Civil Remedy Notice of Insurer Violations
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Filing Number:     788592
Filing Accepted:  10/24/2024
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Complainant
Last/Business Name *  
AGOSTO   First Name   MOISES
Street Address * 534 LOCKBREEZE DRIVE
City, State Zip * DAVENPORT, FL 33897
Email Address * JJS@WEKLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   AGOSTO   First Name   MOISES
Policy # * P000522053 Claim #* 253907
Attorney
Attorney is Applicable
Last Name* SAIDENSTAT First Name * JEFFREY Initial
Street Address* 800 EAST BROWARD BLVD. SUITE 510
City, State Zip* FORT LAUDERDALE , FL 33301
Email Address * JJS@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SECURITY FIRST INSURANCE COMPANY
NAIC Company Code 10117
 
Name of individual responsible for violation (if any):* ALEXANDER WALTER; LICENSE NUMBER W621487; TODD MIGACZ
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

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

At all times material hereto, Security First Insurance Company insured Moises Agosto’s home under a policy of insurance. The subject policy provides coverage for sudden and accidental losses and damages arising from hurricanes. The loss payment provision and governing law provides that the insurer has a fiduciary duty to in good faith promptly investigate, adjust, and issue payment of the undisputed amount of the loss and damages. See Doe v. Allstate Ins. Co., 653 So. 2d 371, 374 (Fla. 1995) (stating that the obligation of insurance company toward insured is a "fiduciary duty requiring the exercise of good faith"). Security First Insurance Company failed to pay the insured's claim under the homeowner's insurance policy when, under all of the circumstances, it could and should have done so, had it acted fairly and honestly and with due regard for the interests of insured. Security First Insurance Company issued the policy at issue, Policy No. P000522053 to Moises Agosto, for the policy period of April 14, 2022 to April 14, 2023. On March 5, 2024, Mr. Agosto filed an insurance claim with Security First Insurance Company for damages sustained by Hurricane Ian on September 29, 2022. Mr. Agosto reported this claim less than two years from the date Hurricane Ian made landfall in the State of Florida. On April 12, 2024, Security First Insurance Company summarily denied Mr. Agosto’s claim based on the assertion that a mid-term policy endorsement, applies to Mr. Agosto’s claim. In June of 2024, after Security First Insurance Company failed to indemnify Mr. Agosto for the loss, and after Moises Agosto complied with the conditions precedent to filing suit, Moises Agosto filed a lawsuit in Polk County, Florida, Case No. 2024-CA-002247. On July 30, 2024, Security First Insurance Company field a motion to dismiss Moises Agosto's lawsuit. The basis of the motion to dismiss is the assertion that the mid-term policy endorsement applies to Moises Agosto’s claim; along with the argument that the post-amended version of § 627.70132(2) applies to Mr. Agosto's claim. Security First Insurance Company's position as it relates to Mr. Agosto's claim are both contrary to law. Florida and Federal Courts have held that policy mid-term endorsements, like the one in the matter, are invalid as to losses that preceded the endorsement. See. Security Ins. Co. v. Baad, 657 So. 2d 10, 10 (Fla. 3d DCA 1995). In regards to the argument that the post-amended version of § 627.70132(2) applies to Mr. Agosto's claim, Florida law is clear that amendments to statutes that alter a party’s substantive rights do not apply retroactively. The Florida Supreme Court has held that where the legislature passes new legislation changing an insured’s substantive rights, such legislation may only apply prospectively to insurance policies issued after the effective date of the legislation (even where the legislature expressed an intent for their legislation to apply retroactively). See Menendez v. Progressive Exp. Ins. Co., Inc., 35 So. 3d 873, 878 (Fla. 2010). Further, the application of the amended version of § 627.70132(2) would also violate the Florida Constitution, Article I, Section 10. Lastly, the endorsement Security First Insurance Company is relying on creates a material change to the terms and conditions of the original policy. As such, there are notice requirements prescribed in § 627.4133 that Security First Insurance Company has failed to comply with. For those reasons alone, the endorsement is unenforceable. See U.S. Fire Ins. Co. v. Southern Sec. Life Ins. Co., 710 So.2d 130 (Fla. 5th DCA 1998). On October 14, 2024, Mr. Agosto's attorney filed a response to Security First Insurance Company's Motion to Dismiss. On October 15, 2024, Mr. Agosto's attorney sent Security First's attorney a 57.105 letter and motion in regards to Security First's Motion to Dismiss. Civil Remedy Notice 786907 was also filed on October 15, 2024. On October 23, 2024, Security First Insurance Company withdrew its Motion to Dismiss, filing thereafter on the same day, an Answer and that contained twelve (12) affirmative defenses. The eighth affirmative defenses raises the same arguments Security First made in