Civil Remedy Notice of Insurer Violations
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Filing Number:     786313
Filing Accepted:  10/10/2024
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Complainant
Last/Business Name *  
SULISUFAY   First Name   LAURA AND JASON
Street Address * 8525 NORTHTON GROVES BLVD.
City, State Zip * ODESSA, FL 33556
Email Address * LAURA.TOPALLI@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SULISUFAY   First Name   LAURA AND JASON
Policy # * 757565 Claim #* 012011
Attorney
Attorney is Applicable
Last Name* MARTINEZ First Name * KELLI Initial
Street Address* 3411 W. FLETCHER AVE, STE. B
City, State Zip* TAMPA , FL 33618
Email Address * PRESUIT@SULILAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   VYRD INSURANCE COMPANY
NAIC Company Code 17153
 
Name of individual responsible for violation (if any):* RICKIE KUBIAK, MIKE ARVIDSON, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, VYRD INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Violation of Code of Ethics
Other : Not treating the Insured with good faith claims conduct
Other : Looking for ways to deny full recovery to the Insured
Other : Looking for ways to delay full recovery to the Insured
Other : Failing to properly investigate the Insured’s loss
Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made.
Other : Not adjusting claims and evaluating loss properly
Other : Shifting the burden of insuring the loss to the Insured
Other : Failing to implement proper standards for the adjustment and investigation of claims
* 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.
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)(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.

THE POLICY LANGUAGE RELEVANT TO THE VIOLATIONS INCLUDES ALL APPLICABLE LOSS PAYMENT AND COVERAGE PROVISIONS OF POLICY NUMBER 757565, INCLUDING THE DECLARATIONS PAGE AND ALL ENDORSEMENTS TO THE POLICY, WITH RESPECT TO COVERAGES A, B, C, AND D. ADDITIONALLY, ANY SECTIONS RELIED UPON BY THE INSURER IN ITS FAILURE TO FULLY PAY THE CLAIM, INCLUDING THE DUTIES IN THE EVENT OF LOSS PROVISIONS AND THE POLICY'S EXCLUSION OF COVERAGE PROVISIONS. THE VIOLATIONS ALLEGED ARE ALSO STATUTORILY BASED AND DO NOT RELY ON ANY SPECIFIC POLICY LANGUAGE. 627.70131(7)(a) Within 60 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer’s claim payment is less than specified in any insurer’s detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. Any payment of an initial or supplemental claim or portion of such claim made 60 days after the insurer receives notice of the claim, or made more than 15 days after there are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. 627.70131 (1)(a) - Upon an insurer's receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer's claim file and dated. A communication made to or by a representative of an insurer with respect to a claim shall constitute communication to or by the insurer.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Vyrd Insurance Company has committed the following in handling the insured’s claim: 1. Failing to act in due diligence and good faith to resolve claims 2. Placing the financial interest of the Carrier before that of the Insured 3. Looking for ways to deny benefit payments and otherwise “low ball” or “stone wall” claims. 4. Not adjusting the claims promptly and fairly 5. Not attempting in good faith to settle claims 6. Conducting Inadequate investigations 7. Failing to employ policies and procedures to conduct adequate investigations 8. Failing to provide an estimate that complies with the Florida Building Codes. 9. Shifting the burden of investigating the loss onto the Insured. 10. Misrepresenting the terms of the insurance policy. Laura Sulisufay and Jason Sulisufay are homeowner’s with an all-risks insurance policy issued by Vyrd Insurance Company (hereinafter “Carrier”),. On or about July, 12th,2024, while the policy was in full force and effect, the Insured’s property located at 8525 Northton Groves Blvd. Odessa, FL 33556, sustained significant damage as a result of water leak. The insured promptly reported the claim and fully cooperated with the carrier’s investigation. The Carrier assigned claim number 012011 to the loss. The carrier utilizes FKS Insurance as a third party claims administrator. After reporting the claim, Carrier retained an unqualified and biased field adjuster, Mike Ardvison, to adjust the loss. The carrier also retained Rickie Kubiak as the desk adjuster. Both Mike and Rickie work for FKS Insurance on behalf of Vyrd Insurance Company. The adjusters and FKS Insurance, had a financial incentive to adjust the loss in a manner that would minimize Vyrd Insurance Company’s losses. Instead of adjusting the claim fairly, honestly, in good faith, and with due regard for the Insured’s interest, the adjuster made a conscious effort to ignore evidence of covered losses to the property and direct physical damage. On or about July 12th, 2024 the Sulisufay’s suffered a major water loss from a failed washing machine on the 2nd floor of their primary residence. They immediately called a local restoration company “DryOps” to mitigate damages and immediately reported the claim. The loss originated in the laundry room located in the 2nd floor of the residence where the washing machine is located. The subject washing machine is approximately 2 years old and was purchased brand new & professionally installed through Costco who sold them the appliance. Vyrd assigned Mike Arvidson to inspect the loss. On July 13th, 2024 Chad from DryOps sent a email to Vyrd Insurance company and stated the following: Dear Claims Department, I am writing on behalf of DryOPS LLC to formally request to exceed the caps and limitations for emergency services, specifically for water mitigation, restoration, and remediation services. Due to a Category 2 water intrusion, we need to remove baseboards, trim, and vinyl plank flooring, and use drying equipment and strategies immediately to prevent secondary damage. The Insured has been informed of the situation. Attached is our agreement with the homeowner, including "Direction to Pay" (Section 3.f.) and "Letter of Protection" (Section 5.a.). The current situation