Civil Remedy Notice of Insurer Violations
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Filing Number:     787891
Filing Accepted:  10/21/2024
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Complainant
Last/Business Name *  
GORDON   First Name   DEON
Street Address * 6168 GUILFORD CREST DR
City, State Zip * APOLLO BEACH, FL 33572
Email Address * DHGORDON777@HOTMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GORDON   First Name   DEON
Policy # * HOH294189 Claim #* H010024793
Attorney
Attorney is Applicable
Last Name* INNOCENT First Name * KIMBERLY Initial
Street Address* 1580 SAWGRASS CORPORATE PARKWAY, SUITE 130
City, State Zip* SUNRISE , FL 33323
Email Address * KIMBERLY@INNOCENTLAWFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* ANDRE HUDSON
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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)(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.
* 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 COVERAGES COVERAGE A – Dwelling We cover: 1. Paragraph 1. is deleted and replaced by the following. 1. The dwelling on the “residence premises” used mainly as your private residence, including attached structures and attached wall-to-wall carpeting if damage to the dwelling is caused by a covered loss. 2. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises." This coverage does not apply to land, including land on which the dwelling is located. SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. 9. Glass or Safety Glazing Material is deleted and replaced by the following. 9. Glass or Safety Glazing Material a. We cover: (1) The breakage of glass or safety glazing material which is part of a covered building, storm door or storm window; (2) The breakage, caused directly by Earth Movement, of glass or safety glazing material which is part of a covered building, storm door or storm window; and (3) The direct physical loss to covered property caused solely by the pieces, fragments or splinters of broken glass or safety glazing material which is part of a building, storm door or storm window. b. This coverage does not include loss: (1) To covered property which results because the glass or safety glazing material has been broken, except as provided in a.(3) above. (2) On the “residence premises” if the dwelling has been “vacant” or “unoccupied” for more than 30 consecutive days immediately before the loss, except when the breakage results directly from Earth Movement as provided for in a.(2) above. A dwelling being constructed is not considered “vacant” or “unoccupied”. Loss to glass covered under this ADDITIONAL COVERAGE 9. will be settled on the basis of replacement with safety glazing materials when required by ordinance or law. This coverage does not increase the limit of liability that applies to the damaged property. SECTION I – CONDITIONS 2. Your Duties After Loss. The first paragraph is deleted and replaced by the following: 2. Your Duties After Loss. In case of a loss to covered property, we have no duty to provide coverage under this Policy if the failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: Paragraph 2.a. is deleted and replaced by the following: a. Give prompt notice to us or our agent; Except for reasonable emergency measures taken under SECTION I – Property Coverages, Reasonable Emergency Measures, there is no coverage for repairs that begin before the earlier of: (1) 72 hours after we are notified of the loss; (2) The time of loss inspection by us; or (3) The time of other approval by us; If you unreasonably deny us accessto inspect the loss during the period in a.(1) above, coverage for repairs beyond reasonable emergency measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. If windstorm coverage is provided in this policy, then in the case of a windstorm or “hurricane loss”, you must give us notice of the initial claim, “supplemental claim”, or “reopened claim” within three years after the hurricane first made landfall or the windstorm caused the covered damage. The following is added to 2. Your Duties After Loss. h. At our request, provide to us or execute an authorization which allows us to obtain on your behalf, records and documentation we deem relevant to the investigation of your loss. i. To the degree reasonably possible, (1) Retain the damaged property; (2) Allow us to inspect, subject to i.(1) above, all damaged property prior to its removal from the “residence premises”; and (3) Keep an accurate record of repair expenses. The following is added to the end of 2. Your Duties After Loss. The duties listed apply regardless of whether you, an “insured” seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. 3. Loss Settlement. Paragraphs b.(4) and (5) have been deleted and replaced by the following: (4) We will initially pay at least the actual cash value of the insured loss, less any applicable deductible. We will pay any remaining amount necessary to perform such repairs as work is performed and expenses are incurred. If a total loss of a building or structure insured under this policy occurs, we will pay the replacement cost coverage without reservation or holdback of any depreciation in value, subject to policy limits.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Heritage Property & Casualty Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Deon Gordon and Shelly Gordon’s (“INSUREDS”) claim of loss. INSURER’S principal address is 1401 N Westshore Blvd. Tampa, FL 33607. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSUREDS' insurance claim for damages. INSURER has failed to promptly settle the INSUREDS’ insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSUREDS' pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSUREDS under the policy. This claim involves the INSUREDS' property located at 6818 Guilford Crest Dr, Apollo Beach, FL 33572, which sustained significant damage from a Wind damage loss on or around September 28, 2022. Specifically, the INSUREDS reported a Hurricane Ian-related loss on or around September 28, 2022, under the subject policy issued by Heritage. Following this report, Heritage’s adjuster inspected the property and confirmed damage consistent with the claim, including water stains on ceilings, temporary repairs to drywall, stucco cracks, and the roofing system. On September 5, 2024, Andre Hudson, on behalf of Heritage, issued a Request for Information Letter that misleadingly suggested coverage might not exist for the reported date of loss, stating: *"We identified the following questions that may restrict, limit, or preclude recovery of the damages reported: **Whether there was a policy of insurance in effect for the reported date of loss." Heritage did not produce a certified copy of the policy confirming coverage until September 30, 2024, despite multiple prior requests. This delay led to an erroneous change of the date of loss to January 9, 2024, after the coverage had lapsed. Further, on October 14, 2024, Heritage sent a letter incorrectly denying coverage for the claim, alleging a breach of the policy condition that requires prompt notice of the claim and submission of relevant records and documents. This denial came despite the INSUREDS repeatedly advising that they were unaware of the extent and nature of the damage until on or about August 30, 2024. Upon discovering the damage and its potential connection to a January wind event, they promptly reported the loss on September 4, 2024, consistent with their obligations under the policy. The INSUREDS made reasonable efforts to inspect their property and notify Heritage as soon as they identified that the damage could lead to a claim. Additionally, the Insureds timely responded to: - Heritage’s Reservation of Rights letter dated September 5, 2024, on September 5, 2025. - Heritage’s September 5, 2024, Request for Information Letter on September 13, 2024. - Heritage’s Additional Request for Information Letter dated September 30, 2024, on October 9, 2024. - Heritage’s actions constitute violations of Florida’s Unfair Claim Settlement Practices Act, Fla. Stat. §§ 624.155 and 626.9541, including: - § 626.9541(1)(i)3b: Misrepresenting pertinent facts or insurance policy provisions related to coverages at issue. Heritage misrepresented coverage status and breached its duty to clearly communicate policy provisions to the Insured. - § 626.9541(1)(i)3c: Failing to acknowledge and act promptly upon communications regarding the claim. Heritage failed to provide a certified copy of the policy in a timely manner, despite repeated requests. - § 626.9541(1)(i)3d: Denying claims without conducting reasonable investigations based on available information. Heritage denied coverage based on an alleged failure to provide prompt notice, despite evidence that the Insureds acted as soon as they discovered the potential loss. - § 626.9541(1)(i)2: Making a material misrepresentation to an insured or any other person having an interest in the proceeds payable under the policy, for the purpose of effecting settlement on less favorable terms than those contemplated by the policy. The INSUREDS have retained a Loss Consultant, Adam Donatelle of Donatelle Claim Advisors, who has prepared an estimate of the INSUREDS' damages, which totals $87,476.80. Therefore, demand is hereby made as follows: Estimate $87,476.80 Less Deductible $5,711.00 TOTAL $81,765.80. The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSUREDS may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSUREDS were and still are, forced to expend out of pocket monies to submit their insurance claim, e.g., retaining a loss consultant, an attorney, and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSUREDS. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSUREDS is wrongful conduct. Furthermore, the INSUREDS contend that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. Heritage’s repeated misrepresentations, failure to provide necessary documentation, and unjust denial of the claim demonstrate a general business practice that restricts the Insureds' rights under the policy. To cure these violations, Heritage must: 1. Reopen the Hurricane Ian claim, with a date of loss on or around September 28, 2022, and reclassify the January 9, 2024, claim as closed in error. 2. Pay the claim in full, based on the verified damages reported by Heritage’s field adjuster. 3. INSURER must tender to the INSUREDS $81,765.80 as set forth above plus interest. 4. Provide written confirmation of coverage for the reported date of loss and promptly issue any undisputed payment. Heritage has 60 days from the date of this notice to cure the violations outlined herein by adjusting the claim fairly, in good faith, and in accordance with the policy terms and applicable law. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155.
