Civil Remedy Notice of Insurer Violations
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Filing Number:     786045
Filing Accepted:  10/7/2024
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Complainant
Last/Business Name *  
O’NEIL   First Name   MICHAEL AND LENORA
Street Address * 16225 JAYESS LN.
City, State Zip * NORTH FORT MYERS, FL 33917
Email Address * SISONEIL44@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   O’NEIL   First Name   MICHAEL AND LENORA
Policy # * FPH3-000097430 Claim #* 01000065773
Attorney
Attorney is Applicable
Last Name* O'NEIL First Name * JONATHAN Initial N.
Street Address* 203 FORT WADE RD. SUITE 260
City, State Zip* PONTE VEDRA , FLORIDA 32081
Email Address * JONATHAN@WOOLSEYMORCOM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
Name of individual responsible for violation (if any):* JOHN SELPH (FLA. ADJ. LIC. #A238274) AND SHANE BERTELS (FLA. ADJ. LIC. #W908310)
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Other : Wrongful claim denial
Unfair Trade Practice
Other : Unfair claim settlement practices
Other : Unreasonable investigation
Other : Failure to act on claim
Other : Failure to conduct a reasonable investigation based on available information
Other : Failure to maintain proper complaint handling procedures
Other : Misrepresenting the insurance policy provisions to the insured
Other : Misrepresenting Florida statutory provisions to the insured
Other : Misrepresenting facts to the insured
Other : Failure to acknowledge and act promptly upon communications with respect to claims
Other : Denying claims without conducting reasonable investigations based upon available information
* 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)(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.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* 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 - PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure for sudden and accidental physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. **** B. Coverage C – Personal Property We insure for sudden and accidental direct physical loss to covered property described in Coverage C caused by any of the following perils unless the loss is otherwise excluded or limited in this policy . . . 2. Windstorm or hail **** [A]ny ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. **** D. Coverage D – Loss of Use **** E. Additional Coverages 1. Debris Removal. ***** 2. Reasonable Emergency Repairs. **** 11. Ordinance Or Law. **** 13. “Fungi”, Mold, Wet Or Dry Rot, Or Bacteria a. The amount shown in the Schedule above is the most we will pay for: (1) The total of all loss payable caused by “fungi”, mold, wet or dry rot, or bacteria; (2) The cost to remove “fungi”, mold, wet or dry rot, or bacteria from covered property; (3) The cost to tear out and replace any part of the building or other covered property as needed to gain access to the “fungi”, mold, wet or dry rot, or bacteria; and (4) The cost of testing of air or property to confirm the absence, presence or level of “fungi”, mold, wet or dry rot, or bacteria whether performed prior to, during or after removal, repair, restoration or replacement. The cost of such testing will be provided only to the extent that there is a reason to believe that there is the presence of “fungi”, mold, wet or dry rot, or bacteria. **** Also refer to: Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

624.155(1)(a)(1) – violating 626.9541(1)(i) 626.9541(1)(a)(1) -- misrepresenting the terms of an insurance policy. 626.9541(1)(i) -- unfair claim settlement practices. Facts of the case: First Protective Insurance Company (“FRONTLINE”) has committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of FRONTLINE; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) FRONTLINE has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring. In Florida, the work of adjusting insurance claims engages the public trust. FRONTLINE has breached this duty by its adjustment of the insured’s claim of loss. FRONTLINE has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above. FRONTLINE has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Despite the insured’s timely notification to FRONTLINE of their insurance claim, FRONTLINE has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. FRONTLINE has failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, FRONTLINE has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of the damages. In exchange for a premium paid by the insured, FRONTLINE issued the subject all-risk insurance policy which provided coverage for the insured property from October 8, 2021, through October 8, 2022, for “sudden and accidental physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy.” As such, the subject all-risk Policy contains coverage for all direct physical losses to the insured property unless the loss is specifically and unambiguously excluded from coverage by the Policy. On or about September 28, 2022, the insured property suffered a windstorm loss as a result of Hurricane Ian, and the insured immediately submitted a claim to FRONTLINE for property damage, i.e., wind, storm, rain, and water intrusion damage throughout the insured property. Hence, the insured suffered a substantial loss regarding the real property and continue to suffer such loss. Having suffered such substantial damage, the insured promptly notified FRONTLINE of the loss in an effort to mitigate the current damage and prevent the exacerbation of any additional losses. The desired result did not follow. FRONTLINE since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, FRONTLINE