Civil Remedy Notice of Insurer Violations
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Filing Number:     788365
Filing Accepted:  10/23/2024
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Complainant
Last/Business Name *  
JLRM, LLC   First Name  
Street Address * 428 DEL PRADO BLVD N
City, State Zip * CAPE CORAL, FL 33909
Email Address * YIA24@YOURINSURANCEATTORNEY.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JLRM, LLC   First Name  
Policy # * SPPK0002256-03 Claim #* 10002318
Attorney
Attorney is Applicable
Last Name* DIAMOND First Name * PETER Initial
Street Address* 2601 S BAYSHORE DRIVE 5TH FLOOR
City, State Zip* COCONUT GROVE , FLORIDA 33133
Email Address * PD@YOURINSURANCEATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SAFEPOINT INSURANCE COMPANY
NAIC Company Code 15341
 
Name of individual responsible for violation (if any):* SUSAN CAMPBELL
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Failure to timely adjust the claim and pay the claim within the prescribed statutory claim period
* 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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
* 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 entire policy is incorporated herein as a basis for the specific policy language for which is relevant to the violation.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Shortly after Hurricane Ian the Insured filed an insurance claim against the insurer for various damages. The carrier acknowledged the claim and commenced claim investigation and adjustment. The insurer failed to make a claims determination within the prescribed statutory deadline and when the carrier did make payment. The carrier made an Actual Cash value (ACV) payment of $941,431.07. The insured completed the necessary repairs and demanded the carrier to pay the withheld depreciation of $47,796.67. The insured provided a proof of those repairs. The carrier is wrongfully withholding depreciation totaling $47,796.67. Further, the insured provided a claim for Business Interruptions. The insured provided support for this interruption of damage. Simply put, the insured has lost rent of over $5,000.00 per month since the date of loss, which far exceeds the value limits for Business Interruption. Demand is made for $203,556.34. The damages evaluated by the carrier are insultingly low. With regard to the damage to the insured property, the carrier turned a blind eye to reality and instead claimed to see/find $941,431.07 in total damages to the property. Please note that the insured timely submitted a sworn statement in proof of loss totaling $2,209,750.00 in building damages. Moreover, the carrier did not issue any payment for the Loss of Business Income, despite the insured proving a loss of business income in the amount of $91,800.00. The carrier is not attempting and has not attempted, 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 the insured’s interests. As stated above, the carrier received the insured’s SSPOL. Since that time, the carrier has not issued full payment and instead has dragged its feet in adjusting the claim and more importantly resolving the claim. The insured has attempted in good faith to resolve this matter, but the carrier refuses to respond. In fact, the insured sent its most recent demand to the carrier on August 8, 2024, via email. The insured has followed up multiple times, and the carrier refuses to respond. The carrier has also withheld depreciation in the amount of $47,796.67. The carrier has completely failed to promptly settle the insured’s claim, despite a clear obligation to settle a claim should have become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. The Carrier failed to acknowledge and act promptly upon communications with respect to claims. The insured has been left in the dark regarding the end date for claim resolution and all along the carrier has not fully indemnified the insured who has suffered tremendous losses. The insurer should have recognized immediately that the insurer low balled the insured on claim value and should immediately tender payment for the full value of the claim. To cure this blatant bad faith claim handling, the insurer can immediately tender the following amount $139,596.67 for indemnity. Additionally, the insured seeks compensation for attorney's fees and costs of $13,959.67 plus interest, as well as $50,000.00 for the bad faith delay and claims handling failures. Total Damages to resolve this entire CRN, conditioned on a release, is $203,556.34.