its Motion to Dismiss: the assertion that the mid-term policy endorsement applies to Plaintiff’s claim. As stated above, Security First's position is not supported by fact or law. Further, the remaining affirmative defenses contain avoidances that were not raised by Security First Insurance Company prior to litigation. Security First Insurance Company raised post-loss obligation defenses for the first time in its Answer and Affirmative Defenses. More specifically, Security First Insurance Company’s Seventh, Tenth and Eleventh Affirmative Defenses raise post-loss obligation defenses not previously raised by Security First prior to litigation ensuing. Security First Insurance Company raised policy exclusion defenses for the first time in its Answer and Affirmative Defenses. Specifically, the Third, Fourth, Ninth and Twelfth Affirmative Defenses raise policy exclusions not previously raised by prior to litigation ensuing. Further, the Fifth Affirmative Defense asserts Mr. Agosto's roof was not damaged; an allegation not previously raised prior to litigation ensuing. The Mend the Hold Doctrine Prohibits Security First Insurance Company from raising defenses not raised before litigation. The “mend the hold” doctrine prohibits a party to a contract from changing his reasons for refusing to perform on the contract after litigation has begun. Harbor Ins. Co. v. Continental Bank Corp., 922 F.2d 357, 362 (7th Cir. 1990). Florida courts have likewise applied the “mend the hold” doctrine to preclude parties from changing their position during litigation in an attempt to create a “catch 22" situation for their adversary. O’Bryan v. Linton, 41 So. 2d 169, 171 (Fla. 1949) (party cannot assert new grounds for defense after litigation has commenced); Salcedo v. Asociacion Cubana, 368 So. 2d 1337, 1339 (Fla. 3d DCA 1979) (defendant attempted to change its position regarding applicable statute of limitations); Heimer v. Travelers Ins. Co., 400 So. 2d 771, 772-774 (Fla. 3d DCA 1981) (defendant attempted to avoid the admissions contained in its answer after having its answer stricken for failure to comply with discovery orders). The “mend the hold” doctrine has been applied most frequently to insurance companies that change their reasons for refusing to pay a claim after litigation commences. Harbor Ins. Co., supra, 922 F.2d at 363. The “mend the hold” doctrine bars the Insurance Company from adding to its grounds of denial. As noted by the Seventh Circuit in Harbor Ins. Co., the doctrine is connected to “considerations of good faith and ethical obligations in contract considerations,” particularly in the realm of insurer obligations. Id. 36. Similarly, the court in Employers Ins. of Wassau v. Bodi-Wachs Aviation Ins. Agency, Inc., 846 F. Supp. 677, 685 (N.D. Ill. 1994) (emphasis added), held: [T]he doctrine that teaches that when a party initially asserts a specific reason or reasons for its being freed from an otherwise binding contractual obligation, it will not be allowed to advance any different or additional grounds during the course of litigating the matter. The Bodi-Wachs Aviation court found that the insurer could not assert that the policy was violated by the insured’s failure to provide timely notice where “the total omission of [that] contention from [the] original declination of coverage creates a ‘mend your hold’ type of bar.” Id. Security First Insurance Company has a regular business practice of failing to adequately adjust its policyholder’s claims and undervalues the claims to save itself money. It is clear that the insurer’s general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, adjusting, investigating has caused the insured to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue. That said, and even though Security First Insurance Company knows that it has a fiduciary duty to promptly adjust insurance claims, it failed to institute the necessary policies, procedures, guidelines and protocols to adjust insurance claims promptly and pursuant to the policy’s Loss Payment Provision. By way of the cited legal authorities and considerations, Security First Insurance Company knew that it had an obligation to treat all insureds equally and honestly. However, and for their own financial interest, they will only start to fully consider their obligations as stated herein if the insured retains legal representation and pursues a legal action which exposes them to liabilities and costs. Even then, they will withhold monies owed in an unjust effort to limit/delay their liabilities in relation to the statutory considerations and otherwise. To cure the above stated immoral, deceptive, unlawful and generally described bad faith conduct which is part of a general business practice that is knowingly being utilized by Security First Insurance Company for self-gain, Security First Insurance must: (1) withdraw the affirmative defenses listed above; (2) accept coverage for the subject claim; (4) promptly make payment pursuant to the policy’s Loss Payment Provision for covered damages in the amount of $71,181.00 (4) tender interest on any overdue payments; and (5) acknowledge liability for taxable cost and reasonable attorneys in the pending lawsuit.
