Civil Remedy Notice of Insurer Violations
Login

Filing Number:     789940
Filing Accepted:  11/1/2024
         Print Filing
Complainant
Last/Business Name *  
GRIMES   First Name   CURTIS
Street Address * 1604 SNAPPER ST
City, State Zip * SAINT CLOUD, FL 34771
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   GRIMES   First Name   CURTIS
Policy # * 988736812 Claim #* 0674985734
Attorney
Attorney is Applicable
Last Name* PARDO First Name * ERIKA Initial
Street Address* 618 E SOUTH STREET, SUITE 500
City, State Zip* ORLANDO , FL 32801
Email Address * ERIKA@THEPARDOLAWFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CASTLE KEY INDEMNITY COMPANY
NAIC Company Code 10835
 
Name of individual responsible for violation (if any):* ISAIAH GIBERT
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
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)(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.
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.

Governed by the cited authorities, the subject policy provides coverage for sudden and accidental losses and damages arising from windstorm. 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. Furthermore, the policy provides coverage for assessments in relation to remediation, as well as the amount necessary to perform remediation. SECTION I - YOUR PROPERTY Losses We Cover Under Coverages A and B: We will cover sudden and accidental direct physical loss to property described in Dwelling Protection–Coverage A and Other Structures Protection–Coverage B except as limited or excluded in this policy. Our Settlement Of Loss We will settle any covered loss with you unless another payee is named in the policy. We will settle within 20 days after the amount of loss is finally determined. This amount may be determined by an agreement between you and us, an appraisal award or a court judgment. 17. Mold, Fungus, Wet Rot And Dry Rot Remediation As A Direct Result Of A Covered Water Loss In the event of a covered water loss under Dwelling Protection– Coverage A, Other Structures Protection–Coverage B or Personal Property Protection–Coverage C, we will pay up to $10,000 for mold, fungus, wet rot or dry rot remediation
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Complainant and Insured, Curtis Grimes (hereinafter referred to as “Complainant”), maintained a homeowner’s policy of insurance (“Policy”) with Castle Key Indemnity Company ("Castle Key”), which provides coverage for sudden and accidental damages and losses arising from windstorm (“Loss”). The Loss caused substantial, direct and consequential damages, and ASI's general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claims, has caused the Complainant to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue. The stated misconduct outlined below is collectively referred to as “Bad Faith,” and the specific, straightforward factual and/or legal considerations in relation thereto are further outlined below for its consideration in accordance with Fla. Stat. Sec. 624.155 and the cited legal authorities associated therewith. On or about March 15, 2022, the Complainant's property sustained damage due to a windstorm event. Damages manifested later in time. Complainant suffered direct physical loss to the subject property and hired Full Pro Restoration Inc. to perform the necessary, industry wide practice of performing moisture meter assessments coupled with the corresponding thermal imaging, to detect latent conditions, which, if undetected, will serve to create toxic conditions at the subject property. During the adjustment of the claim, all relevant documents from Full Pro. Restoration Inc., were dutifully provided. To date, no adjuster and/or qualified expert has been retained by Castle Key to dispute findings of elevated latent levels of water moisture at the subject property via the moisture meter assessments coupled with the corresponding thermal imaging. Moreover, OGA Solution LLC was retained to perform mold testing at the subject property. All relevant documents from OGA Solution LLC were dutifully provided during the pre-suit adjustment of the claim. To date, no adjuster and/or qualified expert has been retained by Castle Key to dispute the positive findings of mold at the subject property. Pursuant to the positive findings of mold, the Complainant hired Full Pro. Restoration Inc. to perform the necessary, industry-wide practice of mold remediation, given the positive findings of mold at the subject property. All relevant documentation in relation to the mold remediation performed by Full Pro. Restoration Inc., were dutifully provided to Castle Key. To date, no adjuster and/or qualified expert has been retained by Castle Key to dispute the necessity and/or reasonable course of repairs by way of the mold remediation services provided. Castle Key inspected the subject property by way of a field adjuster by the name of Isaiah Gibert (hereinafter referred to as “Mr. Gibert”). It is believed that Mr. Gibert is not and has not been disclosed as a qualified expert to attest as to the cause and/or full extent of the damages at the subject property. In addition, as of the date of this filing, Mr. Gibert has failed to dispute the latent water damages that were detected via the moisture meter assessments and/or corresponding thermal imaging, as well as the necessary water remediation services provided, coupled with the mold testing (which was found positive), and corresponding mold remediation to protect the inhabitants of the subject property from toxic conditions. Based on the insufficient adjustment of the claim as outlined herein, Castle Key on or about July 3, 2022, issued a wholly unsatisfactory valuations of $807.05, which did not exceed the deductible of $1,000.00. In opposition to same, the Complainant (through his retained counsel) has obtained a repair or damage estimate with a valuation of $140,491.23, that duly takes into consideration the full extent of the latent conditions, that serve to create a plethora of extra contractual damages that continue to accrue, given Castle Key's general business practice of failing to adjust the full extent of the damages as outlined herein. In other words, the Complainant hereby notified ASI of its unsatisfactory, lowball valuation of the underlying claim. To cure the above stated immoral, deceptive, unlawful and collectively defined general business practice of bad faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the insured’s interests being implemented, Castle Key must perform as follows within 60 days of receiving this CRN: I. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same, and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainant as per the industry wide accepted standards outlined herein; II. Take corrective action and allow in association with the mandatory appraisal provision outlined herein, to serve as a means to draw a swift resolution as to the disputed amount of the loss as a preferred alternative dispute resolution to resolve this claim. To hold otherwise, would allow Castle Key's bad faith claims handling described above to leave the insureds, the insured’s counsel, the insurer’s counsel, and even the judiciary guessing as to when and how Castle Key will duly perform. These continuously vacillating positions and cherry-picking of the described bad faith conduct outlined herein, not only serves to maximize Castle Key’s prospective financial gains by being able to avoid paying benefits, it also serves to minimize Castle Key’s loss adjusting expenses as it sees fir to the invariable detriment of the insureds, the Complainants, and ultimately the tax paying citizens of this State that bear the expense of the judicial system, which needs to be unraveled due to the tangled web created by Castle Key.
Comments
User Id Date Added Comment
joanna.opato@allstate.com 12-24-2024 December 24, 2024 VIA CRN ONLINE SYSTEM Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Building, 200 Gaines Street Tallahassee, FL 32399-0322 Re: Complainant: Curtis Grimes DFS File No.: 789940 Insured: Curtis Grimes Insurance Company: Castle Key Indemnity Company Claim No.: 0674985734 Dear Sir or Madam: This letter is Castle Key Indemnity Company’s (“Castle Key”) response to the above-referenced Civil Remedy Notice. This response is provided on behalf of Castle Key and all of its employees, agents, officers and affiliates. The Department accepted the CRN on 11/1/2024. Therefore, this response has been timely filed within the statutory deadline. As a preliminary matter, Castle Key at all times during the handling of this claim acted fairly and honestly toward its insured. Castle Key fully and fairly considered information in regard to the matters at hand and fully observed its contractual, statutory and administrative obligations. Castle Key has carefully reviewed, considered, and evaluated the alleged violations charged and believes they are completely without merit. Castle Key wholly denies any and all allegations of wrongdoing, claim delay, claim denial, unfair claims handling, unsatisfactory settlement offer, unfair trade practice, misrepresentation or bad faith in connection with the above claim. Additionally, the CRN is defective and either does not sufficiently state the circumstances at hand or does so inaccurately. Accordingly, the CRN should be rejected Complainants’ CRN violates the requirements set forth in the Florida courts’ jurisprudence for civil remedy notices. It fails to meet even the most basic requirements of the statute. Accordingly, Castle Key respectfully requests the Department return the CRN and insist Complainants provide the specific facts required for civil remedy notices. See Section 624.155(3)(c), Florida Statutes. These requirements arise from the provisions of Section 624.155(3)(a) & (b), Florida Statutes. 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. 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 Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1284 (Fla. 2000) (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). 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. There are requirements for a valid civil remedy notice. Section 624.155(3), Florida Statutes. Section 624.155 mandates Complainants 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. 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. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008). Complainants’ CRN violates the specificity requirement. As such, Castle Key would like this opportunity to set forth an accurate factual background, and thereby correct omissions in Complainants’ CRN. Castle Key received its first notice of loss on June 22, 2022, for damages allegedly sustained by a wind hail story to the roof on March 15, 2022, to the property located at 1604 SNAPPER ST SAINT CLOUD FL 347717541. During this claim a prompt investigation was made, and an inspection was done by the appropriate Castle Key representative. Additionally, there was detailed follow up communication by Castle Key during all phases of this claim. Castle Key has fulfilled and is fulfilling its duties as provided under the terms and conditions of the insurance policy. Castle Key does not consider there to have been any violation of the referenced statutory provisions or otherwise. At all times during the investigation of the subject claim, Castle Key acted diligently and in good faith to resolve same. Castle Key reserves all of its rights. If anyone at the Department has any questions concerning this matter, please contact Castle Key at our office for a further response. Sincerely, CASTLE KEY INDEMNITY COMPANY
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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




DFS-10-363
Rev. 10/14/2008