involves a significant Category 2 water loss caused by a washing machine failure, requiring urgent water mitigation per the ANSI/IICRC S500-2021 Standard for Professional Water Damage Restoration. Essential equipment has already been deployed, and mitigation procedures are in progress. We request confirmation that coverage for this situation is allowable and can extend beyond the standard limitations. We will provide continuous updates per your requests and upload images to the designated link below throughout the project. For further clarification or inquiries, please contact me via phone or email. Please direct all future email correspondence regarding this claim to chad@dryops.com. Thank you for your prompt attention to this matter. https://dryops.com/claims/12011/ Claim # 12011 Policy # 757565 Regards, Chad Rodrigues Manager 813-733-1800 -- This was the first time Vyrd was notified that we were requesting to exceed any and all caps related to water mitigation, mold remediation etc, in order to prevent further damage to the property. Laura Sulisufay then emailed Vyrd again to confirm receipt of the email and asked when a inspection will be occurring. On July 15th, 2024 Jason Sulisufay again left a voicemail and sent a email asking when the property will be inspected as the contractor is going to begin removing the wet flooring. On July 16th, 2024 DryOps sent the following email to Vyrd: Good morning, It was nice speaking with you yesterday about the Sulisufay claim. I just want to confirm that I have the correct email address and to reiterate that, based on our discussion, EMS coverage has been extended. We will be providing you with the photo documentation and dry logs upon completion of the EMS process. Today, we are moving forward with removing the vinyl plank flooring due to water migrating under it because of capillary action. We will document the process as we go. The removed flooring will be kept onsite for the field adjuster to inspect. On the surface we estimate that approximately 400 square feet of wet flooring will be removed. The removal is scheduled to begin today at 11am. If there are any concerns or if you wish for us not to proceed please contact us before 11am in response to this email, please email me directly at chad@dryops.com. Thank you. Regards, Chad Rodrigues In response to this email, Rickie Kubiak on behalf of Vyrd advised to cotniue with reasonable and necessary mitigation measures. On or about July 17th, 2024, Mike Ardvison inspected the property. Mike did not have a moisture meter or thermal imaging camera with him. DryOps was also present and explained the scope of the damages. Also on July 17th, 2024, Jason Sulisufay advised Vyrd that the warranty repair company for the washing machine will be inspecting on July 22nd, 2024. Rickie asked for more information about the washing machine which Jason Sulisufay emailed the original order from Costco dated April 13th, 2022, photo of the washing machine label with serial number, and warranty info. On July 19th, we advised that the warranty repair guy had a cancellation and inspected the house on July 19th. Jason Sulisufay sent Vyrd a copy of the service work order. DryOps noticed signs of microbial growth and The Sulisufay’s retained Rogina, LLC for a mold assessment. On July 21st, 2024 Jason Sulisufay submitted the Rogina, LLC Invoice, protocol, photos and air quality results. Jason Sulisufay also advised that the house is no longer fit to live as he has 3 small children, two who were born premature, and needed to secure a different place to live in order to maintain his standard of living. He provided Vyrd with incurred costs of the deductible which was paid to DryOps in the amount of $2500, $1050 to Rogina, LLC, and $6,690.09 for a AIRBNB Rental. On July 24th, 2024 Rickie Advised the field adjuster report was received. On August 1st, 2024, Jason Sulisufay advised it was over a week since Vyrd had received the field adjuster estimate yet it was not disclosed. Rickie then sent a copy of the estimate on August, 1st, 2024. Vryd asked for more photos showing 10sq ft of mold despite being provided a copy to link with photos and photos taken my the mold assessor. Vyrd advised a coverage determination would be made next week. Vyrd then asked us to retain the damaged part, and the insured advised that it has not been removed and the warranty repair company would be coming to the house again on August 13th, 2024 to repair the washing machine. Then in a email and letter dated August 8th, 2024 Vyrd issued a initial payment partial denial letter and estimate. There were numerous issues with what was provided by Vyrd. For example, Vyrd incorrectly stated we never requested to exceed the cap for mold testing yet DryOps already sent a email with their work authorization where they requested to exceed caps related to mitigation. Mold testing is part of mitigation and reasonable repairs used to prevent further damage to the property. Worse, the estimate prepared by Vyrd does not conform with Industry standards and did not account for direct physical loss to the property. There was not 1 square foot of allowance for Drywall despite the severe water damage to the property. Further, the Laundry Room where the loss occurred was absent from Vyrd’s estimate, along with the hallway bathroom and Fireplace. Also, Vyrd incorrectly included certain areas under the “Matching Undamaged Property” provision despite the flooring being continuous. Despite being placed on notice on July 21st, 2024 that the house was not habitable, Vyrd FAILED to pay any money for additional living expenses that were incurred. Vyrd also applied the amount of limit towards the deductible but did not reimburse The Sulisufay’s for the deductible that was already paid to DryOps despite being placed on notice that the deductible was already paid. On August 9th, 2024, DryOps sent final invoices for all completed work totaling $55,820.05 along with supporting documentation and photographs. On August 13th, 2024 Jason Sulisufay again followed up with Vyrd regarding the missing items from Vyrd’s Estimate and ALE payments. Also, requested what is the status of the DryOps invoices being paid as we do not want a