Civil Remedy Notice of Insurer Violations
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Filing Number:     792076
Filing Accepted:  11/13/2024
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Complainant
Last/Business Name *  
MACEDONIA INDEPENDENT FREE METHODIST CHURCH   First Name  
Street Address * 1465 SOUTH CENTRAL AVENUE
City, State Zip * APOPKA, FL 32703
Email Address * THEBECKETTS@EMBARQMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MACEDONIA INDEPENDENT FREE METHODIST CHURCH   First Name  
Policy # * 0087670-02-222817 Claim #* 1459128
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*   CHURCH MUTUAL INSURANCE COMPANY, S.I.
NAIC Company Code 18767
 
Name of individual responsible for violation (if any):* DEWADE WIGGINS, CHRISTINE THOMAS, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY CHURCH MUTUAL INSURANCE COMPANY, S.I. INVOLVED IN THE CLAIM.
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Building Coverage provisions Personal Property 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. Church Mutual Insurance Company, S.I. (“INSURER”) has breached the public’s trust by its adjustment of Macedonia Independent Free Methodist Church (“INSURED”) claim of loss. Church Mutual Insurance Company, S.I.’s mailing address is 3000 Schuster Lane, Merrill, WI 54452. 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 1465 South Central Avenue, Apopka, FL 32703 which sustained significant damage from water which caused the building to be in a state of collapse on or about September 27, 2021. The INSURER’s investigation concluded that this loss was caused by the HVAC system. The INSURER tendered payment for the ensuing water damage, however, has failed to tender the full amount of benefits due to the INSURED. The INSURED retained William F. Stuhrke, PhD, P.E., to inspect the property and prepare a report in July of 2022. Mr. Stuhrke found that the ceiling/roof structure and exterior side walls were found to be in a state of collapse and the sanctuary area was unsafe and in danger of complete collapse. He went on to state that no occupancy should be permitted. See report attached hereto. The INSURED retained Structural Engineering and Inspections, Inc. to inspect the property in December of 2023. Byron Anderson, PE, inspected the property and details extensive damage to the masonry and roof framing system which puts the current structure in danger of collapse. Mr. Anderson concluded that the roof framing system is no longer providing adequate support to safely occupy the structure; and that the current roof and ceiling framing configuration is not adequate and requires replacement to properly meet, and conform to, the minimum design requirements of the Florida Building Code. The masonry walls supporting the roof structural system are significantly out of plumb and the masonry walls and foundation have likely been compromised and will require replacement. See report attached hereto. The Structural Engineering and Inspections, Inc. report was submitted by Ross Legal Group to the INSURER on or about July 3, 2024. The INSURED’s attorney followed up with the INSURER on July 29, 2024 inquiring when the INSURER will be making a coverage decision. Then on July 30, 2024, Tracy Pingel of Church Mutual responded to the follow-up advising that the adjuster has been on leave since April 2024 and no correspondence from the INSURED’s representatives. At no time was the INSURED asked to clarify the documentation submitted for better understanding by the INSURER. Then on September 4, 2024 the INSURED received a letter form the INSURER acknowledging receipt of the July 30th correspondence, and requesting an additional 30 days to complete their investigation. Therefore, after the 30 days passed and no further word from the carrier, on October 18, 2024 the INSURED submitted a Notice of Intent to Initiate Litigation. See all correspondence attached hereto. The INSURER has been on notice of a collapse at the insured location since at least August 23, 2022, when its own expert Donan informed Church Mutual that the “drywall was sagging” due to a water leak, and that the “ridge beam was sagging and additional broken structural elements”. See Donan report attached, page 3. Further, on page 5 of the report, Donan informed Church Mutual that the “east structure’s ridge line sags…and the south facing walls of the east structure lean outward at the top….the angle of the south wall measures 86.6 degrees near the south west window”. Finally, the conclusion of the report is that the engineering firm was “concerned that the exterior walls of the structure are leaning, and the roof framing is cracked, broken and separated”. Further, the firm recommended that the building be shored as it is “unsafe and no one should enter the east structure. In this regard, Church Mutual has been aware as to the cause of the loss since the day it received this report, and was on notice of a collapse of the structure, such that