Civil Remedy Notice of Insurer Violations
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Filing Number:     786814
Filing Accepted:  10/14/2024
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Complainant
Last/Business Name *  
TAPP   First Name   FRANK AND PAMELA
Street Address * 2755 BLUEBIRD AVE
City, State Zip * NORTH PORT, FL 34286
Email Address * PAMMYQ88@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   TAPP   First Name   FRANK AND PAMELA
Policy # * EDH4026574-05 Claim #* EDI951191
Attorney
Attorney is Applicable
Last Name* FRANKEL First Name * SCOTT Initial
Street Address* 800 EAST BROWARD BOULEVARD, SUITE 510
City, State Zip* FORT LAUDERDALE , FLORIDA 33301
Email Address * SF@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   EDISON INSURANCE COMPANY
NAIC Company Code 12482
 
Name of individual responsible for violation (if any):* BRIDGETTE BROOKS; MASON MINISTER
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* 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)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Policy language: AGREEMENT We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the “residence premises” shown in the Declarations, including structures attached to the dwelling; and PERIL INSURED AGAINST 1. We insure for direct physical loss to the property described in Coverages A, B and C caused only by the peril of windstorm or hail unless the loss is excluded in EXCLUSIONS. C. Loss Settlement In this Condition C., the terms “cost to repair or replace” and “replacement cost” do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.8. Ordinance Or Law under PROPERTY COVERAGES. I. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Any loss payment will be paid to you and them, as each interest appears. Loss will be payable: 1. 20 days after we receive your proof of loss and reach written agreement with you; or 2. 60 days after we receive your proof of loss and: a. There is an entry of a final judgment; or b. There is a filing of an appraisal award or a mediation settlement with us. 3. Within 90 days after we receive notice of an initial, reopened, or supplemental property insurance claim from you, where for each initial, reopened, or supplemental property insurance claim, we shall pay or deny such claim or portion of such claim, unless there are circumstances beyond our control which reasonably prevent such payment. Paragraph 3. above does not form the sole basis for a private cause of action against us.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Frank and Pamela Tapp (“Insured”) purchased an insurance policy ("Policy") from Edison Insurance Company (“Carrier”) with effective coverage on the date of loss, on or about September 28, 2022, and Policy number EDH4026574-06 to insure their property located at 2755 Bluebird Ave, North Port, FL 34286 ("Property"). On or about September 28, 2022, the Property suffered severe wind damage to the roof, exterior and interior as a result of the passing of Hurricane Ian ("Loss"). Upon becoming aware of the damage to the Property, the Insured reported damage to the Property as a result of the Loss. The Carrier acknowledged the claim and assigned claim number EDI951191 ("Claim") to the Loss. During its investigation of the claim, the Carrier first sent a field adjuster. After the field adjuster’s inspection, he rendered an estimate, but failed to take into account numerous areas of damage, such as the sliding glass doors and cracked floor tile, along other things. The Carrier happily relied upon the field adjuster’s low-ball estimate and initially paid an unacceptable amount to cover all of the damages to put the Property back into its pre-loss condition, $12,853.09. Thereafter, due to the Insureds lack of familiarity with homeowners’ claims and lack of confidence in their Carrier to abide by the insurance contract after receiving the initial payment, the Insured contacted a public adjusting firm, SoFlo Public Adjusters (“SoFlo”), to inspect the property and provide direction as to how to handle the claim and quantify the damages observed. After confirming the presence of damage to the Property, SoFlo signed up the Insured and promptly communicated its involvement with the Carrier, acting as the Insured’s representative from that point forward. Then, SoFlo requested the Carrier to perform a reinspection due to the damages unaccounted for in the initial field adjuster’s estimate. Mr. Mason Minister inspected the property on behalf of the Carrier, rendered a new estimate, and two additional payments were made in the amount of $112.81 and $224.74 respectively. This acted like a slap in the face wherein the Carrier may have paid more to the adjuster to reinspect than the additional payment made on the claim, when it was clear the Carrier was missing areas of damage. It is egregious that the Carrier continued its behavior of intentionally excluding areas of damage that the Carrier’s insureds are stating were damaged directly due to the storm, while the Carrier has little to no evidence saying otherwise. The Carrier is required to give the benefit of the doubt to its Insureds and act in good faith in its adjusting of the subject claim. Here, however, the Carrier failed to do so, and instead choose to ignore damage and underpay its Insureds to the delight of its shareholders. Furthermore, due to the Carrier’s efforts to withhold information relating to its investigation, which has continued after the Insured’s were forced to hire an attorney and file a lawsuit against the Carrier, the Insureds