has failed and refused to properly settle the insured’s claim in good faith. The insured has requested that FRONTLINE conduct an investigation, admit coverage, and pay damages; FRONTLINE has failed and refused to do so. In short, FRONTLINE has failed to handle its insured’s claim in good faith in violation of Fla. Stat. 624.155(1)(b)(1), 624.155(1)(b)(3), and 626.9541(1)(i). Based upon FRONTLINE’s investigation and property inspection, which confirmed damage, FRONTLINE nevertheless sent correspondence to the insured dated December 17, 2022, (signed by FRONTLINE’s adjuster, John Selph - Fla. Adj. Lic. #A238274) confirming partial coverage, denying the remainder, and issuing payment for only $536.96. In regard to insurance contracts, a specific refusal to pay a claim is the breach which triggers the cause of action. Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 892 (Fla. 2003); Donovan v. FRONTLINE Fire and Cas. Co., 574 So. 2d 285, 286 (Fla. 2nd DCA 1991) (finding that a breach of contract takes place at the moment the insurance company refuses to pay a claim). Therefore, FRONTLINE breached the Policy. Moreover, FRONTLINE’s argued exclusions and/or limitations to coverage are devoid of anti-concurrent causation language. Thus, “coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause.” Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694, 699 (Fla. 2016). In addition, under the Policy, any ensuing loss to property not excluded or excepted in this policy is covered. Hence, there are a myriad of coverages under the Policy that would provide coverage for the loss. Nevertheless, FRONTLINE failed and refused to acknowledge the covered loss and pay all amounts due and owing for the loss. Therefore, FRONTLINE breached the Policy. Questioning the propriety of FRONTLINE’s coverage denial, and given the extensive nature of the physical damage, the insured retained a loss consultant, Bay Area Public Adjusters (“BAPA”), to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on its investigation, BAPA determined that a windstorm (Hurricane Ian) on or about September 28, 2022, caused damage throughout the exterior of the insured property (particularly the roof warranting its replacement), including openings, which allowed wind and rain to intrude into the interior causing additional damage. Moreover, BAPA determined that at least $153,233.86 (dwelling), 1,825.78 (other structures), and $19.42 (contents), totaling at least $155,079.06 worth of repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss. Moreover, the insured incurred at least $6,000.00 in additional living expenses as a result of the loss. As such, the insured has sustained damages of at least $161,079.06. Nevertheless, FRONTLINE failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, FRONTLINE breached the Policy. Thereafter, the insured sent correspondence to FRONTLINE enclosing their Sworn Statement in Proof of Loss, the supporting BAPA report outlining the cause, scope, and cost of the loss along with other supporting documents and requested FRONTLINE to reconsider its coverage denial. Nevertheless, FRONTLINE failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, FRONTLINE breached the Policy. On October 7, 2024, the insured sent correspondence to FRONTLINE enclosing their Sworn Statement in Proof of Loss, the supporting BAPA report outlining the cause, scope, and cost of the loss along with other supporting documents, the Notice of Intent to Initiate Litigation, and requested FRONTLINE to reconsider its coverage denial. To date, FRONTLINE has failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, FRONTLINE breached the Policy. As such, FRONTLINE’S coverage denial is a blatant misrepresentation of the available coverages under the Policy in direct violation of Fla. Stats. 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), 626.9541(1)(a)(1), and 626.9541(1)(i)(2) and is nothing more than a mere pretext to wrongfully deny and delay this claim. As a result, FRONTLINE has materially misrepresented the coverages under the subject policy to the insured for the purpose and with the intent of effecting settlement of the insured’s claim on less favorable terms than those provided in, and contemplated by, the subject policy in direct violation of Fla. Stat. § 626.9541(1)(i)(2). Further, FRONTLINE is in violation of Florida statutes §§ 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), and 626.9541(1)(a)(1) by misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue; and also in violation of Fla. Stat. 626.9541(1)(i)(3)(d) by denying the insured’s claim without conducting a reasonable investigation based upon available information. In summary, the insured’s loss is clearly covered by the terms of the policy of insurance with FRONTLINE. However, FRONTLINE chose to deny coverage for the insured’s loss. Despite clear evidence that the damage was covered and caused by a covered peril, the claim was denied. To date, FRONTLINE continues to deny the insured and its insured’s full indemnity for the claim. While FRONTLINE refuses to honor this claim, a jury in Lee County will likely do what FRONTLINE has refused; exercise the benefit of doubt in favor of the insured in finding full coverage for this loss. Indeed, the insured will undoubtedly meet the burden of proof at trial, under the FRONTLINE all-risk policy, to show that, while FRONTLINE provided insurance coverage, damage occurred to the insured property. