Civil Remedy Notice of Insurer Violations
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Filing Number:     791507
Filing Accepted:  11/12/2024
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Complainant
Last/Business Name *  
POPPELL   First Name   MARGARET BETH AND CHRISTOPHER
Street Address * 1577 ALLIGATOR DRIVE
City, State Zip * ALLIGATOR POINT, FL 32346
Email Address * BETHP@THEPOPPELLFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   POPPELL   First Name   MARGARET BETH AND CHRISTOPHER
Policy # * 1501-2300-6212 Claim #* FL24-0115165
Attorney
Attorney is Applicable
Last Name* SUNDBERG First Name * WILLIAM Initial
Street Address* 107 W FIFTH AVE
City, State Zip* TALLAHASSEE , FLORIDA 32303
Email Address * BILL@SUNDBERGPA.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* JENNIFER CASCO
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Unsatisfactory Settlement Offer
Other : FAILURE TO ACT ON CLAIM
Other : UNREASONABLE INVESTIGATION
* 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This Notice is based on Statutory Violations listed in this Notice and Coverage B and Debris Removal sections of the policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE INSURANCE COMPANY ISSUED A POLICY OF INSURANCE TO THE INSURED WHICH PROVIDED COVERAGE FOR CERTAIN LOSSES. DURING THE POLICY PERIOD ON OR ABOUT JULY 5, 2024, FIRE CAUSED A TOTAL LOSS TO THE INSURED PROPERTY. THE INSURED PROPERTY SUFFERED DAMAGE WHICH WAS AND IS COVERED BY THE INSURANCE POLICY. THE INSUREDS REPORTED THE LOSS IMMEDIATELY TO THE INSURANCE COMPANY AND HAVE COMPLIED WITH ALL CONDITIONS OF THE POLICY. JENNIFER CASCO IS THE PERSON RESPONSIBLE FOR THE CLAIM AND THE INFORMATION REGARDING THE FACTS GIVING RISE TO THE ALLEGATIONS OF THIS CRN. ALTHOUGH MS. CASCO SUBMITTED FULL PAYMENT FOR COVERAGE A AND COVERAGE C UNDER THE POLICY, SHE HAS LOW BALLED OR UNDERPAID COVERAGE B AND DEBRIS REMOVAL. THE ATTORNEY FOR THE POPPELLS SENT VARIOUS EMAILS TO MS. CASCO TO SHOW THAT THERE WAS A SEPARATE STRUCTURE FOR STORAGE AND LAUNDRY THAT HOUSED A WASHER/DRYER, AN EXTRA REFRIGERATOR AND A BAIT FREEZER. THIS STRUCTURE HAD PLUMBING AND A WINDOW AC UNIT. FURTHER, MS. CASCO WAS PROVIDED WITH QUOTES FOR THE REPLACEMENT OF THE PICKET FENCE AND TREX DECKING. THE DECKING ALONE WAS VALUED AT 18,414. THE FENCE AND DECKING WERE NOT ATTACHED TO THE MAIN HOME AND WOULD BE COVERED UNDER COVERAGE B. THE POPPELLS ALSO PROVIDED QUOTES FOR DEBRIS REMOVAL AND DEMO OF THE REMAINS OF THE HOME FOR 10,000 AND 9,500. MS. CASCO HAS NOT RESPONDED TO ANY OF THESE EMAILS ABOUT PAYING THE REMAINDER OF COVERAGE B OR ABOUT PAYING FOR DEBRIS REMOVAL. EMAILS WERE SENT TO HER MAKING THESE REQUESTS FOR PAYMENT ON SEPTEMBER 17, 2024, OCTOBER 14, 2024 AND AGAIN ON NOVEMBER 4, 2024. THE LAST EMAIL STATED THAT A CRN WOULD BE FILED IF SHE DID NOT MAKE THE FINAL PAYMENTS UNDER THE POLICY. THE FULL POLICY LIMITS SHOULD ALSO BE PAID PER THE VALUED POLICY LAW IN FLORIDA AS THIS HOME WAS A TOTAL LOSS. THE AMOUNT OWED UNDER COVERAGE B WAS 43,500 AND THE ONLY AMOUNT PAID BY THE CARRIER WAS 4,734.62 FOR COVERAGE B. NOTHING HAS BEEN PAID FOR DEBRIS REMOVAL. THE INSURED HAS MADE AN APPLICATION FOR INSURANCE BENEFITS UNDER THE POLICY BUT THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSURED IS ENTITLED FOR THE LOSS. THE INSURANCE COMPANY HAS BREACHED THE POLICY OF INSURANCE BY FAILING TO PAY ALL OF THE BENEFITS DUE UNDER THE POLICY. THE INSURANCE COMPANY HAS FAILED TO SATISFACTORILY SETTLE THIS CLAIM AND HAS DEPRIVED THE INSURED OF A PROPER RESOLUTION OF THIS CLAIM. THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PROPERLY INVESTIGATE THE LOSS AND HAS FAILED AND/OR REFUSED TO TENDER THE PROPER AMOUNT OF INSURANCE BENEFITS DUE AND OWING TO THE INSURED. IN ORDER TO CURE THE CONDUCT GIVING RISE TO THE VIOLATIONS DESCRIBED HEREIN, THE INSURANCE COMPANY MUST ISSUE PAYMENT FOR ALL THE COVERED DAMAGES. THE INSURANCE COMPANY MAY CURE THE ALLEGATIONS GIVING RISE TO THIS NOTICE BY TENDERING A CHECK IN THE AMOUNT OF 38,765.38 FOR COVERAGE B AND 9,500 FOR DEBRIS REMOVAL PLUS APPLICABLE INTEREST WITHIN THE 60 DAY CURE PERIOD, JOINTLY PAYABLE TO THE INSURED AND SUNDBERG, P.A.
