Civil Remedy Notice of Insurer Violations
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Filing Number:     787180
Filing Accepted:  10/16/2024
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Complainant
Last/Business Name *  
VARGAS   First Name   JUANA
Street Address * 2312 E. 110TH AVENUE
City, State Zip * TAMPA, FL 33612
Email Address * JEFF@WEKLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   VARGAS   First Name   JUANA
Policy # * P000177961 Claim #* 252554
Attorney
Attorney is Applicable
Last Name* SAIDENSTAT First Name * JEFFREY Initial
Street Address* 800 EAST BROWARD BLVD. SUITE 510
City, State Zip* FORT LAUDERDALE , FL 33301
Email Address * JEFF@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SECURITY FIRST INSURANCE COMPANY
NAIC Company Code 10117
 
Name of individual responsible for violation (if any):* JOHN JOINER-LICENSE # W166594
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
* 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)(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)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Loss Payment provision found in the homeowner's policy authorizes payment in the event of a covered loss to insured property.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

At all times material hereto, Security First Insurance Company insured Juana Vargas’s home under a policy of insurance. The subject policy provides coverage for sudden and accidental losses and damages arising from plumbing failures. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages. See Doe v. Allstate Ins. Co., 653 So. 2d 371, 374 (Fla. 1995) (stating that the obligation of insurance company toward insured is a "fiduciary duty requiring the exercise of good faith"). Security First Insurance Company failed to pay the insured's claim for a plumbing loss under the homeowner's insurance policy when, under all of the circumstances, it could and should have done so, had it acted fairly and honestly and with due regard for the interests of insured. Security First Insurance Company failed to act with diligence and thoroughness in investigating the facts specifically pertinent to coverage. Security First Insurance Company failed to attempt to settle the liability claim in the face of the coverage dispute. Security First Insurance Company failed to assess the substance of the coverage dispute or the weight of legal authority on the coverage issue. Security First Insurance Company has a regular business practice of failing to adequately evaluate its policyholder’s claims and undervalues the claims to save itself money. It is clear that the insurer’s general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, adjusting, investigating has caused the insured to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue. Security First Insurance Company also has a regular business practice of retaining unreliable vendors, including adjusters and engineers, to assist in its intentional effort to deny its policyholder rightful benefits. That said, and even though Security First Insurance Company knows that it has a fiduciary duty to promptly adjust insurance claims, it failed to institute the necessary policies, procedures, guidelines and protocols to adjust insurance claims promptly and pursuant to the policy’s Loss Payment Provision. By way of the cited legal authorities and considerations, Security First Insurance Company knew that it had an obligation to treat all insureds equally and honestly. However, and for their own financial interest, they will only start to fully consider their obligations as stated herein if the insured retains legal representation and pursues a legal action which exposes them to liabilities and costs. Even then, they will withhold monies owed in an unjust effort to limit/delay their liabilities in relation to the statutory considerations and otherwise. To cure the above stated immoral, deceptive, unlawful and generally described bad faith conduct which is part of a general business practice that is knowingly being utilized by Security First Insurance Company for self-gain, Security First Insurance Company must: (1) accept coverage for the subject claim; (2) promptly make payment pursuant to the policy’s Loss Payment Provision for covered damages in the amount of $30,815.00 (3) tender interest on any overdue payments; and (4) acknowledge liability for taxable cost in the pending lawsuit.
