Civil Remedy Notice of Insurer Violations
Login

Filing Number:     786338
Filing Accepted:  10/10/2024
         Print Filing
Complainant
Last/Business Name *  
SHEPARDSON   First Name   AARON AND JOLENE
Street Address * 4902 LONDONDERRY DRIVE
City, State Zip * TAMPA, FL 33647
Email Address * AARONSHEP1@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SHEPARDSON   First Name   AARON AND JOLENE
Policy # * HOH636093 Claim #* H010017337
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*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* HEWLEY HINDS (FLA. ADJ. LIC. # W456278)
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 COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. **** [A]ny any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered. **** B. Coverage C – Personal Property We insure for direct physical loss to the property described in Coverage C caused a peril listed below unless the loss is excluded in SECTION I – EXCLUSIONS . . . 2. Windstorm Or Hail. **** COVERAGE D – Loss of Use We will pay the additional expenses you incur from a covered loss, but no more than the limit of liability shown for Coverage D in the Declarations for the following: 1. Additional living expenses incurred by you so that your household can maintain its normal standard of living when a loss covered under this Section makes that part of the “residence premises” where you reside not fit to live in. Payment will be for the shortest time required to repair or replace the damage or, if you permanently relocate, the shortest time required for your household to settle elsewhere. 2. If civil authority prohibits you from use of the “residence premises” as a result of direct damage to neighboring premises by a Peril Insured Against in this policy, we cover the Additional Living Expenses as provided under 1. above for no more than two weeks. The periods of time for expenses described above are not limited by the expiration of this policy. We do not cover loss or expense due to cancellation of a lease or agreement. **** ADDITIONAL COVERAGES 1. Debris Removal. We will pay your reasonable expense for the removal of: a. Debris of covered property if a Peril Insured Against that applies to the damaged property causes the loss; or b. Ash, dust or particles from a volcanic eruption that has caused direct loss to a building or property contained in a building. This expense is included in the limit of liability that applies to the damaged property. If the amount to be paid for the actual damage to the property plus the debris removal expense is more than the limit of liability for the damaged property, an additional 5% of that limit of liability is available for debris removal expense. We will also pay your reasonable expense, up to $500, for the removal from the "residence premises" of: a. Your tree(s) felled by the peril of Windstorm or Hail; b. Your tree(s) felled by the peril of Weight of Ice, Snow or Sleet; or c. A neighbor's tree(s) felled by a Peril Insured Against under Coverage C; provided the tree(s) damages a covered structure. The $500 limit is the most we will pay in any one loss regardless of the number of fallen trees. 2. Reasonable Repairs. In the event that covered property is damaged by an applicable Peril Insured Against, we will pay the reasonable cost incurred by you for necessary measures taken solely to protect against further damage. If the measures taken involve repair to other damaged property, we will pay for those measures only if that property is covered under this policy and the damage to that property is caused by an applicable Peril Insured Against. **** 3. Trees, Shrubs and Other Plants. We cover trees, shrubs, plants or lawns, on the "residence premises," for loss caused by the following Perils Insured Against: Fire or lightning, Explosion, Riot or civil commotion, Aircraft, Vehicles not owned or operated by a resident of the "residence premises," Vandalism or malicious mischief or Theft. We will pay up to 5% of the limit of liability that applies to the dwelling for all trees, shrubs, plants or lawns. No more than $500 of this limit will be available for any one tree, shrub or plant. We do not cover property grown for "business" purposes. This coverage is additional insurance. **** “Fungi”, Mold, Wet or Dry Rot, Or Bacteria a. We will pay up to the amount stated in the Declarations for Limit of Liability for “Fungi” Coverage for: (1) The total of all loss payable under Section I – Property Coverages caused by or resulting directly or indirectly from “fungi”, mold, wet or dry rot, or bacteria; (2) The cost to remove “fungi”, mold, wet or dry rot, or bacteria from property covered under Section I – Property Coverages. (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. b. The coverage described in a. only applies when such loss or costs are a result of a Peril Insured Against that occurs during the policy period and only if all reasonable means were used to save and preserve the property from further damage at and after the time the Peril Insured Against occurred. c. We will pay up to $1,000 for the cost of testing of air or property to confirm the absence, presence or level of “fungi”, mold, wet or dry rot, or bacteria 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 or that the presence of “fungi”, mold, wet or dry rot, or bacteria is in dispute by us and you. 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: Heritage Property & Casualty Insurance Company (“HERITAGE”) 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 HERITAGE; 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) HERITAGE 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. HERITAGE has breached this duty by its adjustment of the insured’s claim of loss. HERITAGE 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. HERITAGE 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 HERITAGE of their insurance claim, HERITAGE has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. HERITAGE 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, HERITAGE 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, HERITAGE issued the subject insurance policy which provided coverage for the insured property from September 8, 2022, through September 8, 2023 for “risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.” 