Comments
User Id Date Added Comment
jbrookings@safepointins.com 12-20-2024 December 20, 2024 VIA EMAIL: PD@YOURINSURANCEATTORNEY.COM Peter Diamond, Esq. 2601 S Bayshore Drive, 5th Floor Coconut Grove, Florida 33133 RE: Insured: JLRM, LLC Claim Number: 10002318 Policy: SPPK0002256-03 Date of Loss: 9/28/2022 CRN Filing Number: 788365 Dear Sir/Madam: Please allow this to serve as SafePoint Insurance Company (“SafePoint”) formal response to the above-referenced Civil Remedy Notice (“Purported Notice”) filed on behalf of JLRM, LLC (“Insured” / “Complainant”). The Florida Department of Financial Services accepted the Purported Notice, in form only, on October 23, 2024. As a preliminary matter, the parties have reached an amicable resolution of the disputed claim on December 10, 2024. Notwithstanding, the Purported Notice was filed in connection with an alleged insurance claim for property damage by the Insured. The Purported Notice names SafePoint and alleges Claim Delay, Unsatisfactory Settlement Offer, Unfair Trade Practice and Failure to timely adjust the claim and pay the claim within the prescribed statutory claim period allegedly in violation of Sections 624.155(1)(b)(1); 624.155(1)(b)(3); 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(c); 626.9541(1)(i)(3)(e) and 626.9541(1)(i)(3)(g) Florida Statutes. The Purported Notice is a legal nullity for the four reasons discussed below. SafePoint reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. 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; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added); The Florida Supreme Court has held that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10-363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. Deficiency #1 Section 624.155(3)(b)(4), Florida Statutes, requires the CRN to reference 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. Complainant is the Insured and not third-party; therefore, the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. It does not. Rather, the Purported Notice makes a vague and general reference to subject provisions from an unknown insurance policy and states the following: “The entire policy is incorporated herein as a basis for the specific policy language for which is relevant to the violation.” General, vague and overbroad references to policy provisions does not satisfy the specificity required by § 624.155(3)(b)(4), Fla. Stat. As such, the Purported Notice is deficient as a matter of law. This deficiency applies to all allegations in the Purported Notice, including but not limited to Claim Delay, Unsatisfactory Settlement Offer, Unfair Trade Practice and Failure to timely adjust the claim and pay the claim within the prescribed statutory claim period allegedly in violation of Sections 624.155(1)(b)(1); 624.155(1)(b)(3); 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(c); 626.9541(1)(i)(3)(e) and 626.9541(1)(i)(3)(g) Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Junior Julien v. United Property and Casualty Insurance Company, No. 4D19-2763. In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Purported Notice fails to “state with specificity” the policy language at issue. Deficiency # 2 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply specific facts or circumstances that explain the allegations. Rather, the Purported Notice contains incorrect facts and fails to explain how the purported facts constitute violations of Florida law. For example, the Purported Notice states, “The insurer failed to make a claims determination within the prescribed statutory deadline and when the carrier did make payment.” However, these statements are entirely conclusory, and inaccurate. This is a claim for roof and interior damage that was late reported by Claimant’s attorney, Gauthier Murphy & Houghtaling LLC on October 28, 2022, thirty (30) days after the alleged date of loss, September 28, 2022. On November 13, 2022, SafePoint retained an independent adjuster, Insurance Claims Unlimited who inspected the subject property and documented any visible damage, including wind damage to the roof system and water damage to the interior retail spaces. On November 23, 2022, to further assist in the investigation of the loss SafePoint retained HVACi investigators to evaluate the rooftop HVAC units. The HVACi report recommended the replacement of 5 condenser units, and 9 HVAC systems due to wind and impact damage. As such, on January 16, 2023, contrary to the assertions in the Purported Notice, “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…” SafePoint promptly notified the Complainant of its coverage decision and approved the covered portion of the loss. Interior repairs were excluded from the estimate as they are the responsibility of the individual tenants. SafePoint prepared an estimate for the replacement cost value – Building Cost of Repairs, totaling $786,811.82. After accounting for Co-Insurance adjustments ($739,603.11), Recoverable Depreciation ($111,610.23), Non-Recoverable Depreciation ($0.00), and the Hurricane Deductible ($77,112.00), a net payment of $550,880.88 was issued to the Complainant. Further, contrary to the assertion in the Purported Notice, “With regard to the damage to the insured property, the carrier turned a blind eye to reality and instead claimed to see/find $941,431.07 in total damages to the property”, however, that amount of damages was