Civil Remedy Notice of Insurer Violations
Login

Filing Number:     786715
Filing Accepted:  10/14/2024
         Print Filing
Complainant
Last/Business Name *  
EDWARDS/EDWARDS   First Name   FRANK/ANNMARIE
Street Address * 230 NW MAGNOLIA LAKES BOULEVARD
City, State Zip * PORT ST. LUCIE, FL 34986
Email Address * BARON592001@YAHOO.COM, EDWARDS567@BELLSOUTH.NET
Complainant Type: * Insured
Insured
Last/Business Name*   EDWARDS/EDWARDS   First Name   FRANK/ANNMARIE
Policy # * 5259065300 Claim #* 01000111392
Attorney
Attorney is Applicable
Last Name* PETTINATO First Name * DAVID Initial J
Street Address* 1000 W. CASS STREET
City, State Zip* TAMPA , FL 33606
Email Address * DPETTINATO@OLDERLUNDYLAW.COM, DJP-PARALEGALS@OLDER
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
Name of individual responsible for violation (if any):* ROD JACKSON, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Failure to properly investigate claim and with due regard to Insured’s interest
Other : Failure to acknowledge and act promptly to communications regarding claim
* 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)(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.

ADD’L STATUTES VIOLATED Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 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 which reasonably prevent such acknowledgment. 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. Such acknowledgment must be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment must provide necessary claim forms, and instructions, including an appropriate telephone number. Unless otherwise provided by the policy of insurance or by law, within 14 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 which reasonably prevent the commencement of such investigation. Within 7 days after the insurer’s assignment of an adjuster to the claim, the insurer must notify the policyholder that he or she may request a copy of any detailed estimate of the amount of the loss generated by an insurer’s adjuster. After receiving such a request from the policyholder, the insurer must send any such detailed estimate to the policyholder within the later of 7 days after the insurer received the request or 7 days after the detailed estimate of the amount of the loss is completed. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. Within 90 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 90 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. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured must select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. POLICY LANGUAGE The Insureds may not be in possession of a complete copy the applicable policy of insurance, however, the specific policy language relevant to the violations outlined below is contained within First Protective Insurance Company d/b/a Frontline Insurance’s Homeowners policy, Policy No. 5259065300, issued to the Insureds including, but is not limited to, the following: Coverage A-Dwelling provisions Coverage B-Other Structures provisions Coverage C-Personal Property provisions Coverage D-Loss of Use provisions - Additional Living Expenses Additional Coverages provisions - Debris Removal - Reasonable Repairs - Ordinance Or Law Limited Fungi, Wet or Dry Rot, or Bacteria Coverage endorsement The Declarations Page Loss Payment or Loss Settlement provisions Duties in Event of Loss Policy provisions The insurance policy's definition sections The insurance policy's exclusion of coverage provisions Please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insureds for the April 16, 2023, wind and/or hail loss.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the Public Trust. FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE (“FRONTLINE”) has breached this duty by its failure or refusal to acknowledge its Insureds’ claim of loss. FRONTLINE has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations as set forth above. FRONTLINE has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds’ insurance claim for damages. To date, notwithstanding the Insureds’ pleas, FRONTLINE has continued to refuse to acknowledge its obligation to acknowledge and pay the full amount of its Insureds’ claim. This complaint is made on behalf of the Insureds, FRANK AND ANNMARIE EDWARDS (“MR. AND MRS. EDWARDS”). Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155. In consideration of the premium paid to it by MR. AND MRS. EDWARDS, FRONTLINE issued a Homeowners policy, Policy No. 5259065300 (hereinafter referred to as “The Policy”), to MR. AND MRS. EDWARDS wherein the insurance policy provided coverage for all losses, including wind and/or hail, except those losses which were expressly excluded. The policy was in full force and effect at the time the damage occurred as a result of wind and/or hail, and the ensuing damages as a direct result thereof, to the insured premises located at 230 NW Magnolia Lakes Blvd., Port St. Lucie, FL 34986, on or about April 16, 2023. MR. AND MRS. EDWARDS’ insured property sustained damage to the interior and exterior of their home. On the exterior, MR. AND MRS. EDWARDS’ insured property sustained damages to the roofing system including but not limited to sheathing, shingles, drip edge, flashing, exhaust, cap, etc. On the interior, MR. AND MRS EDWARDS’ insured property sustained damages including but not limited to the insulation, drywall, pain, ceiling, flooring, etc. in