Comments
User Id Date Added Comment
todd.migacz@securityfirstflorida.com 11-14-2024 Via Electronic Filing: Florida Department of Financial Services Bureau of Consumer Assistance c/o: Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0322 Via Email: Jeffrey Saidenstat, Esquire 800 East Broward Blvd. Suite 510 Fort Lauderdale, FL 33301 JJS@weklaw.com Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION Filing No.: 788592 Insured: Moises Agosto Insurer: Security First Insurance Company Claim No.: 253907 Policy No.: P000522053 Date of Loss: 9/29/2022 Dear Sir or Madam: The undersigned attorneys represent Security First Insurance Company (hereinafter referred to as (“Security First”) with respect to the above-referenced Civil Remedy Notice of Insurer Violation (hereinafter referred to as “CRN”). This response is provided on behalf of Security First and all of its employees, agents, officers, and affiliates. The Department accepted the CRN on October 24, 2024. At all times during the investigation and adjustment of Moises Agosto’s claim, Security First has acted in good faith. Security First has also acted fairly and honestly towards the claim and has acted with due regard for Agosto’s interests. Moreover, Security First has acted in conformity will all other requirements set forth in section 624.155, Florida Statutes. Further, Security First has investigated and adjusted the claim pursuant to the appropriate standards governing the investigation of claims. I. Specificity Requirement Agosto’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for civil remedy notices, and it fails to meet the requirements of the Statute. Respectfully, Security First requests the Department return the CRN and instruct that Agosto provide the facts required for civil remedy notices. See Section 624.155(3)(c), Florida Statutes. These requirements arise from the following provisions of Section 624.155: (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days' written notice of the violation. If the department returns a notice for lack of specificity, the 60-day time period shall not begin until a proper notice is filed. (b) The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require (emphasis added): 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. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad-faith actions, the Legislature provided this sixty-day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1284 (Fla. 2000). Thus, the CRN cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So.2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So.2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”). In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiff’s counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiff’s counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be clearer. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So.2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. II. The Elements of a Valid Civil Remedy Notice There are at least eight requirements for a valid civil remedy notice. Pursuant to Section 624.155(3)(c)’s requirement that a civil remedy notice must set forth the “facts and circumstances giving rise to the violation,” a valid civil remedy notice must contain the following: 1. “explain how the [insurer] violated [the statutes],” Heritage Corp., 580 F.Supp. 2d at 1299; 2. “explain the amounts of damage at issue caused by the [insurer’s] alleged statutory violations,” rather than caused by the loss itself, Id.; 3. provide the facts showing “knowledge and/or delay on the insurance company’s part,” 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1192 (N.D. Fla. 2008). 4. provide the facts supporting the specific contractual damages allegedly owed rather than merely the policy limits, Id. at 1193; 5. if an inadequate investigation is alleged, the civil remedy notice must be specific enough to allow the insurer to conduct an additional investigation, Nowak v. Lexington Ins. Co., 464 F.Supp.2d 1248, 1252 (S.D. Fla. 2006). Additionally, subsections (3)(a)1., 3., and 4. require: 6. “the statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated;” 7. “the name of any individual involved in the violation;” and 8. “reference to specific policy language that is relevant to the violation.” As noted, the first five requirements mandate the insured to provide specific facts and circumstances of the alleged violations. This would necessarily include specific facts regarding the method of the investigation; the reasons the investigation was improper or otherwise inadequate; the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. To allege an inadequate investigation, the Notice must include specific facts regarding the method, rather than merely the results. Valenti, 2006 WL 1627276, at *1. Florida law does not allow an insured, without providing any facts, to allege that the insurer’s only option to avoid bad faith is paying whatever the insured demands. 316, Inc., 625 F.Supp.2d at 1194. Requirements two and four regarding the alleged damages must also be specifically provided in the civil remedy notices. Importantly, the Talat court held that payment of undisputed damages within the cure period is sufficient to preclude a statutory bad faith action. In that circumstance, the insurer has “timely paid ‘the damages’ and has corrected ‘the circumstances giving rise to the violation’ within the meaning of [Section 624.155(2)(d), Florida Statutes].” Id. at 1281. The insurer is not required to pay any compensatory damages that flow from any alleged delay in settling the claim. Importantly, only the contractual benefits are owed during the 60-day cure period. To provide an insurer with the notice of the contractual and extra-contractual damages, Florida law clearly requires facts supporting the amount. Merely requesting policy limits without any basis renders the civil remedy notice invalid. If the civil remedy notice does not satisfy each of the eight elements, it cannot be considered valid pursuant to the Florida case authority cited above. Agosto’s CRN is deficient for a number of reasons. For starters, the CRN fails to reference any of the specific policy language that it contends Security First has offended in the handling of their claim. In addition, it fails to include necessary facts that provide context to their statutory allegations. The aggregate of the CRN’s deficiencies causes the CRN to fall woefully short of providing notice to Security First of any alleged wrongdoing, and these glaring deficiencies deny Security First the ability to cure the alleged wrongdoing within sixty (60) days. II. Factual Background The subject claim was given a date of loss of September 28, 2022 making