Civil Remedy Notice of Insurer Violations
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Filing Number:     788955
Filing Accepted:  10/28/2024
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Complainant
Last/Business Name *  
DEAN   First Name   NANCY
Street Address * 4331 BURTON STREET
City, State Zip * MARIANNA, FL 32446
Email Address * NONE
Complainant Type: * Insured
Insured
Last/Business Name*   DEAN   First Name   NANCY
Policy # * 1501-1903-9167 Claim #* FL-24-0103655
Attorney
Attorney is Applicable
Last Name* LIGMAN First Name * JOSEPH Initial
Street Address* 15715 S. DIXIE HWY, STE 319
City, State Zip* MIAMI , FLORIDA 33157
Email Address * NONE
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* JEFF GIBBS, ALL UNKNOWN ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNIVERSAL WHO ALSO PERFORMED THE ACTS DESCRIBED BELOW IN RELATION TO THE ADJUSTMENT OF THE SUBJECT CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Claim Denial
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Failure to Properly Investigate Claim with Due Regard to Insured's Interest
* 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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

FLORIDA STATUTES VIOLATED (continued) 627.70131(1)(a) - Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgment. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer’s claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. 627.70131(2) - Such acknowledgment shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgment reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgment shall provide necessary claim forms, and instructions, including an appropriate telephone number. 627.70131(5)(a) - Within 90 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. Any payment of an initial or supplemental claim or portion of such claim made 90 days after the insurer receives notice of the claim, or made more than 15 days after thise are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured shall select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED 69B-220.201(3) Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: 69B-220.201(3)(b) An adjuster shall treat all claimants equally. 69B-220.201(3)(b)1 An adjuster shall not provide favored treatment to any claimant. 69B-220.201(3)(b)2 An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(e) An adjuster shall handle every adjustment and settlement with honesty, integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. 69B-220.201(3)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(j) - An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim options in accordance with the terms and conditions of the insurance contract. 69B-220.201(3)(k) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. 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". 2. We do not cover land, including land on which the dwelling is located. D. Coverage C – Personal Property 1. Covered Property We cover personal property owned or used by an "insured" while it is anywhere in the world. After a loss and at your request, we will cover personal property owned by: a. Others while the property is on the part of the "residence premises" occupied by an "insured"; or b. A guest or a "residence employee", while the property is in any residence occupied by an "insured". E. Coverage D – Loss Of Use The limit of liability for Coverage D is the total limit for the coverages in 1. Additional Living Expense, 2. Fair Rental Value and 3. Civil Authority Prohibits Use below. 1. Additional Living Expense If a loss covered under Section I makes that part of the "residence premises" where you reside not fit to live in, we cover the Additional Living Expense, meaning any necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living. Payment will be for the shortest time required to repair or replace the damage or, if you permanently relocate, the shortest time required for your household to settle elsewhere. 2. Fair Rental Value If a loss covered under Section I makes that part of the "residence premises" rented to others or held for rental by you not fit to live in, we cover the fair rental value of such premises less any expenses that do not continue while it is not fit to live in. However, we do not cover any fair rental value arising out of or in connection with “homesharing host activities”. Payment will be for the shortest time required to repair or replace such premises. ADDITIONAL COVERAGES 2. Reasonable Emergency Measures a. We will pay up to the greater of $3,000 or 1% of your Coverage A limit of liability for the reasonable costs incurred by you for necessary measures taken solely to protect covered property from further damage, when the damage or loss is caused by a Peril Insured Against. b. We will not pay more than the amount in a. above, unless we provide you approval within 48 hours of your request to us to exceed the limit in a. above. In such circumstance, we will pay only up to the additional amount for the measures we authorize. If we fail to respond to you within 48 hours of your request to us and the damage or loss is caused by a Peril Insured Against, you may exceed the amount in a. above only up to the cost incurred by you for the reasonable emergency measures necessary to protect the covered property from further damage. c. If, however, form UPCIC 201 15 is a part of your policy and a covered loss occurs during a “hurricane occurrence”, the amount we pay under this additional coverage is not limited to the amount in a. above. d. A reasonable measure under this Additional Coverage may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To the degree reasonably possible, the damaged property must be retained for us to inspect. e. This coverage does not: (1) Increase the limit of liability that applies to the covered property; or (2) Relieve you of your duties, in case of a loss to covered property, as set forth in Section I – Condition C. (3) Pay for property not covered, or for repairs resulting from a peril not covered, or for loss excluded from this Policy. SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure against direct physical loss to property described in Coverages A and B. However, loss does not include and we will not pay for any “diminution in value”. B. Coverage C – Personal Property We insure for direct physical loss to the property described in Coverage C caused by any of the following perils unless the loss is excluded in Section I – Exclusions. However, loss does not include and we will not pay for any “diminution in value”. 