Civil Remedy Notice of Insurer Violations
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Filing Number:     792627
Filing Accepted:  11/15/2024
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Complainant
Last/Business Name *  
CAPE TOWNE CONDOMINIUM ASSOCIATION, INC.   First Name  
Street Address * 4514-4516 SANTA BARBARA BLVD
City, State Zip * CAPE CORAL, FL 33914
Email Address * REMINGTON@LAWHUGGINS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   CAPE TOWNE CONDOMINIUM ASSOCIATION, INC.   First Name  
Policy # * CRP 0000080-04 Claim #* 01000064647
Attorney
Attorney is Applicable
Last Name* HUGGINS First Name * JEFFERY Initial R
Street Address* 6421 N FLORIDA AVE D-598
City, State Zip* TAMPA , FLORDIA 33604
Email Address * REMINGTON@LAWHUGGINS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CENTAURI SPECIALTY INSURANCE COMPANY
NAIC Company Code 12573
 
Name of individual responsible for violation (if any):* CAROL CRUMP, VALERIE GREGG, MICHAEL HINZ
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
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.
624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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)(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)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees 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).
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.

The Insurer has not provided a copy of the Policy, despite the Insured’s request. The violations described herein derive from Florida law concerning insurers’ obligations to their insured. See, e.g., Fla. Stat. Chapters 626, 627. Specific policy language that may be relevant to the violations include, but are not limited to, the following: Building Coverage provisions, All Additional Coverages provisions, All Coverages provided by Endorsement or Rider, The Declarations, Page Loss Payment, Settlement provision, and the insurance policy's definition section.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insurer’s adjuster(s) assigned to this claim were/are: Carol Crump, Valerie Gregg, Michael Hinz. Hereinafter referred to as the “Adjuster” or “Adjusters”. - The Insured suffered a loss due to Hurricane Ian, which occurred on or about September 28, 2022. The Insured’s covered property was damaged by the loss. - On April 13, 2023, the Insurer admitted that the Property sustained damage from the Loss that was covered by the Insured’s insurance policy (policy number stated above; hereinafter the “Policy”)—for which the Insurer assessed a replacement cost value of $48,713.65 (“Insurer Estimate”), a mere 7% of the Insured’s estimate to repair the property. The Insurer Estimate was prepared and authored by Adjuster Hinz. The Insurer Estimate was patently deficient in that it omitted entire categories of damage that would have been visible to and recognizable by any person viewing the damaged Property, let alone a qualified insurance adjuster. It is important to note that some of these damages are not latent; they are patent and easily observable through cursory investigation. Upon review of the Insurer’s estimate, it became clear to the Insured that the Insurer patently undervalued the replacement cost value of the Property by omitting obvious damages and that the Insured would not fully restore the Property to the condition it was in prior to the loss by failing to pay the Insured all the benefits to which the Insured is entitled under the Policy for the loss. In this way, the Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 624.155(1)(b)(2) by making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. The insurer 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. Moreover, the Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. And, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - The Insured hired Premier Claims (“Premier”) to assist in the proper administration of the insurance claim. Having conducted thorough investigations and analysis, Premier prepared an estimate of costs to repair the damaged property in the amount of RCV $732,032.00. Premier sent the Insurer a letter of representation on November 8, 2022, providing Premier’s claim file and requesting information—including a copy of the policy, claim payment history, and other claim documents. - Despite the Insured’s November 8, 2022 request for the same, the Insurer has not provided a copy of the Policy, a claim payment history, and other requested claim documents. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon communications with respect to claims. - It was not until April 13, 2023—about five months after the Claim was submitted—that the Insurer paid or denied any portion of the Claim. The Insurer violated Fla. Stat. § 626.9541(1)(i)(4) by failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed. See also Fla Stat § 627.70131(5)(a) ("Within 90 days after an insurer receives notice of [a] ... supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim"). Moreover, the insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer 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. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon communications with respect to claims. - On April 13, 2023, Adjuster Crump sent a letter underpaying the claim based upon a report from the insurer’s field adjuster that failed to account for the proper repair of the observed damages. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices as a result. - Due to the extent of damages and the requirement of a proper repair under Florida law, a full roof replacement would be warranted under the Policy. Desirous to avoid this cost, Adjuster Crump wrongfully underpaid the insurance claim by making the above misrepresentations. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(3) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - On April 13, 2023—about five months after the Claim was submitted— Adjuster Crump sent the Insured correspondence indicating that $17,992.83 (approximately 2%) of the Claim would be paid. However, she provided scant rationale as to how she arrived at this figure/percentage despite the detailed corroborative information provided by the Insured. In this way, the insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 624.155(1)(b)(2) by making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. The insurer 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. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. - Moreover, Adjuster Crump denied approximately 98% of the Claim. However, in this correspondence or at no point did Adjuster Crump meaningfully explain why 98% of the Claim was being denied. Here, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. And, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - The Insurer’s conduct in this case is one instance a pattern of business practice designed to avoid or delay coverage determinations for claims, supplemental claims, and/or additional claims by failing to render a determination when requested, failing to make payments of undisputed amounts of claims, and 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. - To cure the conduct giving rise to the violations described herein, insurer must: (i) pay the total replacement cost value of the Insured’s Claim in the amount of $732,032.00, less prior payments and the deductible; (ii) make payment of any pre-judgment interest owed under Florida law; (iii) make payment for the additional expense incurred by the Insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim.
