Civil Remedy Notice of Insurer Violations
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Filing Number:     790468
Filing Accepted:  11/6/2024
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Complainant
Last/Business Name *  
SEQUIS/SEQUIS   First Name   WILSON/KRISTIN
Street Address * 11917 MANGO GROVES BOULEVARD
City, State Zip * SEFFNER, FL 33584
Email Address * WILSONSEQUIS@GMAIL.COM, KRISTIN.SEQUIS@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SEQUIS/SEQUIS   First Name   WILSON/KRISTIN
Policy # * SFLH0463232-09 Claim #* 61569
Attorney
Attorney is Applicable
Last Name* DAVID First Name * PETTINATO Initial J
Street Address* 1000 W. CASS STREET
City, State Zip* TAMPA , FL 33606
Email Address * DPETTINATO@OLDERLUNDYLAW.COM, DJP-PARALEGALS@OLDER
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SAFEPOINT INSURANCE COMPANY
NAIC Company Code 15341
 
Name of individual responsible for violation (if any):* JOSHUA CHUDNOW, JAYSON ENGELKE, JILMA FIGUEREDO NOVO, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SAFEPOINT INSURANCE COMPANY INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Failure to properly investigate claim and with due regard to Insured’s interest
Other : Failure to acknowledge and act promptly to communications regarding claim
* 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.
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.

ADD’L STATUTES VIOLATED §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 a representative of an insurer with respect to a claim shall constitute communication to or by the insurer. §627.70131(2) Such acknowledgment must 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 must provide necessary claim forms, and instructions, including an appropriate telephone number. §627.70131(3)(d) Within 7 days after the insurer’s assignment of an adjuster to the claim, the insurer must notify the policyholder that he or she may request a copy of any detailed estimate of the amount of the loss generated by an insurer’s adjuster. After receiving such a request from the policyholder, the insurer must send any such detailed estimate to the policyholder within the later of 7 days after the insurer received the request or 7 days after the detailed estimate of the amount of the loss is completed. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. §627.70131(7)(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. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer’s claim payment is less than specified in any insurer’s detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. 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 there 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 must 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. POLICY LANGUAGE 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 SafePoint Insurance Company’s Homeowners policy, Policy No. SFLH0463232-09, issued to the Insureds including, but is not limited to, the following: Coverage A-Dwelling provisions Coverage B-Other Structures provisions Additional Coverages provisions - Debris Removal - Reasonable Repairs - Ordinance Or Law The Declarations Page Loss Payment or Loss Settlement provisions Duties in Event of Loss Policy provisions The insurance policy's definition sections The insurance policy's exclusion of coverage provisions Please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insureds for the January 9, 2024, wind and/or hail loss.
 
* 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. SAFEPOINT INSURANCE COMPANY (“SAFEPOINT”) has breached this duty by its failure or refusal to acknowledge its Insureds’ claim of loss. SAFEPOINT has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations as set forth above. SAFEPOINT has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds’ insurance claim for damages. To date, notwithstanding the Insureds’ pleas, SAFEPOINT has continued to refuse to acknowledge its obligation to acknowledge and pay the full amount of its Insureds’ claim. This complaint is made on behalf of the Insureds, WILSON AND KRISTIN SEQUIS (“MR. AND MRS. SEQUIS”). Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155. In consideration of the premium paid to it by MR. AND MRS. SEQUIS, SAFEPOINT issued a Homeowners policy, Policy No. SFLH0463232-09 (hereinafter referred to as “The Policy”), to MR. AND MRS. SEQUIS wherein the insurance policy provided coverage for all losses, including wind and/or hail, except those losses which were expressly excluded. The policy was in full force and effect at the time the damage occurred as a result of wind and/or hail, and the ensuing damages as a direct result thereof, to the insured premises located at 11917 Mango Groves Boulevard, Seffner, FL 33584, on or about January 9, 2024. MR. AND MRS. SEQUIS’ insured property sustained damages to the exterior of the home including but not limited to the shingles, sheathing, ridge caps, drip edge, flashing, felt, as well as their fence. MR. AND MRS. SEQUIS timely notified SAFEPOINT of the damages and opened a claim pursuant to the terms and conditions of the Policy. In response, SAFEPOINT assigned the claim to its representative to adjust and investigate the loss, as well as a field adjuster to inspect the damages. On February 21, 2024, SAFEPOINT’S representative visited the insured property and performed a cursory and inadequate investigation of the damaged property. On February 23, 2024, SAFEPOINT submitted a Determination Letter to MR. AND MRS. SEQUIS, stating they “identified the following damages as being related to the windstorm. However, upon pulling the weather report, it showed no hailstorm in your area for the date of loss for you claim which therefore means there was no hail damage to your roof. Also observed was damage from wear and tear, deferred maintenance, that is typical for a roof of this age and material.” SAFEPOINT also stated that the amount of damage to the property was less than the deductible and unable to make a payment on the claim. Concerned that SAFEPOINT had no intention to fairly investigate and adjust their claim, MR. AND MRS. SEQUIS retained the services of an insurance claim professional from Utopia Public Adjusting (‘UTOPIA’), to assist in submitting their claim to SAFEPOINT which would adequately and fairly detail all the damages sustained as a result of the loss. On March 25, 2024, David Hogan of Utopia Public Adjusting submitted a Letter of Representation to SAFEPOINT. On May 8, 2024, after completing a thorough and comprehensive inspection and investigation of the Property, Mr. Hogan authored an estimate of the damages to restore the property to its pre-loss condition, which totaled a loss of $35,443.45. This estimate was inclusive of the full extent of damages located to the roof, fence, and the exterior of MR. AND MRS. SEQUIS’ insured property, as detailed above. This estimate was promptly submitted to SAFEPOINT. To date, SAFEPOINT has failed to tender any supplemental insurance benefits. SAFEPOINT has admitted that MR. AND MRS. SEQUIS sustained covered damages as a result of the wind and/or hail loss that occurred on or about January 9, 2024 but has denied tendering all owed insurance benefits to MR. AND MRS. SEQUIS. Pursuant to Florida Statute §626.9541(1)(i)(4), SAFEPOINT is required to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after SAFEPOINT received notice of the residential property insurance claim, determine the amounts of partial or full benefits, and agree to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). As SAFEPOINT has failed to do so, SAFEPOINT has wrongfully denied coverage. Since the beginning of the claim, SAFEPOINT has engaged in a pattern of delay, denial, and reckless disregard for MR. AND MRS. SEQUIS’ rights. The actions of SAFEPOINT listed herein have been continuing in nature and given the totality of the circumstances, which includes SAFEPOINT’S adjustment, actions and/or omissions post the filing of this CRN. MR. AND MRS. SEQUIS contend that given the past experience in this matter with SAFEPOINT, it is reasonably foreseeable that SAFEPOINT’S current actions will extend to its entire conduct in the handing of their claim, including the acts or omissions of SAFEPOINT and/or its representatives, until the final resolution of their claim. As such, MR. AND MRS. SEQUIS contend adequate notice has been given should SAFEPOINT’S actions and violations listed herein continue after the expiration of this notice. SAFEPOINT has failed and/or refused to settle the claim when it could and should have done so had it acted fairly and honestly towards MR. AND MRS. SEQUIS, and has failed to take into account the information and evidence provided that contradict its decisions. SAFEPOINT’S conduct has been reckless and unfair to MR. AND MRS. SEQUIS, and has caused and continues to cause additional damages throughout the property. This is evidenced by the delay in paying the claim and the failure of SAFEPOINT to evaluate the claim in total. To date, SAFEPOINT has failed and/or refused to provide MR. AND MRS. SEQUIS with all the necessary insurance benefits due and owing and has not tendered the full amount needed to repair the Property despite knowing that MR. AND MRS. SEQUIS have sustained covered damages to their insured property. As SAFEPOINT must admit, it