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 942 (Fla. 4th DCA 2018). With the data presented within FRONTLINE’s investigation and BAPA’s investigation, FRONTLINE’s burden to demonstrate by the greater weight of the evidence that all the physical damage to the insured property was caused solely by excluded perils under the policy and not in combination with a covered peril has not and cannot be met. See Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694 (Fla. 2016). Despite clear indicators of covered damage, FRONTLINE nevertheless inexplicably denied the insured’s claim. As of today, FRONTLINE has failed and refused to inform the insured of their rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has failed and refused to adequately indemnify the insured for the loss and defiantly continues to do so. Indeed, from the time of receiving the claim, FRONTLINE has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss. Notably, under Florida law, “[t]he filing of a lawsuit does not extinguish the insurer’s obligations under the policy to adjust and pay the claim.” Tristar Lodging, Inc. V. Arch Specialty Ins. Co., 434 F. Supp. 2d 1286, 1289 (M.D. Fla. 2006). To date, the insured has made a good faith effort to comply with all of the requirements under the subject policy of insurance, and it is only fair that FRONTLINE do the same. Yet, that is not the case. The insured feel that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, FRONTLINE is putting the insured property at risk. As responsible property owners, the insured purchased insurance to protect the property, paid all of the premiums, and have kept up to date with the responsibilities under the policy. Yet, when the insured needed to rely on the insurance because of this unforeseen loss, FRONTLINE turned its back and delayed and wrongfully denied coverage that the insured are rightfully owed. Ultimately, FRONTLINE has failed and refused to properly investigate the loss. The insured has requested that FRONTLINE admit coverage and pay damages, FRONTLINE has failed and refused to do so, and continues to refuse to fully indemnify the insured for the loss and pay the amounts necessary to properly repair the insured’s property, despite knowing it is required to do so. In short, FRONTLINE has failed to handle its insured’s claim in good faith. In Florida, the work of adjusting insurance claims engages the public trust; FRONTLINE has breached this duty by its insufficient adjustment of the insured’s claim. FRONTLINE has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. FRONTLINE has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Florida statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insured may mitigate their damages to put them back into the position they were prior to loss as quickly as possible. FRONTLINE breached this duty. The actions taken by FRONTLINE in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such a frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541. FRONTLINE’S actions amount to but are not limited to the following: 1. Claim delay 2. Wrongful claim denial 3. Unfair trade practice 4. Unfair claim settlement practices 5. Unreasonable investigation 6. Failure to act on claim 7. Failure to conduct a reasonable investigation based on available information 8. Failure to maintain proper complaint handling procedures 9. Misrepresenting the insurance policy provisions to the insured 10. Misrepresenting Florida statutory provisions to the insured 11. Misrepresenting facts to the insured 12. Failure to acknowledge and act promptly upon communications with respect to claims 13. Denying claims without conducting reasonable investigations based upon available information 14. 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. 15. 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. 16. Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 17. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 18. Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed. Therefore, to cure the defects outlined in this civil remedy notice, FRONTLINE must: (1): Admit full coverage for the insured’s loss; and (2): Tender all insurance monies due and owing to the insured for the loss under the subject Policy; A copy of this form submitted to the FDFS has been emailed and/or uploaded and also printed out and mailed to the following parties providing them notice of the filing of this civil remedy notice: First Protective Insurance Company P.O. Box 958405 Lake Mary, FL 32795 claims@flhi.com
Comments
User Id Date Added Comment
jonathan@woolseymorcom.com 02-04-2025 2025-02-04 - WITHDRAWN
mshifrin@bressler.com 11-13-2024 Via E-Mail: jonathan@woolseymorcom.com gclarke@woolseymorcom.com Jonathan O’Neil, Esq. Woolsey Morcom, PLLC 203 Fort Wade Road, Suite 260 Ponte Vedra, FL 32081 Re: Insured: Michael and Lenora O’Neil Claim No.: 01000065773 Policy No.: FPH3­000097430 Date of Loss: September 29, 2022 Property Address: 16225 Jayess LN, North Fort Myers, Florida 33917 To Whom It May Concern: Please accept this response on behalf of First Protective Insurance Company (“Frontline”) response to the Civil Remedy Notice No. 786045, filed on behalf of Michael and Lenora O’Neil (the “Complainants”) which pertains to the Insureds Michael and Lenora O’Neil (“Insureds”), and accepted by the Florida Department of Financial Services on October 7, 2024. The Civil Remedy Notice alleges that Frontline 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)(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. • 626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). To summarize the below, Frontline hereby denies all of the allegations contained in the CRN, including but not limited to any allegation