Civil Remedy Notice of Insurer Violations
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Filing Number:     791078
Filing Accepted:  11/8/2024
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Complainant
Last/Business Name *  
PREMIER RESORT & MANAGEMENT, INC.   First Name  
Street Address * 3301 S., 930 N., 730 N., 2560 N. ATLANTIC AVENUE
City, State Zip * DAYTONA BEACH SHORES, FL 32118
Email Address * FIRM@FLORIDAINSLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PREMIER RESORT & MANAGEMENT, INC.   First Name  
Policy # * ESP1005841-01 Claim #* 000013859040
Attorney
Attorney is Applicable
Last Name* CIOCCHETTI First Name * MICHAEL Initial
Street Address* 125 N. RIDGEWOOD AVENUE, SUITE 100
City, State Zip* DAYTONA BEACH , FLORIDA 32114
Email Address * FIRM@FLORIDAINSLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   ARCH SPECIALTY INSURANCE COMPANY
NAIC Company Code 21199
 
Name of individual responsible for violation (if any):* EDWARD WALSH, LARRY KAPLAN, SONYA GONZALEZ, ROBERT W. MURRAY, ANDREW NOBOA
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
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.
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.
* 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 Building Coverage and Business Interruption Coverage portions of the multiple Policies are relevant to the Claims.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of the insured, PREMIER RESORT & MANAGEMENT, INC. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155. In consideration of the premium paid to it, the carriers, ARCH SPECIALTY INSURANCE COMPANY, INDEPENDENT SPECIALTY INSURANCE COMPANY, , CERTAIN UNDERWRITERS AT LLOYDS, LONDON SUBSCRIBING TO BINDING AUTHORITY B604510568622021, and INTERSTATE FIRE & CASUALTY INSURANCE COMPANY (“Carriers”), issued multiple policies, Policy Nos. ESP1005841-01 (ARCH), VNB-CA-003808-01 (INDEPENDENT SPECIALTY), VRN-CN-003808-01 (UNDERWRITERS), and VUX-CN-003808-01 (INTERSTATE) to PREMIER RESORT & MANAGEMENT, INC. (“Insured”) where the policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 3301 S. Atlantic Ave., Daytona Beach Shores 32118, 930 N. Atlantic Ave., Daytona Beach Shores 32118, 730 N. Atlantic Ave., Daytona Beach Shores 32118 and 2560 Atlantic Ave., Daytona Beach 32118. The policies were in full force and effect at the time the damage occurred from Hurricane Ian, and the ensuing damage as a direct result thereof, to the Insured Properties, on or about September 29, 2022. Thereafter, the Carriers were timely notified of the Losses. In particular, the Carriers were put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policies. Claim numbers 000013859040 (ARCH), SDA22041690 (INDEPENDENT SPECIALTY), 957019 (UNDERWRITERS), 1000380338 (INTERSTATE), (“Claim”) were assigned to the Losses. The Carriers sent adjusters, consultants and engineers to the Insured Properties to perform various inspections. The Carriers performed cursory inspections of the Insured Properties and failed to retain unbiased experts necessary to scope the entirety of the Losses and covered repairs necessary to restore the Insured Properties to their pre-loss conditions. This was done deliberately by Carriers to undervalue portions of the claims. The Carriers know their aforementioned investigations are insufficient and that they have failed to provide proper payment to restore the properties to their pre-loss conditions. These inspections placed The Carriers on notice of the severity of the Losses. Throughout the claim, the Insureds were represented by a public adjuster who ensured the proper estimation of the losses and compliance with all Policy conditions. The public adjuster submitted comprehensive estimates to the Carriers for the full scope of damages to the Insured Properties. The Carriers disregarded these comprehensive estimates, and, instead, underpaid the Claims. The Carriers have refused to reassess their payments of benefits and the basis of the payments and have refused to properly adjust and settle the Claims. The Carriers submitted numerous overwhelming requests to the Insureds for documents despite being provided with necessary documentation showing the Insureds had not been indemnified for their extensive losses to their buildings as well as the Business interruption portions of their Claims. The Carriers violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve these claims when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insureds with due regard for their interests. When the Carriers were confronted with comprehensive estimates and verifiable cause of Losses, the Carriers chose to underpay the Insureds’ valid Claims for extensive damages that exceed the amount paid. The Carriers violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insureds that Policy coverage was unavailable for the Insureds’ Claims and Losses to the Insured Properties. This misrepresentation was made in an attempt to underpay the Insureds’ Claims and escape without paying for the full extent of substantial damage. The Carriers violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with comprehensive estimates and verifiable cause of Losses, the Carriers apparently had no system or standards prepared or implemented which would allow them to evaluate the Claims as submitted by its Insureds. The Carriers violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to the coverages at issue. This has been discussed fully hereinabove. The Carriers have refused to properly assess their payment of benefits and the basis of payments and have refused to properly adjust and settle the claims constituting unfair claim settlement practices under Florida Statute §626.9541(1)(i)(3)(i). The Carriers can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insureds under the terms and conditions of the Policies.
