspect the roof on May 23, 2024, no storm damage could be found. The shingles on the roof were well adhered to the roof and showed no sign of damage beyond general wear and tear common to a roof that is approximately 17 years old. State Farm notified Complainants that damage from wear, tear and deterioration is not covered under the policy purchased by Complainants in its letter dated June 17, 2024. Rather than supply any evidence of the storm damage being claimed, Complainants retained counsel who then filed this CRN and a Notice of Intent to Initiate Litigation, providing an inflated estimate for a roof replacement for the first time. The photographs submitted with the estimate show more chalk marks and a person’s hand manipulating the roof shingles on or around September 30, 2024, but no evidence of storm damage, therefore, no coverage could be afforded. Complainants’ CRN cites to multiple statutes alleging they have been violated without facts that would support such conclusions beyond demanding undisputed payment of an arbitrary and unreasonable amount. Each statute is addressed more specifically below: • 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. State Farm was not put on notice, prior to receiving this CRN, of any demand for payment or estimate of damages. No specific facts have been provided in this CRN to support the allegation that State Farm would not attempt to settle this claim or that Complainants or their representatives made any attempt to settle this claim with State Farm prior to filing this CRN and lawsuit, and thus, this CRN fails to put State Farm on notice of the alleged violation. • 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. As stated above, the only delays in handling this claim were by the Complainants themselves who failed to report any claim for nearly a year after the damages allegedly occurred. By the time of the inspection, no storm damages were observed. State Farm was not put on notice, prior to receiving this CRN, of any demand for payment or estimate of damages. No specific facts have been provided in this CRN to support the allegation that State Farm would not attempt to settle this claim or that Complainants or their representatives made any attempt to settle this claim with State Farm prior to filing this CRN and lawsuit, and thus, this CRN fails to put State Farm on notice of the alleged violation. • 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Complainants make this generic and conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. As stated above, State Farm inspected, evaluated, and communicated its evaluation of the damages to Complainants and their representatives. State Farm nevertheless continues its efforts to resolve any dispute. • 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. This broad, generic and vague allegation is not supported by any specific facts in the CRN and is clearly refuted by the actual facts of this claim as explained above. This CRN lacks the specificity required to put State Farm on notice of any alleged communication to which State Farm is accused of not acknowledging. • 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. This CRN cites to no facts supporting this allegation and falsely accuses State Farm of not responding to written requests, all to which State Farm responded timely. This allegation further falsely accuses State Farm, of not responding to a proof-of-loss, when no such statement was ever submitted to State Farm by the Complainants. This CRN is therefore rendered inaccurate and inadequate to put State Farm on notice of any alleged violation. • 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. Complainants make this false allegation despite receiving correspondence explaining State Farm’s findings. As described above, State Farm timely inspected, evaluated, and communicated its evaluation of the damages to Complainants and invites Complainants to submit any evidence of purported storm damage. • 626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. This CRN cites to no facts supporting this allegation. This CRN is too vague and generic to put State Farm on notice of any alleged violation. • 626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. This CRN cites no fact supporting this allegation, rendering this allegation too vague to put State Farm on notice of any alleged violation. • 626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). The specific statute subsection cited pertains to personal injury protection, thus making this CRN nonsensical and inapplicable allegation in a claim for homeowner’s insurance benefits, as stated above. No payment was due in this matter and no documentation or records of any kind were submitted by Complainants in order to substantiate any covered loss occurred. State Farm inspected, evaluated, and communicated its evaluation of coverage to Complainants and continues in its attempts to resolve any dispute through counsel. We believe that the above establishes with clarity that State Farm has at all times acted in the utmost good faith in handling this claim. State Farm denies committing any alleged violations referenced in the CRN and reserves all rights.
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