coverage would apply. As the current structure of the church shall not be occupied as is in danger of collapse and makes the church’s current condition dangerous as defined by the Florida Building Code, the church has been unable to resume normal activities. In this regard, the total institutional income interruption would amount to the total profit lost, plus the ongoing expenses. The INSURED mitigated their damages and provided notice as soon as the damages were reasonably known to Insured. INSURER failed to adequately adjust and pay claim. INSURER failed to properly compensate insureds for damages covered by the Policy and restore the property to a pre-loss condition. At this time, Church Mutual is in violation of Florida Statute 627.70131 which states that insurers must pay or deny a claim within 90 days of receiving notice. A claim for damages was reported years ago for collapse, as the building was rendered unusable and dangerous. The building has collapsed and is being shored. A claim for collapse was made when the Church reported the damage, and Church Mutual’s expert engineer confirmed same. Further, payment was issued by the Church, acknowledging coverage for the loss, albeit not enough money to effectuate repairs. Therefore, demand is hereby made as follows: Estimate $317,000.00 Less Prior Payments $14,119.93 Less Deductible n/a TOTAL $302,880.07 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 $302,880.07 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: SEI Engineering report, William F. Stuhrke, PhD, P.E. report
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 04-25-2025 The Insured, MACEDONIA INDEPENDENT FREE METHODIST CHURCH, hereby provides notice to the Department of Financial Services and CHURCH MUTUAL INSURANCE COMPANY, S.I. that an amicable resolution to the issues outlined in Civil Remedy Notice filing #792076 have been resolved between the parties through settlement. Accordingly, MACEDONIA INDEPENDENT FREE METHODIST CHURCH hereby withdraws Civil Remedy Filing #792076 filed 11/13/2024.
dena.sacharow@kellerlandsberg.com 01-10-2025 January 10, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: Complainant: Macedonia Independent Free Methodist Church Policy No.: 0087670-02-222817 Claim No.: 1459128 DFS File No. 792076 Dear Sir/Madam: Please be advised that this firm has been retained to represent Church Mutual Insurance Company (“CMIC”) in the above-referenced matter. This shall serve as CMIC’s formal response to the Civil Remedy Notice (DFS File No. 792076) filed by Macedonia Independent Free Methodist Church (“Complainant” or “Insured”) on November 13, 2024. CMIC denies all allegations of violations of Florida law and policy provisions regarding the claim adjudication of this matter. CMIC issued Policy No. 0087670-02-222817 to Complainant relative to the property located at 1465 S Central Ave, Apopka, Florida 32703 (“Property”) for the policy period of May 18, 2021 through May 18, 2022 (“Policy”). A. Civil Remedy Notice Deficiencies The Civil Remedy Notice filed by Complainant alleges that CMIC purportedly violated several statutory sections under §624.155(1), and §626.9541(1), Florida Statutes. CMIC contends that the Civil Remedy Notice filed by Complainant is deficient as a matter of law as it fails to comply with section 624.155, Florida Statutes. See, Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); 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, Complainant 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; 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 Notice filed by Complainant fails to meet the requirements of section 624.155, Florida Statutes, for several reasons. First, the Notice does not identify specific relevant policy language that would support any of the purported violations. When required to identify the specific policy language relevant to the violation, Complainant refers to entire sections of the Policy. The Notice is deficient for failing to identify with specificity applicable policy language compared to the facts. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021) (affirming a trial court order granting a motion to dismiss based on the finding that the civil remedy notice was deficient where the insured “listed nearly all policy sections and cited thirty-five statutory provisions”); Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136, 138 (Fla. 5th DCA 2022) (affirming dismissal of claim for bad faith on the basis that the civil remedy notice was deficient for the same reasons set forth in Julien); Boone v. State Farm Fla. Ins. Co., No. 6D23-1178, 2023 WL 2800296, at *1 (Fla. 6th DCA Apr. 6, 2023). Similar to Julien and Demase, Complainant applied a broad, kitchen sink like approach to its Notice by claiming violations of entire sections of policy provisions. The Notice also completely fails to provide any grounds or basis for how the cited provisions were allegedly implicated or any facts that would support