Comments
User Id Date Added Comment
emily@lawhuggins.com 08-05-2025 The Insureds hereby withdraw this CRN in its entirety.
kmixon@gspalaw.com 12-17-2024 December 17, 2024 Via Electronic Filing Department of Financial Services Civil Remedy Notice Department 200 East Gaines Street Tallahassee, Florida 32399 RE: Insured: Cape Towne Condominium Association, Inc. Claim No.: 01000064647 Policy No.: CRP 0000080-04 Date of Loss: September 28, 2022 Our File No.: LILP.48434-BV CRN No.: 792627 Dear Sir or Madam: Centauri Specialty Insurance Company (“Centauri” or “Insurer”) is in receipt of the Civil Remedy Notice of Insurer Violation (“Notice”), submitted by Jeffrey R. Huggins, Esq. on behalf of the complainant, Cape Towne Condominium Association, Inc. (“Insured”). The Notice was marked accepted by the Department of Financial Services on November 15, 2024 and was assigned Filing Number 792627. The Notice relates to claim number 01000064647, with an alleged loss for damages to property resulting from Hurricane Ian. (“Claim”). Initially, Centauri asserts the Notice fails to comply with the requirements of Florida Statutes §624.155, in that it fails to set forth the specific policy language relevant to any alleged violation. Further, the Notice fails to include specific facts or circumstances to support the vague, conclusory allegations asserted in the Notice. Notwithstanding the failure of the Notice to comply with Florida Statute §624.155, Centauri does hereby respond to the allegations of the Notice so as to avoid any presumption that may be made by lack of response, notwithstanding the clear documented facts that are contrary to the unsupported allegations asserted in the Notice. Centauri expressly denies the allegations asserted in the Notice – that may be referenced by statute or otherwise - to the extent it alleges lack of a timely response to the notice of claim, implementing proper standards in its inspections and investigation of the claim, that it did not diligently and properly respond to and evaluate the claim, or satisfy its contractual and indemnity obligations to the insured. The documented facts and communications in the claim clearly reveal that Centauri responded timely, properly advised of the information and access for inspections to allow Centauri to make a determination of the loss. To the extent the allegations relate to a purported delay in the claims decision, Centauri notes that such delay was reasonable due to the circumstances and challenges in the full investigation of the claim and that the delay had been the result of factors beyond its control which had prevented it from making an immediate decision. Further, the Notice seems to suggest that Centauri’s adjustment and payments were not reflective of the repairs necessary to address the covered damages, yet there was nothing submitted by the Insured, despite repeated requests for same, that would have allowed Centauri to consider its potential additional coverage and/or indemnity obligations. Accordingly, as of the date of this response, however, Centauri has made its coverage decision and advised the Insured of its coverage obligations under the Policy. As to the alleged factual basis asserted for the submission of the Notice, Centauri responds as follows: Claim Denial: This allegation is without basis and therefore denied. As of the date of this response, Centauri has acknowledged coverage for certain damages resulting from the covered loss and provided adequate information related to its coverage decision. The Notice alleges that Centauri has wrongfully denied the claim is false. Claim Delay: This allegation is without basis and therefore denied. Centauri investigated and evaluated this matter promptly and in good faith, it advised the Insured of its position throughout the claims process, and made a timely claim determination after multiple inspections and assessment of damages to the property after the impediments to its ability to complete its investigation had been removed. The Notice fails to address or set forth any of the detail of the actions undertaken by Centauri to maintain communication with the Insured and their representatives while it completed an evaluation of the claim as attempts were made by Centauri to contact the Insured’s representative to obtain additional and necessary information to address the potential for a supplement to the original adjustment. Unsatisfactory Settlement Offer: This allegation is without basis and therefore denied. The Notice was submitted without an explanation as to why the Insured and/or their representative failed to address repeated requests for documentation/information that would have allowed Centauri to address a potential supplement to the original adjustment. As of the date of this response, Centauri had investigated and evaluated this matter and has provided payment for repairs necessary to the property determined to have been the result of wind damage as set forth in its Policy. As such, this perceived unsatisfactory settlement offer is without any merit or support. Unfair Trade Practice: This allegation is without basis and therefore denied. The Notice fails to provide any detail of what exactly Centauri did which would have resulted