are less able to specifically state all individuals involved in the foregoing allegations of bad faith. The Insureds plan on filing a renewed Civil Remedies Notice once depositions are compelled by the Court and the Insureds discover more specifics on the Carrier’s mishandling of the claim. Since the Insureds became aware of the damages to the Property, they have acted promptly in reporting the claim and mitigating further damage to the Property. They have cooperated in all ways possible with every request of the Carrier. The Insureds have fully complied with all applicable Policy provisions requiring cooperation with the investigation; however, the Carrier has unequivocally failed to properly adjust this Claim, as further elaborated above. Rather than paying the actual damages and/or trying to settle with the Insured, the Carrier has continued its pre-suit failures to act in good faith into litigation, delaying any prompt resolution of the claim. The Carrier has not attempted, in good faith, to settle this claim when, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholders and with due regard to the policyholders' interests. As a result of this incident, the Insured has suffered damage to the building on the subject Property and loss of use of the Property and possessions therein. As a direct consequence of the Carrier’s failure to adjust this Loss in good faith and make any payment, the Insured continues to be without adequate compensation for the damages sustained at the Insureds' Property more than twenty-four (24) months ago. By stating the above detailed facts, it is clear that the Carrier has violated the following Florida statutes: • 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 Insureds and with due regard for their interest; • The Carrier had no evidence that their Insureds weren’t being truthful that their tile flooring was damaged as a result of Hurricane Ian, however, it continues to refuse to pay for its repairs. • 624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. • Multiple times the Carrier sent coverage decision letters and plainly attached excerpts from the Policy without fully explaining how they apply in this claim and why those provisions are being invoked to withhold payment from their Insureds • 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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims; • 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. • 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. • 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. • 626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. • 626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement • Multiple times the Carrier sent coverage decision letters and plainly attached excerpts from the Policy without fully explaining how they apply in this claim and why those provisions are being invoked to withhold payment from their Insureds To date, the Carrier has acted in bad faith, failed to provide coverage under the Policy to the Insured. The Insured's property continues to be in disarray as the Insured is without funds to put their property into its pre-loss condition. As a direct result of Carrier’s drastic underpayment of the Claim and breach of the Florida Statutes, the Insureds were forced to seek the help of licensed professionals to assist them, including a public adjuster and legal counsel. Due to the amount of time that has passed since the date of loss and the information discussed above, there is irrefutable evidence that Carrier knowingly and intentionally, and in bad faith delays the settlement process in order to further disadvantage the Insureds. The financial detriment caused to the Insureds is a direct result of the Carrier’s reckless treatment of the claims process. The Insured submitted all documents requested in a timely fashion, made their property available for inspection, submitted estimates and requests. However, the Carrier failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim. To deny the Insured the benefit clearly due and owing under the Policy, for which they have time and time again been making premium payments for and after they have satisfied all of their obligations is morally and ethically reprehensible, and reeks of Unfair Claims Practice and Bad Faith. Upon information and belief, the aforementioned actions complained of, among others, were made by the Carrier so often as to constitute a general business practice, evidencing a motive to enhance the Carrier’s profits, and designed to cause a detrimental effect to its policyholders. The above clearly depicts that the Carrier adjusted this claim in bad faith, continue to act in bad faith towards its Insured, and that the Carrier is in direct violation of Unfair Claims Practices. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should the Carrier fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Carrier must: (1) Immediately tender 100,000.00 in US dollars to the Insured which is fairly owed to the Insured under the insurance policy and would reasonably compensate the Insured in order to put the Property back to its pre-loss condition; (2) Agree to reimburse the Insured for interest on the amount of benefits that was found to be due and owing to the Insured, relating back to the date of loss; (3) if the Carrier does not agree with the amount listed above to reasonably compensate the Insured for the Loss, then the Insured demands the Carrier to reach out to the Insured’s representative to negotiate in good faith to resolve this claim amicably.
