Civil Remedy Notice of Insurer Violations
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Filing Number:     789355
Filing Accepted:  10/30/2024
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Complainant
Last/Business Name *  
QUILES   First Name   BISMARK
Street Address * 616 WASHINGTON WAY
City, State Zip * HAINES CITY, FL 33844
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   QUILES   First Name   BISMARK
Policy # * 07963637 Claim #* SL232081678
Attorney
Attorney is Applicable
Last Name* GUTIERREZ First Name * DANIEL Initial
Street Address* 924 DELANEY AVENUE
City, State Zip* ORLANDO , FLORIDA 32806
Email Address * SERVICE@DGPALAW.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):* JANETTRA MCPHERSON
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Claim Denial
Unsatisfactory Settlement Offer
Unfair Trade Practice
* 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)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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.
* 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 coverage decision correspondence incorrectly relies on the following policy language from CIT HO-3 06 23, which states in part the following: . . . SECTION I – EXCLUSIONS A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. . . . 11. Existing Damage Existing Damage, also known as pre-existing damage, means: a. Damages which occurred prior to policy inception regardless of whether such damages were apparent at the time of the inception of this Policy or discovered at a later date; b. Damages existing prior to the time of loss; or c. Any unrepaired part or portion of a loss to property for which you have made an insurance claim, whether or not paid by insurance. Paragraph c. above does not apply, for the same loss, to a reopened claim or a supplemental claim described under SECTION I – CONDITIONS, Condition V. However, under this Exclusion A.11. any ensuing loss to property described in SECTION I – PROPERTY COVERAGES not otherwise excluded or excepted in this Policy is covered. This Exclusion A.11. does not apply in the event of a total loss caused by a Peril Insured Against. SECTION I – CONDITIONS T. Policy Period This Policy applies only to loss which occurs during the policy period.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about December 16, 2023, the home of Bismark Quiles and Gretchen Rivera (hereinafter referred to the “Insureds”) was damaged by a storm. Specifically, the roof and exterior were damaged and interior water damages ensued. The Insured reported these damages to their homeowners’ insurance company, Slide Insurance Company (hereinafter referred to as “Insurer”). The Insurer responded to the claim and inspected the damages. In correspondence dated April 8, 2024, the Insurer advised that they completed their investigation and found that there is wind damage on all slopes of the roof or elevation of the home. However, they stated that they had determined that the damage was preexisting prior to the reported date of loss and prior to the 10/23/23 policy assumption with Slide Insurance. Therefore, Slide denied the claim. However, at no point did the letter provide any explanation as to how they were able to determine when the observed storm damages occurred or who’s opinion they were relying on for this determination. As the Insureds recalled the storm that caused the damage to the property and believed it to be during the Slide policy, they retained a public adjuster and then an attorney to assist with the claim. Despite being notified of the dispute, Slide has taken no action to conduct further investigation or provide an explanation for how they concluded that the loss pre-dated the policy assumption. The Insureds received an estimate for storm damages that included replacement of the roof and totaled $62,171.30 RCV. If any additional information or documentation is needed for the Insurer to further consider the claim, then the Insurer failed to advise of what information is necessary for the processing of the claim and why it is necessary. It is clear that the carrier is not treating the Insureds with good faith claims conduct by failing to pay a claim clearly owed, not adjusting the claim and evaluating the loss properly, failing to promptly and fairly provide full and prompt indemnity to the Insureds, failing to advise of any information necessary for further processing of the claim, failing to provide a reasonable explanation in writing of the basis in the insurance policy in relation to the facts for the denial of the claim, and failing to implement proper standards for the adjustment and investigation of claims by its adjusters. This Insurer is placing the company’s interests before the Insured’s interests when a reasonable carrier in a similar position would have provided full coverage. In particular, it is a business practice of the Insurer to make determinations that storm damages predate the policy assumption with the intent of effecting settlement of such claims on less favorable terms than those provided by the policy. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the Insured’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of the estimate provided by the Insureds’ adjuster and in compliance with the policy 2.) Pay the Insureds’ attorneys’ fees and costs as they have been forced to retain counsel; 3.) Pay the statutory interest on the amount of unpaid damages from the date the loss was reported to the date payment is finally made. A copy of this form has been submitted to the FDFS and has been printed out and mailed to the following parties providing them notice of the filing of the Civil Remedy Notice: Slide Insurance Company 4221 W Boy Scout Blvd Tampa, Florida 33607 Certified Return Receipt # 9589 0710 5270 1009 7571 45
Comments
User Id Date Added Comment
