Civil Remedy Notice of Insurer Violations
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Filing Number:     786567
Filing Accepted:  10/11/2024
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Complainant
Last/Business Name *  
MULLINS   First Name   PEGGY
Street Address * 3225 WHITE OAK ROAD
City, State Zip * LORIDA, FL 33587
Email Address * TYLERBMULLINS45@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MULLINS   First Name   PEGGY
Policy # * 59-CP-M156-2 Claim #* 59-57M4-50V
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W
Street Address* 2790 SUNSET POINT RD
City, State Zip* CLEARWATER , FL 33759
Email Address * GRANT@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* MIKE MATHENY, ALISIA MARTIN, CHRIS COCKE, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, STATE FARM FLORIDA INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unfair Trade Practice
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
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 : Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
Other : Failing to implement proper standards for the adjustment and investigation of claims
Other : Making material misrepresentations
* 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)(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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language. "It is an accepted principle of law that when parties contract upon a matter which is the subject of statutory regulation, the parties are presumed to have entered into their agreement with reference to such statute, which becomes a part of the contract, unless the contract discloses a contrary intention." Westside EKG Assocs. v. Found. Health, 932 So. 2d 214, 216 (Fla. 4th DCA 2005), aff'd, 944 So. 2d 188 (Fla. 2006).
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

State Farm Florida Insurance Company (the "Insurer") 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 Insurer 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) denying a claim which it knew or should have known the policy and Florida law provided coverage for; and 9) making material misrepresentations On or about September 28, 2022, while the subject policy was in full force and effect, the Insured's property was severely damaged by Hurricane Ian. The areas impacted include but are not limited to the shingle roofing system, modified bitumen roof, metal roof, large dock, small dock, exterior, stairs, and two bedrooms. The Insured timely submitted a claim on October 11, 2023, to the Insurer for hurricane damage and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 59-57M4-50V to the loss and sent a field adjuster to inspect the property on October 27, 2023. Then in a letter dated October 27, 2023, the Insurer notified the Insured that it was denying coverage for the loss. This coverage decision is incorrect. Denying coverage for the damage was wrongful as the damages are covered under the policy. Given the denial, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from Hurricane Ian, the Insured retained a public adjuster. After assessing the damage and the true scope of repairs, the public adjuster produced an estimate identifying $73,758.10 in covered damage to the dwelling. The foregoing estimate, photographs, and a letter of representation from the public adjuster were sent to the Insurer. 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 adjuster failed to conduct a thorough and adequate investigation, or the adjuster 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 Insurer misrepresented the loss and wrongfully denied coverage for the damage sustained to the Insured's property. According to the claims determination letter, the Insurer's field adjuster observed damage to the insured property but attributed the cause of this damage causes excluded under the policy. However, the Insurer never retained a professional engineer to determine the cause of this damage. Instead, the Insurer relied upon the causation opinions of a lay witness who will likely testify during his deposition that the Insurer never retained him to male any causation opinions and lacks the credentials to even do so. Furthermore, the Insurer claimed the observed damage did not stem from the reported date of loss. The Insurer knows or should know that a denial based on a disputed date of loss is improper when damage did in fact occur from a covered peril within the effective policy period. It is the Insured's duty to report when damage results from a covered peril and that which occurs within the effective policy period. Correspondingly, the Insurer has an obligation to determine whether a covered peril caused the alleged damages within the policy period irrespective of a disputed date of loss. Additionally, the Insurer alleged in the claims determination that the Insured failed to timely report the loss. It is unreasonable to suggest the Insurer was somehow prejudiced because the Insured reported this loss approximately a year after the storm. Florida law and the policy itself do not require instantaneous notice. Even if a year is somehow considered late notice, Florida law requires the Insurer to demonstrate prejudice stemming from the late reporting. The claims determination letter fails to elucidate