it a Hurricane Ian claim. The subject claim was reported to Security First on March 5, 2024. That is 525 days after the alleged date of loss. In response, Security First had roofing contractor and field inspector inspect the Insured Property. Upon review of all of the reports and photos, Security First issued its coverage determination on April 12, 2024, determining and sending to Integrity Claims Group the following: Thank you for being a valued customer of Security First Insurance (SFI). We are writing to inform you that we have received your claim report for damages in the above reference claim (252656). This loss was reported on 3/5/2024 with a date of loss of 9/29/2022. The reported cause of loss was Wind – Hurricane. The reported date of loss exceeds the notice requirement pursuant to Fl. Statute §627.70132 which requires that all claims be reported before the expiration of one year from the date of loss. Additionally, requests to reopen a claim must be made before the expiration of one year from the reported date of loss. This deadline is in effect regardless of whether the cause of loss is a covered loss. Please refer to the Florida Statute language below: 627.70132 Notice of property insurance claim. — (2) A claim or reopened claim, but not a supplemental claim, under an insurance policy that provides property insurance, as defined in s. 624.604, including a property insurance policy issued by an eligible surplus lines insurer, for loss or damage caused by any peril is barred unless notice of the claim was given to the insurer in accordance with the terms of the policy within 1 year after the date of loss. . . . Please refer to your Homeowners 3 Special Form 03 20, endorsed by Special Provisions Florida 07 21, and Change to Claims Reporting Timeline 01 23: SECTION I – CONDITIONS 2. Your Duties After Loss. In case of a loss to covered property, we have no duty to provide coverage under this policy to an “insured”, or to an “assignee”, if the failure of you, an “insured” seeking coverage, an “assignee”, or a representative of any of these to comply with the following duties is prejudicial to us: a. Give prompt notice to us or our agent. (1) Except for Reasonable Emergency Measures taken as described in Section I – Additional Coverages, Reasonable Emergency Measures, there is no coverage for permanent repairs that begin before the earlier of: (a) 72 hours after we are notified of the loss; (b) The time of loss inspection by us; or (c) The time of other approval by us. (2) Any claim or “reopened claim”, as those terms are defined in Florida Statute 627.70132, is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. Any “supplemental claim”, as that term is defined in Florida Statute 627.70132 is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. Therefore, in accordance with current Florida law, there is no coverage for the reported claim. By investigating your claim and sending this letter, Security First Insurance has neither waived nor intends to waive any legal or policy terms, conditions, rights, provisions or requirements. Likewise, your receipt of this letter and your cooperation with our investigation does not waive any of your rights or obligations under the policy. If you have additional documents, records or information that you believe may have an impact on our coverage decision, or if you have any questions about this letter or your claim, please contact me. You may mail or email documentation to us at the addresses listed below. Once repairs to your property have been completed, please provide us with copies of any documents showing the completed repairs. These documents may include photographs, receipts, paid invoices, permit inspection documents, or any other documentation that you may have. III. The Allegations Are Without Merit Security First was prejudiced by the alleged date of loss being reported over a year after it allegedly occurred. Agosto was put on notice of the change in statute on multiple occasions. This was done per the requirements in the policy itself, and per the statute that the policy references. IV. The Statutory Allegations Are Without Merit The CRN alleges several statutory violations without adequate facts to support the same. The factual analysis above, however, implicitly addresses many of the unsupported statutory allegations set forth in the CRN, making it clear that Security First acted fairly in evaluating and investigating the claim. Consequently, allegations of unsatisfactory settlement offer and unfair trade practice, as well as the following statutory allegations are unsupported and largely without merit. 624.155(1)(b)(1) Not attempting in good faith to settle claims when, under the circumstances, it could and should have done so, it had acted fairly and honestly toward its insured and with due regard for her or his interests. Wood has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 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. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim and properly adjusted the same, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Wood provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 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. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. 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). Agosto has failed to allege facts that support this statutory allegation. Security First has been honest and fair in the evaluation of the claim, and therefore Security First demands that Agosto provide documentation to support this statutory allegation. V. Conclusion The facts referenced in the Civil Remedy Notice are inaccurate, incomplete, and premature. Simply because you disagree with Security First does not establish that Security First acted in bad faith. You have not produced any evidence to substantiate the aforementioned allegations. Furthermore, the bare nature of the Civil Remedy Notice does not allow for a more specific response to the alleged violations. Security First will provide a further response and consider same if and when any additional information is provided relative to any alleged violation. Security First continues to reserve all of its rights. We trust this fully and adequately responds to any inquiry regarding the claim of Security First. If you have any questions or require further clarification with regard to the above, please do not hesitate to contact us. Sincerely, /s/ Todd Migacz, Esquire Todd Migacz, Esquire Florida Bar No: 96678 Attorney for the Defendant Security First Insurance Company 1001 Broadway Avenue Ormond Beach, Florida 32714 Todd.Migacz@securityfirstflorida.com
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