lien on our house. He also sent the work order from the warranty repair company and asked where to mail the damaged part. On August 14th, 2024, nearly 1 month since incurred ALE invoices were submitted, Jason Sulisufay asked again on the status of payments. On August 19th, 2024, Jason Sulisufay again submitted additional ALE invoices which were incurred. Laura Sulisufay then again reached out as Vyrd continued to ignore and delay our requests for reimbursement which started on July 21, 2024. Given the vastly underestimated cost of repairs, the Insured’s disagreement with the coverage decision, and the scope and nature of the damage resulting from the loss, the delays in payments for incurred costs, the Insured disputed the coverage determination and submitted a sworn statement in proof of loss for $207,591.39 which was a fair and reasonable assessment of the loss and included incurred ALE expenses to date. The Sulisufay’s retained the services of Assess Building Consultants, LLC who is a licensed contractor to provide a estimate of the damages which totaled $130,804.77 and included storage of personal property. DryOps submitted to final invoices for repairs made that were $42,610.26 and $13,209.79 for mold. Also submitted was a initial mold assessment invoice for $1,050.00 and clearance testing for $1030.00 from Rogina, LLC which were paid. Also, submitted was two incurred invoices for additional living expenses from AirBNB for $6,690.01 and $12,103.72. Lastly, a laundry invoice from Happy Nest for $92.84. On August 22, 2024 Vyrd acknowledged the sworn proof of loss and issued payment for part of the AirBNB invoice, storage for 1 month, u-haul, and happy nest laundry. Vryd FAILED to pay the other ALE invoice timely despite it being incurred. Vyrd continued to delay the claim by stating the 2nd AirBnB receipt needs to be itemized with a price breakdown of the entire amount. This is not required by the policy but in good faith on August 24th, 2024, we sent all screenshots we could from the AirBNB app. On August 29th, 2024 again The Sulisufay’s followed up with Vyrd on the status of the 2nd ALE payment, and wanting a claim update. Vyrd advised us to hold off on any work due to the differences in scope which included missing drywall, the fireplace, and several rooms that were omitted from the field adjuster estimate and followed up on status of EMS payments. On August 29th, 2024, 10 days after the sworn proof of loss was submitted, Vyrd advised us that he requested the property to be reinspected. This was done to further delay the claim and in violation of FL Stat. 627.70131 (3)(a) which states “Unless otherwise provided by the policy of insurance or by law, within 7 days after an insurer receives proof-of-loss statements, the insurer shall begin such investigation as is reasonably necessary unless the failure to begin such investigation is caused by factors beyond the control of the insurer”. Also, on August 29th, 2024, Vyrd advised the review of the DryOps water mitigation and mold remediation should be completed next week. This was another false promise and another week passed by without payment. Also, on August 29th, 2024 Jason Sulisufay provided Vyrd with another incurred ALE expense from AirBNB for $8,923.66 and again asked for contact information for who will be reinspecting as no one has reached out. On September 3rd, 2024 Vyrd issued ALE payment for $12,103.72 , but did not include ALE for the most recent expense submitted on August 29th, 2024 for $8,923.66. Vyrd also acknowledged the proof of loss on September 3rd, 2024 but said it could not accept or reject it because it wants a reinspection by a General Contractor from Wareham Construction and Alan Dunlavy with SEA limited to address the washing machine part that failed. Vyrd, still could not provide contact information to schedule these inspections. On September 6th, 2024, Frustrated with the further delays of the claim by Vyrd Insurance, Jason Sulisufay reached out to Desk Adjuster Rickie advising him it has been 57 days since the loss occurred, 19 days since the proof of loss was submitted yet no one has reached out for a inspection and how we have $8,923.66 in ALE expenses past due. After that email was sent, finally a representative from Wareham construction reached out and the first available inspection was scheduled for September 17th, 2024 and Vyrd was advised of the same. On September 17th, 2024, Adam from Wareham Construction inspected the property for a mere 68 minutes and he is not a licensed insurance adjuster. Again on September 18th, 2024, Jason Sulisufay reached out to Vyrd to request a status update on the claim as we are unable to commence repairs due to Vyrd failing to pay for direct physical loss and asking no repairs to be made until they can inspect and agree on scope, also requesting a update on the past due ALE payments and past due contractor invoices. Then on September 23rd, 2024 Laura Sulisufay reached out to Vyrd as the claim has been ongoing for more than 60 days, Vyrd not requesting reinspections timely, delaying payement, and not being reimbursed for ALE. On September 23rd, 2024 an engineering inspection occurred. Rickie from Vyrd stated on September 23rd, 2024, The coverage determination has already been issued, and that occurred within the 60-day timeframe. The engineer and GC were requested timely. I will be reaching out to DryOps this week to discuss their estimates. The 3rd ALE request has already been submitted for approval. I should have that this week. You can begin repairs if you have not already, so you may return to your residence. I should have the GC Estimate by October 4, 2024. The engineer stated that the washing machine was not repaired completely, so we will need to know if the washing machine is fully functional after the repair technician comes back to complete the repairs. DryOps does not collect deductibles for VYRD. The deductible was addressed in the initial payment. In response to Rickie’s email, Jason Sulisufay advised Vyrd that, It has now been 80 days since the loss occurred, and VYRD has NOT accounted for one square inch of drywall, despite there being direct physical damage to it. Additionally, VYRD still has not