Comments
User Id Date Added Comment
evelyn.cranford@qpwblaw.com 12-03-2024 VIA ELECTRONIC SUBMISSION: civilremedy@myfloridacfo.com Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 R/E: Complainants: Frank Tapp and Pamela Tapp (“Complainant[s]” or “Insured[s]”) Claim No: EDI951191 (“Subject Claim”) Policy No: EDH4026574-05 (“Policy”) Loss Location: 2755 Bluebird Ave, North Port, FL 34286 (“Property”) CRN Filing No: 786814 CRN Date: 10/14/2024 Dear Sir or Madam: The undersigned counsel represents Edison Insurance Company (“Edison”) in regard to the alleged dispute as to Subject Claim number EDI951191 reportedly involving Hurricane Ian occurring on or about September 29, 2022, made under the Policy of insurance Edison issued the Insureds, Frank Tapp and Pamela Tapp, bearing policy number EDH4026574-05 for the Property located at 2755 Bluebird Ave, North Port, FL 34286. Please accept this correspondence as Edison’s response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed with the Department of Financial Services (“DFS”) by attorney Scott Frankel, Esq. on behalf of the Complainants and accepted for filing by the DFS on October 14, 2024 (filing number 786814). The Complainants alleged violations of the following statutory provisions in CRN filing number 786814 dated October 14, 2024: ALLEGED STATUTORY VIOLATION(S) 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. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. Page 2 of 9 624.155(1)(b)(2): Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 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. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed Page 3 of 9 Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. 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. Edison specifically denies the Complainants’ allegation that it has violated the above-mentioned statute. In addition to the allegation specifically denied above, Edison generally denies any and all additional allegations presented in this CRN, as Edison has not violated any statute, Code or Rule. SPECIFICITY REQUIREMENTS Florida Statute requires that a CRN state the facts and circumstances giving rise to the alleged violations with specificity sufficient to allow an insurer to “cure” the alleged violations within the sixty-day statutory period. See Fla. Stat. § 624. 155(3)(b)(2); see also Lane v. Westfield Ins. Co., 862 So. 2d 774, 777 (Fla. 5th DCA 2003), Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Specifically, Fla. Stat. § 624.155(3)(b)(2) requires the Complainant to set forth with specificity, sufficient factual allegations to state a prima facie case of an insurer violation, so as to put the insurer on notice and be afforded the opportunity to cure the deficiency. However, here, the CRN is deficient and defective in that it fails to state with sufficient specificity the necessary facts in support of the Insured’s allegations, including but not limited to those that would be necessary for Edison to “cure” the alleged violations. Further, the subject CRN provides what appears to be boilerplate and conclusory statements, which fail to sufficiently describe the claim specific facts related to Edison’s handling of the Subject Claim allegedly constituting violations of the statutes cited therein. Thus, because the allegations in the CRN are incomplete and / or incorrect, they fail to provide actual notice of the specific allegations and the actions that Edison could undertake to cure any alleged violations. See 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193 (N. D. Fla. 2008). For the reasons set forth herein, the subject CRN is a nullity and should be rejected because the CRN fails to comply with the specific requirements mandated by Florida Statutes §624.155. Additionally, the CRN fails to identify with specificity the specific policy language relevant to the alleged violations and fails to provide the specific underlying facts that form the basis for the alleged violations. Instead, most of the Policy language cited in the CRN here is overbroad and the CRN does not specify the specific Policy language within the cited section nor Page 4 of 9 the relevant supporting facts indicating how the Policy language identified pertains to the alleged violations. Blanket references to policy provisions and statutes without specification deems the CRN deficient. See Julien v. United Property and Casualty Insurance Co., (Fla. 4th DCA 2020). Specifically, the subject CRN vaguely references the following Policy language without any further specification or information: AGREEMENT We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the “residence premises” shown in the Declarations, including structures attached to the dwelling; and PERIL INSURED AGAINST 1. We insure for direct physical loss to the property described in Coverages A, B and C caused only by the peril of windstorm or hail unless the loss is excluded in EXCLUSIONS. C. Loss Settlement In this Condition C., the terms “cost to repair or replace” and “replacement cost” do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.8. Ordinance Or Law under PROPERTY COVERAGES. I.Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Any loss payment will be paid to you and them, as each interest appears. Loss will be payable: 1. 20 days after we receive your proof of loss and reach written agreement with you; or 2. 60 days after we receive your proof of loss and: a. There is an entry of a final judgment; or b. There is a filing of an appraisal award or a mediation settlement with us. 3. Within 90 days after we receive notice of an initial, reopened, or supplemental property insurance claim from you, where for each initial, reopened, or supplemental property insurance claim, we shall pay or deny such claim or portion of such claim, unless there are circumstances beyond our control which reasonably prevent such payment. Paragraph 3. above does not form the sole basis for a private cause of action against us. Page 5 of 9 For the reasons set forth herein, Edison hereby objects to the subject CRN and states it does not intend to waive, ratify or otherwise accept the deficiencies in the CRN, and reserves the right to contest the legal adequacy of the CRN hereinafter as appropriate. The Complainants’ failure to sufficiently describe the factual circumstances to support the alleged statutory violations in the CRN precludes Edison from evaluating what error, if any, allegedly occurred during the claim process. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported and / or incorrect allegations with no basis in fact or circumstances. The vague conclusory statements are not sufficient. Consequently, the CRN lacks the requisite minimal specificity and Edison is unable to determine what specifically the Complainants are claiming was done by or on behalf of Edison that constitutes the bad faith alleged. Due to the absence of sufficiently specific, accurate information regarding the alleged acts or omissions by Edison which allegedly give rise to any violation of the Civil Remedy Statute, Edison is limited in its ability to set forth specific facts to address and/or refute these unsubstantiated assertions in this response. Notwithstanding, Edison explicitly denies any and all alleged violations of any applicable Florida Statute in the adjustment of the Subject Claim and realleges and re-asserts its specific denials to the alleged violations in the subject CRN as set forth above. In addition, Edison denies that it has conducted any improper practices regarding “claim delay, unsatisfactory settlement offer, unfair trade practices, failure to properly investigate claim with due regard for Insured’s interest, failure to acknowledge and act promptly to communications regarding claim and failure to pay claim in full ” as listed under the “Reasons for Notice” portion of the CRN. Accordingly, and without waiver of its objections, rights and defenses, Edison maintains that it has acted and continues at all times to act in good faith during the investigation and adjustment of the Subject Claim. Further, Edison wishes to dispel even the slightest inference of any statutory violation and reiterates below the various reasons which clearly show the proper handling of the Subject Claim by Edison. Moreover, as stated in Demase v. State Farm Florida Insurance Company (Fla. 5th DCA November 14, 2022), and as a condition precedent to bringing a first-party bad faith case, a complainant must provide timely notice of the alleged violation to the authorized insurer and to the DFS. The Complainant here failed to provide such timely notice to Edison as required. BACKGROUND FACTS The tenor and inferences of statutory violations in the subject CRN are wholly without merit and Edison denies each and every one. Below are some of the relevant facts regarding the Subject Claim, many of which the Complainants failed to include in the CRN. Page 6 of 9 Contrary to the vague and overbroad allegations in the CRN, Edison in fact conducted a detailed and thorough investigation into the Subject Claim prior to reaching its coverage decision. Specifically, Edison promptly assigned claim number EDI951191 to the Subject Claim upon receiving first notice of loss (“FNOL”) of same on or about September 30, 2022. That same day, Edison sent the Insureds and the Insureds’ insurance agent written correspondences acknowledging receipt of the Subject Claim. Field Adjuster Gerriet Muller with Allcat Claims Solutions (“FA Muller”) was assigned to the Subject Claim and on or about October 18, 2022, FA Muller completed the initial inspection of the Property in connection with the Subject Claim, which included examination and photographing of the roof, exterior, other structures and interior by FA Muller. Based on its initial investigation, Edison determined there was coverage under the Policy for the Subject Claim as outlined in Edison’s initial coverage letter to the Insureds dated December 10, 2022 signed by Supervising Adjuster Ranell Green (“SA Green”). Specifically, Edison’s December 10, 2022 coverage letter explained that, based on Edison’s