how the provisions are relevant to any claimed violation. For the same reasons set forth in Julien and Demase, Complainants Notice is deficient. Second, Florida Statute § 624.155 specifically limits application of the statute to violations of six statutory provisions (§§ 626.9541(1)(i), (o), or (x); 626.9551; 626.9705; 626.9706; 626.9707; or 627.7283) or three prescribed scenarios under subsection (b). However, the Notice alleges violation of provisions under Section 627.70131 as the basis for Complainant’s claimed violations, which is not within the scope of the Fla. Stat § 624.155 and the applicable six provisions. Any claims outside the scope of the requirements of the statute are inapplicable and render the Notice invalid. Third, the Notice alleges violation of section 624.155(1)(b)(3) regarding failing to settle claims under one portion of the insurance policy coverage to influence settlement under other portions of available coverage. However, the Notice does not contain facts to support that multiple coverages were or are at issue or anything that would suggest any use of leverage to the disadvantage of Complainant. Fourth, the Notice alleges a violation of section 626.9541(1)(i)(3)(a) for failing to adopt standards for the proper investigation of claims. However, Complainant has not provided any facts or details to support that the carrier did not engage in a proper investigation of the claim. Instead, Complainants asserts that, in its opinion, the claim payment was “not enough money to effectuate repairs.” This allegation does not provide any support for how or why Complainant believes the investigation was allegedly improper, but simply highlights what appears to be a dispute regarding amount. Fifth, the Notice is deficient because it was prematurely served. As will be explained in detail below, the Notice was served contemporaneous with a request by CMIC to open a claim for “collapse.” CMIC had not had an opportunity to complete its evaluation as to the “collapse” claim pursuant to the Complainant’s request to open a “collapse” claim before the Notice was served. The filing of a premature civil remedy notice is a tactic commonly taken by Vanessa Ross, Esq., counsel for Complainant. In reviewing the Civil Remedy Notice database, Ms. Ross filed 68 Civil Remedy Notices in 2024, sometimes multiple per day, and over 1,100 since 2017. Many of these notices contain the same form language as that set forth in the Civil Remedy Notice at issue here, with minor differences regarding the different losses, and were used by counsel as leverage rather than for the proper purpose of a Civil Remedy Notice. Prior to serving the Civil Remedy Notice, the Complainant, through counsel, submitted a Notice of Intent to Initiate Litigation. Prior to serving the Civil Remedy Notice, CMIC responded to the Notice by specifically requesting the Complainant participate in mediation as a method of alternative dispute resolution. CMIC requested Complainant provide the names of several proposed mediators or participate in mediation through the Florida Department of Financial Services mediation program. As of the filing of this Response, the Complainant and its counsel have not responded to this request, have not made any effort to coordinate mediation pursuant to CMIC’s request or taken any action which would permit CMIC to engage in a meaningful resolution of both the Notice of Intent and this Civil Remedy Notice. For this reason, the Notice should be found improper and deficient. This is only a sampling of the bases for how the Civil Remedy Notice is deficient. For the aforementioned reasons, Complainant’s Civil Remedy Notice is deficient and insufficient as a matter of law. The Notice is also deficient for setting forth incomplete and inaccurate facts regarding the underlying matter. The following shall provide you with the pertinent facts and circumstances regarding this matter which demonstrates that CMIC has not violated any policy or statutory provisions, that the Notice contains inaccurate facts and that CMIC has acted in good faith. B. The Subject Claim The following represents a summary of the pertinent facts as it relates to the subject claim. The following should not be construed to represent every fact regarding the claim or lawsuit or every action or communication during the course of CMIC’s evaluation of the claim or during the lawsuit involving the subject claim. In September 2021, a claim was submitted to CMIC for water damage to the ceiling in the sanctuary which purportedly occurred on or about September 27, 2021. Based on representations by representatives of the Complainant and CMIC’s investigation, it was determined that the water damage to the sanctuary was caused by a leak from the HVAC unit(s)/system which was located in the attic above the sanctuary ceiling. The cause of loss to the HVAC system was wear and tear. CMIC issued its initial coverage determination and payment for covered ensuing water