paid our EMS contractor's past-due invoice. VYRD’s estimate specifically states, "No supplemental payment will be considered without prior approval of VYRD. If your contractor’s estimate is greater or additional damages are found, contact us prior to signing any contracts or proceeding with the work." Due to the inaccurate adjustment of the loss, we hired a building consultant who accounted for all damages and submitted a proof of loss to VYRD. Despite the passage of 30 days since the proof of loss was submitted, we have yet to receive the supplemental payment. Furthermore, we still have not been fully reimbursed for ALE, which was submitted on 8/29/24. With the AIRBNB rental expiring on 10/14/2024, we will now require additional ALE. Additionally, Hurricane Helene has greatly devastated our area, which may result in further construction delays. No contractor will agree to do the work based on VYRD’s estimate, as it did not include any drywall or account for the laundry room (where the loss occurred), the bathroom next to the laundry room, or the fireplace—all of which suffered direct physical damage from the loss. You claim that a coverage determination was made within 60 days, but this is not fully accurate, as VYRD has still not paid for items that were damaged due to direct physical loss, nor for the EMS contractor, and is more than 30 days behind on our ALE payments. These delays represent multiple breaches of the terms and conditions of the policy, as well as violations of Florida Consumer Protection statutes. We have complied with three different inspections at the property. Please advise what factors beyond VYRD's control are hindering the finalization of the claims investigation so we can move forward. Will VYRD be paying the entire estimate that we submitted so we can start work? We are unable to begin any repairs because VYRD instructed us not to proceed if there is a difference in scope until VYRD provides approval. However, you also told us to begin repairs. Does this mean you are agreeing to our full scope and will be paying for it? You also claim that DryOps does not collect deductibles for VYRD. I am confused, as DryOps is a contractor. Are you stating that we should not pay our deductible to a contractor? If so, who is supposed to collect our deductible? Please advise, as we have already paid our deductible to our contractor. Lastly, please advise if you will be paying us interest for the delayed payments. It also appears VYRD is incorrectly applying the matching limitation to all of the flooring despite the flooring and the underlayment being continuous, which should not fall under the matching limitation. Matching of undamaged property should only apply where there is a transition strip. As of October 10th, 2024, Vyrd has not issued payment on the past due ALE, has not made any payment to DryOps and has continued to delay the claim in bad faith. Despite being on of Florida’s newest insurer’s Vyrd has had over 125 Civil Remedy Notices filed, since November of 2022, indicating this is a common business practice. Worst still, Carrier failed to retain qualified experts necessary to identify the repairs necessary to restore the property to its pre-loss condition within reasonable time. Under the circumstances surrounding this claim, had Carrier acted fairly and honestly toward the Insured and with due regard for the Insured’s interests, Carrier could and should have attempted in good faith to settle this claim. Carrier did not and, instead, dishonestly and unfairly placed its own interests well ahead of those of the Insured. In doing so, Carrier violated Section 624.155(1)(b)(1), Florida Statutes. Carrier’s use of unqualified and bias adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition evidences Carrier’s failure to adopt and implement standards for the proper investigation of claims in violation of Section 626.9541(1)(i)(3)(a), Florida Statutes. Carrier’s use of unqualified and bias adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidences Carrier’s failure to conduct a reasonable investigation based upon available information. When applying the facts present here to Florida law, it is clear that Carrier is acting in bad faith. 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 based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Carrier has breached this duty by refusing to properly and timely adjust the loss. Moreover, Section 69B-220.201 of the Florida Administrative Code defines Carrier’s adjusters conduct here as an unfair claims settlement practice. Specifically, Section 69B-220.201(3) provides that “[a]n adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured” and that “[a]n adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.” As detailed above, Carrier’s investigation and adjustment of this claim was done in a manner prejudicial to Insured, was incomplete, and lacked truthful and unbiased reports of the facts. Upon receiving notice of the loss, the Insurer had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return the home to its pre-loss condition. However, when the Insurer conducted its inspection of the insured property, the Insurer’s representatives failed to conduct a thorough and adequate investigation, or the representatives intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after investigating. As a result, the Insurer breached the policy by failing to fully indemnify the Insured for the covered loss. The conduct outlined above is done within the Insurer’s routine course of the business. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer’s claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured’s interests or safety. In Florida, the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully denied full coverage for the claim. Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer’s actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer’s actions amount to but are not limited to the following: 1. Claim Delay: The Carrier has delayed processing the claim, causing frustration and inconvenience to the Insured. 2. Lack of Good Faith Conduct: The Carrier has not treated the Insured with good faith conduct expected when handling claims. 