Civil Remedy Notice of Insurer Violations
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Filing Number:     788665
Filing Accepted:  10/24/2024
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Complainant
Last/Business Name *  
SELIGA   First Name   JIM
Street Address * 1330 TALON WAY
City, State Zip * MELBOURNE, FL 32934
Email Address * APRILSELIGA@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SELIGA   First Name   JIM
Policy # * H3FL000016106 Claim #* 202408003525
Attorney
Attorney is Applicable
Last Name* STRUBLE First Name * MATTHEW Initial
Street Address* 325 FIFTH AVENUE, SUITE 103
City, State Zip* INDIALANTIC , FLORIDA 32903
Email Address * SERVICE@STRUBLECOHEN.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SLIDE INSURANCE COMPANY
NAIC Company Code 17227
 
Name of individual responsible for violation (if any):* AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SLIDE INSURANCE COMPANY RELATED TO THIS CLAIM.
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.
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.

There are no policy provision specifically at issue or in dispute, the policy provides coverage resulting from Wind but Slide Insurance Company has failed to extend coverage for repairs needed for the 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.

Insurer issued an insurance policy bearing policy number H3FL000016106, which insured the property located at 1330 Talon Way, Melbourne, Florida 32934. The policy was in effect when the property sustained damage on or about April 11, 2024, when damage was caused by Wind. Slide Insurance Company (“Insurer”) received notice of the claim for property damage resulting from Wind, and related damages on or about April 11, 2024. The damage was reported to Insurer which assigned Claim Number 202408003525 to the claim and investigated the claim. Insurer failed to retain the experts needed to perform the inspection and needed to address the damage at issue and determine the repairs needed to restore the property. Insurer has been provided with documents establishing that the claim is covered, despite this being apparent from the condition of the property alone. Insurer has failed to extend coverage for payments owed and has refused to attempt to settle the claim with its insured. Insurer’s delay in issuing payment is causing and will cause the insured to sustain extra-contractual damages not covered by the property, including loss of use and enjoyment of the property and related damages, costs associated with hiring adjusters and experts, among other damages and these uninsured damages would not have occurred but for the insurer ’s failure to timely issue payments owed. In this claim and as a business practice, insurer fails to retain experts needed to investigate claims, ignores evidence establishing coverage and avoids covered repairs to attempt to avoid issuing payments owed pursuant to the insurance policy. Insurer can cure these violations by attempting to settle the claim in good faith and issuing payment for the remaining contractual damages owed. As Insurer is aware, issuing payment for contractual damages owed will preclude recovery of extra-contractual damages already incurred, and that will be incurred, and the contractual damages should immediately be paid and be paid within 60 days from the date of this notice. Due to applicable Florida Statutes, and the insurance policy’s payment provisions, the payment issued should also include interest. If insurer contends there is somehow more information needed that was not already provided, it should immediately advise the insured’s attorney what information is needed. Insurer has been provided with information establishing that the claim is covered but has failed to extend coverage for the claim. Insurer’s denial of the claim and refusal to issue payment is a breach of the insurance policy.
Comments
User Id Date Added Comment
mthornton@slideinsurance.com 12-19-2024 Via E-mail & Posting on DFS Website Matthew Struble, Esq. Struble Cohen 325 Fifth Ave, Ste 103 Indialantic, FL 32903 service@strublecohen.com Complainant: Jim Seliga Insured: Jim Seliga Claim No: 202408003525 Policy No: H3FL000016106 CRN Filing No.: 788665 Dear Matthew Struble: Please allow this correspondence to serve as Slide Insurance Company’s (“Slide”)’s response to the Civil Remedy Notice (“CRN”) filed on behalf of Jim Seliga (“Insured”). The CRN was accepted by the Department on October 24, 2024. Without waiving any objections to the sufficiency of the CRN, and specifically subject to a reservation of all rights and defenses herein, Slide denies all allegations that it violated Florida Statutes or other codes, regulations, and/or rules in this matter. Slide challenges the validity of the CRN as it fails to identify the specific policy terms the Insured claims Slide failed to follow, nor do the allegations as stated give rise to any violation of Florida law or insurance policy. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, 879 (Fla. 4th DCA 2021); Demase v. State Farm Florida Insurance Company, 351 So.3d 136, 138-39 (Fla. 5th DCA 2022) (holding the trial court properly determined a civil remedy notice that failed to state with specificity the relevant policy language was legally insufficient). In fact, the CRN is devoid of any facts specific to the underlying claim, including the alleged cause of the loss, damages, or individuals who would have knowledge of the purported conduct and alleges a different date of loss than reported by the Insured in the claim. Thus, the CRN is deficient and should be returned by the Department. CLAIM FACTS Slide acquired a homeowners’ insurance policy from Citizens Property Insurance Corporation issued to the Insured for property located at 1330 Talon Way, Melbourne, Florida, for the period of March 14, 2024 to March 11, 2025, (the “Policy”). On August 23, 2024, the Insured filed a claim for damage from leaks through the patio roof and / or exterior wall of the dwelling. The date of loss was reported as August 22, 2024. Slide acknowledged receipt of the claim and assigned a licensed field adjuster to inspect the property. At the inspection on August 28, 2024, the field adjuster observed staining and cracking on the ceiling, walls, and baseboards around a sliding glass door in the living room / kitchen. Bubbling paint was also noted below a window in the dining room. The field adjuster inspected the rooms located above the areas of water damage and was unable to find any damage. Due to inclement weather, the field adjuster returned to the property on August 30, 2024, to complete an assessment of the roof and exterior. No wind or storm damage was found. Rather, the field adjuster noted a deck was installed over the flat roof and there is a gap between the deck and exterior wall where the rolled roofing is exposed. This area is near the water intrusion observed in the living room / kitchen area. The field adjuster also documented sealant around an exhaust on the left slope of the roof. Based on the investigation, including but not limited to the on-site inspection, the Insured was advised on or about September 17, 2024, that the claim was precluded from coverage under the Policy’s terms, conditions, exclusions, and limitations. An explanation of the coverage decision was sent to the Insured in accordance with the Policy and Florida Statute. The same day the coverage decision was sent to the Insured, Ask An Adjuster Space Coast, LLC (“Public Adjuster”), submitted a letter of representation on the Insured’s behalf. No further communication was received from the Insured or their representatives until receipt of a letter of representation from Struble Cohen, PA, on or about October 10, 2024. Six (6) days later, the Insured’s Public Adjuster submitted an estimate on their behalf alleging damages of $106,593.02 under the Policy. Notably, the estimate includes replacement of the deck installed over the roof, replacement of the flat roof, and extensive interior repairs including to areas never before reported as damaged by the purported loss. The instant Civil Remedy Notice and a Property Insurance Notice of Intent to Initiate Litigation were then filed by the Insured’s attorney on October 24, 2024. To date, no information has been presented by the Insured or their representatives that would alter Slide’s understanding of the loss or coverage. Slide maintains that it has acted in accordance with the terms of the subject insurance policy and the law in its adjustment of the claim. The facts and circumstances set forth in the CRN are misleading, vague, and incomplete. The Insured has presented no evidence to support the allegations of claim denial, claim delay, or unsatisfactory settlement offer. Rather, the facts show Slide promptly investigated the loss and made communications as necessary to adjust the claim, in compliance with the Policy and Florida Statute. DENIAL OF ALL VIOLATIONS OF FLORIDA STATUTE The CRN asserts Slide violated §§ 624.155(1)(b)(1), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(1)(i)(3)(d), Fla. Stats. Notwithstanding any challenges to the CRN’s legal sufficiency, and specifically subject to a reservation of all defenses and/or rights, Slide categorically denies all violations of Florida Statutes or any other codes, regulations, and/or rules in its handling of the subject loss. The underlying claim was adjusted in as thorough and expedient a manner as possible. The facts demonstrate Slide employed proper claims practices in the investigation including, but not limited to, a prompt inspection of the Insured’s property and timely communications with the Insured and/or their representatives. Following the adjustment of the claim, the Insured was advised in writing of the coverage decision and basis for same. Upon receipt of correspondence from the Insured via their attorney notifying Slide of a dispute with the coverage decision, Slide reopened the claim for further investigation, however, the Insured filed this CRN before Slide had the opportunity to address their claims and additionally alleged damages. Thus, the violations asserted in the CRN are baseless and Slide asserts strict compliance with its statutory obligations. CONCLUSION In conclusion, the documented facts contradict all allegations that Slide has in any manner acted improperly or contrary to its contractual obligations to the Insured. In filing this response, Slide does not intend to waive any rights or defenses that it may have in law or the policy. Rather, Slide expressly reserves all such rights and defenses without exception or limitation. Should there be any questions or further inquiry with respect to this matter, please contact the undersigned at mthornton@slideinsurance.com. Sincerely, /s/ Marianne Thornton Marianne Thornton, Esq. Staff Counsel
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