Comments
User Id Date Added Comment
taylor@floridainslaw.com 04-15-2025 The Carrier has resolved the Civil Remedy Notice to the satisfaction of the Insured, and the Insured hereby withdraws the instant CRN.
aschultz@cozen.com 01-07-2025 Arch Specialty Insurance Company (“Arch”) is in receipt of a Civil Remedy Notice no. 791078 (“CRN”). The CRN was filed by Michael Ciocchetti, Esq. on behalf of Complainant Premier Resort & Management, Inc. (“Complainant” or “Insured”) on November 8, 2024. Arch has retained this firm to respond to the CRN. This response is timely made. I. THE CIVIL REMEDY NOTICE DOES NOT COMPLY WITH FLORIDA LAW. As stated by the Florida Supreme Court, the purpose of a Civil Remedy Notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). The purpose of Fla. Stat. §624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003). Further, a Civil Remedy Notice must be sufficiently specific to provide the insurer with an opportunity to cure the alleged violations. This would include i) identifying the specific policy provision(s) at issue, ii) citing specific language of the statutory provision(s) the insurer allegedly violated, and iii) specifically identifying what actions the insurer must take to remedy the alleged violations. Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. Aug. 13, 2010); Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299-1300 (S.D. Fla. 2008). Here, the CRN is generally devoid of facts and merely contains allegations and accusations without support. It accordingly, does not enable Arch to cure any alleged violations. The practice of filing non-specific, boilerplate Civil Remedy Notices does not comply with Florida’s statutes and caselaw. Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, (Fla. 4th DCA 2021). Arch categorically denies the allegations of wrongful conduct, bad faith, misrepresentation, breach of contract, and/or any purported violation of Florida law. Please allow the below to summarize Arch’s position and its good faith investigation (which it conducted alongside the other insurers listed in the CRN, who are separately responding to a similar notice directed to them). II. THE GOOD FAITH INVESTIGATION A commercial property insurance policy, which Arch identifies with the policy number ESP1005841-0, was issued to the Insured for the policy period of January 1, 2022 to January 1, 2023 (“Policy”). The Policy, subject to its provisions, conditions, endorsements, limitations, deductibles and exclusions, insures several properties, including a Holiday Inn & Suites located at 930 N Atlantic Ave, Daytona Beach, FL 32118 (“Building 5”), a Best Western located at 730 N Atlantic Ave, Daytona Beach, FL 32118 (“Building 6”), a Holiday Inn Express located at 3301 S. Atlantic Ave, Daytona Beach, FL 32118 (“Building 7”), and a Hilton Garden Inn located at 2560 Atlantic Ave, Daytona Beach, FL 32118 (“Building 8”) (collectively, the “Subject Properties”). Arch participates in the primary layer of coverage, along with Independent Specialty Insurance Company, Certain Underwriters at Lloyds, London, and Interstate Fire and Casualty Insurance Company. The aforementioned insurers, along with Arch, will be collectively referred to herein as “the Market.” On or about October 7, 2022, Arch received notice of a claimed loss at Buildings 5 and 7 due to Hurricane Ian. The Market retained Engle Martin to adjust the loss. Engle Martin engaged Young & Associates to serve as the building consultant and Thornton Tomasetti as the engineer. The Insured retained Tutwiler & Associates (“Tutwiler”) to serve as its public adjuster. Engle Martin, Thornton Tomasetti, and Young and Associates conducted an initial inspection of the Subject Properties with Tutwiler on October 21, 2022. Following this inspection, the Market was advised that the claim includes Buildings 6 and 8 as well. Engle Martin recommended retaining an industrial hygienist, forensic accountant, and contents specialist. EFI Global, Meaden & Moore, and Sentry Salvage were engaged for these respective roles. Additional inspections took place over the following weeks, with the final occurring on December 5, 2022. During these inspections, areas damaged by flood water and wind-driven rain were observed, for which damages were excluded under the Policy. The Market issued an advance payment for mitigation and restoration costs as requested by Tutwiler. On January 10, 2023, the Market issued a reservation of rights letter to the Insured through Tutwiler advising of the exclusions for loss and damage resulting from flood water and wind-driven rain. Thornton Tomasetti issued its reports as to the four properties between February 14, 2023 and April 3, 2023. The reports concluded that there was some damage to the Subject Properties caused by wind from