is implied within every insurance policy a duty of good faith and fair dealings. In an insurance contract, each party is prevented from interfering with the other’s right to benefit from the contract. The obligations of good faith and fair dealings encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. SAFEPOINT is bound to conduct itself with the utmost good faith for the benefit of MR. AND MRS. SEQUIS. However, SAFEPOINT has failed to comply with the obligations in connection with this claim and has never looked at the claim or the contract for insurance with good faith and fair dealing. Instead, SAFEPOINT has looked for ways not to pay the claim in full, or pay the claim at all, and these actions have been to the detriment of MR. AND MRS. SEQUIS. 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 SAFEPOINT have approached this investigation in a manner prejudicial to MR. AND MRS. SEQUIS. SAFEPOINT is using either untrained or improperly trained adjusters in connection with this claim. SAFEPOINT should have been adjusting the loss with MR. AND MRS. SEQUIS but instead, it was looking for ways not to pay the claim at all, or pay the claim in full. If SAFEPOINT handles all the claims in the manner in which MR. AND MRS. SEQUIS’ claim was adjusted, then it is improperly handling all claims. SAFEPOINT has refused and/or failed to comply with The Policy’s cooperation and/or “Loss Payment” provision. Under The Policy, SAFEPOINT was to timely tender undisputed insurance benefits to MR. AND MRS. SEQUIS. SAFEPOINT has failed and/or refused to timely tender owed insurance benefits, undisputed or otherwise. This is a breach of The Policy. SAFEPOINT has refused and/or failed to cooperate and/or “Adjust the Loss” by cooperating with MR. AND MRS. SEQUIS during the claims adjustment process in compliance with The Policy’s “Loss Payment” provision. 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 security against a contingent loss. Florida Statute §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 MR. AND MRS. SEQUIS may mitigate their damages and to put them back into the position they were in prior to the loss as quickly as possible. SAFEPOINT has breached this duty. SAFEPOINT has refused and/or failed to tender all insurance proceeds to MR. AND MRS. SEQUIS upon demand. SAFEPOINT’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 MR. AND MRS. SEQUIS is wrongful conduct. Furthermore, MR. AND MRS. SEQUIS contend that SAFEPOINT’S adjusters and/or representatives financially benefit by such wrongful conduct. It is clear that SAFEPOINT’S adjusters have also failed to adhere to insurance industry rules and guidelines when adjusting a first party claim. It is also evident that SAFEPOINT violated the Florida unfair claims practices, the adjuster’s ethical code of conduct, and acted irresponsibly in the handling of its Insureds’ claims. In this case, MR. AND MRS. SEQUIS paid a hefty premium for a service, the service is called claims adjusting (I encourage you to read the book titled, “The Claims Environment” written by James J. Markham, Kevin M. Quinley, and Layne S. Thompson-this book is taught in every first year AIC course). The claim professional must dispense his or her knowledge and skill for the benefit of society. The general public expects claims representatives to pay all legitimate claims promptly and fairly. The claim professional must harness all of his or her knowledge and expertise to accomplish the objectives of the claim function. He or she must also adhere to the highest degree of ethical conduct. In addition to interacting with other insurance personnel and service providers in a professional manner, the claims professional must deal with public’s and regulator’s expectations. Insurance Companies provide such a vital and necessary service to society that the selling and servicing of insurance is imbued with a public trust. James J. Markham, Kevin M. Quinley, Layne S. Thompson, “The Claims Environment”, Insurance Institute of America, 1st ed., 1993. Accordingly, SAFEPOINT has a contractual and statutory obligation to investigate all possible bases which might support MR. AND MRS. SEQUIS’ claim and cannot deny a claim without thoroughly investigating the foundation for its denial or basis for withholding insurance benefits. SAFEPOINT violated its obligations here. - SAFEPOINT has a contractual and statutory obligation to make a perfunctory investigation, not ignoring evidence that would support MR. AND MRS. SEQUIS’ claim. SAFEPOINT violated its obligations here. - SAFEPOINT has a contractual and statutory obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. SAFEPOINT violated