investigation, it was issuing a check in the net amount of $12,853.09 for repairs to the Dwelling under Coverage A and a check in the net amount of $5,652.56 for repairs to Other Structures under Coverage B. The December 10, 2022 letter also provided that there was a partial denial for the claimed damage to the dining room window caused by wind driven rain, for the claimed damage to the master bedroom caused by surface / flood water, for the claimed damage to a trailer since it was not registered, for the claimed damage to the screens on the screened enclosure, and for tree/debris removal, which is not covered unless it causes damage to covered property. Edison cited the applicable Policy language relied on it its coverage decision for the Subject Claim in the December 10, 2022 coverage letter. An estimate prepared by FA Muller outlining the specific repairs included in Edison’s abovereferenced initial payments accompanied the December 10, 2022 coverage letter, which reflected total coverage of $27,023,14 RCV for the Subject Claim, including $20,657.08 RCV under Coverage A (Dwelling) and $6,366.06 RCV under Coverage B (Other Structures). Thereafter, in January, 2023, Edison received a request that a supplemental claim be opened to address additional claimed damages. Thereafter, Field Adjuster Mason Minister with Allcat Claims Solutions (“FA Minister”) reinspected the Property in connection with addressing the additional damages alleged as part of the Insureds’ supplemental claim. The only additional damage revealed by FA Minister’s reinspection was to the entry ceiling and to a downspout on the rear elevation. FA Minister did not observe any additional storm damage to support the Insureds’ additional claimed damages to the interior, the windows or the rear fence consistent with Hurricane Ian. Based on its supplemental investigation, Edison issued a supplemental coverage letter to the Insureds dated February 6, 2023 signed by Supervising Adjuster Bridgette Brooks (“SA Brooks”) advising that Edison was issuing additional payments of $112.81 for Coverage A – Page 7 of 9 Dwelling and $224.74 for Coverage B. The February 6, 2023 letter to the Insureds reiterated the partial denials outlined in its initial coverage letter and also provided that there were partial denials for the additional claimed damage to the interior based on a lack of storm related opening , for the additional claimed damage for exterior stucco cracks and interior drywall cracks caused by settlement and for the additional claimed damage to the rotted, deteriorated portion of the fence. Edison cited to the applicable Policy language relied on it its supplemental coverage decision letter dated February 6, 2023. FA Minister’s supplemental estimate in support of Edison’s supplemental payments reflected a total claim amount of $27,412.95 RCV. There does not appear to have been any further activity for the Subject Claim until several months later on or about May 11, 2023 when Edison received the Insured’s Notice of Intent to Litigate (“NOIL”), Notice # 109497, with the Insureds’ pre-suit settlement demand of $120,000.00. An estimate prepared by the Insureds’ public adjuster, So Flo. Public Adjusters (“PA”) totaling $166,599.02 RCV, including $151,623.80 RCV for repairs to the Dwelling under Coverage A, $14,315.34 RCV for Coverage B repairs to Other Structures, and $659.88 for Contents under Coverage C was attached to the NOIL in support of the Insured’s additional claimed damages. Edison’s Complex Claims Adjuster Ignacio Hidalgo (“CCA Hidalgo”) timely responded to the Insureds’ NOIL in writing on May 24, 2023, referring the Insured to Edison’s prior coverage letters dated December 12, 2022 and February 6, 2023 and to the corresponding payments for the Subject Claim outlined in said correspondences. Edison rejected the pre-suit settlement demand in the NOIL; however, extended a pre-suit settlement offer of $20,000 to resolve the Subject Claim. It does not appear that the Insureds responded to Edison’s $20,000 presuit settlement offer. However, it appears that on or about June 2, 2023, the Insureds filed a lawsuit in Sarasota County Circuit Court, alleging one count for breach of contract and one count for declaratory relief against Edison in relation to the Subject Claim, which was served on Edison on or about June 14, 2023, and which is still pending (Sarasota County Case number 2023 CA 004771 SC). As evidenced by the foregoing facts, Edison conducted a good faith, comprehensive and prompt investigation of the Subject Claim. Specifically, Edison promptly and consistently communicated with the Insureds/ Insured’s representative(s) and conducted a thorough investigation of the Subject Claim before reaching a coverage decision. Further, Edison explained its initial and supplemental coverage decisions for the Subject Claim to the Insureds in detail in writing and promptly responded to all correspondences from the Insureds / Insured’s representative(s), including the Insured’s NOIL. INACCURACY OF ALLEGATIONS IN THE SUBJECT CRN The specific facts