Hurricane Ian, as set forth in greater detail in the reports. Thornton Tomasetti’s reports have been provided to the Insured. After several requests from Engle Martin, on or about March 25, 2023, Tutwiler provided the Insured’s claim for building and personal property, which included a Statement of Loss for the four loss locations. The Statement of Loss was accompanied by various estimates, business personal property inventories, photographs, and sworn proofs of loss. Following receipt of this documentation, Engle Martin and the consultants Engle Martin engaged reinspected the Subject Properties in the first week of May 2023. At the inspections, the Market’s consultants reviewed all tentative findings and worked to reach an agreement on scope but were unsuccessful. On May 16, 2023, Engle Martin issued a response to the Insured’s proofs of loss, advising that they could not be accepted or rejected as the Market’s investigation was ongoing, and based on the information made available to date, the investigation did not show covered damages totaling the amount stated in the proofs of loss. However, the Market advised that another substantial good faith advance payment was forthcoming. The letter also requested information from the Insured necessary for the adjustment and further reserved rights. The Market issued the second advance payment a few weeks later. On June 27, 2023, Engle Martin provided the Insured with the building damage repair estimates prepared by Young & Associates, the business personal property damage estimates prepared by Sentry Salvage, engineering reports prepared by Thornton Tomasetti, and Sworn Statement in Proof of Loss documents for the remaining undisputed actual cash value. On July 3, 2023, the Insured provided three executed sworn proofs of loss for partial building loss and damage (not inclusive of deductible, depreciation, and prior payments). The Insured also advised that it disagreed with the Market’s assessment of the loss but did not provide any additional information for the Market to consider. Over the following months, Engle Martin remained in contact with Tutwiler while Tutwiler continued its review of Engle Martin’s adjustment. Additionally, over the following months, Engle Martin and Tutwiler continued and completed their adjustment and discussion of the business income claim, and all required payments were issued to the Insured. On January 9, 2024, Engle Martin issued a coverage determination letter on behalf of the Market, which addressed the relevant policy language based on information obtained from the inspections and Thornton Tomasetti’s reports. The letter stated that all amounts determined to be owed to the Insured had already been issued. On February 28, 2024, the Insured provided the consulting engineering reports from its retained engineer, M2E. The M2E reports were vague and cited the potential or likely damage to various components based only on assumptions and observed repairs. The M2E reports maintained that all roof systems need to be replaced, and that there is event related damage to the sliding patio doors, windows, PTAC units, and vertical cracks in the exterior cladding. Further review of the M2E reports at each location revealed the same language was copied and pasted in each report for the sliding patio doors and windows, PTAC units, and vertical cracks in the exterior cladding. Engle Martin requested a construction schedule and a reinspection of the Subject Properties, as well as additional documentation. Engle Martin specifically requested that M2E attend the reinspection. On April 26, 2024, Tutwiler proposed a settlement, but the proposed settlement amount was unsupported and unallocated. Tutwiler did not provide any revised estimates, invoices, contracts, or other supporting documentation reflecting how the settlement proposal amount was determined. In light of the M2E reports and the settlement proposal from Tutwiler, another reinspection went forward with Thornton Tomasetti from May 21-23, 2024. Thornton Tomasetti did not identify any additional damages to consider, nor did the Insured’s public adjuster provide any cost-related documentation. M2E did not attend the reinspection despite Engle Martin’s request. Instead, the Insured requested that Thornton Tomasetti provide any rebuttal or questions regarding the M2E reports. On July 2, 2024, Engle Martin responded to the settlement proposal on behalf of the Market. The letter noted that the documents requested in March 2024 had not yet been provided and reiterated the need for that information. The letter also responded to the Insured’s request for rebuttal or questions regarding the M2E reports. On August 5, 2024, Tutwiler provided cost-related documentation concerning the property damage claims. After review, Engle