mnixon@slideinsurance.com 12-04-2024 Via E-mail & Posting on DFS Website Daniel Gutierrez, Esq. Daniel Gutierrez, P.A. 924 Delaney Ave Orlando, FL 32806 service@dgpalaw.com Claimant: Bismark Quiles Insured: Bismark Quiles Claim No: SL23208167 Policy No: 07963637 Date of loss: 12/16/23 CRN Filing No.: 789355 Dear Mr. Gutierrez: Please allow this correspondence to serve as Slide Insurance Company’s (“Slide”)’s response to the Civil Remedy Notice (“CRN”) that was filed on behalf of Bismark Quiles (“Insured”). Herein, we include a brief factual history of the underlying claim and actions by Slide which reveals it has acted properly in responding to the underlying claim and in compliance with its contractual and legal obligations. Slide denies each and every allegation brought forth in the CRN and denies any wrongdoing in the handling of the underlying claim. Slide further notes that CRN is invalid and improper as the correct claim number is SL23208167, not SL232081678. Nonetheless, Slide denies violating any Florida Statute or Administrative Code as set forth more specifically herein. Moreover, Slide denies violating any provisions or duties set forth in the applicable policy of insurance. Slide further states that the facts and circumstances that are set forth in the CRN, while incomplete and misleading, do not give rise to any violation of any statute or policy provision referenced in the Notice. Furthermore, Slide challenges the validity of the CRN for lacking specificity. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, 879 (Fla. 4th DCA 2021) (affirming dismissal for civil remedy notice’s failure to either strictly, or substantially, comply with statutory specificity requirement); Demase v. State Farm Florida Insurance Company, 351 So.3d 136, 138-39 (Fla. 5th DCA 2022) (holding that the trial court properly determined that a civil remedy notice that failed to state with specificity the relevant policy language was legally insufficient). Finally, the Notice is improper pursuant to Fla. Stat. §624.1551. CLAIM FACTS The underlying claim was reported as a claim for alleged damages on March 7, 2024, for an alleged weather event with a DOL of December 16, 2023. Slide sent Independent Adjuster Holly Weber to inspect the insured property. Based on Slide’s investigation and evaluation of the claim, on or about April 8, 2024, Slide notified the Insured that there is not any coverage for the alleged loss pursuant to the Policy’s terms, conditions, endorsements, limitations, and exclusions. Thus, Slide maintains that it has acted in accordance with the terms of the subject insurance policy, and the law, and has acted in good faith towards the Insured. Slide denies that it violated any statutes or committed the acts asserted in the CRN. Slide neither waives nor is estopped from asserting any and all rights that it may have in law or under the terms of the policy. Slide expressly reserves all such rights without exception or limitation. REASONS FOR THE NOTICE The CRN alleges four (4) reasons for the filing of the Notice. However, no specific facts or circumstances are provided to support these allegations. Notwithstanding, Slide denies each and every allegation of violation individually as follows: 1. Claim Delay: Slide denies any delay in the claims handling process of the underlying loss as is evident from the facts outlined above. Slide promptly acknowledged the claim and timely initiated its investigation of the loss including inspection of the subject property. Slide acted in accordance with its duties and obligations pursuant to the policy of insurance and responded appropriately to information and documentation that was provided. Thus, Slide asserts that this allegation is without basis and therefore denied. 2. Claim Denial: This allegation is without basis and therefore denied. Slide acted in accordance with its duties and obligations pursuant to the policy of insurance as well as Florida law. Accordingly, Slide’s actions are adequately supported by law and fact. Thus, this allegation is without basis and therefore denied. 3. Unsatisfactory Settlement Offer: Slide denies that it extended any unsatisfactory settlement offers to the Insured. Slide promptly investigated the loss and the Insured was notified that there is not any coverage for the alleged loss pursuant to the Policy’s terms, conditions, endorsements, limitations, and exclusions. Slide asserts that it has acted in good faith towards its Insured at all times. Thus, this allegation is without basis and therefore denied. 4. Unfair Trade Practice: There is no basis for this allegation, thus it is wholly denied. The Insured has submitted no facts or circumstances to support this allegation. The handling and administration of this claim occurred with the expediency and timeliness allowed by the statutory requirements imposed upon Slide. At no time did Slide, its agents, or its employees delay the handling, administration, or disposition of this claim. The facts show that Slide acted promptly with respect to the investigation of the underlying claim and made communications as necessary to adjust the claim in a prompt and appropriate manner. Information necessary and relevant to the proceeding of the claim was communicated to the Insured or their representatives in an appropriate and timely manner. ALLEGED STATUTORY VIOLATIONS The CRN alleges multiple statutory violations. However, no specific facts or circumstances are provided to support these allegations. Notwithstanding, Slide denies each and every allegation of statutory violation individually as follows: 1. 624.155(1)(b)(1): Denied. The underlying claim was investigated and adjusted in as thorough and expedient a manner as possible. Following the investigation and evaluation of the underlying claim, the Insured was notified that there is not any coverage for the alleged loss pursuant to the Policy’s terms conditions, endorsements, limitations, and exclusions. Moreover, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 2. 624.155(1)(b)(3): Denied. Slide has not failed to promptly settle the underlying claim. The underlying claim was investigated and adjusted in as thorough and expedient a manner as possible.? Following the investigation and evaluation of the underlying claim, the Insured was notified that there is not any coverage for the alleged loss pursuant to the Policy’s terms conditions, endorsements, limitations, and exclusions. Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it.? Moreover, the insured has submitted absolutely no facts or circumstances supporting this allegation. 3. 