how or why it was prejudiced even though the Insurer physically inspected the Insured Property and concluded the damage stemmed from several excluded causes of loss. The Insurer confuses prejudice for its inadequate investigation. The Insurer refused to retain an engineer to determine whether the observed damage stemmed from a covered peril during the policy period. Instead, the Insurer defaulted to deny coverage. Lastly, the Insurer knows or should know that when independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine. Sebo v. Am. Home Assurance Co., 208 So. 3d 694, 697 (Fla. 2016). The concurring cause doctrine states that coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause. Id. at 698. A covered peril that meets with an uncovered peril may still provide for coverage under a policy when the covered peril triggered the events that eventually led to the loss. Id. at 697. The Insurer intentionally ignored covered damage to deny the reported loss and wrongfully fail to pay the Insured. This is an underhanded attempt to place the financial interests of the Insurer over those of the Insured and to delay and frustrate the Insured's ability to have his claim adjusted promptly to begin restoring his property. Additionally, although there was interior water damage the adjuster did not use a moisture meter. A moisture meter can be purchased online from Amazon for around $40 before tax. The Insurer could purchase a moisture meter and assess thousands of properties with one meter. Instead, the Insurer would rather place its financial interests over those of the Insured by failing to provide the adjuster with the necessary tools to correctly inspect the loss. As a result of the inadequate investigation and surrounding circumstances it is apparent that Insurer significantly underestimated the scope of the loss to the Insured's property. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of Insurer over those of the Insured, to delay the Insured's claim, and to delay the Insured in restoring his property to its pre-loss condition. 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 coverage for a loss that should have been covered under the subject policy. 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 denial 2. Claim delay 3. Not treating the Insured with good faith claims conduct 4. Looking for way to reduce recovery to the Insured 5. Looking for ways to deny recovery to the Insured 6. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 7. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the Insured's' interests 8. Placing the financial interest of the Insurer over that of the health and safety of the Insured 9. Shifting the burden of investigating onto the Insured 10. Conducting inadequate investigations 11. Making material misrepresentations Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1). Admit full coverage for the Insured's loss. (2). Tender full benefits owed to the Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via E-mail: State Farm Florida Insurance Company P.O. Box 106169 Atlanta, GA 30348-6169 statefarmfireclaims@statefarm.com
Comments
User Id Date Added Comment
abaylis@duttonlawgroup.com 11-26-2024 Dear Sir/Madam: This correspondence shall serve as the response of State Farm Florida Insurance Company (“State Farm”) to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) that the Department of Financial Services (“Department”) accepted on October 11, 2024, and that the Insured’s attorney, submitted to the Department. State Farm denies all of the allegations asserted in the Notice and denies any improper conduct or claims response in the handling of these claims. State Farm has acted fairly and with due diligence both in its claim review actions, and towards the Insured, throughout the claim. A first-party bad faith claim is in derogation of the common law and must be strictly construed. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136, 140 (Fla. 5th DCA 2022) (J. Sasso, concurring specially). State Farm denies all the allegations asserted in the Notice and denies any improper conduct or claims response in the handling of these claims. As the facts below show, State Farm has acted fairly and with due diligence both in its claim review actions, and towards the Insured, throughout the claim. FACTS On October 11, 2023, State Farm received notice of a claim for Hurricane Ian damage at the property owned by Peggy Mullins (“Insured”), with a reported date of loss of September 28, 2022. State Farm spoke to the Insured who reported that Hurricane Ian caused damage to the roof, the windows, the siding, a carport, and there was interior leaking in two rooms. The Insured requested that her son, Nicholas Mullins (“Insured’s son”), be the point of contact to schedule the inspection. That same day, October 11, 2023, State Farm spoke to the Insured’s son who reported that he first noticed interior water damage a couple of weeks to a month prior to the claim being reported. The Insured’s son reported that a tree branch went through the carport, and another branch broke a window. The Insured’s son reported a piece of missing vinyl siding of the dwelling. The Insured’s son reported missing shingles and plywood damage to the two dock roofs. The Insured’s son advised that