related to Edison’s handling of the Subject Claim provided above implicitly address many of the vague allegations contained within the Complainants’ CRN and further establish that Edison undertook a thorough investigation in accordance with applicable Page 8 of 9 statutory requirements and professional standards of care. As such, Edison respectfully denies any wrongdoing in the adjustment and handling of the Subject Claim and denies any and all allegations that it committed any acts or violated any Florida statutes or other laws. With the aforementioned facts established, coupled with the Complainants’ failure to sufficiently provide accurate claim specific facts relating to the Subject Claim to support or justify the alleged violations in said CRN, said CRN is baseless and without merit. In light of the Complainants’ failure to comply with the requirements of the Civil Remedy Notice Statute, Edison is unable to fully address the Complainants’ allegations in the Subject CRN. Quite plainly, at all times Edison has acted quickly and responsibly, in good faith and in accordance with the terms and provisions of the applicable policy of insurance as well as with F. S. § 624. 155 and § 626. 9541 and its sub-parts. Further, Edison completed its investigation in accordance with all statutory requirements, effectively rendering all allegations set forth in the Complainants’ CRN moot and unfounded. The Complainants’ CRN fails to indicate how Edison can cure the alleged violations in the CRN. In the context of a first-party insurance claim, the contractual amount due to an insured is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As a result, only the demanded “cures” relating to the payment for covered damages are proper and legal. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000). Further, the purpose of a CRN is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000). Here, the CRN here does not serve this purpose because it does not provide any means whereby Edison can “cure” the alleged defects short of paying additional benefits for the Subject Claim for repairs that are not covered under the Policy. This failure to provide a proper opportunity to cure renders the CRN improper. Longpoint Condominium Associations v. Allstate Ins. Co., 2005 WL 131580 (N. D. Fla. 2005). Moreover, the method for curing the violations alleged in a civil remedy notice are not determined by the insured or the Insured’s assginee. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: 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). . . . To cure an alleged violation and to avoid a civil action, an insurer must pay the claim . . . before the sixty days expire. See Talat Enterprises. v. Aetna Cas. & Sur. Co., 952 F. Supp. 773, 777-778 (M. D. Fla. 1996). Page 9 of 9 Here, Edison properly adjusted the Subject Claim and investigated same in a timely manner. Further, the Complainants have not produced any evidence they are entitled to the additional damages sought. As such, Edison denies all of the allegations contained in the subject CRN, which is defective and improper, as Edison has not violated any statutes. Edison further states that the accusations in the CRN are patently false. CONCLUSION Based on the foregoing, Edison respectfully denies any wrongdoing in the adjustment and handling of the Subject Claim and further denies any and all allegations that it violated any statutes. Instead, Edison acted quickly and responsibly and in accordance with the terms and provisions of the applicable policy of insurance as well as with F.S. §624.155 and §626.9541 and its sub-parts. Contrary to the allegations that Edison violated various statutes in the CRN, at all times Edison has acted in good faith with respect to every aspect of its investigation of the Subject Claim and has also acted fairly and honestly toward its Insureds and with due regard for all involved parties’ interests. In closing, this CRN should be rejected and returned by the DFS due to its failure to comply with Florida Statute §624.155 and Florida Case law. Due to the lack of any factual and circumstantial basis to support the allegations therein, Edison respectfully requests, through this response, that the DFS return and reject the CRN for lack of specificity pursuant to Florida Statutes. Regardless of the rejection, Edison denies all allegations contained in the subject CRN and submits that there are no statutory violations. While the foregoing response by Edison is meant to be comprehensive, it is based upon the limited information provided in the CRN and the information in Edison’s possession to date. If the Complainant feels that Edison is not in possession of all the relevant facts, please inform the undersigneded immediately. Please also note that neither this response or any act or failure to act on the part of Edison, or any agent or representative of Edison, should be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. Very truly yours, QUINTAIROS, PRIETO, WOOD & BOYER, P. A.
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