their guest bedroom. MR. AND MRS. EDWARDS timely notified FRONTLINE of the damages and opened a claim pursuant to the terms and conditions of the Policy. In response, FRONTLINE assigned the claim to its representative to adjust and investigate the loss, as well as a field adjuster to inspect the damages. FRONTLINE’S representative visited the insured property and performed a cursory and inadequate investigation of the damaged property. On June 18, 2024, FRONTLINE submitted a Denial Letter to MR. AND MRS. EDWARDS stating “The inspection revealed no wind, hail, or weather-related damage was observed on the roof. The cracks and displacement of the roof’s tiles are the result of a combination of improper installation, foot traffic/work, and age-related deterioration (wear and tear). The staining on the guest bathroom and front porch ceiling is the result of long-term roof leakage due to inadequate flashing installation. Evidence of long-term leakage is the dark discoloration of the staining on the roof’s framing/sheathing observed in the attic.” Concerned that FRONTLINE had no intention to fairly investigate and adjust their claim, MR. AND MRS. EDWARDS retained the services of an insurance claim professional from Dependable Resolutions (‘DR’) to assist in submitting their claim to FRONTLINE which would adequately and fairly detail all the damages sustained as a result of the loss. MR. AND MRS. EDWARDS’ inspection estimate from Dependable Resolutions totaling $122,127.99 in dwelling damages, was inclusive of the full extent of damages sustained to their insured property, as detailed above. To date, FRONTLINE has failed to tender any supplemental insurance benefits. FRONTLINE has admitted that MR. AND MRS. EDWARDS sustained covered damages as a result of the wind and/or hail loss that occurred on or about April 16, 2023 but has denied tendering all owed insurance benefits to MR. AND MRS. EDWARDS. Pursuant to Florida Statute §626.9541(1)(i)(4), FRONTLINE is required to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after FRONTLINE received notice of the residential property insurance claim, determine the amounts of partial or full benefits, and agree 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). As FRONTLINE has failed to do so, FRONTLINE has wrongfully denied coverage. Since the beginning of the claim, FRONTLINE has engaged in a pattern of delay, denial, and reckless disregard for MR. AND MRS. EDWARDS’S rights. The actions of FRONTLINE listed herein have been continuing in nature and given the totality of the circumstances, which includes FRONTLINE’S adjustment, actions and/or omissions post the filing of this CRN. MR. AND MRS. EDWARDS contend that given the past experience in this matter with FRONTLINE, it is reasonably foreseeable that FRONTLINE’S current actions will extend to its entire conduct in the handing of their claim, including the acts or omissions of FRONTLINE and/or its representatives, until the final resolution of their claim. As such, MR. AND MRS. EDWARDS contend adequate notice has been given should FRONTLINE’S actions and violations listed herein continue after the expiration of this notice. FRONTLINE has failed and/or refused to settle the claim when it could and should have done so had it acted fairly and honestly towards MR. AND MRS. EDWARDS, and has failed to take into account the information and evidence provided that contradict its decisions. FRONTLINE’S conduct has been reckless and unfair to MR. AND MRS. EDWARDS, and has caused and continues to cause additional damages throughout the property. This is evidenced by the delay in paying the claim and the failure of FRONTLINE to evaluate the claim in total. To date, FRONTLINE has failed and/or refused to provide MR. AND MRS. EDWARDS with all the necessary insurance benefits due and owing and has not tendered the full amount needed to repair the Property despite knowing that MR. AND MRS. EDWARDS have sustained covered damages to their insured property. As FRONTLINE must admit, it is implied within every insurance policy a duty of good faith and fair dealings. In an insurance contract, each party is prevented from interfering with the other’s right to benefit from the contract. The obligations of good faith and fair dealings encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. FRONTLINE is bound to conduct itself with the utmost good faith for the benefit of MR. AND MRS. EDWARDS. However, FRONTLINE has failed to comply with the obligations in connection with this claim and has never looked at the claim or the contract for insurance with good faith and fair dealing. Instead, FRONTLINE has looked for ways not to pay the claim in full, or pay the claim at all, and these actions have been to the detriment of MR. AND MRS. EDWARDS. The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of FRONTLINE have approached this investigation in a manner prejudicial to MR. AND MRS. EDWARDS. FRONTLINE is using either untrained or improperly trained adjusters in connection with this claim. FRONTLINE should have been adjusting the loss with MR. AND MRS. EDWARDS but instead, it was looking for ways not to pay the claim at all, or pay the claim in full. If FRONTLINE handles all the claims in the manner in which MR. AND MRS. EDWARDS’S claim was adjusted, then it is improperly handling all claims. FRONTLINE has refused and/or failed to comply with The Policy’s cooperation