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ncarlisle@heritagepci.com 12-02-2024 December 2, 2024 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Deon Gordon Insured: Deon Gordon Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 787891 Claim No: H010024793 Policy No.: HOH294189 Address: 6818 Guilford Crest Dr, Apollo Beach, FL 33572 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 787891, filed on behalf of Heritage’s insured Deon Gordon (“Complainant”). The Department accepted the Notice on October 21, 2024. While Heritage welcomes the opportunity to respond to the Notice filed concerning this claim, it responds to it specifically denying each and every allegation contained in the Notice. Heritage believes that the Notice should be rejected and returned by the Department of Financial Services as it fails to comply with the specific information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions as promulgated in Florida Statute and Florida Case law. More specifically, Florida Statute §624.155(3)(b)(2) requires the Complainant to “describe the facts and circumstances giving rise to the insurer’s violation” to enable the insurer to investigate and resolve the claim. Contrary to the requirement set forth in the statute, this Notice contains overbroad and incorrect allegations, which stem only from the Complainant’s opinions regarding the value of his own claim and, therefore, the Complainant’s opinions regarding Heritage’s adjustment of this claim. Moreover, Florida Statute §624.155(3)(b)(4) requires the Complainant to refer to specific policy language that is relevant to the alleged violation, if any. The Notice contains a list of violations that Heritage has allegedly committed but fails to provide an adequate basis in support of those allegations and, on that basis alone, fails to satisfy the basic requirements of an otherwise proper Notice. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Fla. Stat. §§ 624.155 and 626.9541. As such, the Notice does not comply with Florida law and is legally insufficient. For clarification, Heritage provides a brief history of the claim: Subject to its terms, endorsements, limitations, exclusions, and conditions, the Complainant was issued Policy HOH294189 (“Policy”) for property located at 6818 Guilford Crest Dr, Apollo Beach, FL 33572 (“Property”). The Policy of Insurance applies to direct physical loss of or damage to covered property at the premises described in the Declarations of the Policy or resulting from any Covered Cause of Loss as described in the Policy. Upon receiving the Complainant’s first notice of loss on September 4, 2024, claiming damages from Hurricane Ian on September 28, 2022. Heritage promptly assigned claim number H010024793. On the same day the loss was reported, Heritage issued its acknowledgment letter and Bill of Rights to the Complainant. Heritage also received a letter of representation from the Complainant’s attorney, The Innocent Law Firm. On September 5, 2024, Heritage’s representative made initial contact with Complainant’s attorney, Kimberly Innocent. Following the initial contact, Attorney Innocent wrote back to Heritage informing Heritage that their office submitted the reported date of loss of September 28, 2022 – Hurricane Ian, in error. The e-mail also advised that the Complainant first became aware of the damages on or about August 30, 2024, after a third-party inspection. Attorney Innocent advised that it was believed that the wind event precipitating the damage occurred on or about January 9, 2024. The attorney further requested Heritage’s representative to correct the date of loss in the claim file to reflect the proper wind event date of January 9, 2024. Lastly, the attorney requested Heritage to “promptly advise if there is any issue regarding the policy period in relation to this corrected date of loss.” After the conversation, Heritage issued a Reservation of Rights letter with a Request for Information to assist in investigating the claim. Heritage requested Complainant to provide Heritage an opportunity to obtain Complainant’s recorded statement; the last 3 most recent Mortgage Statements; Pre-Purchase Home Inspection Report, 4 Points Inspection Report, Wind Mitigation Report and the Sellers Disclosure Report; an estimate, photos, report, and other documents associated with the loss. Additionally, Heritage acknowledged the letter of representation the Complainant's attorney provided. As part of the claim handling, Heritage’s field adjuster, Tim Tourville, coordinated an inspection of the Property. Complainant requested the inspection to occur on September 12, 2024, and the on-site inspection documented the interior and exterior conditions of the property. Complainant and his representative, Adam Donatelle, were present for the inspection. The field adjuster noted prior interior and exterior repairs and that the roof was in poor condition. On September 13, 2024, Complainant responded partially to Heritage’s request for information. Heritage received partial pre-purchase home documents, and the loss consultant’s photos and estimate. On September 20, 2024, Heritage’s representative and Complainant’s attorney spoke, and Heritage advised that the date of loss could not be changed and that to address another date of loss, Complainant would need to file another claim with the correct date of loss. Additionally, Heritage advised that it had no affiliation with Aspen Contracting after Complainant’s attorney alleged that Heritage’s representatives came out to the insured’s home without any notice. In response, Complainant’s attorney reiterated that the date of loss of September 28, 2022 – Hurricane Ian could be “noted as opened in error.” The attorney further advised that if Heritage’s representative could not correct the date of loss, then the representative should open a new claim to reflect the accurate date of the wind event [January 9, 2024]. Additionally, the attorney again asked to confirm whether there were any issues regarding the policy period in relation to the corrected date of loss. On