of improper claim denial, wrongful claim denial, unfair trade practice, unfair claim settlement practices, unreasonable investigation, failure to act on claim, failure to conduct a reasonable investigation based on available information, failure to maintain proper complaint handling procedures, misrepresenting the insurance policy provisions to the insured, misrepresenting Florida statutory provisions to the insured, misrepresenting facts to the insured, failure to acknowledge and act promptly upon communications with respect to claims, and/or denying claims without conducting reasonable investigations based upon available information. To the contrary, Frontline states that it has at all times handled and adjusted the Insureds’ claim with utmost good faith. Simply put, Frontline denies any act or omission that could be construed or found to be deemed bad faith and/or a violation of Florida Statutes §626.155 and § 626.9541, whether expressly stated in the CRN or implied. Any and all allegations of bad faith are hereby denied and rejected in their entirety by Frontline. First and foremost, we note the following “technical” and substantive defects with the CRN. The CRN fails to provide specific policy language that is relevant to the alleged violations and instead generally refers to Coverage A, Coverage C, Coverage D, Debris removal, Reasonable Emergency Repairs, ordinance or law, and fungi. The cited language is not even the correct policy language for the applicable special provisions and there is no explanation why or how these provisions are relevant. The CRN then continues with a ‘catch all’ that refences the entire policy including Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all policy provisions. It’s important to note that the Complainant did not include the policy language that Frontline relied upon in rendering its coverage determination. Failure to provide a specific reference to 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. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith that is 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. Importantly, under Florida law, a civil remedy notice must state the facts and circumstances that give rise to an alleged violation with specificity sufficient 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). Failure to satisfy the specificity requirements, including asserting a litany of statutory violations and/or policy provisions without regard for applicability could render a CRN fatally defective. See Julien v. United Prop. & Cas. Ins. Co., 2020 WL 5652364 (Fla. 4th DCA 2021). Merely stating a list of statutory violations is insufficient to inform Frontline about any of the actions that it is alleged to have violated. The Complainants do not provide any explanation or facts to show how or when the Frontline engaged in improper claim delay, wrongful claim denial, unfair trade practice, unfair claim settlement practices, unreasonable investigation, failure to act on claim, failure to conduct a reasonable investigation based on available information, failure to maintain proper complaint handling procedures, misrepresenting the insurance policy provisions to the insured, misrepresenting Florida statutory provisions to the insured, misrepresenting facts to the insured, failure to acknowledge and act promptly upon communications with respect to claims, and/or denying claims without conducting reasonable investigations based upon available information. Similarly, the CRN lacks and specific facts or circumstances which explain how Frontline committed the following: “1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of FRONTLINE; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) FRONTLINE has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring.” These conclusory statements fail to cite any actions that would be indicative of bad faith and as such, this CRN is deficient and invalid to perfect a valid cause of action for bad faith. While the CRN alleges that Frontline ‘misrepresented policy provisions to avoid paying the insured’, it fails to specify when, how or even which policy provisions were misrepresented. Similarly, the CRN alleges that there are a ‘myriad of coverages under the Policy that would provide coverage for the loss’ but doesn’t explain what this means. The reality is that Frontline afforded partial coverage for the loss and explicitly informed the Insureds that the policy excluded damage caused by flooding, surface water and storm surge. The coverage determination letter apprised the Insureds about the specific reasons why coverage was not being afforded for their flood damage. There is no dispute that the Property’s exterior had water lines as high as 18 inches which damaged the fence, exterior, interior and personal contents. There is also no dispute that the Insured has a flood insurance policy with Wright National Flood which the CRN conveniently omits to mention. The CRN, either intentionally or inadvertently, fails to consider the Policy’s water damage exclusion which was expressly cited to in the coverage determination letter and apprised the Insureds that their damage which was caused by flooding, surface water and storm surge were excluded. Instead, the CRN has taken the misguided belief that Frontline breached the policy by failing to pay for all of damages in the Bay Area Public Adjusters estimate (irrespective of whether those were caused by flooding). Contrary to the CRN’s allegations, Frontline did complete a thorough and comprehensive investigation of the loss. Following the initial field adjuster inspection, Frontline