Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 788341

Filing Accepted: 10/23/2024

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Complainant

Last/Business Name *

MARTINEZ

First Name

JULIO

Street Address *

770 PONCE DE LEON BLVD, STE 101

City, State Zip *

CORAL GABLES, FL 33134

Email Address *

JULIO@MSPGLAWGROUP.COM

Complainant Type: *

Other

Insured

Last/Business Name*		DUARTE		First Name		EDGAR
Policy # *		12-1008822-02		Claim #*		12-3007012-22

Attorney

Attorney is Applicable

Last Name*	MARTINEZ First Name * JULIO Initial
Street Address*		770 PONCE DE LEON BLVD, STE 101
City, State Zip*		CORAL GABLES , FL 33186
Email Address *		JULIO@MSPGLAWGROUP.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		TYPTAP INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 15885

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

Reason for Notice *

Other : Bad faith claim negotiation and Improper Denial

* 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.
	626.9541(1)(i)(2)		A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(b)		Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.

* 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 – PERILS INSURED AGAINST A. COVERAGE A – DWELLING AND COVERAGE B – OTHER STRUCTURES 1. We insure against direct physical loss to the property described in Coverage A and B . .

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

On or about July 25 2022, the Insureds suffered a loss on account of Water Damage causing damage to Insureds’ property (hereinafter “Water Damage Claim”). The Insurer assigned claim number 12-3007012-22. However, Insurer failed to promptly acknowledge receiving claim communication, they also failed to pay or deny the claim within 90 days. Insurer has failed to maintain complete claim records and provide required identification an license information to the policy holder. honor Insurer has failed to property calculate interest on undisputed payments. As such, Insurer has failed to fully, or even partially, indemnify the Insureds as it was contractually obligated to do pursuant to the subject Policy. After a lawsuit commenced, the insurer sent the policyholder a notice of nonrenewal, presumably because there is an open claim. Insurer violated numerous Florida Statutes in its handling of Insureds’ claim. Insurer did not attempt in good faith to settle claims when, under all circumstances, it could and should have done so, made a material misrepresentation for the purpose and with the intent of effecting settlement of such claims, loss or damage on less favorable terms than those provided in the policy, and misrepresented pertinent facts or insurance policy provisions relating to Coverages at issue. [626.9541(1)(i)(2)] [626.9541(1)(i)(3)(b)] [624.155(1)(b)1] Further, by ignoring obvious _damage resulting from the claim, Insurer failed to adopt and implement standards for the proper investigation of claims, and effectively denied the remained of Insureds’ claim without conducting reasonable investigations based on available information. [626.9541(1)(i)(3)(d)] [626.9541(1)(i)(3)(a)] Insurer can cure this breach by paying insurance monies due and owed to the Insureds that would reasonably place them back to their pre-loss condition, as well as compensating the Insureds for incurred Additional Living Expenses, as well as any and all reasonable attorney’s fees and costs incurred to them to date in connection with this claim and stemming from the aforementioned violations by the Insurer. This notice is given in order to perfect the right to pursue the Civil Remedy Authorized by this section. Further, by closing this claim out, per the terms and conditions of the policy as alleged by the insured, they will be able to obtain insurance on their property. Insurer did not attempt 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 insured and with due regard for her or his interests, specifically when it refused to renew the policy of insurance with the insured. [624.155(1)(b)1] Curable for $205,846 plus reasonable attorney’s fees and costs

Comments

User Id		Date Added		Comment
claims@typtap.com		12-20-2024		This is TypTap Insurance Company’s (“TypTap”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Complainant Julio Martinez. TypTap reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, TypTap issued payments for it on the information available to TypTap and the circumstances at the time of such payments. TypTap handled the claim in accordance with the policy and all statutory and regulatory requirements. TypTap denies each allegation of bad faith and improper conduct in the CRN. At all times, TypTap acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Otherwise, the CRN is deficient. Generally, pursuant to Florida Statutes, Section 624.155, CRNs must identify and set forth statutory provisions insurers allegedly violated in handling insureds’ insurance claims along with specific, relevant insurance contract language and facts and circumstances. The foregoing provides insurers with notice of alleged statutory violations AND the opportunity to cure such alleged violations. Instead of complying with Florida Statutes, Section 624.155, the Complainant in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; and relied on inaccurate and conclusory statements. The Complainant’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Further, Julio Martinez does not have standing to have filed the CRN as the named Complainant. For instance, TypTap has never provided insurance to Julio Martinez and moreover, Julio Martinez has no cause of action against TypTap for extra-contractual damages or otherwise under Florida law. Furthermore, the Insured’s attorney filed a lawsuit based on the claim prior to the filing of this CRN. Regardless of the fact there were no violations in this claim, any action by TypTap to cure violations alleged in the CRN could have been used against TypTap in the lawsuit. The foregoing shows abuse by the Insured and the Insured’s attorney of the CRN and legal processes. Also and generally, the CRN constitutes an abuse of the CRN process, contravenes the purpose of CRNs, which is to promote resolution of issues in insurance claims. The CRN must be rejected, and it cannot serve as the basis of any action against TypTap. Upon request by the Florida Department of Financial Services, TypTap will provide to the DFS detailed correspondence TypTap provided regarding the claim.

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