Civil Remedy Notice of Insurer Violations
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Filing Number:     789080
Filing Accepted:  10/29/2024
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Complainant
Last/Business Name *  
WINSTEAD   First Name   KIM
Street Address * 1526 HERMITAGE LANE
City, State Zip * CAPE CORAL, FL 33914
Email Address * BOBBY@WINSTEADTURFFARMS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WINSTEAD   First Name   KIM
Policy # * W4777821PNYH Claim #* 47331
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W.
Street Address* 2790 SUNSET POINT ROAD
City, State Zip* CLEARWATER , FLORIDA 33579
Email Address * ASSIST@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* JAKE ANTHONY, A.J. SALTALAMACCHIA, III AND ANY INDIVIDUAL FROM, OR AGENT OF, CERTAIN UNDERWRITERS AT LLOYD’S, LONDON SUBSCRIBING TO POLICY NO. W4777821PNYH WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
Other : Not treating the Insured with good faith claims conduct
Other : Looking for ways to deny full recovery to the Insured
Other : Looking for ways to delay full recovery to the Insured
Other : Failing to properly investigate the Insured’s loss
Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
Other : Not adjusting claims and evaluating loss properly
Other : Shifting the burden of insuring the loss to the Insured
Other : Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
Other : Failing to implement proper standards for the adjustment and investigation of claims
* 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

626.9541(1)(i)(3)(i) Unfair claim settlement practices 627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an insured within 15 calendar days after an individual or entity designated by the insurer receives the insured’s written request, either: A loss run statement. 627.4137(1)(e) - Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer’s claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: a copy of the policy. 627.70131 (1)(a) - upon the Insurer 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 acknowledgement. If the acknowledgement is not in writing, a notification indicating acknowledgement 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. As used in this subsection, “agent” means any person to whom an insurer has granted authority or responsibility to receive or make such communications with respect to claims on behalf of the insurer. This subsection shall not apply to Claimants represented by counsel beyond those communications necessary to provide forms and instructions. Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Certain Underwriters at Lloyd’s, London, Subscribing to Policy No. W4777821PNYH (the “Insurer”) has committed the following in handling the Insured’s claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the policyholder and the Insured; 3) looking for ways to deny benefit payments and otherwise “low ball” or “stone wall” claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; 8) failing to acknowledge and act promptly upon communications with respect to claims; 9) failing to provide a copy of the insurance policy within 30 days; and 10) failing to provide a loss run statement. On or about September 28, 2022, while the subject policy was in full force and effect, the Insured’s property was severely damaged by Hurricane Ian. The areas impacted include but are not limited to the roofing system, exterior, living room, butler’s pantry, hallway, kitchen, master bedroom, master closet, two bedrooms, observation room, pool enclosure, and boat dock. The Insured timely submitted a claim to the Insurer for hurricane damage and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 4381643 to the loss. Given the scope and nature of the damage resulting from Hurricane Ian, the Insured retained a public adjuster. After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $420,482.09 in covered damage to the dwelling, $5,745.45 in covered damage to other structures, and $18,408 for the screen enclosure special limit. The Insured also retained legal counsel. The Insured’s legal counsel sent the Insurer a letter of representation on June 24, 2024. Within the letter, legal counsel requested a copy of a loss run statement. The Insurer and its agents failed to comply with Fla. Stat. § 627.444 by not providing the Insured and the Insured’s representatives with a loss run statement The Insurer and its agents have not acknowledged the request for a loss run statement nor has a loss run statement been provided. Upon an Insurer receiving a written request for a loss run statement, the Insurer is required, within fifteen (15) calendar days, to provide either a loss run statement or information on how to obtain a loss run statement at no charge through a consumer reporting agency. There has been no response within fifteen (15) calendar days of the Insured’s written request and the Insurer has not provided information on how to obtain a loss run