there was food loss because they lost power for approximately two weeks, but was unaware of any other personal property damage. The Insured’s son reported that no water mitigation had been performed to date. State Farm issued the homeowner’s bill of rights and temporary repairs letters that day. On October 16, 2023, State Farm advised the Insured that a representative from Seek Now would conduct the exterior inspection, and a State Farm adjuster would inspect the interior. The exterior inspection was scheduled to take place on October 23, 2023. The interior inspection was scheduled to take place on October 27, 2023. That same day, October 16, 2023, State Farm issued its reservation of rights letter (“ROR”), via email and certified mail, as there were questions whether there was a loss during the policy period; whether there was a loss caused by a peril insured against; whether immediate notice of the loss was given; and there were questions about the date of loss. On October 23, 2023, Luiz Coutinho with Seek Now (“inspector”), conducted the roof and exterior inspection on behalf of State Farm in the presence of the Insured’s son. The inspector photographed the roof and exterior elevations of the main dwelling, the carport, and the two docks. The inspector did not inspect the interior of the property. On October 27, 2023, Mike Matheny (“Field Adjuster”), conducted the interior inspection on behalf of State Farm in the presence of the Insured’s son. The Field Adjuster observed water damage to the window in the Florida room. The Insured’s son reported that they did not have photographs of damage immediately after the storm, but the damage was getting worse over time. That same day, October 27, 2023, State Farm issued its coverage determination letter finding that there was a covered loss at the Insured’s property. State Farm prepared its estimate for the covered damage in the amount of $7,438.85 to repair the carport. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Under separate cover, State Farm issued the Department’s mediation letter, advising the Insured of their right to seek mediation in the event of a dispute. On June 10, 2024, State Farm received a letter of representation (“LOR”) from Coastal Claims Services, Inc. (“Public Adjuster”), along with a request for a copy of the policy and the coverage determination letter. On June 21, 2024, State Farm received the Public Adjuster’s estimate. Based upon the Public Adjuster’s estimate, State Farm requested that the Field Adjuster schedule an additional inspection with the Public Adjuster to inspect newly claimed damages. On June 27, 2024, the Field Adjuster contacted the Public Adjuster and provided dates for an additional inspection. On June 28, 2024, the inspection was scheduled to take place on July 3, 2024. On June 29, 2024, the Public Adjuster told State Farm that they would not be present for the inspection, but the Insured’s son would be available to provide access for the inspection. State Farm also sent a copy of the policy to the Public Adjuster that day. On July 3, 2024, the Field Adjuster conducted an additional inspection in the presence of the Public Adjuster and the Insured’s son. The Field Adjuster inspected the newly reported areas on the upstairs landing. On July 5, 2024, State Farm issued its updated coverage determination letter to summarize the results of its additional inspection. State Farm did not find any accidental direct physical loss to the main dwelling roof and gutters. The damages to the docks were pre-existing and pre-dated the date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. On July 25, 2024, State Farm informed the Public Adjuster that it was standing on the coverage decision. On October 11, 2024, State Farm received the subject Civil Remedy Notice which was filed by Grant Krapf, Esq. (“Insured’s Attorney”). On October 16, 2024, State Farm received a letter of representation from the Insured’s Attorney. The Insured’s Attorney also requested a loss run statement, a copy of the policy, a statement of the policy or coverage defenses, and the claim documentation. On October 17, 2024, State Farm acknowledged the Insured’s Attorney’s representation. State Farm advised that a copy of the policy was requested and would be provided upon receipt. THE CIVIL REMEDY NOTICE (“the Notice” or “CRN”) Notice Against When asked to identify the person or persons most responsible for or most knowledgeable of the allegations, the Notice states “Mike Matheny, Alisia Martin, Chris Cocke, and other individual from, or agent of, State Farm Florida Insurance Company who was involved in the claim.” However, the CRN fails to state any specific facts that Mike Matheny, Alisia Martin, Chris Cocke, or any other individual was responsible for or otherwise knowledgeable of. Civil remedy notices require specificity. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021) (strictly construing section 624.155, requiring specific individuals, and dismissing overly broad allegations). The CRN’s lack of specificity is improper and fails to comply with section 624.155. Without providing any specific allegations, the CRN is impermissibly vague, overly broad, and statutorily deficient. Nevertheless, State Farm denies that any of its adjusters, supervisors, management, and/or other individuals violated any policy or statutory provision. At all times, State Farm acted fairly and with due diligence both in its claim review actions, and towards the Insureds and their representatives, throughout the claim. Reasons for Notice The following reasons are listed for the Notice: claim denial; claim delay; unfair trade practice; not treating the Insured with good faith claims conduct; looking for ways to deny full recovery to the Insured; looking for ways to delay full recovery to the Insured; failing to properly investigate the Insured’s loss; failing to provide the Insured with the full benefits awarded under the contract of insurance; not training, supervising, or managing adjusters properly so that prompt and full payments are made; not adjusting claims and evaluating loss properly; shifting the burden of insuring the loss to the Insured; intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured; failing to implement proper standards for the adjustment and investigation of claims; and making material misrepresentations. Each of these reasons are without factual support and are denied. State Farm addresses each reason below. Claim Denial: There are no facts to support this allegation that State Farm wrongfully denied the Insured’s claim. The Notice merely alleges that State Farm did not pay the estimate provided by the Public Adjuster. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Claim Delay: There are no facts to support this allegation. The Notice provides conclusory allegations that the claim was promptly submitted, and State Farm failed to pay the estimate that was provided by the public adjuster. However, the claim was not reported until more than a year after the alleged date of loss. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Unfair Trade Practice: This reason is unsupported by the facts or the CRN. The CRN provides conclusory allegations that State Farm’s adjuster failed to properly adjust the loss, failed to utilize an engineer, and failed to use a moisture meter. There are no allegations of bad faith claims handling. There is no requirement to utilize an engineer when adjusting a claim. There is no specific requirement to utilize a moisture meter. Rather, the facts above show that there was no necessity for a moisture meter. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Nevertheless, State Farm denies any and all conclusory allegations that it has engaged in any unfair trade or business practices to avoid or delay payment of claims. State Farm has, at all times, acted in the best interest of the Insured in evaluating, inspecting, and adjusting the claim. Not treating the Insured with good faith claims conduct: There are no facts to support this allegation. The Notice provides conclusory allegations that State Farm failed to pay the estimate that was provided by the public adjuster. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Looking for ways to deny full recovery to the Insured: There are no facts to support this allegation. State Farm’s coverage decision includes all of the covered damage observed to the property associated with the reported date of loss. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Looking for ways to delay full recovery to the Insured: There are no facts to support this allegation. State Farm’s coverage decision was timely issued once the claim was reported. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Failing to properly investigate the Insured’s loss: There are no facts to support this allegation. State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Failing to provide the Insured with the full benefits awarded under the contract of insurance: There are no facts to support this allegation. State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Not training, supervising, or managing adjusters properly so that prompt and full payments are made: There are no facts to support this allegation. No persons are identified that were allegedly not trained, supervised, or managed properly. The CRN is also devoid of any facts showing that State Farm’s adjusters failed to promptly evaluate and issue the full payment for the covered loss as provided under the policy of insurance. State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Not adjusting claims and evaluating loss properly: There are no facts to support this allegation. No persons are identified that allegedly failed to adjust or evaluate the claim. The CRN is also devoid of any facts showing that State Farm’s adjusters failed to promptly evaluate and issue the full payment for the covered loss as provided under the policy of insurance. State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Shifting the burden of insuring the loss to the Insured: There are no facts to support this allegation. State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured: The CRN fails to state any specific facts to support this allegation. The CRN makes conclusory allegations that State Farm failed to acknowledge the covered damage contained in the public adjuster’s estimate. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Failing to implement proper standards for the adjustment and investigation of claims: There are no facts to support this allegation. No persons are identified that were allegedly not trained, supervised, or managed properly. The CRN is also devoid of any facts showing that State Farm’s adjusters failed to promptly evaluate and issue the full payment for the covered loss as provided under the policy of insurance. No alternative “standards” or other means and methods are listed in the CRN that State Farm could or should have implemented. Rather, State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. Making material misrepresentations: The CRN fails to state any specific facts to support this allegation. The CRN makes conclusory allegations that State Farm failed to acknowledge the covered damage contained in the public adjuster’s estimate. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm has opened coverage and issued payment. State Farm issued payment in the amount of $1,078.29 after applying the depreciation and $5,974.00 deductible. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Therefore, this reason is unsupported, is conclusory, and is denied. No Violation of Statute(s) The documented facts clearly reflect that State Farm promptly responded to the Insured’s claim, performed a professional inspection of claimed damages, and advised the Insured of State Farm’s position on coverage. State Farm acted fairly and reasonably toward the Insured. Its handling of the claim was responsive to the Insured, and State Farm remained professional while seeking full and complete information in accordance with the specific terms of the insurance policy in considering whether coverage exists, or payment was due. Additionally, the Notice lists additional allegations of statutes that State Farm allegedly violated that are improper. A claim for bad faith based on violation of a statute can be brought only as provided by section 624.155(1)(a)–(b). State Farm does not waive any objections by responding to the allegations contained within the CRN. Each of the statutory provisions alleged are addressed below. Section 624.155(1)(b)(1), Florida Statutes: State Farm denies violation of section 624.155(1)(b)(1), because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations in a timely manner. State Farm has opened coverage and issued payment for the actual cash value of the damage in accordance with the policy and Florida law. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Therefore, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(2), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(2), as it did not make any material misrepresentations towards the Insured or any other person. The Notice fails to provide any facts to support this allegation. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations in a timely manner. State Farm has opened coverage and issued payment for the actual cash value of the damage in accordance with the policy and Florida law. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Therefore, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(3)(a), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(a), as it has adopted and implemented standards for the proper investigation of claims. The CRN is also devoid of any facts showing that State Farm’s adjusters failed to promptly evaluate and issue the full payment for the covered loss as provided under the policy of insurance. No alternative “standards” or other means and methods are listed in the CRN that State Farm could or should have implemented. Rather, State Farm’s coverage decision includes all of the covered damage observed to the property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations in a timely manner. State Farm has opened coverage and issued payment for the actual cash value of the damage in accordance with the policy and Florida law. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Therefore, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(3)(b), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(b), as it has never misrepresented any facts or terms of the insurance policy relating to coverages. No questions relating to policy provisions or interpretation were ever submitted to State Farm. State Farm’s evaluation and coverage determination was consistent with, and supported by, the physical evidence observed at the subject property. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations in a timely manner. State Farm has opened coverage and issued payment for the actual cash value of the damage in accordance with the policy and Florida law. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Therefore, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(3)(d), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(d), as it promptly and timely provided a coverage decision along with its explanation behind its decision. As previously stated, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations in a timely manner. State Farm has opened coverage and issued payment for the actual cash value of the damage in accordance with the policy and Florida law. State Farm did not find, however, any damage to the main dwelling related to the reported date of loss. State Farm did not find any additional covered damage to the exterior doors and windows nor the interior areas related to the reported date of loss. State Farm’s investigation revealed age, wear, and deterioration unrelated to the date of loss. State Farm observed damage to the two dock roofs that was consistent with the prior damages from a prior claim that was not repaired. The observed damage to the interior Florida room wall was the result of multiple wind and rain events over a period of time and was not covered under the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Therefore, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(3)(i), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(i), as it has adopted and implemented standards for the proper investigation of claims. Further, this allegation is inapplicable to the instant claim because the alleged subsection relates to the failure to pay personal injury protection (“PIP”) benefits in the time periods stated in section 627.736(4)(b). This claim involves a residential property insurance policy and does not involve a PIP claim. Therefore, this allegation is unsupported, inapplicable, and is denied. Alleged Policy Violations The CRN states that the violations are statutorily based and do not rely on any specific policy language. Therefore, the Insured is not alleging any policy violations and is precluded from later claiming any policy violations. Civil remedy notices must contain the specific policy language claiming to be at issue. C.f. Julien, 311 So. 3d at 879; Boone v. State Farm Fla. Ins. Co., 48 Fla. L. Weekly D718a (Fla. 6th DCA April 6, 2023); Massey Constr. Grp., Inc. v. Heritage Prop. & Cas. Ins. Co., 30 Fla. L. Weekly Supp. 768a (Fla. 20th Cir. Ct. Nov. 29, 2022) (including virtually the entire policy language is not specific). Nevertheless, State Farm denies any alleged violations of the provisions of the subject policy of insurance. At all times during the handling and investigation of the Insured’s claim, State Farm has followed each and every applicable policy provision and endorsement under the subject policy of insurance. The Proposed Cure is Invalid The Notice also does not properly allege what State Farm must do to cure these purported defects. State Farm did not commit any violations to cure. In addition, the Insured did not allege valid methods for curing the violations as alleged in a Civil Remedy Notice of Insurer Violations. A civil remedy notice is “designed to be a cure period that will encourage payment of the underlying claim, and avoid unnecessary bad faith litigation.” Demase v. State Farm Fla. Ins. Co., 239 So. 3d 218, 221 (Fla. 5th DCA 2018) (quoting Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1282 (Fla. 2000). The Florida Supreme Court has explained the requirement to provide a valid cure: Section 624.155 does not impose on an insurer the obligation to pay whatever the Insured demands. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. § 624.155(2)(d). Talat Enters., 753 So. 2d at 1282 (citing Talat Enters. Inc. v. Aetna Cas. & Sur. Co., 952 F. Supp. 773, 777-78 (M.D. Fla. 1996)). The Notice states the following: Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1). Admit full coverage for the Insured’s loss. (2). Tender full benefits owed to the Insured under the insurance contract. This purported cure is precisely the type of expansive and illogical demand that the Florida Supreme Court rejected in Talat. The purported “cure” is vague and overly broad, failing to even provide an alleged amount necessary to “cure” the alleged violations. The Notice also fails to contain any specific facts showing that State Farm or its agents acted in bad faith in the investigation, inspection, evaluation, or handling of this claim. There are no allegations of bad faith claims handling that are supported by the policy or Florida law. Therefore, the purported “cure” and CRN are invalid. CONCLUSION State Farm has handled the Insured’s claim with diligence and has, at all times, acted fairly in the adjustment of the claim and has treated the Insured with honesty and due regard to their interests, and State Farm has done so in compliance with the policy of insurance and Florida law. Once posed, State Farm promptly responded to the claim by promptly sending out an inspector to inspect the Insured’s property, to include speaking to the Insured. Thereafter, State Farm corresponded regularly with the Insured and advised the Insured of State Farm’s coverage determination. If the Insured honestly believes that there was any type of violation, State Farm has requested and continues its requests that the Insured cooperate and provide specific information with respect to each alleged violation, including the name of each individual involved, the date of each violation, a description of each violation, and copies of documentation referencing each violation. As it stands now, the Notice is insufficient for the purpose of allowing State Farm to fully respond and/or remedy the alleged violations, if any. State Farm has tried to fully and adequately respond to the Insured’s allegations alleged in the Notice filed with the Department. Should the Department have any questions or further inquiry with respect to this matter, please contact the undersigned. Sincerely, DUTTON LAW GROUP, P.A. SCOTT W. DUTTON, ESQUIRE
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