its obligations here. - SAFEPOINT has a contractual and statutory obligation not to deny the claim based on standards known to be impermissible or on an interpretation contrary to established law. SAFEPOINT violated its obligations here. These actions and violations were either done intentionally or as the result of SAFEPOINT’S failure to adopt and implement the proper standards of the investigation and adjustment of claims. Overall, SAFEPOINT’S investigation of the claim was inadequate and contrary to its obligations under the insurance policy and Florida law. MR. AND MRS. SEQUIS have done everything legally requested by SAFEPOINT to date. To cure the violations set forth in this Civil Remedy Notice, SAFEPOINT must now agree to acknowledge its duties and obligations under the law in adjusting its Insureds’ claim, and tender rightfully owed insurance benefits to return MR. AND MRS. SEQUIS to their pre-loss condition. Further, to cure the violations set forth in this Civil Remedy Notice, MR. AND MRS. SEQUIS hereby request that SAFEPOINT tender at this time, or prior to the expiration of the statutory cure period, the amount of MR. AND MRS. SEQUIS’ damage estimate and demand which accurately reflects the true nature and extent of MR. AND MRS. SEQUIS’ damages. Therefore, SAFEPOINT should tender $35,443.45 (less any prior payments, depreciation, excess policy limits, and/or deductible) in insurance benefits at this time. Although MR. AND MRS. SEQUIS have made a demand for payment in the amount of $35,443.45 (less any prior payments, depreciation, excess policy limits, and/or deductible) and have provided SAFEPOINT with all the necessary documentation in support thereof, they may still be willing to consider and to potentially accept any reasonable counter-offer made by SAFEPOINT. Therefore, if SAFEPOINT is not in agreement with MR. AND MRS. SEQUIS’ reasonable demand for payment of their rightfully owed insurance benefits being submitted at this time, MR. AND MRS. SEQUIS hereby request that SAFEPOINT now make a reasonable counter-offer before the expiration of the cure period. MR. AND MRS. SEQUIS still hope that their claim can be resolved amicably. The concept of insurance is that insurance is the insurer’s granting of 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 specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that MR. AND MRS. SEQUIS may mitigate their damages and to put them back into the position they were in prior to loss as quickly as possible. SAFEPOINT breached this duty. This notice is given in order to perfect the right to pursue the civil remedy authorized and pursuant to Florida Statute §624.155, including any and all bad faith/extra contractual, should SAFEPOINT fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. While no specific “cure amount” is required for this Civil Remedy Notice to be valid, MR. AND MRS. SEQUIS will consider the allegations contained herein “cured” if SAFEPOINT, without any requirement for a release: (1) Immediately tenders the amount of MR. AND MRS. SEQUIS damage estimate in the amount of $35,443.45 (less any prior payments, depreciation, excess policy limits, and/or deductible), which accurately reflects the true nature and extent of the damages to the Dwelling / Other Structures; (2) Agrees to reimburse MR. AND MRS. SEQUIS for their expenses incurred by having to retain a public adjuster to present their claim; and (3) Immediately tenders the amount of statutory interest due and owing to MR. AND MRS. SEQUIS pursuant to Florida Statute §627.70131(5)(a). (4) Immediately provides MR. AND MRS. SEQUIS with the documentation SAFEPOINT has used and/or continues to contend, supports the claim determination made by SAFEPOINT in the adjustment of MR. AND MRS. SEQUIS’ claim. Specifically, SAFEPOINT must provide MR. AND MRS. SEQUIS with its claim estimate(s), supporting photographs and/or videos, as well as any and all reports of any expert(s) or other individuals retained on behalf of SAFEPOINT upon which SAFEPOINT has relied on in reaching and/or further supporting its coverage determination in MR. AND MRS. SEQUIS’ claim. MR. AND MRS. SEQUIS continue to remain open to a fair and reasonable settlement offer from SAFEPOINT in an effort to avoid additional delay, costs and expenses, and hereby request the same prior to the expiration of the statutory “cure” period. MR. AND MRS. SEQUIS have provided SAFEPOINT with all necessary estimates, documentation, etc. in support of the claim. SAFEPOINT must act fairly and honestly in its response to MR. AND MRS. SEQUIS’ request for a prompt, fair and reasonable settlement offer and resolution of the claim.