1) looking for ways to deny coverage, pay less, delay payment and otherwise “low ball” or “stone wall” claim; 2) failure to pay claim in full; 3) failure to promptly investigate claim; 4) failure to properly investigate claim; 5) failure to adjust loss; 6) failure to act in due diligence and good faith to resolve claim; 7) placing financial interest of insurer before that of policy holders and claimants; 8) failure to properly train, evaluate and manage adjusters. Universal has violated the above ethical codes, statutes, and policy provisions by retaining adjusters who, or instructing adjusters to, knowingly underprice and under-scope losses. This creates a situation where adjusters write estimates and adjust losses in a manner prejudicial to the insured by not providing sufficient funds to place the insured in their pre-loss condition, which is what the policy provides for subject to its terms and conditions. The situation created is untenable for the insured. They cannot properly repair the property and return to their normal life. Meanwhile their mortgagee may claim that the homeowner is not protecting the mortgagee’s interest. Additionally, the underwriting department of the insurer may demand that repairs be made prior to renewing or issuing a new policy at the expense of the insured, or worse deny a future claim based upon the insured’s inability to fully repair the property which was the result of the insurer’s bad faith adjustment of the current claim. All of which are bad faith business practices designed to ensure that the insurer pays out as little as possible on any given claim and creates circumstances where it can deny future claims.
 
* 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. Universal Property & Casualty Insurance Company (hereinafter “Universal”) has breached this duty by its adjustment of its Insureds’ claim of loss. Universal’s actions/inactions have forced my client to endure hardship well beyond the covered loss. At no point in the claim process has the insured been treated fairly or in good faith by Universal. On or about January 9, 2024, the insured suffered damage to their home as a result of a tornado, which is a covered cause of loss under their policy of insurance. The insured made a claim for damages shortly thereafter. After inspection by Universal’s representatives, coverage for the loss was afforded and a paltry payment of $399.39 was made after application of the $1,000.00 deductible. Damages to the interior of the dwelling were covered by Universal, although severely underpaid. However, in a leap of logic, Universal denied coverage for damages to the roof on the basis of wear and tear. The insured submitted an estimate totaling approximately $107,000.00, which received no meaningful response. The insured also requested appraisal, and was rejected. After making its initial determination of the claim Universal made it quite clear that it had no intention of dealing fairly with the insured. Once it became abundantly clear to the insured that they would be unable to obtain fair treatment from Universal the insured was forced to file the instant Civil Remedy Notice and a lawsuit for breach of contract. The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of Universal have approached this investigation in a manner prejudicial to the Insured. Universal is using either untrained or improperly trained adjusters in connection with this claim. Universal should have been adjusting the loss with the Insured but instead, it was looking for ways not to pay the claim at all or not pay the claim in full. If Universal handles all the claims in the manner in which the Insured’s claim was adjusted, then it is improperly handling all claims. Universal’s conduct has been reckless and unfair to the Insured. This is evidenced by the delay in paying the claim, undervaluation of the claim, and the failure of Universal to evaluate the claim in total. The Insured was and still is forced to expend out of pocket monies in order to force Universal to honor its obligations under the insurance policy and pay all the insurance proceeds due and owing. Universal has refused and/or failed to comply with The Policy’s cooperation and/or Loss Payment provision. Under The Policy, Universal was to timely tender undisputed insurance benefits to the Insured. Universal has failed and/or refused to timely tender owed insurance benefits, undisputed or otherwise. This is a breach of The Policy. Universal has refused and/or failed to cooperate and/or adjust the Loss by cooperating with the Insured during the claims adjustment process in compliance with The Policy’s Loss Payment provision. This is a breach of The Policy. Universal has a contractual obligation to not make a perfunctory investigation, and not ignore evidence that would support the Insured’s claim. This is a breach of The Policy. Universal has a contractual obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. Universal has ignored damages in the property and has failed to acknowledge the full scope of the loss despite inspection. This is a breach of The Policy. The concept of insurance is that