Comments
User Id Date Added Comment
oc1102@universalproperty.com 12-19-2024 December 19, 2024 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 791507 Filing Date: 11/12/2024 Complainant(s): Margaret Beth and Christopher Poppell Insured(s): Margaret Beth and Christopher Poppell Policy No.: 1501-2300-6212 Claim No.: FL24-0115165 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, William Sundberg, on behalf of Complainants, Margaret Beth and Christopher Poppell (also referenced as the “Insureds.”) The Notice alleges violations of Sections 624.155 and 626.9541, Florida Statutes. Universal denies the allegations contained in the Notice. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notice is deficient as a matter of law as it fails to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Section 624.155(3)(b), Florida Statutes the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language, 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...; 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Department of Financial Services (“DFS”), created form DFS-10-363, which lays out 15 requirements that the Complainant must respond to with specificity. The Florida Supreme Court holds 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). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant has specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). To begin, the Notice fails to meet the requirements of Section 624.155, Florida Statutes on several grounds. First, the 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 Section 624.155, Florida Statutes, the Complainants must name the individual(s) involved with specificity as it relates to the purported violation to allow Universal to properly investigate the allegations. The Notice lacks the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Notice states, “JENNIFER CASCO.” The Notice fails to include any specific facts as to how Ms. Casco is knowledgeable of the facts giving rise to any purported allegation(s). Therefore, the Notice does not have the requisite specificity as to whom the Complainants are asserting has knowledge as to any allegation to put Universal on Notice of what needs to be cured. Accordingly, the Complainants’ Notice is insufficient as a matter of law. Second, the Notice fails to satisfy Section 624.155(3)(b)(4), Florida Statutes, in that it fails to reference specific policy language relevant to any alleged violation. Instead, the Notice states, “[t]his Notice is based on Statutory Violations listed in this Notice and Coverage B and Debris Removal sections of the policy.” Thus, the Complainants admit that Universal in fact did not violate any specific policy language but fails to provide any specificity as to how any statutes were violated. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Lastly, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notice fails to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Notice asserts general allegations consisting largely of boilerplate, conclusory and inaccurate statements rather than specific allegations of facts regarding any alleged misconduct or statutory violations. As an example, the Notice states: THE INSURED HAS MADE AN APPLICATION FOR INSURANCE BENEFITS UNDER THE POLICY BUT THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PAY THE FULL BENEFITS TO WHICH THE INSURED IS ENTITLED FOR THE LOSS. THE INSURANCE COMPANY HAS BREACHED THE POLICY OF INSURANCE BY FAILING TO PAY ALL OF THE BENEFITS DUE UNDER THE POLICY. THE INSURANCE COMPANY HAS FAILED TO SATISFACTORILY SETTLE THIS CLAIM AND HAS DEPRIVED THE INSURED OF A PROPER RESOLUTION OF THIS CLAIM. THE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO PROPERLY INVESTIGATE THE LOSS AND HAS FAILED AND/OR REFUSED TO TENDER THE PROPER AMOUNT OF INSURANCE BENEFITS DUE AND OWING TO THE INSURED. The Notice wholly fails to identify any specific facts or circumstances which support any of the above-listed conclusory and/or boilerplate allegations. It is evident that the statement of facts falls short of the specificity required by Section 624.155, Florida Statutes. As a result, Complainants failed to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. In summary, as outlined above, the Complainants fail to respond to each of the fields set forth on the DFS Form with the requisite specificity including, but not limited to, the failure 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, the failure to reference specific policy language relevant to the alleged violation, and the failure to allege any specific conduct on the part of Universal that would violate any policy provision or statute. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with the facts and circumstances regarding this claim, which shall demonstrate that Universal has not violated any Policy terms or statutory provisions. On July 5, 2024, Universal received notice from the Insured, Margaret Poppell, the insured location had damage which occurred that same day. Universal inspected the property and documented and visible damage. Universal issued an undisputed payment to the Insureds in the full amount of its estimate, pursuant to the terms of the Policy. Universal denies the allegations asserted in the Notice. An insurer is not required to pay whatever amount an insured demands. As outlined above, the alleged statutory violations set forth in the Notice are devoid of factual support and are without merit. We trust that the foregoing is sufficient to advise you of Universal’s position with regard to this matter and fully responds to the Notice file by the Complainants. Sincerely, /s/ Ozzy Cudila Ozzy Cudila, Esq. Associate General Counsel
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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