in an unfair trade practice. There was no specificity other than to state that Centauri has, among other things, denied the claim and failed to issue payment and act recklessly with regard to the Insured’s rights. The Notice seems to allege that the lack of payment on the Insured’s claim somehow equates to an unfair trade practice. The remaining Reasons for the Notice are nothing more than unsubstantiated allegations meant to track the language of the Florida Statutes and therefore Centauri denies any wrongdoing and any such alleged bad faith conduct with respect to the Insured’s claim. ALLEGED STATUTORY VIOLATIONS: 624.155(1)(b)(1): This allegation is denied. Centauri acted in good faith at all time and acted in accordance with the policy of insurance and the Florida Statutes. There exist no facts or circumstances to support this allegation in the Notice. 624.155(1)(b)(2): This allegation is denied. Centauri issued the necessary payments as per the Policy and also provided written explanation for same. There exist no facts or circumstances to support this allegation in the Notice. 624.155(1)(b)(3): This allegation is denied. Following an investigation, Centauri was able to provide the Insured with coverage and advise of its indemnity obligations as set forth in the Policy. There exist no facts or circumstances to support this allegation in the Notice. 626.9541(1)(i)(3)(a): This allegation is denied. Centauri has adopted and implemented standards for the proper investigation of claims. Centauri acted in good faith at all times and acted in accordance with Florida Statutes. Absolutely no facts or circumstances supporting this allegation have been provided by Complainant in the Notice. 626.9541(1)(i)(3)(b): This allegation is denied. Centauri has not misrepresented any facts or policy provisions in any form and specifically not in regard to coverages at issue. The policy of insurance clearly outlines coverages and exclusions and Centauri has applied these provisions. Centauri acted in good faith at all times and acted in accordance with the policy of insurance and Florida Statutes. There exist no facts or circumstances to support this allegation in the Notice. 626.9541(1)(i)(3)(c): This allegation is denied. Centauri has acknowledged and acted promptly upon all communications in this claim. All communications were acknowledged at all times. There exist no facts or circumstances to support this allegation in the Notice. 626.9541(1)(i)(3)(d): This allegation is denied. Centauri has acknowledged and acted promptly to conduct the necessary inspections of the property as circumstances would allow. There exist no facts or circumstances to support this allegation in the Notice. 626.9541(1)(i)(3)(f): This allegation is denied. Centauri noted and communicated its findings to its Insured well-within the time specified to provide a coverage decision as there were factors beyond its control which had prevented it from making the initial coverage decision. As of the submission of this response, in no way did Centuari fail to provide an explanation for its coverage evaluation and conclusion. There exist no facts or circumstances to support this allegation in the Notice. 626.9541(1)(i)(4)): This allegation is denied. First, the statute referenced in the allegation is inapplicable to this particular Policy period. Second, the allegation is incorrect because Centauri issued all payments in accordance with the statute and in accordance with its payment obligations as set forth in the Policy. There exist no facts or circumstances to support this allegation. 626.9541(1)(i)(3)(i): This allegation is denied as it is inapplicable to the Claim referenced in this Notice. The Complainant also asserts what Centauri must do to ‘cure’ the subject conduct referenced in the Notice, which includes general and conclusory assertions, without definition. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, “Section §624.155 does not impose on the insurer the obligation to pay whatever the insured demands….Section §624.155(2)(d) would have no effect or purpose under such an interpretation.” Talat, 753 So.2d at 1282 citing Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co.. 952 F.Supp. 773,777-778 (M.D. Fla. 1996). CONCLUSION/SUMMATION: The Notice fails to comply with the statutory requirements of Florida Statutes §624.155. Centauri has nevertheless fully responded herein to the conclusory allegations asserted in the Notice. Centauri has diligently and reasonably responded in the claim in an effort to bring the claim to an amicable resolution in accordance with the information provided in the claim, the inspection, and the terms of the insurance contract. It has at all times acted fairly in the administration of the claim, in compliance with the terms of the insurance policy and Florida law. Centauri has attempted to fully and adequately respond to each of the Complainant’s allegations in the Notice filed with the Department. Should the Department have any questions or further inquiry with respect to this matter, please contact the undersigned. Very truly yours, GROELLE & SALMON, P.A. /s/ Nestor A. Marante Nestor A. Marante For the Firm
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