insurance is the insurer’s granting of timely and prompt indemnity or F.S. § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the Insured may mitigate their damages and to put them back into the position they were in prior to the loss as quickly as possible. Universal has breached this duty. Universal has refused and/or failed to tender all insurance proceeds to the Insured upon demand. Universal’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 Insured is wrongful conduct. Furthermore, the Insured contends that Universal’s adjusters and/or representatives financially benefit by such wrongful conduct. Therefore, to cure the defects outlined in this Civil Remedy Notice, Universal must: Create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and to avoid this from occurring in the future; Universal must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims, and for the training and supervision of employees with regard to these types of claims to ensure Universal’s claims handling procedures with regard to these types of losses are adequate to stop further Insureds from being treated unfairly and wrongfully; Universal must acknowledge damages to the dwelling, other structures, and contents which Universal knows, or should know are covered under the subject policy of insurance. Universal must act fairly and honestly towards the Insured and with due regard for their best interests in attempting to settle the Insured’s claim; and Universal must immediately tender all insurance benefits due and owing to the Insured under the Policy pursuant to the relevant policy provisions provided therein that would reasonably place the Insured back to their pre-loss condition, including, but not limited to all interest due and owing under applicable Florida Statutes. The insured contends that the cure amount is up to and including policy limits under all relevant coverages, but which is best reflected in the estimate presented by the insured to Universal by the insured’s representatives as a good faith estimation of the loss.
Comments
User Id Date Added Comment
sm1130@universalproperty.com 12-17-2024 December 17, 2024 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 788955 Filing Date: 10/28/2024 Complainant(s): Nancy Dean Insured(s): Nancy Dean Policy No.: 1501-1903-9167 Claim No.: FL-24-0103655 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by attorney, Joseph Ligman, on behalf of Complainant, Nancy Dean (also referenced as “Insured.”) The Notice alleges violations of Sections 624.02, 624.155, 626.9541, and 627.70131, Florida Statutes and Florida Administrative Code: 69B-220.201. Universal denies the allegations contained in the Notice. Additionally, Universal denies that it violated these or any statutes, Administrative Code, Florida law or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notice is deficient as a matter of law as it fails to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Section 624.155(3)(b), Florida Statutes, the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language, 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...; 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Department of Financial Services (“DFS”) created form DFS-10-363, which lays out 15 requirements that the Complainant(s) must respond to with specificity. The Florida Supreme Court holds 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). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant(s) specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). To begin, the Notice fails to meet the requirements of Section 624.155, Florida Statutes on several grounds. First, the Civil Remedy Notice requires the Complainant(s) “pursuant to section 624.155, F.S. please indicate all statutory provisions alleged to have been violated.” The Notice filed by Complainant in this matter includes almost every statutory provision that could be claimed against an insurance company, without the requisite specificity as to how, if at all, they are relevant or applicable to any facts alleged in the Notice. Because the Notice fails to identify any specific statutes, Universal is unable to properly respond and it does not comply with Florida Statute Section 624.155. Second, the Notice fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of Section 624.155, Florida Statutes, the Complainant(s) must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to properly investigate the allegations. The Notice lacks the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Notice states “JEFF GIBBS…” however, the Notice fails to include any specificity as to what facts the named individual has knowledge of that gave rise to any purported allegation(s) and/or what, if anything, he did or failed to do as it relates to the claim at issue. The Complainant also attempts a “catch-all” by stating “ALL UNKNOWN ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNIVERSAL WHO ALSO PERFORMED THE ACTS DESCRIBED BELOW IN RELATION TO THE ADJUSTMENT OF THE SUBJECT CLAIM” which significantly prejudices Universal because the Complainant is failing to notify Universal of the individuals that purportedly committed statutory violations or the specific statutory violations any individual purportedly committed. The failure to provide the requisite specificity precludes Universal from taking any corrective action and potentially curing any purported allegation. Accordingly, the Notice is insufficient as a matter of law. Third, the Notice fails to satisfy Sec. 624.155(3)(b)(4), Fla. Stat., because it fails to reference specific policy language relevant to any alleged violation. Instead, the Notice improperly cites Section 627.70131, Flat. Stat., and Section 69B-220.201 of the Florida Administrative Code, however, these are not policy provisions within the Policy and moreover, there are no facts specified to place Universal on notice of how it allegedly violated these statutes or code. When the Notice does reference the policy, it references various policy provisions and categories of coverage but fails to specify any facts regarding how those provisions were violated. The Complainant provides no guidance or explanation such that it is unclear what policy language applies to any alleged violation and Universal is left to wonder what policy provisions Complainant believes were allegedly violated or breached and why. General, vague, or overbroad references to policy provisions and categories of coverage do not satisfy the specificity required by Section 624.155(3)(b)(4), Fla. Stat. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Fourth, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notice fails to specify sufficient facts that would put Universal on notice it violated any policy provision or statute. The Notice asserts general allegations consisting of speculative, inaccurate, conclusory and boilerplate statements rather than providing specific facts to support any allegation. For example, the “facts and circumstances” section of the Notice states: “The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of Universal have approached this investigation in a manner prejudicial to the Insured. Universal is using either untrained or improperly trained adjusters in connection with this claim. Universal should have been adjusting the loss with the Insured but instead, it was looking for ways not to pay the claim at all or not pay the claim in full. If Universal handles all the claims in the manner in which the Insured’s claim was adjusted, then it is improperly handling all claims. Universal’s conduct has been reckless and unfair to the Insured. This is evidenced by the delay in paying the claim, undervaluation of the claim, and the failure of Universal to evaluate the claim in total.” This type of conclusory conjecture fails to specify any factual support for same. The Complainant is required to provide with specificity the facts and circumstances giving rise to the alleged violation strictly related to Complainant’s allegations, not conjecture or speculation. The Notice does not specify sufficient facts to support any alleged violation by Universal of any policy provision or statute. Moreover, the Notice alleges Universal breached Section 624.02, Florida Statutes, but fails to provide facts to specify how this statute was breached. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. As a result, the Complainant fails to comply with the requirements provided in Section 624.155(3)(b)(2), Fla. Stat. Lastly, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects. A Civil Remedy Notice aims to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000). Section 624.155, Florida Statute, however, does not impose on an insurer the obligation to pay whatever amount its insureds demand. Talat, 753 So. 2d at 1282. On 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 insureds. See Talat, 753 So. 2d at 1281. Notably, Universal asserts that by the Insured initiating litigation before filing the Notice and/or the cure period expiring, prejudices Universal’s ability to cure any purported allegation in the Notice. In summary, as outlined above, the Complainant fails to respond to each of the fields set forth on the DFS Form with the requisite specificity including, but not limited to, the failure to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations, the failure to reference specific policy language relevant to the alleged violation, the failure to allege any specific conduct on the part of Universal that would violate any policy provision or statute and the failure to provide a proper means whereby Universal can “cure” the alleged defects. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notice. On February 12, 2024, Universal was untimely notified by Acentria Insurance that the roof of the insured location was damaged on January 9, 2024. Universal inspected the property and documented any visible damage. Universal, in accordance with the terms and conditions of the Policy, issued payment in the full amount of its estimate for the interior dwelling damages observed, less applicable deductible. Additionally, Universal timely advised the Insured that the roofing property damage was not covered under the terms of the Policy. Under the terms of the Policy, Universal will initially pay at least the actual cash value of the insured loss, less any applicable deductible. It will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. Subsequently, the Insured submitted a competing estimate totaling $130,485.07 prepared by Moreau Consultants Inc. on her behalf. Universal advised the Insured that based on the facts known to date, no additional amounts were owed. Additionally, Universal advised the Insured of the Policy’s alternative dispute resolution methods. Thereafter, on October 15, 2024, the Insured initiated litigation against Universal in Circuit Court in and for Jackson County under Case No. 24000176CAAXMX. Thus, at the time the Notice was filed, the parties were and continue to litigate their disputes to determine what, if any, additional coverage exists under the terms of the Policy. Universal did not breach any duty to its Insured. An insurer is not required to pay whatever amount its insured demands. As outlined above, the alleged statutory violations set forth in the Notice lack factual support and are without merit. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Universal complied with all policy provisions and applicable Florida law regarding the evaluation of this claim. We trust the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the Notice filed by the Complainant.? Sincerely, /s/ Stephen Methe Stephen Methe
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