Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 787446

Filing Accepted: 10/17/2024

Print Filing

Complainant

Last/Business Name *

AINORIS

First Name

JOSEPH

Street Address *

34 CANTERBURY WOODS

City, State Zip *

ORMOND BEACH, FL 32174

Email Address *

SNAPDOG72@AOL.COM

Complainant Type: *

Other

Insured

Last/Business Name*		PIRAINO		First Name		ARLEEN
Policy # *		FPW2022514-15		Claim #*		FPI243315

Attorney

Attorney is Applicable

Last Name*	HUFFMAN First Name * SAMANTHA Initial M
Street Address*		2300 MAITLAND CENTER PARKWAY SUITE 106
City, State Zip*		MAITLAND , FL 32751
Email Address *		SHUFFMAN@SERRANOCAGAN.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		FLORIDA PENINSULA INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10132

Name of individual responsible for violation (if any):* MARISOL ALVAREZ
Type of Insurance * Residential Property & Casualty

Reason for Notice *

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)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(e)		Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
	626.9541(1)(i)(3)(f)		Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
	626.9541(1)(i)(3)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
	626.9541(1)(i)(3)(h)		Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
	626.9541(1)(i)(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.

SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section)

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

to a weather-related incident. Insured reported the loss thereafter to FLORIDA PENINSULA INSURANCE COMPANY ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # FPW2022514-15 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # FPI243315. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $1,395.37 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about 09/16/2024, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice are done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 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)(c): Failing to acknowledge and act promptly upon communications with respect to claims; 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed; 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 626.9541(1)(i)(3)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $59,158.36, less any applicable deductible and prior payment to the Insured, to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.