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 April 24, 2023, the insured property suffered a hail and windstorm loss, and the insured immediately submitted a claim to HERITAGE for property damage, i.e., storm, hail, wind, rain, and water intrusion damages 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 HERITAGE 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. HERITAGE since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, HERITAGE has failed and refused to properly settle the insured’s claim in good faith. The insured have requested that HERITAGE conduct an investigation, admit coverage, and pay damages; HERITAGE has failed and refused to do so. In short, HERITAGE 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 HERITAGE’s investigation and property inspection, which confirmed windstorm damages, HERITAGE nevertheless sent correspondence to the insured dated May 29, 2024, (signed by HERITAGE’s adjuster, Hewley Hinds - Fla. Adj. Lic. # W456278) and communicated its unequivocal denial of the claim. 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. State Farm 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, HERITAGE breached the Policy. Moreover, HERITAGE’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, HERITAGE failed and refused to acknowledge the covered loss and pay all amounts due and owing for the loss. Therefore, HERITAGE breached the Policy. Concerned with the accuracy of HERITAGE’s coverage denial, and given the extensive nature of the physical damage, the insured retained a loss consultant, Synergy Claims Group (“SCG”) to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on its investigation, SGC determined that a hail and windstorm on or about April 24, 2023, including storm, wind, and hail, caused damage to the exterior of the insured property (particularly the roof warranting replacement), creating openings which allowed wind and rain to intrude into the interior of the property causing additional damage. Moreover, SCG determined that at least $236,660.22 worth of repairs would be required to return the property to its pre-loss condition as a result of the hail and windstorm loss. Nevertheless, HERITAGE failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, HERITAGE breached the Policy. Thereafter, the Insured sent correspondence to HERITAGE enclosing their Sworn Statement in Proof of Loss, the supporting SCG outlining the cause, scope, and cost of the loss and other supporting documents, and requested HERITAGE to reconsider its coverage denial. On July 12, 2024, HERITAGE sent correspondence to the insured (signed by HERITAGE’s adjuster, Hewley Hinds - Fla. Adj. Lic. # W456278) and summarily reaffirmed its coverage denial. Therefore, HERITAGE breached the Policy. On October 10, 2024, the insured sent correspondence to HERITAGE enclosing the Sworn Statement in Proof of Loss, the supporting SCG report outlining the cause, scope, and cost of the loss and other supporting documents, the Notice of Intent to Initiate Litigation, and requested HERITAGE to reconsider its coverage denial. To date, HERITAGE has failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, HERITAGE breached the Policy. As such, HERITAGE’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, HERITAGE 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, HERITAGE 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 HERITAGE. However, HERITAGE chose to deny coverage for the insured’s loss. Despite clear evidence that the damages were covered and caused by a covered peril, the claim was denied. To date, HERITAGE continues to deny the insured and its insured full indemnity for the claim. While HERITAGE refuses to honor this claim, a jury in Hillsborough County will likely do what HERITAGE 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 HERITAGE all-risk policy, to show that, while HERITAGE 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 the HERITAGE’s investigation and SCG’s investigation, HERITAGE’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, HERITAGE nevertheless inexplicably denied the insured’s claim. As of today, HERITAGE 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, HERITAGE 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 HERITAGE do the same. Yet, that is not the case. The insured feels that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, HERITAGE is putting the insured property at risk. As a responsible property owner, the insured purchased insurance to protect the property, paid all of the premiums, and has 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, HERITAGE turned its back and delayed and wrongfully denied coverage that the insured is rightfully owed. Ultimately, HERITAGE has failed and refused to properly investigate the loss. The insured has requested that HERITAGE admit coverage and pay damages, HERITAGE 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, HERITAGE has failed to handle its insured’s claim in good faith. In Florida, the work of adjusting insurance claims engages the public trust; HERITAGE has breached this duty by its insufficient adjustment of the insured’s claim. HERITAGE 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. HERITAGE 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. HERITAGE breached this duty. The actions taken by HERITAGE 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. HERITAGE’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, HERITAGE 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: Heritage Property & Casualty Insurance Company PO Box 20947 Tampa, FL 33622 claims@heritagepci.com hhinds@heritagepci.com
Comments
User Id Date Added Comment
jonathan@woolseymorcom.com 02-18-2026 Withdrawn.