engaged a professional engineer who re-inspected the property on July 9, 2024. Frontline also made repeated requests for documents and information that was necessary to adjust the loss. To wit, on November 18, 2022, Frontline requested copies of the Insureds flood insurance records from the public adjuster which was never produced. Frontline subsequently issued requests for information via correspondence dated May 31, 2024, July 11, 2024, and August 26, 2024. These letters reiterated requests for the Insureds to provide copies of their flood records, proof of repairs for their prior roof claim 0100029178, all related rebuild estimates/invoices, and supporting documentation for certain items that were included in the Bay Area Public Adjuster estimate. Despite repeated follow-up attempts to secure the Insureds compliance with their post-loss obligations, to date, the Insureds have not provided any documentation of their flood claim nor any of the post-loss repair and payment records. The CRN alleges without any specific facts that Frontline breached duties and its handling/adjustment of claim were willful, wanton, and with complete disregard for the rights of the insured and occurs with such frequency to indicate a general business practice. The only thing willful or wanton with Frontline’s handling and adjustment of the claim was its desire to achieve the correct result. Although the CRN alleges that Frontline failed to implement standards for proper investigation of a claim it doesn’t explain why or how the investigation was improper or which standards or guidelines Frontline failed to implement. Similarly, the list of 18 conclusory allegations towards the end of the CRN lacks any specific factual support. It's clear that the Insureds have taken an overly broad and vague “kitchen sink” approach to drafting this CRN as it concerns policy provisions and the statutory violations asserted, which is improper under Florida law. On these grounds, the CRN is deficient on its face, and thus, invalid. See Julien v. United Prop. & Cas. Ins. Co., 2021 WL 824438 (Fla. 4th DCA 2021). While the CRN places the blame on Frontline for improperly delaying the claim or wrongfully denying coverage, it completely avoids the applicable policy exclusions and the Insureds failure to comply with their Policy’s post-loss obligations. Rather than cooperate with Frontline’s investigation and provide the requested information, the Insureds instead opted to file this conclusory and inaccurate CRN. Finally, the proposed cure is deficient. The purpose of the statute’s requirement is to allow an insurer against which such a notice is filed to both understand and effectively be allowed to cure any purported violations. See Longpoint Condo. Assoc. v. Allstate Ins. Co., 2005 U.S. Dis. LEXIS 43917, *7 n. 3 (N.D. Fla. June 1, 2005) (citing Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1281-82 (Fla. 2000)). This CRN, however, does not actually put Frontline on notice of what is specifically required to “cure” the CRN. It simply demands that Frontline admit full coverage (irrespective of any policy terms) and tender all money owed - which is functionally the equivalent of “pay me what you owe me.” Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, *5 (S.D. Fla. 2010). Accordingly, it fails to state a clear or otherwise ascertainable cure. To be abundantly clear, the Complainant fails to provide any specific facts or circumstances giving rise to the alleged violation in the CRN, and instead simply alleges inaccurate and misconstrued facts as well as non-specific unsupported allegations against Frontline as alleged acts of bad faith. Furthermore, the Complainant fails to cite any actions that would be indicative of bad faith and mischaracterize the statutory regulations governing the handling and adjustment of an insurance claim. The CRN filed on behalf of the Complainant fails to set forth any specific acts, facts, or circumstances, which would give rise to the claimed statutory violations, thus preventing Frontline from providing any meaningful or complete response thereto. For these reasons, Frontline denies and rejects the instant CRN as it fails to comply with the requirements of Fla. Stat. § 624.155. Fla. Stat. § 624.155(1)(b)(1) requires that a civil remedy notice of insurer violation “state with specificity”, inter alia, the facts and circumstances giving rise to the violation(s) alleged. In sum, Frontline affirmatively denies that it failed to properly investigate and adjust the subject claim. In fact, Frontline contends that it has acted at all times with the utmost good faith towards the Insureds as well as the Complainant, and that Frontline has properly handled and investigated the subject insurance claim. To the extent that this response does not address each and every allegation of bad faith conduct made by the insureds, Frontline hereby expressly denies any and all allegations of bad faith conduct or omission set forth in the CRN, and/or any alleged violation of Florida Statute §624.155 or any other statutory or administrative code section set forth therein. Again, Frontline insists that it has acted, at all times, in utmost good faith. Simply put, Frontline denies any act or omission that could be construed or found to be deemed bad faith and/or a violation of Florida Statute §624.155. Should you need any additional information from First Protective Insurance Company regarding the foregoing, please feel free to contact the undersigned. Very truly yours, /s/ Michael Shifrin Michael Shifrin, 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