and/or “Loss Payment” provision. Under The Policy, FRONTLINE was to timely tender undisputed insurance benefits to MR. AND MRS. EDWARDS. FRONTLINE has failed and/or refused to timely tender owed insurance benefits, undisputed or otherwise. This is a breach of The Policy. FRONTLINE has refused and/or failed to cooperate and/or “Adjust the Loss” by cooperating with MR. AND MRS. EDWARDS during the claims adjustment process in compliance with The Policy’s “Loss Payment” provision. This is a breach of The Policy. The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that MR. AND MRS. EDWARDS may mitigate their damages and to put them back into the position they were in prior to the loss as quickly as possible. FRONTLINE has breached this duty. FRONTLINE has refused and/or failed to tender all insurance proceeds to MR. AND MRS. EDWARDS upon demand. FRONTLINE’S refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards MR. AND MRS. EDWARDS is wrongful conduct. Furthermore, MR. AND MRS. EDWARDS contend that FRONTLINE’S adjusters and/or representatives financially benefit by such wrongful conduct. It is clear that FRONTLINE’S adjusters have also failed to adhere to insurance industry rules and guidelines when adjusting a first party claim. It is also evident that FRONTLINE violated the Florida unfair claims practices, the adjuster’s ethical code of conduct, and acted irresponsibly in the handling of its Insureds’ claims. In this case, MR. AND MRS. EDWARDS paid a hefty premium for a service, the service is called claims adjusting (I encourage you to read the book titled, “The Claims Environment” written by James J. Markham, Kevin M. Quinley, and Layne S. Thompson-this book is taught in every first year AIC course). The claim professional must dispense his or her knowledge and skill for the benefit of society. The general public expects claims representatives to pay all legitimate claims promptly and fairly. The claim professional must harness all of his or her knowledge and expertise to accomplish the objectives of the claim function. He or she must also adhere to the highest degree of ethical conduct. In addition to interacting with other insurance personnel and service providers in a professional manner, the claims professional must deal with public’s and regulator’s expectations. Insurance Companies provide such a vital and necessary service to society that the selling and servicing of insurance is imbued with a public trust. James J. Markham, Kevin M. Quinley, Layne S. Thompson, “The Claims Environment”, Insurance Institute of America, 1st ed., 1993. Accordingly, FRONTLINE has a contractual and statutory obligation to investigate all possible bases which might support MR. AND MRS. EDWARDS’S claim and cannot deny a claim without thoroughly investigating the foundation for its denial or basis for withholding insurance benefits. FRONTLINE violated its obligations here. - FRONTLINE has a contractual and statutory obligation to make a perfunctory investigation, not ignoring evidence that would support MR. AND MRS. EDWARDS’S claim. FRONTLINE violated its obligations here. - FRONTLINE has a contractual and statutory obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. FRONTLINE violated its obligations here. - FRONTLINE has a contractual and statutory obligation not to deny the claim based on standards known to be impermissible or on an interpretation contrary to established law. FRONTLINE violated its obligations here. These actions and violations were either done intentionally or as the result of FRONTLINE’S failure to adopt and implement the proper standards of the investigation and adjustment of claims. Overall, FRONTLINE’S investigation of the claim was inadequate and contrary to its obligations under the insurance policy and Florida law. MR. AND MRS. EDWARDS have done everything legally requested by FRONTLINE to date. To cure the violations set forth in this Civil Remedy Notice, FRONTLINE must now agree to acknowledge its duties and obligations under the law in adjusting its Insureds’ claim, and tender rightfully owed insurance benefits to return MR. AND MRS. EDWARDS to their pre-loss condition. Further, to cure the violations set forth in this Civil Remedy Notice, MR. AND MRS. EDWARDS hereby request that FRONTLINE tender at this time, or prior to the expiration of the statutory cure period, the amount of MR. AND MRS. EDWARDS’S damage estimate and demand which accurately reflects the true nature and extent of MR. AND MRS. EDWARDS’S damages. Therefore, FRONTLINE should tender $122,127.99 (less any prior payments, depreciation, excess policy limits, and/or deductible) in insurance benefits at this time. Although MR. AND MRS. EDWARDS have made a demand for payment in the amount of $122,127.99 (less any prior payments, depreciation, excess policy limits, and/or deductible) and have provided FRONTLINE with all the necessary documentation in support thereof, they may still be willing to consider and to potentially accept any reasonable counter-offer made by FRONTLINE. Therefore, if FRONTLINE is not in agreement with MR. AND MRS. EDWARDS’S reasonable demand for payment of their rightfully owed insurance benefits being submitted at this time, MR. AND MRS. EDWARDS hereby request that FRONTLINE now make a reasonable counter-offer before the expiration of the cure period. MR. AND MRS. EDWARDS still hope that their claim can be resolved