3. Attempt to Reduce Recovery: The Carrier has actively sought ways to minimize the amount owed to the Insured under the policy. 4. Attempt to Deny Recovery: The Carrier has looked for reasons to deny coverage altogether, rather than fulfill its obligations under the policy. 5. Failure to Property Evaluate Loss: Claims have not been assessed accurately or promptly, resulting in delays and incomplete indemnity for the Insured. 6. Inadequate Training and Supervision of Adjusters: The Carrier has not ensured its adjusters are adequately trained to handle claims promptly and fairly. 7. Placing Company Interests over Insured Interests: The Carrier has prioritized its financial interests over the health and safety of the Insured. 8. Failure to Provide Complaint Estimates: Estimates provided by the Carrier do not comply with Florida Building Codes. 9. Shifting Investigation Burden to Insured: The Carrier has unfairly placed the burden of investigating the claim onto the Insured. 10. Conducting Inadequate Investigations: The Carrier’s Investigation into the claim have been insufficient or cursory. Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: 1. Admit full coverage for the Insured’s loss and tender all additional amounts owed under the Policy for the covered loss to the insured property Please email any responses to this civil remedy notice to presuit@sulilaw.com A copy of this form submitted to the FDFS has been sent via email to the following parties, providing them notice of the filing of the civil remedy notice: • Vyrd Insurance Company via DFS Filing • Claims Department, Vyrd Insurance Company via email; • Laura & Jason Sulisufay via email to laura.topalli@gmail.com
Comments
User Id Date Added Comment
Presuit@sulilaw.com 06-25-2025 The parties have reached an agreement and this CRN is hereby withdrawn.
cmaukonen@chartwelllaw.com 12-08-2024 December 8, 2024 VIA CERTIFIED MAIL AND E-MAIL: Laura and Jason Sulisufay c/o Kelli Martinez, Esq. Suli Law 3411 W. Fletcher Ave, Suite B Tampa, FL 33618 presuit@sulilaw.com Re: Complainants/Insureds: Laura and Jason Sulisufay Insurer: VYRD Insurance Company DFS Filing Number: 786313 Filing Accepted Date: October 10, 2024 Policy Number: 757565 Claim Number: 012011 Date of Loss: July 12, 2024 Dear Ms. Martinez: This firm represents VYRD Insurance Company (hereafter “VYRD”) in connection with a claim submitted by Laura (“Topalli”) and Jason Sulisufay (hereinafter “the Complainants”), following a reported water loss occurring on or about July 12, 2024. This correspondence shall serve as a formal response by VYRD to the Civil Remedy Notice of Insurer Violation (hereinafter “CRN”), filing number 786313, recently submitted on behalf of the Complainants and associated with policy number 757565, and claim number 012011. VYRD denies each and every allegation brought forth in the CRN and denies any wrongdoing in the handling of this matter. Below we include a detailed factual history of the claim handling and actions by VYRD, which clearly reveals VYRD acted properly in responding to the claim, and is in compliance with both its contractual and legal obligations. VYRD would further state that the Complainants’ CRN is defective as it fails to comply with the strict governing requirements contained within Florida Statute Section 624.155. Namely, the statute requires that a CRN shall “state with specificity . . . [t]he facts and circumstances giving rise to the violation.” Fla. Stat. § 624.155(3)(b)2. Under Florida law, a civil remedy notice must state the facts and circumstances that give rise to an alleged violation with such specificity sufficient to allow an insurer to cure any alleged violation within the 60-day statutory period. See Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). The Complainants’ CRN is deficient as the limited facts and circumstances set forth therein are false, incomplete, and misleading. Additionally, the CRN includes a blanket list of nine (9) statutory provisions alleged to have been violated. The referenced statutes and code sections, however, do not appear to be pertinent to the subject claim, and the CRN fails to specify each statutes’ relative applicability to same. Further, the CRN does not contain facts addressing and supporting each of the alleged statutory violations against VYRD, but rather sets forth only stock, conclusory allegations of purported bad faith. For these reasons alone, the CRN is defective on its face. In light of the incomplete, misleading, and false allegations set forth in the CRN, VYRD hereby provides the Department of Financial Services with the following facts of the claim that, in and of themselves, disprove all of the allegations brought forth in the CRN. VYRD hereby asserts that all actions taken in the handling of this claim were done so in good faith for the purpose of fair and timely disposition of this matter. CLAIM FACTS On July 12, 2024, the Complainants reported their claim for damages to VYRD. The claimed damages were the result of a washing machine leak that caused water damage. The claimed date of loss was July 12, 2024. On July 12, 2024, VYRD sent the Complainants a letter acknowledging their alleged loss and explaining to the Complainants what to expect next on. Specifically, VRYD’s letter stated that the Complainants should expect an inspection of the insured property, a file review and a final recommendation. VRYD also reminded the Complainants of their duties after loss and right to mediation. On July 17, 2024, VYRD’s Field Adjuster inspected the insured property. On July 17, 2024, the Complainants received an invoice from Rogina LLC in the amount of $1,050.00. On August 1, 2024, VYRD emailed the Complainants and provided a copy of VYRD’s estimate and the 7 Day Estimate Insured Letter. On August 7, 2024, VYRD sent its Initial Payment Partial Denial Letter regarding the Complainants’ claim. The letter stated that VYRD’s inspection revealed ensuing water damage and repairs for matching to undamaged property to the following rooms: the kids’ room, upstairs hallway, loft, master bedroom, baby’s room, upstairs office, stairs, mother’s room, half bath, living room, dining room, sitting room, downstairs office and entry/foyer. The letter noted