Comments
User Id Date Added Comment
mbakas@safepointins.com 01-02-2025 January 2, 2025 VIA EMAIL: DPETTINATO@OLDERLUNDYLAW.COM; DJPPARALEGALS@OLDER.COM David J. Pettinato, Esq. 1000 W. Cass Street Tampa, FL 33606 RE: Insured: Wilson/Kristin Sequis/Sequis Claim Number: 61569 Policy: SFLH0463232-09 Date of Loss: 1/9/2024 CRN Filing Number: 790468 Dear Sir/Madam: This is the formal response of SafePoint Insurance Company (“SafePoint”) to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that was filed on behalf of Wilson/Kristin Sequis/Sequis (“Complainant” / “Insured”). The Florida Department of Financial Services accepted the Purported Notice, in form only, on November 6, 2024. As a preliminary matter, on November 19, 2024, David Pettinato, Esq., filed a Notice of Intent to Litigate (“NOITL”) on behalf of the Complainant. In response to the NOITL, on December 3, 2024, SafePoint advised it was invoking appraisal. As such, the Purported Notice is entirely premature and moot as the outcome of the binding Appraisal remains pending. Nevertheless, the Purported Notice was filed in connection with Complainant’s insurance claim for property damage. The Purported Notice names SafePoint and alleges “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” “Unfair Trade Practice,” “Failure to properly investigate claim and with due regard to Insured’s interest,” “Failure to acknowledge and act promptly to communications regarding claim” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h) and 627.70131(1)(a); 627.70131(2); 627.70131(3)(d); 627.70131(7)(a) Florida Statutes. The Purported Notice is a legal nullity for the reasons discussed below. ^ 1 SafePoint specifically denies each and every allegation contained in the Purported Notice. Additionally, SafePoint denies that it violated these or any statutes, Florida law or policy provisions regarding the claim adjustment of this matter. ^ 1 SafePoint reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, 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. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added); The Florida Supreme Court has held 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). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10-363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. The Purported Notice fails to meet the requirements of Fla. Stat. § 624.155 on the following grounds: Deficiency # 1 The Purported Notice lists the Insured as “WILSON/KRISTIN SEQUIS/SEQUIS” and fails to list the additional Insured on the property, “AFFORDABLE HOUSING DEPT-ISAOAATIMA”. Thus, the CRN is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. Deficiency # 2 Section 624.155(3)(b)(3), Florida Statutes, requires that the CRN state with specificity the name of any individual involved in the violation. The Purported 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 Fla. Stat. § 624.155, the Complainant must name the individual(s) involved with specificity as it relates to the purported violation to allow SafePoint to properly investigate the allegations. Here, the Complainant does not identify the person or persons at SafePoint with the most knowledge of the facts regarding any alleged violation(s), rather it states: “JOSHUA CHUDNOW, JAYSON ENGELKE, JILMA FIGUEREDO NOVO, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SAFEPOINT INSURANCE COMPANY INVOLVED IN THE CLAIM.” The Purported Notice does not have the requisite specificity as to whom the Complainant is asserting has knowledge as to each specific allegation contained in the Purported Notice. Accordingly, Complainants’ Purported Notice is insufficient as a matter of law. Thus, the CRN is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. Deficiency # 3 Section 624.155(3)(b)(4), Florida Statutes, requires the CRN to reference specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third- party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. The Complainant is the Insured and not a third-party claimant; therefore, the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. It does not. Rather, the Purported Notice states broad generalities, for example, the Purported Notice states: “Coverage A-Dwelling provisions Coverage B-Other Structures provisions Additional Coverages provisions - Debris Removal - Reasonable Repairs - Ordinance Or Law The Declarations Page Loss Payment or Loss Settlement provisions Duties in Event of Loss Policy provisions The insurance policy's definition sections The insurance policy's exclusion of coverage provisions Please advise if there are other applicable policy provisions that are not cited above but would provide coverage to the Insureds for the January 9, 2024, wind and/or hail loss.” Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” “Unfair Trade Practice,” “Failure to properly investigate claim and with due regard to Insured’s interest,” “Failure to acknowledge and act promptly to communications regarding claim” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h) and 627.70131(1)(a); 627.70131(2); 627.70131(3)(d); 627.70131(7)(a) Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Junior Julien v. United Property and Casualty Insurance Company, No. 4D19-2763. In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Purported Notice fails to “state with specificity” the policy language at issue. Deficiency # 4 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply specific facts or circumstances that explain the allegations. Rather, the Purported Notice contains incorrect facts and fails to explain how the purported facts constitute violations of Florida law. The Purported Notice is riddled with general allegations consisting of conclusory and inaccurate statements rather than specific allegations of fact regarding any alleged misconduct or statutory violations. For example, the Purported Notice states, “MR. AND MRS. SEQUIS timely notified SAFEPOINT of the damages and opened a claim pursuant to the terms and conditions of the Policy.” However, these statements are conclusory, inaccurate and without factual basis. This is a claim for roof damage only (no interior damage reported) to the property that was late reported on February 15, 2024, thirty-seven (37) days after the alleged date of loss, January 9, 2024. On February 21, 2024, SafePoint inspected the property and documented any visible damage including damage related to a windstorm. Upon review of the weather report, it was noted that there was no hailstorm in the area on the date of loss, indicating that there was no hail damage to the roof. Additionally, the roof showed signs of wear and tear and deferred maintenance. The Policy does not provide coverage for damage due to wear & tear, wet &/or dry rot, defects in construction and/or materials and/or designs, and/or deferred maintenance. Thus, SafePoint, prepared an estimate in the amount of $862.73 under Coverage A – Dwelling for the covered portion of the loss. However, that amount fell below insured’s deductible of $1,000.00 and no payment was rendered. On February 23, 2024 contrary to the Purported Notice assertion, SafePoint Insurance Company failed “… 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” the Insured was promptly notified in writing and provided a detailed explanation as to why no payment was issued for the covered portion of the loss as the amount due was under the deductible. Further, as previously noted above, on November 19, 2024, Safepoint received Complainant’s NOITL. In a good faith effort to resolve any outstanding disputes Safepoint invoked Appraisal pursuant to F.S. 627.70152(4)(b) that states, in pertinent part, “[i]f an insurer is responding to a notice provided to the insurer alleging an act or omission by the insurer other than a denial of coverage, the insurer must respond by making a settlement offer or requiring the claimant to participate in appraisal or another method of alternative dispute resolution.” In this instance, appraisal was properly invoked as coverage was opened and a dispute remains regarding the scope and price of coverage. The District Court of Appeal of Florida, Fourth District, held that appraisal is appropriate when a property insurer has not wholly denied coverage, and their remains a dispute among the parties whether the claimed damage resulted from a covered or uncovered cause. Merrick Preserve Condominium Association, Inc. v. Cypress…, 315 So.3d 45 (2021). Furthermore, the Florida legislature has demonstrated strong support for alternative dispute resolution, including appraisal, by codifying Section 624.155(3)(f), Florida Statutes, that states in pertinent part, a (civil remedy) notice required under this subsection may not be filed within 60 days after appraisal is invoked by any party in a residential property insurance claim. This statutory provision is intended to afford the appraisal process an opportunity to resolve disputes without the necessity of litigation. However, it is noteworthy the instant Purported Notice was filed prior to the NOITL. This procedural maneuver effectively precluded SafePoint from invoking appraisal until after the Purported Notice was filed, thereby circumventing the legislative intent of the statute and the intended application of the law. Finally, the Policy itself, SECTION 1 – CONDITIONS - Mediation or Appraisal - provides for Mediation or Appraisal as an appropriate alternative dispute resolution method. As this dispute is now set for appraisal, as required and favored by Florida law, this Purported Notice is entirely premature and moot as the outcome of the binding Appraisal remains pending. Finally, the Purported Notice makes boilerplate recitations of statutes and conclusory statements without the requisite specificity. Specificity is of particular importance for this Purported Notice as Complainant generally alleges that SafePoint violated, Section 626.9541(1)(i)(3)(b), “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Purported Notice does not set forth any facts regarding any misrepresentations made by SafePoint and does not identify the person or persons who made such misrepresentations. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. This deficiency applies to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” “Unfair Trade Practice,” “Failure to properly investigate claim and with due regard to Insured’s interest,” “Failure to acknowledge and act promptly to communications regarding claim” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(g), 626.9541(1)(i)(3)(h) and 627.70131(1)(a); 627.70131(2); 627.70131(3)(d); 627.70131(7)(a) Florida Statutes. Deficiency # 5 The Purported Notice does not supply necessary information that would allow SafePoint to “cure” the alleged violations without paying benefits which are not due and owing to the Complainant, as required by Florida law. The purpose of a Civil Remedy Notice is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). However, Section 624.155, Florida Statute, does not impose on an insurer the obligation to pay whatever an insured demand. Talat, 753 So. 2d at 1282. To 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 insured. See Talat, 753 So. 2d at 1281. Here the Complainant seeks extracontractual damages including but not limited to, “… Agrees to reimburse MR. AND MRS. SEQUIS for their expenses incurred by having to retain a public adjuster to present their claim”. Consequently, the Purported Notice is deficient as it fails to afford SafePoint the opportunity to cure the alleged violations without incurring extracontractual damages. SafePoint is only obligated to pay contractual amounts owed to cure a civil remedy. See id. at 1278. STATUTORY ALLEGATIONS 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. SAFEPOINT denies the allegation that it violated the above referenced statute. 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. SAFEPOINT denies the allegation that it violated the above referenced statute. §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 a representative of an insurer with respect to a claim shall constitute communication to or by the insurer. SAFEPOINT denies the allegation that it violated the above referenced statute. §627.70131(2) Such acknowledgment must 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 must provide necessary claim forms, and instructions, including an appropriate telephone number. SAFEPOINT denies the allegation that it violated the above referenced statute. §627.70131(3)(d) Within 7 days after the insurer’s assignment of an adjuster to the claim, the insurer must notify the policyholder that he or she may request a copy of any detailed estimate of the amount of the loss generated by an insurer’s adjuster. After receiving such a request from the policyholder, the insurer must send any such detailed estimate to the policyholder within the later of 7 days after the insurer received the request or 7 days after the detailed estimate of the amount of the loss is completed. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. SAFEPOINT denies the allegation that it violated the above referenced statute. §627.70131(7)(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. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer’s claim payment is less than specified in any insurer’s detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. 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 there 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 must 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. SAFEPOINT denies the allegation that it violated the above referenced statute. The allegations set forth in the Purported Notice are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and intended solely to tarnish SafePoint’s name and reputation. SafePoint has at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. SafePoint unequivocally denies each and every allegation asserted in the Purported Notice. At no time has SafePoint breached any duty to the Complainant. An insurer is not required to pay whatever amount the Insured demands. SafePoint conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. SafePoint promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. SafePoint retained a field adjuster and conducted an inspection of the subject property to investigate the Complainant’s claim. Safepoint made a coverage decision and prepared an estimate for the covered portion of the loss. Thereafter, SafePoint properly invoked appraisal in response to the NOITL thus rendering this Purported Notice moot. Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, SafePoint denies any wrongdoing. It specifically denies that it committed the acts asserted or violated Florida Statutes as alleged in the Purported Notice. Please be advised, by this letter, SafePoint neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, SafePoint hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/ Ari A. Zeltzer Ari A. Zeltzer, Esq. Staff Counsel SafePoint Insurance Cc: Florida Department of Financial Services
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