September 23, 2024, Heritage’s representative responded to Complainant’s attorney advising that if this date of loss 9/28/2022 was incorrect, a new claim reflecting the correct date of loss needed to be reported. In response, Attorney Innocent reiterated a prior request that the claim be closed as opened in error and a new claim opened with the correct date of loss, and asked if the new claim has been opened to avoid unnecessary delays in the adjustment. On September 30, 2024, Heritage’s representative submitted a certified copy of the Policy to Complainant’s attorney. Heritage also submitted a second request for information. On October 2, 2024, Complainant’s attorney advised that they reported on September a new claim on September 27, 2024, with the correct date of loss – January 9, 2024. Heritage’s claims department advised that they were having system issues, that the report would have to be inputted manually into the system, and that no claim number had been generated. On October 9, 2024, in response to Heritage’s second request for information, Complainant’s attorney provided additional availability for a recorded statement, resubmitted partial pre-purchase home documents, and the loss consultant’s photos and estimate. The written response further advised Heritage that ‘it appears that a recorded statement is no longer necessary since Heritage has confirmed that the Insureds’ coverage was transferred to Citizens on the date of loss, which is believed to be January 9, 2024. As such, we respectfully request that both claims be updated to reflect that they were opened in error.” It further stated that “[t]he undersigned law firm erroneously reported the claim with a date of loss of September 28, 2022, and has subsequently reported a new claim as instructed, with the corrected date of loss of January 9, 2024, which has been assigned claim no.HOH294189. Based on the response received, it appears that the Insureds’ coverage was transferred to Citizens at that time. As such, we respectfully request that both claims be updated to reflect that they were opened in error.” October 14, 2024, after conducting a reasonable investigation based on available information to Heritage, in accordance with its obligations under §627.70131, Fla. Stat., Heritage issued a letter including a written explanation of the coverage decision to Complainant, which included pertinent facts and insurance policy provisions relating to coverages at issue. The letter further cited that Complainant’s attorney has advised that the date of loss of September 28, 2022, was reported in error, and the actual date is January 9, 2024. Additionally, Complainant’s attorney has acknowledged that Heritage policy was not in effect on the new date of loss of January 9, 2024, which is a material aspect to the claim. Therefore, Heritage denied coverage for the claim based upon a breach of the policy condition that requires prompt notice of the claim and to provide records and documents we deem relevant to the investigation of the claim. Additionally, Heritage informed that as part of the investigation, Heritage requested the services of an engineering firm, ESI Engineering Systems, to confirm the cause and origin of any damage to the property as a result of the reported loss. However, Heritage was not able to complete the investigation as Complainant’s attorney advised that the claim was reported in error, as Complainant’s policy with Heritage was not in effect for the correct date of loss, which was repeatedly reported to be January 9, 2024. On October 21, 2024, in response to the coverage determination, Complainant’s attorney wrote to Heritage disputing the coverage determination letter. Additionally, Complainant’s attorney requested that the Hurricane Ian claim, with a date of loss on or around September 28, 2022, be reopened, and the January 9, 2024, claim should be reclassified as closed in error. The attorney asked for the earliest availability for both the recorded statement and the engineering inspection. On the same day, Complainant's attorney filed this notice, to which Heritage has responded. On October 28, 2024, a Notice of Intent to Initiate Litigation (“NOI”) was filed through the Department. In the notice, Complainant alleged that “[o]n September 5, 2024, Heritage misleadingly suggested that coverage might not exist for the reported date of loss and delayed providing a certified copy of the policy until September 30, 2024, despite repeated requests. Heritage’s actions contributed to an erroneous change of the date of loss to January 9, 2024, after coverage had lapsed. On October 14, 2024, Heritage denied the claim, citing failure to provide prompt notice, despite the Insureds’ timely reporting once they discovered the damage on August 30, 2024.” Heritage responded to the NOI by maintaining its decision to prior denial of coverage. Additionally, a reinspection of the property has been coordinated as requested by Complainant’s counsel. Notwithstanding the unsupported and contradictory allegations in the NOI and Notice, it appears that the Complainant has been shopping for a date of loss and picking the carrier it wants to have an alleged claim adjusted. In accordance with Fla. Stat. §624.155, the Civil Remedy Notice requires Complainant, “to indicate all statutory provisions alleged to have been violated.” The Notice alleges the reasons for the Notice are the following: Claim Denial The Notice fails to state who, how, and when a “claim denial” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Unfair Trade Practice The Notice fails to state instances of “unfair trade" practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Further, the Notice filed in this matter alleges Heritage violated the following statutory provisions: 1. 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly toward its Complainant and with due regard for his or her interests. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. 2. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information do not support a covered loss as demanded by Complainant. Further, the Notice fails to specifically identify the “misrepresenting facts or insurance policy provision” allegedly committed by Heritage. Therefore, this is an unsupported, sweeping allegation and is without merit. 3. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Additionally, the Notice fails to specifically identify how Heritage fails “to adopt and implement standards for the proper investigation of claims.” Therefore, this is an unsupported, sweeping allegation and is without merit. 4. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received and obtained do not support a covered loss as demanded by Complainant. Further, the Notice fails to specifically identify the “misrepresenting facts or insurance policy provision” allegedly committed by Heritage. Therefore, this is an unsupported, sweeping allegation and is without merit. 5. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always promptly acknowledged communications and acted promptly in furtherance of the resolutions of the claim. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received and obtained do not support a covered loss as demanded by Complainant. The Notice fails to specifically identify instances where Heritage failed “to acknowledge and act promptly upon communications.” Therefore, this is an unsupported, sweeping allegation and is without merit. 6. 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. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has promptly provided a reasonable explanation in writing to Complainant of the basis in the insurance policy, in relation to the facts or applicable law, for the denial. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. The Notice fails to specifically identify instances where Heritage failed “to promptly provide a reasonable explanation in writing to the insured [. . .].” Therefore, this allegation is an unsupported, sweeping allegation and without merit. As detailed by the facts stated above, Heritage Property & Casualty Insurance Company did not violate any of the statutes mentioned above sections. Heritage has diligently and thoroughly investigated the subject claim, followed up with Complainant for reinspection and documents supporting their claim, and provided a coverage determination. The purpose of the Civil Remedy Notice is to provide the insurer notice of the issue its Complainant has with the claim and what it is seeking to remedy that issue. However, it is important to note that Insurers are not required to pay any amount demanded by their Complainants to avoid a bad-faith claim. Rousso v. Liberty Surplus Ins. Corp., 2010 U.S. Dist. LEXIS 82328, at *14-15 (S.D. Fla. Aug. 13, 2010). The Florida Supreme Court has held that an insurer's appropriate response to a Civil Remedy Notice filed pursuant to Fla. Stat. 624.155 is “based upon the insurer's good-faith evaluation of what is owed on the insurance contract.” Vest v. Travelers Ins. Co., 753 So. 2d 1270, 1275 (Fla 2000). The Court further stated, “What is owed on the contract is . . . governed by whether all conditions precedent for payment contained within the policy have been met.” Id. For its part, an insurer “must evaluate a claim based upon proof of loss required by the policy and its expertise in advance of a determination by a court or arbitration.” Id. at 1275-76. See also Julien. Heritage’s position is that it has complied, in good faith, with these obligations. Furthermore, the Complainant’s Notice failed to provide any cure for the alleged defects as required by Florida Case law. Specifically, the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000), provides that the scope of what can be “cured” is limited to the alleged non-payment of the contractual amount due the Complainant. Talat also commented that “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the Complainant. In the context of a first-party insurance claim, the contractual amount due to the Complainant 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. In short, similarly to Rousso, the Notice reflects a “shotgun-blast effort to hit a lot of targets with a single salvo. This approach is contrary to the purpose of the statute.” The Notice must reflect a good-faith effort to inform Heritage of how it has fallen short of its obligations under the policy and what it can do to fix its shortcomings. Thus, the Notice is insufficient as a matter of law. Under § 624.155, Heritage is entitled not only to a clear proposed solution, but also more and accurate details about how Heritage fell short of its obligations to provide coverage pursuant to the terms of the insurance agreement. As such, the Notice is deficient, and the Complainant has failed to comply with several conditions precedent to bringing a claim under §624.155. Heritage Property & Casualty Insurance Company believes that the Notice should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Moreover, regardless of the rejection, Heritage denies all allegations contained in the Notice and submits there are no violations. While this response is meant to be comprehensive, Heritage Property & Casualty Insurance Company’s response above is based upon the limited information provided in the Notice and the information we have to date. If Complainant feels that Heritage does not have all the facts, please inform Heritage immediately. In closing, Heritage denies each and every assertion of bad faith in the Notice. And, notwithstanding the foregoing, nothing in this letter should be construed as a waiver or surrender of the policy terms, limitations, exclusions, conditions or agreements, nor should this letter be considered an exhaustive recitation of the deficiencies in the Notice. Heritage reserves the right to supplement its response at a later time. Should the Department have any questions, concerns, or require any additional information regarding this matter, please feel free to contact the undersigned at your convenience. Sincerely, /s/ Priscila Ferreira Priscila Ferreira, Esq. Claims Counsel Heritage Property & Casualty Insurance Co.
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