that a payment in the amount of $30,868.46 had been issued under separate cover. The breakdown of same is as follows: The letter also noted that a portion of the claim payment was paid under the Matching of Undamaged Property Special Liability Endorsement, which is included within the Complainants’ Policy. Additionally, the letter noted that the limit available under the Complainants’ policy for the Matching of Undamaged Property Coverage is $7,010.00 and VYRD applied the All Perils Deductible in the amount of $2,500.00 to the excess value over the policy limit which had fully absorbed the Insured’s deductible. Lastly, the letter discussed the applicable policy provisions and how the Insureds could obtain recoverable depreciation. On August 8, 2024, VYRD sent its Mold Testing Payment Policy Limits Letter to the Complainants. The letter noted that a payment in the amount of $1,000.00 had been issued for the Rogina LLC mold testing. The breakdown of same is as follows: The letter noted that the limit available under the Complainants policy for mold testing was $1,000.00. On August 19, 2024, the Complainants submitted their Sworn Statement in Proof of Loss disputing VYRD’s claims determination. On August 22, 2024, VYRD emailed the Complainants and included the ALE Payment Letter. The payment of $7,577.38 was mailed to the Complainants and stated that VYRD received the Complainants’ Executed Sworn Proof of Loss and Rebuild Estimate. VYRD estimate also received the 2nd AirBnB receipt, but VYRD would need an itemized receipt with a price breakdown of the entire amount similar to the 1st receipt that the Complainants submitted. On September 3, 2024, VYRD sent its SPOL Acknowledgment Letter to the Complainants. VYRD noted that it received the Complainants’ SPOL in the amount of $207,591.39 dated August 19, 2024. VYRD acknowledged receipt of the SPOL and advised that the SPOL is neither accepted or rejected because VYRD requested a reinspection by a General Contractor and an inspection by an Engineer to address the washing machine. Additionally, VYRD noted that it acknowledged receipt of the Insureds’ Building Consultant’s estimate in the amount of $130,804.77, but the receipt of the estimate should not be assumed or construed as its agreement with the contents of the estimate. On September 17, 2024, VYRD’s independent General Contractor with Wareham Construction inspected the insured property. On September 23, 2024, VYRD’s independent engineer, Chris Downing, PE, of Envista Forensics, inspected the insured property. On October 1, 2024, VYRD spoke with Chad from DryOps regarding the DryOps invoice. VYRD stated that it had a peer review done of the water mitigation documents and the peer review was at approximately $3,500.00 versus the $42,610.26 invoiced by DryOps. On October 10, 2024, the Complainants filed their Civil Remedy Notice, Filing Number 786313. Furthermore, VYRD issued another supplemental payment to the Complainants for additional documents provided and continues to communicate with the Complainants’ counsel. As demonstrated by the above detailed factual summary, VYRD has been engaging in a timely, thorough, and good faith evaluation of this claim. As shown, VYRD has, at all times, fully complied with all obligations imposed by the subject Policy and Florida law. ALLEGED REASON FOR NOTICE: Claim Denial: VYRD denies any improper claim denial in the adjustment of this claim as evident from the facts above. In fact, the Complainants’ claim was not denied. Certain damages were afforded coverage and other damages were excluded pursuant to specific provisions under the Complainants’ Policy with VYRD. To date, the Complainants have provided no plausible evidence to dispute VYRD’s coverage determinations. At all times material hereto, VYRD acted in accordance with its duties and obligations pursuant to the policy of insurance. Claim Delay: VYRD denies any delay in the claims handling and process of the loss as evident from the facts outlined above. VYRD promptly adjusted and evaluated the Complainants’ claim, affording coverage for the Complainants’ loss. VYRD has acted, and continues to act, in accordance with its duties and obligations pursuant to the policy of insurance. Unsatisfactory Settlement Offer: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. It is clear from the facts outlined herein that the handling and administration of the claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. The facts show that VYRD acted promptly with respect to the investigation of the underlying claim. VYRD made all communications required to adjust this claim in a prompt and appropriate matter. As outlined above, the facts of this claim show that at no time did VYRD, its agents, or its employees partake in any unfair claim settlement practices and VYRD acted in full and strict compliance with the statutory and contractual requirements imposed upon VYRD. Unfair Trade Practice: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. It is clear from the facts outlined herein that the handling and administration of this claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. The facts show that VYRD acted promptly with respect to the investigation of the underlying claim. VYRD made all communications required to adjust this claim in a prompt and appropriate matter. As outlined above, the facts of this claim set forth herein evidence expedient and timely administration of this claim and full and strict compliance with the statutory and contractual requirements imposed upon VYRD. Violation of Code of Ethics: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. VYRD acted in full and strict compliance with the statutory, ethical, and contractual requirements imposed upon VYRD. Not Treating the Insured with Good Faith Claims Conduct: VYRD denies any wrongful or improper treatment of the Complainants. The Complainants submit no facts or circumstances to support this allegation. VYRD acted in accordance with its duties and obligations pursuant to the Policy of insurance and acted as promptly to thoroughly investigate the claim prior to making the determination as to coverage for the alleged loss. Looking for Ways to Deny Full Recovery to the