Comments

User Id		Date Added		Comment
SHUFFMAN@SERRANOCAGAN.COM		03-02-2025		THE COMPLAINTANT HEREBY WITHDRAWS THIS CRN
april@zinoberdiana.com		12-13-2024		RE: Complainant(s): Joseph Ainoris Insured(s): Arleen Piraino (“Insured”) DFS File No.: 787446 Date of Filing: October 17, 2024 Claim No.: FPI243315 Policy No.: FPW2022514-15 Property: 34 Canterbury Woods, Ormond Beach, FL 32174 Dear Ms. Huffman: We represent Florida Peninsula Insurance Company (hereinafter, “Florida Peninsula”) in the dispute filed by you on behalf of Joseph Ainoris as the Complainant (hereinafter, “Complainant”), against Florida Peninsula for Claim No. FPI243315. This correspondence constitutes Florida Peninsula’s Response to the Civil Remedy Notice of Insurer Violation which your office filed on behalf of the Complainant on October 17, 2024, with the Florida Department of Financial Services (“DFS”), DFS filing number 787446 (hereinafter, the “CRN”). While Florida Peninsula welcomes the opportunity to respond to this CRN, Florida Peninsula specifically denies each and every allegation contained in the CRN filed in relation to this claim. Further, Florida Peninsula asserts that the CRN should be rejected and returned by DFS, as the CRN fails to comply with the specific information requirements as set forth within § 624.155, Florida Statutes, and Florida case law, and is therefore facially invalid and deficient. I. The CRN fails to satisfy the requirements of Florida law. Concerning the contents of the CRN, the law requires strict compliance with the specificity requirements in § 624.155, Florida Statutes, which the CRN fails to satisfy. Both § 624.155(3), Florida Statutes, and the Civil Remedy Notice form require the Complainant to specifically state, among other things, the statutory provisions, including the specific language of the statute, which the insurer allegedly violated, the facts and circumstances giving rise to the violation, the name of any individual involved in the violation, and the specific policy language that is relevant to the violation. Additionally, § 624.155(3)(b) mandates that the Civil Remedy Notice must be “on a form provided by the [Department] and shall state with specificity … such other information as the department may require.” (emphasis added). Further, the purpose of the specificity requirement for a civil remedy notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects and otherwise avoid litigation. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278, 1283-4 (Fla. 2000); Rousso v. Liberty Surplus Ins. Corp., 2010 U.S. Dist. LEXIS 82328 (S.D. Fla. Aug. 13, 2010). Uninformative recitations that do not inform the insurer of the facts underlying the alleged violations or match up with the statutes that the complainant identifies as the statutes that were purportedly violated are insufficient to fulfill the requirements of § 624.155. Rousso, 2010 U.S. Dist. LEXIS 82328. The CRN fails to meet the specificity requirements of § 624.155, Florida Statutes, and therefore is invalid and deficient. Notably, in contravention of the statutory and form requirements that a complainant must state the specific statutory provisions allegedly violated and the facts and circumstances giving rise to the violation, the CRN identifies numerous statutory provisions (almost every potential statute) including some contained in the narrative section but not included in the designated list section and some identified in the section for the policy language but never further mentioned or expanded upon, though they are not wholly relevant or applicable to the alleged facts or claimed violations contained in the CRN or fail to correlate with any specific facts or circumstances giving rise to the alleged violations. Likewise, the CRN identifies certain “reason[s] for notice” without providing sufficient facts to support each. Additionally, 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, incomplete, generic, conclusory, and insufficient allegations with no basis in fact or circumstance, as well as omits specific facts to support its allegations of violations. The CRN includes a minimal information, commentary on unsupported, conclusory accusations, unqualified opinion, legal conclusions, conjecture, and inaccurate statements of facts cast in the light most favorable to the Complainant and his representatives. In short, the facts alleged are simply inaccurate, fail to paint a complete picture of the handling of this claim, fail to apprise Florida Peninsula of how its actions constituted a violation of said statutes, or were identified without any factual support. II. Despite the deficiencies, Florida Peninsula denies all allegations contained in the CRN. Notwithstanding the deficiencies in the CRN and without waiving the objections above, Florida Peninsula explicitly denies any violation of the Florida Statutes sections referenced in the CRN. Florida Peninsula hereby denies each and every allegation contained in the CRN, either explicitly or implicitly, and denies any wrongdoing in the handling of this matter. Rather, Florida Peninsula handled the claim both diligently and properly under the terms and conditions of the insurance policy, as well as in accord with Florida law. Florida Peninsula denies each and every allegation contained in the CRN and responds to them individually as follows: The Complainant lists the following purported reasons for submitting the CRN which are 1) Unsatisfactory Settlement Offer. As indicated in detail below, the CRN fails to establish or set forth any specific facts that would support the allegations asserted in support of the perceived violations and Florida Peninsula denies each and every allegation. Specifically, Florida Peninsula responds as follows: Allegation of Unsatisfactory Settlement Offer: This allegation is wholly without basis in law or in fact and is therefore denied. Counsel for Complainant should immediately withdraw this allegation from the CRN as it cannot be established by any credible evidence. Florida Peninsula handled the claim both diligently and properly under the terms and conditions of the insurance policy as well as in accord with Florida law, a determination of coverage was made based on a good faith investigation and the terms and conditions of the subject policy and payment was issued for the appropriate covered damages, a good faith attempt to investigate this claim has and continues to be made, and at all times material to this claim, Florida Peninsula has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, as it does on every claim. Moreover, the subject CRN cites numerous (virtually every one which is impermissible) statutes Florida Peninsula has allegedly violated. While Florida Peninsula categorically and unequivocally denies violating any statutes, Florida Peninsula will briefly address the specific statutes alleged to have been violated, in an abundance of caution. § 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. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. At no time has Florida Peninsula acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 624.155(1)(b)(1) and has in no way violated said statutory provisions. § 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. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. At no time has Florida Peninsula acted dishonestly or unfairly toward the Insured and/or her representatives. Moreover, it is unclear what other portions of the policy coverage Complainant claims Florida Peninsula was trying to influence the settlements of. All actions have been performed in good faith for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 624.155(1)(b)(3) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for proper investigation of claims. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. Florida Peninsula has always implemented standards for investigating and adjusting claims commensurate with the requirements of Florida Statutes, and it will continue to do so. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(a) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims Florida Peninsula denies this allegation. The CRN sets forth no actual accurate facts to support this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. After the claim was reported, Florida Peninsula immediately began its thorough investigation and issued its coverage determination letter promptly and timely. Additionally, Florida Peninsula promptly acted and responded to all received documents and information provided with regards to the claim. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. Notably, the CRN wholly fails to identify any specific communications which Florida Peninsula did not promptly respond to or acknowledge. On the contrary, Florida Peninsula has, in fact, communicated promptly with the Insured and her representatives. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(c) and has in no way violated said statutory provisions. § 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. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula promptly and timely issued its coverage determination and all communications to the Insured in accordance with statutory requirements. Moreover, no proof of loss statements were submitted to Florida Peninsula for this claim, therefore rendering this subsection completely inapplicable. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. At no time has Florida Peninsula acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(e) and has in no way violated said statutory provisions. § 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. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a prompt and detailed explanation to the Insured regarding its coverage determination. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. Notably, despite the Insured’s delay in reporting the claim until June 11, 2024, Florida Peninsula issued its detailed coverage determination on August 5, 2024, providing the basis for its decision, and the accompanying estimate. On the other hand, the Complainant fails to specify how or why the communications from Florida Peninsula were not sufficient other than essentially disagreeing with the decision. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(f) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination. In Florida Peninsula’s communications and correspondences, Florida Peninsula provided reasonable and detailed explanations regarding its coverage determinations to the Insured and her representatives, explained what information was necessary, and explained why the requested information was necessary. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy or without being given the opportunity to fully investigate the claim. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. Florida Peninsula continuously provided clear communications and explanations to the Insured and her representatives regarding the investigation of the claim and additional information to be provided to Florida Peninsula to assist in the further and thorough investigation of the claim. Moreover, the Complainant fails to specify how or why the communications from Florida Peninsula were not sufficient other than essentially disagreeing with the decision. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(g) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. Florida Peninsula denies this allegation. The CRN sets forth absolutely no actual facts to support this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Florida Peninsula retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Florida Peninsula made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination. In Florida Peninsula’s communications and correspondences, Florida Peninsula provided reasonable and detailed explanations regarding its coverage determinations to the Insured and her representatives, explained what information was necessary, and explained why all requested information was necessary. While Florida Peninsula has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Florida Peninsula is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy or without being given the opportunity to fully investigate the claim. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. Florida Peninsula continuously provided clear communications and explanations to the Insured and her representatives regarding the investigation of the claim and additional information to be provided to Florida Peninsula to assist in the further and thorough investigation of the claim. Moreover, the Complainant fails to specify how or why the communications from Florida Peninsula were not sufficient other than essentially disagreeing with the decision. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Florida Peninsula acted in accordance with Florida Statute § 626.9541(1)(i)(3)(h) and has in no way violated said statutory provisions. § 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). Florida Peninsula denies this allegation. The CRN sets forth no actual facts to support this allegation, and moreover cannot ever include facts to support this alleged statutory violation. The statute cited pertains only to personal injury protection insurance claims, whereas the policy and claim at issue are for a homeowners policy and claim. Therefore, the cited statute is inapplicable, and it is unclear as to why this statute has been included as Florida Peninsula could not have possibly violated this subsection. Moreover, to the extent the Complainant intended to include § 626.9541(1)(i) as a “catchall” to all subsections within 626.9541(1)(i), this improperly makes it over general and unclear as to what provisions and subsections within 626.9541(1)(i) Florida Peninsula allegedly violated. Notwithstanding, Florida Peninsula vehemently denies that it violated § 626.9541(1)(i) and any portion or subsection within. Florida Peninsula handled the claim both diligently and properly under the terms and conditions of the insurance policy, as well as in accord with Florida law, a determination of coverage was made based on a good faith investigation and the terms and conditions of the subject policy, a good faith attempt to investigate this claim has and continues to be made, and all parties have and continue to act fairly and honestly towards the Insured and with due regard for the interests of the Insured. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Florida Peninsula and its agents assisting in the investigation of the subject claim. At no time has Florida Peninsula acted dishonestly or unfairly toward the Insured and/or her representatives. At no point has Florida Peninsula violated § 626.9541(1)(i) or any portion or subsection within with regards to the claim. Alleged Violations of Policy of Insurance The CRN requires the Complainant to include the specific policy language that is relevant to the violation. Rather than complying with this requirement, the CRN only generally and vaguely refers to virtually every portion of the Policy by referencing “SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section)”. This is clearly improper, nonspecific, over generalized, and noncompliant with the CRN requirements. Moreover, it is clearly not specific but it cites sections of the policy for which no claim for benefits were requested. The failure to comply with this requirement or to provide factual support as to what and how Florida Peninsula purportedly violated the policy prevents Florida Peninsula from engaging in any meaningful review of the policy terms and conditions or actions that the Complainant takes issue with and addressing any issues regarding the policy. Florida Peninsula cannot hit a moving target by attempting to determine what provisions of the policy are actually at issue. As for public policy, this appears to be the exact purpose for the statutory requirements referenced above, which you have violated by failing to accurately provide the policy provisions at issue. Moreover, to the extent the Complainant subsequently intends to rely on specific additional policy provisions, he is precluded from doing so as he failed to properly include those provisions in the CRN. Notwithstanding, Florida Peninsula denies violating any provision or duty set forth in the policy. Thus, the CRN is deficient because it has failed to comply with this requirement wholly. Alleged Factual and Circumstantial Support for the CRN A review of the facts and circumstances surrounding the investigation and claim decisions on the subject claim reveals Florida Peninsula acted in good faith and diligently investigated, handled, and adjusted the claim at issue in this dispute. Florida Peninsula acted fairly, honestly, and in good faith, acknowledged and acted promptly upon receipt of the claim, attempted in good faith to adjust the claim pursuant to the terms of the policy, took reasonable steps to investigate the claim, communicated reasonably and honestly with the Insured and the Insured’s representatives about the claim, and provided the Insured reasonable explanations for its actions. The subject claim involves alleged windstorm damage with a reported date of loss of January 9, 2024 to the property located at 34 Canterbury Woods, Ormond Beach, FL 32174 (the “Property”) not reported to Florida Peninsula until June 11, 2024. Despite the delay in reporting the claim, Florida Peninsula promptly responded with acknowledgement of the claim and the Homeowner Claims Bill of Rights and initiated its investigation of the claim, which included an inspection of the Property by a qualified independent adjuster. Florida Peninsula made a determination of coverage on this claim based on the totality of its diligent, reasonable, and good faith investigation and the terms and conditions of the subject policy and Florida law. Based on the investigation, Florida Peninsula issued its coverage determination letter on October 5, 2024 providing a detailed explanation advising as to the scope of the covered damage, providing the accompanying estimate and issuing the payment for the roof repairs covered by the Policy less the deductible and recoverable depreciation. Florida Peninsula has continued to promptly and fairly adjust the claim as information is made available to it. Florida Peninsula promptly and honestly made all coverage determinations based on its reasonable investigation of the claim. Moreover, contrary to the Complainant’s claims, Florida Peninsula has and continues to promptly respond to all communications, communicate honestly with the Insured and her representatives, and conduct a fair and good faith ongoing investigation of the claim. There is no indication in the CRN nor anywhere within the record evidence to suggest that Florida Peninsula handled the subject claim in bad faith or incongruent with the applicable Florida Statutes. Rather, the record evidence establishes the opposite, and shows that Florida Peninsula properly handled and adjusted the subject claim and has continued to do so from the time it was first received through the present. Furthermore, under the circumstances, and upon information and belief, the filing of the CRN appears to be an effort to strong-arm Florida Peninsula into payment for repairs and excessive benefits for which the Complainant is not entitled under the policy. The disagreement with the claim decision does not in any way constitute bad faith on the part of Florida Peninsula. Under the circumstances presented, Florida Peninsula cannot in good faith issue a payment for damages that are claimed and demanded by the Complainant as doing so would, in essence, breach Florida Peninsula’s duty of good faith and fair dealing owed toward each and every one of its other policyholders. Accordingly, there is no evidence that Florida Peninsula has acted in any way, whatsoever, contrary to the terms of the policy or in violation of the statutes listed in the CRN. III. Demands to Cure Defects. Moreover, the CRN does not specify a cure for the alleged violations that comports with the provisions of the subject Policy. Further, the CRN requests “cures” that are improper according to Florida law and Fla. Stat. §624.155. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278, 1281 (Fla. 2000). The Talat decision provides that a “cure” must be limited to contract damages. Additionally, Section 624.155, Florida Statutes, does not impose on an insurer the obligation to pay whatever its insured demands. Talat, 753 So. 2d at 1282. On the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. The subject Notice is deficient as it does not provide an opportunity to “cure” the alleged violations without imposing obligations on Florida Peninsula not owed or contemplated by the Policy. To the extent the CRN requests anything other than contract proceeds, the CRN is defective and should be rejected. The offer to cure in the CRN, rather, is illusory and even a reading of the CRN in a light most favorable to the Complainant requires that it be invalidated and rejected. Notably, the CRN requests that in order to cure the alleged violations, Florida Peninsula must tender payment in the amount of $59,158.36, less the deductible and prior payment. Based on its thorough investigation, the information received at this time, and the terms and conditions of the Policy, Florida Peninsula properly determined the amount of covered damages, issued payment for that amount less the deductible, and determined no additional amounts were due and owing. IV. Conclusion. In closing, Florida Peninsula first believes that the CRN does not comply with section 624.155, Florida Statutes, and should therefore be rejected and returned by DFS due to its failure to comply with § 624.155, Florida Statutes, and Florida case law. Regardless of the rejection and lack of compliance, Florida Peninsula denies all allegations contained in the CRN and submits there are no violations. While this Response is meant to be comprehensive, Florida Peninsula’s Response above is based upon the limited information provided in the CRN and the information we have to date. If the Complainant feels that we are not in possession of all the facts, please inform us immediately. Please note that Florida Peninsula’s Response is not necessarily exhaustive and does not preclude us from asserting any other valid reason for the lack of compliance with Florida Statute § 624.155. Also, this letter or any act or failure to act on the part of Florida Peninsula or any agent or representative of Florida Peninsula should not 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. We trust that this Response addresses the allegations of insurer violation alleged in the CRN filed on October 17, 2024. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned.

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