statement at no charge through a consumer reporting agency. This Insurer has breached its duty to settle claims in good faith when, under all the circumstances, it could and should have done so. The Insurer and its agents have not acted fairly and honestly toward the Insured and the Insured’s representatives. Lastly, the Insurer has failed or refused to promptly acknowledge the Insured’s communications in an attempt to frustrate and delay the resolution of the Insured’s claim. The Insurer continued to delay and frustrated the Insured’s ability to have his claim adjusted promptly to begin restoring his property by failing to timely provide the Insured with the policy after requested by the Insured through his representatives. The Insured, through his representatives, requested the policy several times with no response. The policy was not received within 30 days of the first written request of the Insured. Each Insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the Insured, a statement, under oath, of a corporate officer or the insurer’s claims manager or superintendent, a copy of the policy. Fla. Stat. 627.4137(1)(e). Further, the Insurer failed to respond within 14 days to the Insured, and his agents’ requests. The Insured’s legal counsel first sent its letter of representation on June 24, 2024. Legal counsel sent follow-up emails on July 9, and 17, 2024. The Insurer finally responded on July 17, 2024—more than 14 days after June 24, 2024. The response simply stated, “please know that I am in receipt of the attached. I am the TPA handling this claim. Thanks.” This response did not address any of the requested documents included in the June 24, 2024, communication. To date, the Insurer has not provided any of the documentation requested in the June 24, 2024, letter. Upon an Insurer’s receiving a communication with respect to a claim, the Insurer is required, within fourteen (14) calendar days, to 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 prevents such acknowledgement. There has been no response within the fourteen (14) calendar days of receipt of the Insured’s communication and the Insurer has not alleged any factors beyond its control that would make such communication impossible. Insurers have a duty to settle claims in good faith when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for her interests. The Insurer has failed or refused to promptly acknowledge the Insured’s communications in an attempt to frustrate and delay the resolution of the Insured’s claim. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer’s claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured’s interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer’s actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer’s actions amount to but are not limited to the following: 1. Claim delay 2. Not treating the Insured with good faith claims conduct 3. Looking for way to reduce recovery to the Insured 4. Looking for ways to deny recovery to the Insured 5. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 6. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the Insured's interests 7. Placing the financial interest of the Insurer over that of the health and safety of the Insured 8. Shifting the burden of investigating onto the Insured 9. Failing to acknowledge and act promptly upon communications with respect to claims 10. Failing to provide a copy of the insurance policy within 30 days 11. Failing to provide a loss run statement Therefore, to cure the defects outlined in this civil remedy notice, the insurer must: (1) Admit full coverage for the Insured’s loss. (2) Tender full benefits owed to the Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via E-Mail: Certain Underwriters at Lloyd’s, London Subscribing to Policy No. W4777821PNYH 14 W. Patrick St., Suite 201 Frederick, MD 21701 janthony@synergyadj.com
Comments
User Id Date Added Comment
wcollum@butler.legal 02-10-2025 February 10, 2025 Via Electronic Filing Florida Department of Financial Services Bureau of Consumer Services – Civil Remedy Larson Building, 200 East Gains Street Tallahassee, FL 32399-0322 Re: DFS Filing Number: 789080 Filing Accepted: 10/29/2024 Complainant: Kim Winstead Insureds: Robert L. Winstead and Kim P. Winstead Policy Number: W4777821PNYH Date of Loss (as reported): September 29, 2022 Locations: 1526 Hermitage Lane, Cape Coral, Florida 33914 Claim Number: 47331 Our File Number: 3139-2407384 Dear Sir/Madam: The undersigned, William B. Collum, Esq., represents Certain Underwriters at Lloyd’s, London subscribing to policy number W4777821PNYH in the above-referenced claim and presents this correspondence in reply to the Civil Remedy Notice of Insurer Violation numbered 789080 filed by Kim Winstead, as the sole Complainant (“Civil Remedy Notice”). On December 18, 2024, I, as legal counsel to Certain Underwriters at Lloyd’s, London subscribing to policy number W4777821PNYH, wrote the Department memorializing Kim Winstead’s