damages to the sanctuary, after application of the deductible and less recoverable depreciation, on or about November 30, 2021. On January 14, 2022, Deborah Beckett, on behalf of the Insured, provided an estimate prepared by Jeremiah Ofori of ProRestore Services in the amount of $19,517.08, which included repairs to the Worship Hall (the Sanctuary) and the Congregation Hall (“ProRestore Estimate”). Glenn Gledhill re-inspected the insured property on behalf of CMIC on March 2, 2022. At the time of the reinspection, Ronald Beckett, on behalf of the Insured, confirmed that there was no damage in the Congregation Hall as a result of the September 27, 2021 loss. Mr. Gledhill requested that Mr. Ofori remove the Congregation Hall from the ProRestore Estimate and advised of several other objections to various line items in the ProRestore Estimate. Mr. Ofori agreed to remove the Congregation Hall from the ProRestore Estimate, which reduced the ProRestore Estimate to approximately $16,873.21. Mr. Gledhill prepared a supplemental estimate totaling $16,651.02 for repairs to the sanctuary, which was provided to Mr. Ofori and Mr. Ofori, on behalf of the Insured, agreed to resolve the claim based on Mr. Gledhill’s supplemental estimate. On April 29, 2022, CMIC issued its supplemental coverage letter and supplemental payment in accordance with the Policy and the agreement reached between Mr. Gledhill and Mr. Ofori. CMIC issued actual cash value payments totaling $14,119.93, after reduction of depreciation and the deductible. After resolution of the water damage claim, and during Mr. Ofori’s performance of repairs relative to the water damage claim, on or about July 19, 2022, Mr. Ofori removed the ceiling drywall in the sanctuary and “noticed some Collar Ties and rafters were broken” and that “at some point the collar ties broke and started to push the exterior wall out.” Apparently, from that point forward, the Insured seemingly conflated the damage discovered when the ceiling was removed with the ceiling stain and water damage caused by the HVAC leak. While CMIC continued to evaluate the water damage claim based on information provided by the Insured, the information and investigation revealed two independent causes of damage: (1) water staining and drywall ceiling damage caused by a HVAC leak; and (2) structural damage caused by improper installation of the HVAC system in the interior of the sanctuary which affected the load carrying capability of the roof structure. In September 2023, CMIC requested the Insured provide a full and complete duly executed Sworn Proof of Loss (“POL”) in accordance with the LOSS CONDITIONS of the Policy. In November 2023, CMIC was provided an executed POL purportedly signed by Ronald Beckett on behalf of the Insured on or about October 19, 2023. The executed POL stated “See Attachment” in response to the “whole loss and damage to the described property as a result of this loss,” the amount the “Insured hereby claims of the company” and “the actual cash value of repairs or replacement being claimed at this time” (lines 4, 5, 6 and 7 of the POL). The attachment to the executed POL was the ProRestore Services replacement cost estimate in the amount of $16,837.21 – the same Estimate for which Mr. Ofori, on behalf of the Insured, and CMIC’s representative reached an agreement to resolve the water damage claim. Based on POL, CMIC fully compensated the Insured for covered ensuing water damages associated with the HVAC water leak. In March 2024, CMIC issued correspondence to the Insured, through its counsel, requesting clarification regarding the scope of damages the Insured was seeking coverage – the amount forth in the POL or based on an alternative damage estimate provided by the Insured to CMIC prior to the execution of the POL and which included rooms and areas of the insured property which were not damaged by the September 27, 2021 loss and/or were not disclosed by the Insured or the Insured’s representatives as damaged as a result of the September 27, 2021 loss, including, but not limited to, the entry/foyer, backroom, kitchen, bathroom 1, bathroom 2, exterior and roof. The March 2024 correspondence also indicated, at least two times, that while documentation had been provided to CMIC contending that a purported “collapse” occurred at the Property, no separate claim for “collapse” had been provided to CMIC for consideration. In July 2024, the Insured, through counsel, submitted an additional engineering report to CMIC within the water damage claim. The correspondence did not advise that the Insured sought to open a “collapse” claim. In October 2024, the Insured submitted a Notice of Intent to Initiate Litigation relating to the HVAC water leak. On November 1, 2024, CMIC responded to the Notice of Intent, reiterating that no claim had been made to CMIC asserting coverage for a “collapse” at the insured property and that no date of loss was identified for the purported “state of collapse” as alleged