Insured: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. VYRD acted in accordance with its duties and obligations pursuant to the Policy of insurance and acted as promptly to thoroughly investigate the claim prior to making the determination as to coverage for the alleged loss. Additionally, the Complainants claim was not denied; therefore, there is no basis for this allegation. Looking for Ways to Delay Full Recovery to the Insured: VYRD denies any delay on its part in the claims handling and process of the loss, as is evident from the facts outlined above. VYRD acknowledged the Complainants’ claim and timely initiated its investigation of the loss. VYRD acted in accordance with its duties and obligations pursuant to the Policy of insurance and acted as promptly as possible under the circumstance to advise the Complainants of the determination as to coverage for the alleged loss. Failing to Properly Investigate to Insured’s Loss: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. The facts show that VYRD acted promptly with respect to the investigation of the underlying claim. VYRD made all communications required to adjust this claim in a prompt and appropriate matter. As outlined above, the facts of this claim set forth herein evidence expedient and timely administration of this claim and full and strict compliance with the statutory and contractual requirements imposed upon VYRD. Failing to Provide the Insured with the Full Benefits Awarded Under the Contract of Insurance in a t[sic]: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. VYRD acted in accordance with its duties and obligations pursuant to the Policy of insurance and acted as promptly to thoroughly investigate the claim prior to making the determination as to coverage for the alleged loss, and issued a coverage determination in accordance with the investigation findings and the terms and conditions of the policy. Not Training, Supervising, or Managing Adjusters Properly so that Prompt and Full Payments are Made: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. At all times, VYRD’s agents, representatives and independent contractors properly handled and processed the claim, as evidenced by the facts outlined above. VYRD acted in accordance with its duties and obligations pursuant to the Policy of insurance and acted as promptly as possible to investigate the claim, communicate with the Complainants, and make a determination as to coverage for the alleged loss. Not Adjusting Claims and Evaluating Loss Properly: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. The facts show that VYRD acted promptly with respect to the investigation of the underlying claim. VYRD made all communications required to adjust this claim in a prompt and appropriate matter. As outlined above, the facts of this claim set forth herein evidence expedient and timely administration of this claim and full and strict compliance with the statutory and contractual requirements imposed upon VYRD. Shifting the Burden of Insuring the Loss to the Insured: There is no basis for this allegation, thus it is denied. The Complainants submit no fact or circumstances to support this allegation. At no time did VYRD, its agents, or its employees shift the burden of insuring the loss to the Complainants. Failing to Implement Proper Standards for the Adjustment and Investigation of Claims: There is no basis for this allegation, thus it is denied. The Complainants submit no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the utmost expediency and timeliness allowed by the statutory and contractual requirements imposed upon VYRD. At no time did VYRD, its agents, or its employees act improperly in the handling, administration, or disposition of this claim. The facts show that VYRD acted promptly with respect to the investigation of the underlying claim. VYRD made all communications required to adjust this claim in a prompt and appropriate matter. As outlined above, the facts of this claim set forth herein evidence expedient and timely administration of this claim and full and strict compliance with the statutory and contractual requirements imposed upon VYRD. ALLEGED STATUTORY VIOLATIONS The Complainant alleges nine (9) statutory violations in the CRN, however, no specific facts or circumstances are provided to support these allegations. The CRN is simply a recitation of general, stock allegations of bad faith conduct, along with a list of statutory violations that are not specifically alleged or described. Notwithstanding, VYRD denies each and every allegation of statutory violation individually as follows: 624.155(1)(b)(1): Denied. Notwithstanding same, VYRD has not failed to attempt to settle this claim in good faith and has always acted fairly and honestly towards the Complainants. VYRD immediately undertook a thorough investigation of the VYRD’s claim. VYRD’s investigation revealed both covered and non-covered damages under the Policy. VYRD promptly provided notice of its coverage determinations and continued to evaluate the claim as additional information was received. At all times material hereto, VYRD was entirely forthcoming with the Complainants, and acted with the utmost good faith and due regard for its interests. As shown in the above factual summary, the conduct of VYRD following its receipt of the first notice of the loss has complied with all aspects of Florida law. The Complainants fail to submit any facts or circumstances in support of this alleged violation. 626.9541(1)(i)(3)(a): Denied. This allegation is without basis. VYRD has adopted and implemented standards for the proper investigation of claims at all times. The aforementioned facts demonstrate that VYRD employed proper practices in the investigation and adjustment of this claim, and in strict compliance with the statutory requirements imposed upon it. Furthermore, the Complainants have submitted no facts or circumstances supporting this allegation. 