determined through an independent appraisal process, conducted under the terms and conditions of the Policy. Both parties participated in this appraisal, each with their own appointed appraiser. The appraisal award (“Award”) issued on June 8, 2023, reflects the findings of this independent assessment, including input from the Complainant's appraiser. Payment was issued to Complainant in full compliance with this Award shortly thereafter on June 14, 2023. Finally, the Purported Notice claims that “SafePoint is wrongfully withholding depreciation totaling $47,796.67.” However, the Policy allows for depreciation, which accounts for the reduction in value due to age, condition, deterioration, and obsolescence. The Policy includes replacement cost coverage, enabling recovery of the withheld amount for recoverable depreciation by providing documentation such as a signed contract for repairs, paid invoices or receipts, or photographs of completed repairs. The amount of recoverable depreciation pursuant to the Award withheld was $40,155.06. Upon receipt of the final repair invoice from Complainant, SafePoint released the full recoverable depreciation per the Award in the amount of $40,155.06 to Complainant on November 13, 2024, well within the cure period of the Purported Notice. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. The above noted deficiencies apply to all allegations in the Purported Notice, including but not limited to Claim Delay, Unsatisfactory Settlement Offer, Unfair Trade Practice and Failure to timely adjust the claim and pay the claim within the prescribed statutory claim period allegedly in violation of Sections 624.155(1)(b)(1); 624.155(1)(b)(3); 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(c); 626.9541(1)(i)(3)(e) and 626.9541(1)(i)(3)(g) Florida Statutes. Deficiency #3 The Purported Notice does not supply necessary information that would allow SafePoint to “cure” the alleged violations without paying benefits which are not due and owing to the Complainant, as required by Florida law. The purpose of a Civil Remedy Notice is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). However, Section 624.155, Florida Statute, does not impose on an insurer the obligation to pay whatever an insured demand. Talat, 753 So. 2d at 1282. To 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. Here, Complainant demands extra contractual damages, “Additionally, the insured seeks compensation for attorney's fees and costs of $13,959.67 plus interest, as well as $50,000.00 for the bad faith delay and claims handling failures.” As such, the Purported Notice is deficient as it does not provide SafePoint an opportunity to “cure” the alleged violations without paying extracontractual damages. As noted by Judge Glazebrook and the Florida Supreme Court, Section 624.155, Florida Statutes does not contemplate requests for payment of attorney’s fees and costs in Civil Remedy Notices. SafePoint is only obligated to pay contractual amounts owed to cure a civil remedy. See id. at 1278. Deficiency # 4 Finally, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity and as outlined herein as well as including but not limited to, the use of the attorney’s firm’s email address, “YIA24@YOURINSURANCEATTORNEY.COM” for that of the Complainant. Therefore, the Purported Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. See Pin Pon, 2020 WL 6588379; 2021 WL 824438. STATUTORY ALLEGATIONS 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. SAFEPOINT denies the allegation that it violated the above referenced statute. The allegations set forth in the Purported Notice are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and intended solely to tarnish SafePoint’s name and reputation. SafePoint has at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. SafePoint unequivocally denies each and every allegation asserted in the Purported Notice. At no time has SafePoint breached any duty to the Complainant. An insurer is not required to pay whatever amount the Insured demands. SafePoint did not fail to promptly settle the claim or attempt to settle the claim in order to influence settlement under a different portion of the policy. SafePoint conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. SafePoint promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. SafePoint retained an independent field adjuster and conducted an inspection of the subject property to investigate the Complainant’s claim. Thereafter, SafePoint made a coverage decision, issued payment to the Complainant, engaged in the appraisal process, issued the awarded amount, and released the recoverable depreciation. This was done in full compliance with the terms and conditions of the Policy, thereby fully satisfying its obligations under all applicable Policy language and statutes for the covered portion of the loss. Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, SafePoint denies any wrongdoing. It specifically denies that it committed the acts asserted or violated Florida Statutes as alleged in the Purported Notice. Please be advised, by this letter, SafePoint neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the Policy. In fact, SafePoint hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/Ari Zeltzer Ari A. Zeltzer, Esq. Staff Counsel SafePoint Insurance Cc: Florida Department of Financial Services
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