agreement to further extend the Civil Remedy Notice response deadline to, and including, February 14, 2025. As a result, this correspondence is timely under the Florida Statutes. The subject policy numbered W4777821PNYH issued to Robert L. Winstead and Kim P. Winstead contains an Arbitration Clause Endorsement requiring that all disputes arising under the policy, including the adjustment of any claim, shall be resolved by mandatory arbitration. Additionally, the Arbitration Clause Endorsement of the policy provides that all disputes are to be governed by the law of the State of New York. Accordingly, Certain Underwriters at Lloyd’s, London subscribing to policy number W4777821PNYH (hereinafter referred to as “Underwriters”) contend that, because the laws of the State of New York (not Florida) apply, Florida law and this Civil Remedy Notice are not applicable to the claim. Moreover, subsequent to the filing of this Civil Remedy Notice, the Complainant and Underwriters reached a global settlement of the claim. Further, the Civil Remedy Notice is being withdrawn. Underwriters’ adjustment of the subject claim was conducted in accordance with the requirements of the law. The allegations in the Civil Remedy Notice are without merit. Underwriters specifically deny each and every violation alleged in the Civil Remedy Notice. Underwriters deny that they engaged in any actions that would be deemed improper. Please do not hesitate to contact me if you should have any questions regarding this matter. Thank you for your consideration of this matter. Respectfully, BUTLER WEIHMULLER KATZ CRAIG LLP /s/ William Collum William B. Collum, Esq. wcollum@butler.legal 813.594.5814 cc: Robert L. Winstead VIA U.S. MAIL & EMAIL Kim P. Winstead assist@krapflegal.com c/o Grant W. Krapf, Esq. Krapf Legal, P.A. 2790 Sunset Point Road Clearwater, Florida 33759
wcollum@butler.legal 12-18-2024 December 18, 2024 Via Electronic Filing Florida Department of Financial Services Bureau of Consumer Services – Civil Remedy Larson Building, 200 East Gains Street Tallahassee, FL 32399-0322 Re: DFS Filing Number: 789080 Filing Accepted: 10/29/2024 Complainant: Kim Winstead Insureds: Robert L. Winstead and Kim P. Winstead Policy Number: W4777821PNYH Date of Loss (as reported): September 29, 2022 Locations: 1526 Hermitage Lane, Cape Coral, Florida 33914 Claim Number: 47331 Our File Number: 3139-2407384 Dear Sir/Madam: The undersigned, William B. Collum, Esq., represents Certain Underwriters at Lloyd’s, London subscribing to policy number W4777821PNYH in the above-referenced claim and presents this correspondence in reply to the Civil Remedy Notice of Insurer Violation numbered 789080 filed by Kim Winstead, as the sole Complainant (“Civil Remedy Notice”). The subject policy numbered W4777821PNYH issued to Robert L. Winstead and Kim P. Winstead contains an Arbitration Clause Endorsement requiring that all disputes arising under the policy, including the adjustment of any claim, shall be resolved by mandatory arbitration. Additionally, the Arbitration Clause Endorsement of the policy provides that all disputes are to be governed by the law of the State of New York. Accordingly, Certain Underwriters at Lloyd’s, London subscribing to policy number W4777821PNYH (hereinafter referred to as “Underwriters”) contend that, because the laws of the State of New York (not Florida) apply, Florida law and this Civil Remedy Notice are not applicable to the claim. Without waiving Underwriters’ position that the law of the State of New York applies to the claim, Underwriters, in the abundance of caution, however, will provide their response to the substance of the Civil Remedy Notice on or before February 14, 2025, as agreed with Complainant, through Complainant’s legal counsel. Prior to the Civil Remedy Notice, Underwriters worked with the Complainant on the investigation of the loss and the claim. In light of the circumstances, the Complainant and Underwriters have agreed to extend the Notice response deadline to, and including, February 14, 2025. Underwriters are continuing to amicably work with the Complainant to address the claim. Underwriters’ adjustment of the subject claim was conducted in accordance with the requirements of the law. The allegations in the Civil Remedy Notice are without merit. Underwriters specifically deny each and every violation alleged in the Civil Remedy Notice. Underwriters deny that they engaged in any actions that would be deemed improper. Please do not hesitate to contact me if you should have any questions regarding this matter. Thank you for your consideration of this matter. Respectfully, BUTLER WEIHMULLER KATZ CRAIG LLP /s/ William Collum William B. Collum, Esq. wcollum@butler.legal 813.594.5814 cc: Robert L. Winstead VIA U.S. MAIL & EMAIL Kim P. Winstead assist@krapflegal.com c/o Grant W. Krapf, Esq. Krapf Legal, P.A. 2790 Sunset Point Road Clearwater, Florida 33759
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