Civil Remedy Notice of Insurer Violations
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Filing Number:     790233
Filing Accepted:  11/4/2024
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Complainant
Last/Business Name *  
KATIPALLI AND LAKSHMI KATIPALLI   First Name   MURALI K.
Street Address * 19216 ROBIN PERCH LANE
City, State Zip * TAMPA, FL 33647
Email Address * MURALI.KATIPALLI@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   KATIPALLI AND LAKSHMI KATIPALLI   First Name   MURALI K.
Policy # * HOH134556 Claim #* H118135
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial
Street Address* 1800 2ND STREET, SUITE 892
City, State Zip* SARASOTA , FLORIDA 34236
Email Address * ESERVICE@ROSSLEGALFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* DARRELL YEAGER, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
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)(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.
* 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 Insureds may not be in possession of a complete copy the applicable policy of insurance, however, the specific policy language relevant to the violations outlined below is contained within Heritage Property & Casualty Insurance Company, Policy No. HOH134556, issued to the Insureds including, but is not limited to, the following: Dwelling Coverage provisions Perils Insured Against Loss Payment Loss Settlement
 
* 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. Heritage Property & Casualty Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Murali K Katipalli and Lakshmi Katipalli (“INSURED”) claim of loss. Heritage Property & Casualty Insurance Company’s mailing address is 1401 North Westshore Boulevard, Tampa, FL 33607. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSUREDS’ property located at 19216 Robin Perch Lane, Tampa, FL 33647 which sustained significant damage from sudden and accidental water loss on or about January 22, 2023. INSURED promptly reported the claim and damage to ceiling and drywall to INSURER. On January 28, 2023, INSURER sent a field adjuster to inspect the property. INSURER requested a preferred vendor; American Leak Detection Services perform an inspection. The preferred vendor of the INSURER performed a biased examination and stated the source of the moisture from the downstairs hallway ceiling had “no evidence of an active pressurized plumbing leak at this time. All water facilities in the upstairs guest bathroom including the sink drain arm, toilet wax ring, shower mixer valve and tub/shower. The drains were tested and/or inspected. A leak was located at the toilet wax ring. When the toilet is flushed, water leaks past the wax ring, dripping onto the ceiling below causing damage. During the testing of the toilet wax ring, the moisture level on the ceiling below increased, confirming the failed wax ring. On February 21, 2023, INSURER sent correspondence to INSURED denying their claim for long term seepage through the toilet wax ring of the upstairs bathroom from wear and tear. Knowing the INSURER did not want to fairly adjust their claim, INSUREDS hired Compass Claims Solutions to perform and inspection and assist with the claim. Compass Claims Solutions inspected the property and found damage to the toilet, hallway by stairs, bedroom by stairs, stairs, and guest bathroom. Damages amounted to $12,353.66. INSURED’s damages was sudden and accident water loss. INSURER owes for ensuing damage. INSURER owes for damages to access the source of the water loss. Therefore, demand is hereby made as follows: Estimate $12,353.66 Less Prior Payments $0 Less Deductible $2,500 TOTAL $9,853.66 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’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 INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER 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 claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $9,853.66 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: American Leak Detection Report 02.09.2023, Denial Letter 02.21.23 Insured’s Estimate 05.08.24
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 12-27-2024 The Insureds, Murali K Katipalli and Lakshmi Katipalli, hereby provide notice to the Department of Financial Services and Heritage Property & Casualty Insurance Company, that the issues outlined in Civil Remedy Notice #790233 have been resolved between the parties and Heritage Property & Casualty Insurance Company has cured all allegations listed therein. Accordingly, Murali K Katipalli and Lakshmi Katipalli, hereby withdrawals Civil Remedy Notice #790233 filed on 11/04/24.
ncarlisle@heritagepci.com 12-19-2024 December 19, 2024 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Murali K. Katipalli and Lakshmi Katipalli Insured: Murali K. Katipalli and Lakshmi Katipalli Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 790233 Claim No: H118135 Policy No.: HOH134556 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 790233, filed on behalf of Heritage’s insured Murali K. Katipalli and Lakshmi Katipalli (“Complainant”). The Notice was accepted by the Department on November 4, 2024. The subject Notice fails to comply with §624.155, Florida Statute, which provides that a Civil Remedy Notice must state with specificity the facts giving rise to the alleged violations and the policy language relevant to the violation, if any. Here, the Complainant did not substantially comply with the specificity standard, and this is more than a mere technical defect. As a result, the Complainant has failed to satisfy the requirement that it identify the specific policy provision relevant to Heritage’s alleged violation and/or the specific facts and circumstances giving rise to the violation and/or the names of any individuals involved in the alleged violations. See Fla. Stat. § 624.155(3)(b). Strict construction of Fla. Stat. § 624.155 demands a specificity level of compliance with the requisite provision of information to the Department and the insurer. See e.g. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). However, here, the Notice fails to meet the stringent standards that are required by Florida Law. Id. Instead, the Notice merely contains a list of violations which Heritage has allegedly committed but the Notice fails to provide an adequate basis in support of those allegations and on that basis alone, the Notice fails to satisfy the basic requirements of an otherwise proper Civil Remedy Notice. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875; Fla. Stat. §§ 624.155 and 626.9541. Furthermore, and without waiving Heritage’s arguments that the Notice is legally insufficient and non-compliant with Florida law, Heritage has at all times performed its obligations under the insurance policy in a prompt and diligent manner with due regard for the interest of its insured. The Notice contains a list of violations which are alleged to have been committed by Heritage. However, none of the listed violations/allegations have occurred and Heritage categorically denies any claims that it has violated the obligations and duties set forth under §624.155 and §626.9541, Fla. Stat., as well as any and all other statutes/regulations/codes/rules raised in the Notice. Furthermore, the Complainant has failed to produce any substantive information and/or documentation to support any of the allegations set forth in the Notice; and as such, the Notice is legally insufficient. Moreover, recently, the parties have reached a settlement agreement and they are currently in the process of finalizing same. As such, this Notice is now moot. Accordingly, Heritage has handled the claim in accordance with the insurance policy, Florida law, and all statutory and regulatory requirements. Therefore, Heritage denies each and every assertion of bad faith in the Notice. And, notwithstanding the foregoing, nothing in this letter should be construed as a waiver or surrender of the policy terms, limitations, exclusions, conditions or agreements, nor should this letter be considered an exhaustive recitation of the deficiencies in the Notice. Heritage reserves the right to supplement its response at a later time. Should the Department have any questions, concerns, or require any additional information regarding this matter, please feel free to contact the undersigned at your convenience. Sincerely, /s/ Benndrick C. Watson Benndrick C. Watson, Esq. Claims Counsel Heritage Property & Casualty Insurance Co. CRN Response
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