in the Notice of Intent. CMIC also advised that, despite issues with the Notice of Intent, CMIC requesting the Complainant participate in mediation as a method of alternative dispute resolution and requested Complainant provide the names of several proposed mediators or participate in mediation through the Florida Department of Financial Services mediation program. Four days later, on November 4, 2024, counsel for the Insured formally requested that a claim be opened to address the purported claim for “collapse” and nine days after that, on November 13, 2024, the Insured filed the Civil Remedy Notice. As noted above, as of the filing of this Response, the Complainant and its counsel have not responded to the request for mediation, have not made any effort to coordinate mediation pursuant to CMIC’s request or taken any action which would permit CMIC to engage in a meaningful resolution of both the Notice of Intent and this Civil Remedy Notice. The Civil Remedy Notice alleges that: “This claim involves the INSUREDS’ property . . . which sustained significant damage from water which caused the building to be in a state of collapse on or about September 27, 2021.” Based on information and documentation provided to CMIC to date, the structural issues at the insured property were not caused by the HVAC water leak that occurred on or about September 27, 2021. Mr. Ofori claimed that, on or about July 19, 2022, after he removed the ceiling drywall in the sanctuary, he “noticed some Collar Ties and rafters were broken” and that “at some point the collar ties broke and started to push the exterior wall out.” Mr. Ofori did not advise that the broken collar ties and rafters were caused by or related to the HVAC water leak or related to any services ProRestore Services provided at the property. Mr. Ofori did not did not identify when the collar ties and/or rafters broke and he did not reference or advise of any “abrupt falling down or caving in” at the insured property while performing his services or at any specific time. The Insured produced a Structural Inspection letter prepared by William F. Stuhreke, PhD, P.E. dated July 26, 2022. While Mr. Stuhrke claimed that the walls, ceiling and roof structure “experienced significant structural damage,” he did not opine that the damage was caused by water, water leak or the HVAC leak. In fact, the term “water” is not referenced anywhere in his letter. To the contrary, he opined that “[t]he original conventional frame rafter and ceiling joist system had been over built to provide for the installation of air conditioning equipment and insulation,” which resulted in the load carrying capability being exceeded. Mr. Stuhreke’s letter also did not identify any date of when the structural damage purportedly occurred and/or whether the condition present at the time of his inspection was the result of an abrupt or sudden incident or event. CMIC retained Donan Engineering and ProNet Group, Inc. while investigating the two independent claims. Both Donan and ProNet opined that the damage to the roof, rafter and ceiling joist system was caused by the improper installation of the HVAC unit in the attic above the sanctuary. This comports with the opinion of Mr. Stuhreke. Donan opined that: “No stains on the roof decking, wood framing or insulation are evidence that the damage was not caused by water leaks.” In addition, ProNet opined that the failure of the roof and attic framing “was present and known for an extended period of time, as evidenced by the numerous and improper repair attempts to the failed framing and at the wall/ceiling interfaces of the sanctuary” and that the “movement was not sudden, nor was it related to any specific one-time weather event.” The Insured produced an Initial Findings Report from Byron K. Anderson, P.E. of Structural Engineering and Inspections, Inc. dated May 16, 2024. The Initial Findings Report summarizes an interview with Insured representative Clarence Bivins which reflects that Mr. Bivins noticed water-stain on the ceiling in 2021 and water dripping from the ceiling drywall which was caused by a clog in the a/c drain. This comports with the cause and scope of the claim as initially reported by the Insured. The Initial Findings Report does not opine that water was the cause of any damage to the roof framing or ceiling joists. Rather, it contends that, at some point after the HVAC leak, the ceiling drywall was removed and, when the drywall was removed, “the ceiling framing system no longer ha[d] planar diaphragm lateral resistance and or stability to help resist the outward forces from the ceiling joist members, in turn, causing the roof framing to drop and top of the masonry wall to displace outward.” Mr. Ofori, who removed the ceiling drywall, did not advise of any “drop” to the roof framing when the drywall was removed. Rather, the removal of the ceiling drywall allowed him to observe broken collar ties and rafters that occurred at some point