626.9541(1)(i)(3)(b): Denied. There is no showing by the Complainants to support this allegation of misrepresentation of pertinent facts or policy provisions relating to the coverages at issue. As shown in the detailed factual summary above, VYRD was forthcoming with the Complainants at all times material hereto, properly advising the Complainants of the applicable coverages at issue. The Complainants do not submit any facts or circumstances in support of this alleged violation. VYRD asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance Policy. 626.9541(1)(i)(3)(c): Denied. This allegation is without basis. As demonstrated above, VYRD promptly acknowledged the claim upon receiving first notice of the reported loss and promptly initiated its investigations. Upon completing its investigations, VYRD promptly noticed the Complainants of its coverage determinations. At all times throughout the handling, adjustment and settlement of this claim, VYRD acted in strict compliance with the statutory requirements imposed upon it. 626.9541(1)(i)(3)(d): Denied. VYRD conducted a thorough investigation based upon all available information prior to making coverage determinations, as well as supplemental payments, and promptly notified the Complainants. VYRD asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance Policy. 626.9541(1)(i)(3)(f): Denied. VYRD conducted a thorough investigation based upon all available information prior to making its coverage determinations, as well as supplemental payments, and promptly notified the Complainants. VYRD asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance Policy. 626.9541(1)(i)(3)(g): Denied. This allegation is entirely without merit. As demonstrated above, VYRD regularly advised the Complainants of the information/documentation necessary for processing of the Complainants’ claim. The Complainants’ assertions to the contrary are wholly without merit. At all times throughout the handling, adjustment and settlement of this claim, VYRD acted in strict compliance with the statutory requirements imposed upon it. 626.9541(1)(i)(3)(h): Denied. Again, there is no showing by the Complainants to support this alleged violation. As set forth above, VYRD provided the Complainants with a clear explanation of any and all requested information, in strict compliance with the statutory requirements imposed upon it. At all times throughout the handling, adjustment and settlement of this claim, VYRD acted in strict compliance with the statutory requirements imposed upon it. 626.9541(1)(i)(4): Denied. This allegation is without basis. The Complainants submitted no facts or circumstances supporting this allegation, simply making conclusory allegations as to the Complainants’ disagreement with VYRD’s investigation, even as they falsely claim that are undisputed amounts of partial or full benefits owed under the pertinent Policy. VYRD has adopted and implemented standards for the proper investigation of claims at all times. ALLEGED VIOLATIONS OF THE INSURANCE POLICY VYRD asserts that the Complainants’ CRN merely sets forth a blanket list of Policy provisions purportedly relevant to the alleged violation(s). The Complainants have failed to reference any specific Policy language, and the failure to provide such specific reference to Policy language is a direct and clear noncompliance with the requirements of Fla. Stat. § 624.155, rendering the CRN deficient on its face as to form and substance. Notwithstanding, VYRD denies violating any provision or duties set forth in the Policy and further asserts compliance with the Policy and all of its provisions and endorsements. VYRD handled the Complainants’ claim with diligence and at all times acted fairly in administration of this claim and treated the Complainants with honesty and with due regard for its interests. All actions by VYRD were done in complete and strict compliance with the Policy. VYRD DENIES ALL ALLEGATIONS IN THE CRN VYRD hereby denies any and all allegations of bad faith by the Complainants, and states that it has, at all times material, handled and adjusted the Complainants’ claim with the utmost good faith. Any and all allegations of bad faith contained within the CRN are expressly rejected by VYRD. As stated above, the CRN is simply a recitation of general, stock allegations of bad faith conduct, along with a list of statutory violations that are not specifically alleged or described. The CRN is therefore non-compliant with Florida Statute Section 624.155(3), which requires that a civil remedy notice of insurer violation “state with specificity”, inter alia, the facts and circumstances giving rise to the violation and the “specific” language of the subject insurance Policy that is relevant to any alleged violations. The Complainants failed to provide any specific and or accurate facts or circumstances giving rise to the alleged violations in the CRN, and instead simply alleges a litany of non-specific, incomplete, misleading, and boilerplate allegations against VYRD as alleged acts of bad faith. There are not sufficient references in the CRN to any specific Policy language that is relevant to the allegations of bad faith. Failure to provide such specific reference to Policy language is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155, and 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, the CRN is denied and rejected. Additionally, as described in detail above, the facts alleged in the CRN are contrary to the actual facts underlying the subject claim. VYRD further denies any and all other allegations not specifically addressed in this response related to the above-referenced Civil Remedy Notice. There has been no violation of the referenced statutory sections by VYRD. By responding to the Civil Remedy Notice filed by the Complainants, VYRD neither waives nor abandons, but rather, expressly reserves any and all rights, claims and defenses it has or may have under the terms and conditions of the Policy and applicable Florida law. Herein, VYRD has attempted to fully and adequately respond to the allegations alleged in the CRN. Should the Florida Department of Financial Services have any questions or further inquiry with respect to this matter, please contact the undersigned. Thank you for your attention to this matter. Very truly yours, CHARTWELL LAW /s/ Chelsea C. Maukonen, Esq. Chelsea C. Maukonen, Esq. cc: Florida Department of Financial Services
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