Comments
User Id Date Added Comment
paul.laborde@securityfirstflorida.com 10-29-2024 10/29/2024 Via Electronic Filing: Florida Department of Financial Services Bureau of Consumer Assistance c/o: Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0322 Via Email: JEFFREY SAIDENSTAT 800 EAST BROWARD BLVD. SUITE 510 FORT LAUDERDALE, FL 33301 JEFF@WEKLAW.COM Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION Filing No.: 787180 Insured: Juana Vargas Insurer: Security First Insurance Company Claim No.: 252554 Policy No.: P000177961 Date of Loss: 12/04/2023 Dear Sir or Madam: This correspondence is in response to the Civil Remedy Notice of Insurer Violations (hereinafter referred to as the “CRN”) was filed by Jeffery Saidenstat on behalf of his client, Juana Vargas (hereinafter referred to as “Insured”). Please be advised that the undersigned represents the interests of Security First Insurance Company (hereinafter referred to as “Security First”) with respect to the above-referenced matter. The Florida Department of Financial Services (hereinafter referred to as “Department”) assigned this CRN an acceptance date of 10/16/2024 and DFS File No.:787180. This matter concerns a property damage claim made by the Insured pursuant to a homeowners’ insurance policy provided by Security First Policy No. P000177961 and assigned Claim No. 252554 As the basis for filing the CRN against Security First, Juana Vargas asserts in the “Reasons for Notice” section violations such as Claim Denial, Claim Delay, and Unsatisfactory Settlement Offer, along with the following statutory violations: 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)(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)(3)(i) Failing to pay personal injury protection Security First welcomes this opportunity to respond to the CRN and denies each allegation contained therein. The allegations made in the CRN are premature, as the insured has failed to perfect the claim for bad faith and the CRN does not meet the specificity requirement of Section 624.155, Florida Statutes. This CRN does not sufficiently support the allegations stated above. As is standard procedure, upon the first notice of the claim, the subject property was dutifully inspected by an SFIC representative which was documented through photographs. I. Perfecting a Claim for Bad Faith SFIC specifically denies all allegations set forth in the Notice. SFIC contends that the Notice should be rejected and returned by the Department of Financial Services as it is premature. Pursuant to statute, there is no potential violation until a breach of contract is established. § 624.1551, Florida Statutes. Accordingly, any Notice filed prior to a finding that SFIC has breached the terms of the policy, is not ripe and is premature and thus fails to perfect Juana Vargas rights to pursue civil remedies under Florida Statutes. II. Specificity Requirement The Insured’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for Civil Remedy Notices. In addition, it fails to meet even the most basic requirements of the Statute. Pursuant to the terms of the statute, (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. a. The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require (emphasis added): b. (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. i. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. ii. The facts and circumstances giving rise to the violation. iii. The name of any individual involved in the violation. iv. 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. v. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad- faith actions, the Legislature provided this sixty-day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1284 (Fla. 2000). Thus, the Notice cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So. 2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”) See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017) (sufficiency means specificity). In Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875, 879 (Fla. 4th DCA 2021), the Honorable Court stated: The Middle District of Florida was confronted with a civil remedy notice that was similarly broad in scope and concluded that listing nearly all policy provisions on the notice did not satisfy the statute. Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). The court explained that “[i]f the statute contained no specificity requirement, [then] the [insureds’] casual ‘reference’ to the entire insurance policy undoubtedly would suffice.” 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 Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiffs’ counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiffs’ counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be more clear. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. III. Conclusion At all times, Security First has acted in good faith in its handling of the claim and it has acted fairly, honestly, and with due regard for the Insured’s interest and in determining obligations to Insured. Specifically, Security First has complied with its obligations under the applicable Florida Statutes and the applicable Security First Insurance policy. Security First specifically denies any claim for bad faith and argues that the insured’s claim for bad faith is premature. Security First continues to reserve all its rights under the policy, at law and in equity. Regardless, Insured’s conclusory allegations fail to place Security First on notice of any purported violations. Furthermore, the Civil Remedy Notice fails to identify how to cure the allegations set forth. The allegations are without basis. It is clear Security First properly handled and adequately investigated the claim. We hope that this response has answered any concerns regarding this matter. If the Department has any question concerning this matter, please do not hesitate to contact me. Sincerely, Paul LaBorde Litigation Specialist Adjuster License # P208776 Security First Insurance Company 1001 Broadway Avenue Ormond Beach, Florida 32714 Paul.laborde@securityfirstflorida.com Telephone Number: 386-868-1762
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