prior to the ceiling drywall removal. While ProNet opined that the removal of the ceiling drywall would not have caused the damage as alleged in the Initial Findings Report because ceiling drywall was not a load-bearing component of, or used as lateral resistance at, the insured property, Mr. Anderson’s report does not support the Insured’s apparent assertion that water was the cause of the structural condition at the insured property. Based on a review of the Civil Remedy Notice, it appears that the Insured is currently alleging a scope of damages for the September 27, 2021 water leak claim not based on the POL previously provided by the Insured and fully paid by CMIC but related to the structural issues at the insured property which were discovered once the drywall ceiling was removed. This damage was not caused by the HVAC water leak. Based on multiple expert opinions obtained by both the Insured and CMIC, the cause of the damage was improper installation of the HVAC unit in the attic above the sanctuary which affected weight load capacity. Even if one were to rely on the opinions of Mr. Anderson set forth in the Initial Findings Report (which are disputed according to ProNet), the purported cause was not water but removal of the drywall (which was removed months after the HVAC leak). In the Notice, the Insured demands payment of the balance of Policy limits due to the structural issues. However, based on the information currently known, the structural issues were not caused by the HVAC water leak. Since there are two independent claims for purported damage at the Property and the Civil Remedy Notice identifies the applicable Claim Number as the HVAC water leak claim, CMIC contends that there were no purported statutory violations at the time of the filing of the Civil Remedy Notice and as of the submission of this Response related to the HVAC water leak claim. Pursuant to the POL received by CMIC from the Insured, CMIC provided full and complete compensation to the Insured relative to the HVAC water leak claim by April 2022. To the extent the Civil Remedy Notice attempts to address the structural issues at the Property and CMIC’s evaluation of the claim related to the purported “collapse,” that claim was evaluated under a different claim number than the Claim Number identified in the Civil Remedy Notice. Because no Civil Remedy Notice has been filed under that Claim Number, CMIC has not addressed them here. Finally, the Civil Remedy Notice alleges that the Insured “mitigated their damages.” It is unclear if this representation relates to the HVAC water leak claim or the separate claim for purported “collapse.” While the Insured may have repaired the HVAC clogged drain, it did not mitigate damages relating to the structural issues. At least as early as Mr. Stuhrke’s July 26, 2022 letter, the Insured was made aware of issues and concerns regarding the structure of the insured property. The Insured was advised on no less than three occasions that the building should be temporarily shored and/or braced. However, as of December 2024, the roof framing and the insured property has not been shored or braced and no action has been taken to mitigate or prevent any additional damage. According to ProNet’s report dated January 6, 2025, there has been exacerbation of and progression to the condition of the insured property. The Insured has a duty to take all reasonable measures to protect the insured property from further damage, which the Insured has apparently failed to do. In addition, the policy contains an exclusion for neglect, which excludes coverage where an insured fails to use all reasonable means to save and preserve property from further damage at and after a loss. C. Current Status As set forth above, as it relates to solely the HVAC water leak claim – the sole claim number identified in the Notice – CMIC took appropriate actions to resolve the claim and its prior payment was in line with the executed POL submitted by the Insured. CMIC contends that there were no alleged violations relating to Claim Number 1459128 and disputes the merits of the Notice and the claimed violations. Nonetheless, on November 1, 2024, CMIC requested the insured participate in mediation relating to the HVAC claim; however, Complainant has not cooperated with CMIC in coordinating mediation, which would have provided CMIC an additional avenue to resolve the issues raised in this Notice. Overall, at all relevant times, CMIC acted in good faith and made good faith attempts to address the HVAC water leak claim to no avail. Complainant’s Notice is deficient and fails as a matter of law. CMIC denies any and all violations claimed in the Notice and denies the allegations as set forth by Complainant. If you have any questions or wish to discuss this matter further, please feel free to contact me. Sincerely, /s/ Dena B. Sacharow Dena B. Sacharow, Esq. cc: Vanessa Ross, Esq. (via email)
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