Martin determined that no additional amounts were owed to the Insured. The documentation also revealed that the Insured had entered into an agreement on June 13, 2022, before Hurricane Ian, to renovate Building 8. The Insured was in the process of completing a full renovation on the interior guest rooms at the time of the loss, yet the Insured was claiming these renovations were necessitated by Hurricane Ian. Additionally, documentation submitted by the Insured reflects that a number of repairs to the roofs have already been made at Buildings 5, 6, and 8, which the Insured claims are temporary repairs. However, Thornton Tomasetti’s inspection of the repairs concluded that the repairs were permanent. The incurred costs of making these repairs, as reflected in the documentation submitted, is substantially less than the Insured’s estimate. No explanation has been provided by the Insured. With respect to business income, this aspect of the loss has been fully adjusted and payment has been issued to the Insured. Via correspondence dated January 19, 2024, Tutwiler confirmed that the Insured is “in agreement with the business income claim adjustment.” III. ANALYSIS On November 8, 2024, the Insured filed the CRN. The CRN is composed of generic, conclusory, and unsupported statements and contains no factual discussion of the circumstances of this loss or what has actually transpired during the adjustment. Further, the CRN generally misstates the facts of the loss. For example, the CRN accuses the Market of performing “cursory inspections” of the Subject Properties. This is false, as the Market has conducted numerous comprehensive inspections, including reinspections, of the Subject Properties with several consultants. Indeed, the report prepared by the Insured’s consultant, M2E, reflects that M2E performed its inspection of all of the properties in one day, whereas the Market’s consultants spent multiple days inspecting the Subject Properties. The CRN also claims that the Market failed to retain “unbiased experts.” These accusations are not supported by any facts and are denied. Further, the CRN is defective as it fails to set forth how the alleged violations can be cured, requesting only the payment “of all funds contractual [sic] owed to the Insureds [sic] under the terms and conditions of the Policies.” The CRN does not state what amounts are purportedly contractually owed to the Insured. The Insured has already been paid what Arch determines is owed for this claim. The CRN is also defective as it incorrectly identifies Sonya Gonzalez, Robert Murray, and Andrew Noboa as “persons representing the insurer.” These individuals are not representatives of Arch. Therefore, Arch does not address any allegations in the CRN concerning Sonya Gonzalez, Robert Murray, and Andrew Noboa. The Market properly handled the adjustment of this claim, utilizing experienced, and competent professionals who have conducted multiple inspections of the Subject Properties. The Market has thoroughly explained its coverage position to the Insured and has paid the amounts owed. In a showing of good faith, the Market issued more than one substantial advance payment to the Insured before the adjustment was even complete. In short, Arch denies all allegations of bad faith conduct in the CRN, or any violation of applicable law. Moreover, Fla. St. § 624.155(5)(b)(1) requires Complainant and its representatives to act in good faith in providing information regarding the claim, making demands, setting deadlines, and attempting to settle the claim. On December 19, 2024, Engle Martin issued a letter to the Insured requesting an Examination Under Oath. The Market is hopeful that the information gathered at the EUO will bring the parties closer to a resolution of this matter. While this response is meant to be comprehensive, this response is based upon the information provided in the CRN and the information it has collected to date. If the Insured feels additional facts are relevant or material facts have been misunderstood, please inform us immediately. Please note that this response is not necessarily exhaustive and does not preclude future assertions of any other valid reason for seeking rejection and return of the CRN. Also, this letter or any act or failure to act should not be construed as a waiver of any rights or defenses available by contract or at law as all such rights and defenses are hereby specifically reserved. Should the Department require further evidence or clarification in the context of the CRN and this response, please do not hesitate to contact the undersigned. Sincerely, John David Dickenson, Esq. Alexandra Schultz, Esq. Cozen O’Connor (561) 750-3850 jdickenson@cozen.com aschultz@cozen.com
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