amicably. The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that MR. AND MRS. EDWARDS may mitigate their damages and to put them back into the position they were in prior to loss as quickly as possible. FRONTLINE breached this duty. This notice is given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155, including any and all bad faith/extra contractual, should FRONTLINE fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. While no specific “cure amount” is required for this Civil Remedy Notice to be valid, MR. AND MRS. EDWARDS will consider the allegations contained herein “cured” if FRONTLINE, without any requirement for a release: (1) Immediately tenders the amount of MR. AND MRS. EDWARDS damage estimate in the amount of $122,127.99 (less any prior payments, depreciation, excess policy limits, and/or deductible), which accurately reflects the true nature and extent of the damages to the Dwelling / Other Structures; (2) Agrees to reimburse MR. AND MRS. EDWARDS for their expenses incurred by having to retain a public adjuster to present their claim; and (3) Immediately tenders the amount of statutory interest due and owing to MR. AND MRS. EDWARDS pursuant to Florida Statute §627.70131(5)(a). (4) Immediately provides MR. AND MRS. EDWARDS with the documentation FRONTLINE has used and/or continues to contend, supports the claim determination made by FRONTLINE in the adjustment of MR. AND MRS. EDWARDS’S claim. Specifically, FRONTLINE must provide MR. AND MRS. EDWARDS with its claim estimate(s), supporting photographs and/or videos, as well as any and all reports of any expert(s) or other individuals retained on behalf of FRONTLINE upon which FRONTLINE has relied on in reaching and/or further supporting its coverage determination in MR. AND MRS. EDWARDS’S claim. MR. AND MRS. EDWARDS continue to remain open to a fair and reasonable settlement offer from FRONTLINE in an effort to avoid additional delay, costs and expenses, and hereby request the same prior to the expiration of the statutory “cure” period. MR. AND MRS. EDWARDS have provided FRONTLINE with all necessary estimates, documentation, etc. in support of the claim. FRONTLINE must act fairly and honestly in its response to MR. AND MRS. EDWARDS’S request for a prompt, fair and reasonable settlement offer and resolution of the claim.
Comments
User Id Date Added Comment
ecaballero@wallenkelley.com 05-29-2025 May 29, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainants: Frank Edwards and Ann Marie Edwards Address: 230 NW Magnolia Lakes Boulevard, Port St. Lucie, FL 34986 Insureds: Frank Edwards and Ann Marie Edwards Policy #: 5259065300 Claim: 01000111392 Attorney: David J. Pettinato, Esq., Older Lundy Koch & Martino Address: 1000 W. Cass Street, Tampa, FL 33606 DOI File #: 786715 Date of Acceptance: October 14, 2024 To Whom It May Concern: Please accept this as the supplemental response of First Protective Insurance Company d/b/a Frontline Insurance (hereafter “Frontline”) to the purported Civil Remedy Notice (hereafter Purported Notice”) filed by the Complainants. This response is specifically in regard to Claim 01000111392. The Insureds are Frank Edwards and Ann Marie Edwards. The property located at 230 NW Magnolia Lakes Boulevard, Port St. Lucie, FL 34986 (hereafter the “Property”) is insured by Frontline under policy 5259065300 with the effective dates of that policy being February 28, 2023, through February 29, 2024. As noted below, this claim has been settled pursuant to a Final Order of Dismissal with Prejudice filed May 22, 2025, and thus, this Civil Remedy is now moot. Statement of Facts This matter arises from an alleged wind and/or hail event at the Insureds’ St. Lucie County residence. Frontline denies the allegations in this Purported Notice and further asserts that this Purported Notice fails to comply with Florida law and is fatally deficient. I. Claim 01000111392 Frontline was provided first notice of this claim on or about April 10, 2024. Frontline immediately assigned claim number 01000111392 and a Claim Examiner to the file. Frontline additionally sent the Insureds a claim acknowledgement letter, the homeowner’s bill of rights and a requested sworn proof of loss. Soon thereafter, Frontline retained an independent adjuster and an engineer to inspect the Insureds’ Property. Frontline communicated with its Insureds and/or their representatives, reviewed the information provided by its Insureds, reviewed all information received through its investigation, inspected the property, including conducting an engineer assessment and tendered a coverage determination. In short, Frontline complied with all its obligations under the Policy, acted in good faith at all times, and denies the spurious and factually incorrect allegations in this Civil Remedy Notice. II. Nature of the Complainants’ Civil Remedy Complaint The Purported Notice names Frontline and alleges the following statutory violations: (1) not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured, (2) 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, (3) 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, (4) failing to adopt and implement standards for the proper investigation of claims; (5) misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (6) failing to acknowledge and act promptly upon communications with respect to claims; (7) 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 offer