626.9541(1)(i)(2): Denied. Slide has not made any material misrepresentations to the Insured or any other person having an interest in the proceeds payable under the subject policy for insurance. The underlying claim has been investigated and adjusted in as thorough and expedient a manner as possible. Slide routinely communicated relevant information to the Insured and/or their representatives. Thus, any such allegation is without merit and unsupported by the facts of the underlying claim. Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 4. 626.9541(1)(i)(3)(a): Denied. This allegation is without basis. Slide has adopted and implemented standards for the proper investigation of claims at all times during the investigation of the subject matter. The aforementioned facts demonstrate that Slide employed proper and customary claims practices in the investigation and adjustment of this claim including, but not limited to, a prompt inspection of the Insured’s property and timely communications with the Insured and their representatives. Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 5. 626.9541(1)(i)(3)(b): Denied.? This allegation is without basis.? Slide has been forthcoming and truthful regarding the pertinent claim facts and/or insurance policy provisions relating to the reported loss. Slide’s correspondences and communications to the Insured and their representatives proves this fact.? Accordingly, Slide asserts its full and strict compliance with the statutory requirements imposed upon it.? Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 6. 626.9541(1)(i)(3)(c): Denied. This allegation is without basis. Slide has consistently acted promptly upon all communications with respect to this claim as previously outlined. Slide has adjusted the underlying loss in as thorough and expedient a manner as possible. Moreover, Slide routinely communicated with the Insured and/or their representatives regarding the underlying claim. Thus, Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Any assertions to the contrary are unsupported by the facts. 7. 626.9541(1)(i)(3)(d): Denied. Slide has not denied the underlying claim without reasonable investigation of the reported loss. As referenced in the factual narrative above, Slide investigated the reported claim and adjusted the loss in as thorough and expedient a manner as possible.? Following the investigation and evaluation of the underlying claim, the Insured was notified that there is not any coverage for the alleged loss pursuant to the Policy’s terms conditions, endorsements, limitations, and exclusions. Accordingly, there is simply no support for this allegation and Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. 8. 626.9541(1)(i)(3)(f): Denied. Slide did not fail to provide an explanation for its denial of the claim. Slide has conducted a reasonable investigation of the reported loss as referenced in the factual narrative above. Thus, there is simply no support for this allegation and Slide asserts its full and strict compliance with the statutory requirements imposed upon it. Finally, the Insured has submitted absolutely no facts or circumstances supporting this allegation. ALLEGED VIOLATIONS OF THE INSURANCE POLICY The CRN fails to allege specific violations of the insurance policy and provides no specific facts or circumstances of wrongdoing. The boilerplate CRN merely sets forth blanket allegations of wrongdoing, without further information. As such, the CRN is defective, as it failed to specifically identify the policy language that is the subject of the alleged violation, and further failed to include sufficient facts to put Slide on notice of the alleged violations. Notwithstanding, Slide denies any and all allegations of policy violations. All actions by Slide were done in compliance with the applicable Policy. As indicated above, Slide thoroughly investigated the reported loss including inspection of the Insured’s property. Thus, it is clear that Slide has acted in compliance with the Policy. Slide asserts that it has at all times complied with the terms of the Policy and has complied with all applicable provisions of the Policy and Florida Statutes in the handling of this matter. STATEMENTS AS TO CURING THE DEFECTS OUTLINED IN THE NOTICE The CRN asserts that Slide must tender all insurance benefits due and owing. Additionally, the CRN alleges that Slide must pay the Insured’s attorneys’ fees and costs when the Insured is not entitled to attorneys’ fees and costs pursuant to Fla. Stat. §627.428(4). Nevertheless, the method for curing violations alleged in a Civil Remedy Notice is not determined by the Insured. Talat Enterprises, Inc. v. Aetna Casualty Surety Co., 753 So. 2d So. 2d 1278 (Fla. 2000). Accordingly, Florida Statutes Section 624.155 does not impose on an insurer the obligation to pay whatever the Insured demands. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. Thus, Slide reasserts that it has acted in good faith towards its Insured at all times. Slide references to all the facts herein, which unequivocally demonstrate Slide’s expedient and timely administration of the Insured’s claim. Slide further asserts its full and strict compliance with the Policy and reiterates that it has acted properly in responding to the underlying claim in compliance with its contractual and legal obligations. Slide denies any wrongdoing in the handling of the underlying claim. Additionally, Slide denies violating any Florida Statute, Administrative Code, or code of ethics. CONCLUSION In conclusion, the documented facts of this claim establish that Slide acted diligently in its claims response and adequately performed its obligations under the policy of insurance and Florida law. Thus, the facts contradict all allegations that Slide has in any manner acted improperly or contrary to its contractual obligations to the Insured in this claim. Herein, Slide has attempted to fully and adequately respond to the allegations the Insured allege in the Civil Remedy Notice of Insurer Violation filed with the Department. Should there be any questions or further inquiry with respect to this matter, please contact the undersigned at (813) 761-1866 or at mnixon@slideinsurance.com. Sincerely, /s/ Michael Nixon Michael Nixon, 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