ncarlisle@heritagepci.com 11-20-2024 November 20, 2024 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Aaron and Jolene Shepardson Insured: Aaron and Jolene Shepardson Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 786338 Claim No: H010017337 Policy No.: HOH636093 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 786338, filed on behalf of Heritage’s insured Aaron and Jolene Shepardson (“Complainant”). The Notice was accepted by the Department on October 10, 2024. The subject Notice fails to comply with §624.155, Florida Statute, which provides that a Civil Remedy Notice must state with specificity the facts giving rise to the alleged violations and the policy language relevant to the violation, if any. Here, the Complainant did not substantially comply with the specificity standard, and this is more than a mere technical defect. As a result, the Complainant has failed to satisfy the requirement that it identify the specific policy provision relevant to Heritage’s alleged violation and/or the specific facts and circumstances giving rise to the violation and/or the names of any individuals involved in the alleged violations. See Fla. Stat. § 624.155(3)(b). Strict construction of Fla. Stat. § 624.155 demands a specificity level of compliance with the requisite provision of information to the Department and the insurer. See e.g. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). However, here, the Notice fails to meet the stringent standards that are required by Florida Law. Id. Instead, the Notice merely contains a list of violations which Heritage has allegedly committed but the Notice fails to provide an adequate basis in support of those allegations and on that basis alone, the Notice fails to satisfy the basic requirements of an otherwise proper Civil Remedy Notice. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875; Fla. Stat. §§ 624.155 and 626.9541. Furthermore, and without waiving Heritage’s arguments that the Notice is legally insufficient and non-compliant with Florida law, Heritage has at all times performed its obligations under the insurance policy in a prompt and diligent manner with due regard for the interest of its insured. The Notice contains a list of violations which are alleged to have been committed by Heritage. However, none of the listed violations/allegations have occurred and Heritage categorically denies any claims that it has violated the obligations and duties set forth under §624.155 and §626.9541, Fla. Stat., as well as any and all other statutes/regulations/codes/rules raised in the Notice. Furthermore, the Complainant has failed to produce any substantive information and/or documentation to support any of the allegations set forth in the Notice; and as such, the Notice is legally insufficient. Heritage sent a licensed adjuster and engineer to inspect the insured property, and after its inspection and underlying investigation of the claim, Heritage sent correspondence, including a coverage determination letter to the insured; wherein, Heritage provided a thorough explanation of the coverage determination. To date, the Complainant has not provided any other information and/or documentation which would alter Heritage’s coverage determination. In the Notice, the Complainant generally alleges that Heritage failed to pay benefits owed, failed to act with due diligence, and engaged in other bad faith conduct. However, no information/documentation has been provided to support these allegations. Accordingly, Heritage has handled the claim in accordance with the insurance policy, Florida law, and all statutory and regulatory requirements. Therefore, Heritage denies each and every assertion of bad faith in the Notice. And, notwithstanding the foregoing, nothing in this letter should be construed as a waiver or surrender of the policy terms, limitations, exclusions, conditions or agreements, nor should this letter be considered an exhaustive recitation of the deficiencies in the Notice. Heritage reserves the right to supplement its response at a later time. Should the Department have any questions, concerns, or require any additional information regarding this matter, please feel free to contact the undersigned at your convenience. Sincerely, /s/ Benndrick C. Watson Benndrick C. Watson, Esq. Claims Counsel Heritage Property & Casualty Insurance Co. CRN Response
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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




DFS-10-363
Rev. 10/14/2008