of a compromise or settlement; (8) failing to promptly notify the insured of any additional information necessary for the processing of a claim; (9) failing to clearly explain the nature of the requested information and the reasons why such information is necessary; (10) 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). The Purported Notice is a legal nullity for the reasons and deficiencies discussed below. Florida Statute 624.155 requires a Claimant to provide the Insurer 60 days, written notice of the violation as a condition precedent of commencing a “bad faith” action. Florida Statute 624.155(3) requires the following five (5) pieces of information: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that the Civil Remedy Notice shall be “on a form provided by the [Department] and shall state with specificity…such other information as the department may require. The Florida Supreme Court has held that section 624.155, Florida Statutes must be “strictly construed.” Talat Enter., Inc. v. Aetna Cas. And Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied with all statutory provisions. III. Civil Remedy Notice Deficiencies i. First Deficiency: Section 624.155(3)(b)(2), Florida Statutes, requires that the Civil Remedy Notice state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply facts or circumstances that explain the allegations. Rather, it includes false and conclusory allegations, incorrect facts, and fails to explain how a thorough investigation and coverage determination, pursuant to the Policy and its terms is a violation of Florida law. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This Purported Notice is also fatally deficient in that it fails to provide any specific facts as to how Frontline misrepresented facts, what standards Complainants are seeking Frontline implement for the proper investigation of claims, how was the investigation conducted by Frontline in any way unreasonable, or how were Frontline’s communications or notification in any way untimely. Rather, it is apparent that the Purported Notice simply disagrees with Frontline’s coverage determination but fails to provide a single fact as to why that determination was improper, incorrect, or in bad faith. Thus, the Purported Notice fails to provide any actual specificity as to the Complaints’ allegations and is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This deficiency applies to all allegations in the Purported Notice as Claimant’s Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i) (3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3) (f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). ii. Second Deficiency: Section 624.155(3)(b)(3) requires that the CRN list the name of any individual involved in the violation. While the Purported Notice lists a single name, it then states, “and all other adjusters, supervisors, management, and individuals associated with or retained by First Protective Insurance Company d/b/a Frontline Insurance involved in the claim.” Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. This deficiency applies to all allegations in the Purported Notice as Claimant’s Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). iii. Third Deficiency: Section 624.155(3)(b)(3), Florida Statutes, requires the Civil Remedy Notice to reference specific policy language that is relevant to the violation. A third-party claimant is not required to reference specific policy language, absent receipt of a copy of the Policy. However, the Claimants in this Purported Notice are not third-party claimants, therefore the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. The Purported Notice does not. Rather it states a brief, general Policy topics, without citing to actual Policy language. Indeed, the Purported Notice invites some unknown party to “please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insureds.” However, the Purported Notice does not reference specific policy language relevant to the alleged violation, nor any specific policy language in support of the very allegations of the Purported Notice, including allegations claiming that Frontline misrepresented pertinent facts, issued an improper coverage determination or insurance policy provisions relating to coverages at issue. Hence, it is clear that the Claimant’s allegations include policy-related violations, and as such it must cite the policy language that is relevant to such violations. It does not. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b) (3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). Florida courts have weighed in on this requirement, finding that "[i]f the statute contained no specificity requirement, [then] the [insureds'] casual 'reference' to the entire insurance policy undoubtedly would suffice." Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021 at 879 (citing Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). Id. But, the court continued, "the Legislature included 'specific' or a variant not once but twice in the statute." Id. As a result, the insureds' listing of whole sections of the insurance policy "appear [ed] to lack specificity." Id. In Julien, the insured cited numerous statutory violations and listed nearly every provision in the Policy. The Fourth District Court of Appeals agreed with the circuit court that the Civil Remedy Notice failed to specify the statutory and policy provisions at issue. Much the same as in Julien, the Purported Notice fails to state with any real degree of specificity the policy language at issue. IV. Settlement Following the cure period for the instant Civil Remedy Notice, the parties agreed to settlement of the instant matter and counsel sent and subsequently received a general release that included the allegations of this Civil Remedy Notice. Moreover, in this release, Frontline specifically did not admit any liability, bad faith, or the allegations contained within this Civil Remedy Notice. The parties received a Final Order of Dismissal with Prejudice from the trial court on May 22, 2025. Accordingly, this Civil Remedy Notice is now resolved and/or moot. IV. Conclusion Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, Frontline denies any wrongdoing. It specifically denies that it violated the insurance policy or Florida Statutes, as alleged in the Purported Notice. Furthermore, Frontline asserts this Purported Notice is factually inaccurate, misrepresents the facts of the claim and fails to comply with Florida Statute 624.155. Further, by this response, Frontline neither waves, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, Frontline hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. Nevertheless, as stated above, due to the final order of dismissal with prejudice, this Civil Remedy Notice is hereby moot. Sincerely, Elibet Caballero, Esq. On Behalf of First Protective Insurance Company d/b/a Frontline
ecaballero@wallenkelley.com 12-05-2024 December 5, 2024 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Complainants: Frank Edwards and Ann Marie Edwards Address: 230 NW Magnolia Lakes Boulevard, Port St. Lucie, FL 34986 Attorney: David J. Pettinato Esq., Older Lundy Koch & Martino Address: 1000 W. Cass Street, Tampa, FL 33606 Loss Location: 230 NW Magnolia Lakes Blvd, Port St. Lucie, FL 34986 Claim: 01000111392 DOL: 04/16/2023 DOI File: 786715 Filing Date: 10/14/2024 To Whom It May Concern: Please accept this as the response of First Protective Insurance Company d/b/a Frontline Insurance (hereafter “Frontline”) to the purported Civil Remedy Notice (hereafter Purported Notice”) filed by the Complainants. This response is specifically in regard to Claim 01000111392. The Insureds are Frank Edwards and Ann Marie Edwards. The property located at 230 NW Magnolia Lakes Boulevard, Port St. Lucie, FL 34986 (hereafter the “Property”) is insured by Frontline under policy 5259065300 with the effective dates of that policy being February 28, 2023, through February 29, 2024. Statement of Facts This matter arises from an alleged wind and/or hail event at the Insureds’ St. Lucie County residence. Frontline denies the allegations in this Purported Notice and further asserts that this Purported Notice fails to comply with Florida law and is fatally deficient. I. Claim 01000111392 Frontline was provided first notice of this claim on or about April 10, 2024. Frontline immediately assigned claim number 01000111392 and a Claim Examiner to the file. Frontline additionally sent the Insureds a claim acknowledgement letter, the homeowner’s bill of rights and a requested sworn proof of loss. Soon thereafter, Frontline retained an independent adjuster and an engineer to inspect the Insureds’ Property. Frontline communicated with its Insureds and/or their representatives, reviewed the information provided by its Insureds, reviewed all information received through its investigation, inspected the property, including conducting an engineer assessment and tendered a coverage determination. In short, Frontline complied with all its obligations under the Policy, acted in good faith at all times, and denies the spurious and factually incorrect allegations in this Civil Remedy Notice. II. Nature of the Complainants’ Civil Remedy Complaint The Purported Notice names Frontline and alleges the following statutory violations: (1) not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured, (2) 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, (3) 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, (4) failing to adopt and implement standards for the proper investigation of claims; (5) misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (6) failing to acknowledge and act promptly upon communications with respect to claims; (7) 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 offer of a compromise or settlement; (8) failing to promptly notify the insured of any additional information necessary for the processing of a claim; (9) failing to clearly explain the nature of the requested information and the reasons why such information is necessary; (10) 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). The Purported Notice is a legal nullity for the reasons and deficiencies discussed below. Florida Statute 624.155 requires a Claimant to provide the Insurer 60 days, written notice of the violation as a condition precedent of commencing a “bad faith” action. Florida Statute 624.155(3) requires the following five (5) pieces of information: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that the Civil Remedy Notice shall be “on a form provided by the [Department] and shall state with specificity…such other information as the department may require. The Florida Supreme Court has held that section 624.155, Florida Statutes must be “strictly construed.” Talat Enter., Inc. v. Aetna Cas. And Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied with all statutory provisions. III. Civil Remedy Notice Deficiencies i. First Deficiency: Section 624.155(3)(b)(2), Florida Statutes, requires that the Civil Remedy Notice state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply facts or circumstances that explain the allegations. Rather, it includes false and conclusory allegations, incorrect facts, and fails to explain how a thorough investigation and coverage determination, pursuant to the Policy and its terms is a violation of Florida law. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This Purported Notice is also fatally deficient in that it fails to provide any specific facts as to how Frontline misrepresented facts, what standards Complainants are seeking Frontline implement for the proper investigation of claims, how was the investigation conducted by Frontline in any way unreasonable, or how were Frontline’s communications or notification in any way untimely. Rather, it is apparent that the Purported Notice simply disagrees with Frontline’s coverage determination but fails to provide a single fact as to why that determination was improper, incorrect, or in bad faith. Thus, the Purported Notice fails to provide any actual specificity as to the Complaints’ allegations and is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This deficiency applies to all allegations in the Purported Notice as Claimant’s Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). ii. Second Deficiency: Section 624.155(3)(b)(3) requires that the CRN list the name of any individual involved in the violation. While the Purported Notice lists a single name, it then states, “and all other adjusters, supervisors, management, and individuals associated with or retained by First Protective Insurance Company d/b/a Frontline Insurance involved in the claim.” Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. This deficiency applies to all allegations in the Purported Notice as Claimant’s Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). iii. Third Deficiency: Section 624.155(3)(b)(3), Florida Statutes, requires the Civil Remedy Notice to reference specific policy language that is relevant to the violation. A third-party claimant is not required to reference specific policy language, absent receipt of a copy of the Policy. However, the Claimants in this Purported Notice are not third-party claimants, therefore the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. The Purported Notice does not. Rather it states a brief, general Policy topics, without citing to actual Policy language. Indeed, the Purported Notice invites some unknown party to “please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insureds.” However, the Purported Notice does not reference specific policy language relevant to the alleged violation, nor any specific policy language in support of the very allegations of the Purported Notice, including allegations claiming that Frontline misrepresented pertinent facts, issued an improper coverage determination or insurance policy provisions relating to coverages at issue. Hence, it is clear that the Claimant’s allegations include policy-related violations, and as such it must cite the policy language that is relevant to such violations. It does not. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to claim delay, unfair trade practice, not treating the insured with good faith claims conduct, failing to properly investigate the insured’s loss, failing to provide the insured with the full benefits awarded under the contract of insurance, and failing to implement proper standards for the adjustment and investigations of claims, supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h), 626.9541(1)(i)(4). Florida courts have weighed in on this requirement, finding that "[i]f the statute contained no specificity requirement, [then] the [insureds'] casual 'reference' to the entire insurance policy undoubtedly would suffice." Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021 at 879 (citing Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). Id. But, the court continued, "the Legislature included 'specific' or a variant not once but twice in the statute." Id. As a result, the insureds' listing of whole sections of the insurance policy "appear[ed] to lack specificity." Id. In Julien, the insured cited numerous statutory violations and listed nearly every provision in the Policy. The Fourth District Court of Appeals agreed with the circuit court that the Civil Remedy Notice failed to specify the statutory and policy provisions at issue. Much the same as in Julien, the Purported Notice fails to state with any real degree of specificity the policy language at issue. IV. Conclusion Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, Frontline denies any wrongdoing. It specifically denies that it violated the insurance policy or Florida Statutes, as alleged in the Purported Notice. Furthermore, Frontline asserts this Purported Notice is factually inaccurate, misrepresents the facts of the claim and fails to comply with Florida Statute 624.155. Further, by this response, Frontline neither waves, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, Frontline hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. Sincerely, Elibet Caballero, Esq. Frontline Insurance Company
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