Civil Remedy Notice of Insurer Violations
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Filing Number:     792757
Filing Accepted:  11/15/2024
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Complainant
Last/Business Name *  
SOSA   First Name   EDGAR
Street Address * 18211 BELLEZZA DRIVE
City, State Zip * ORLANDO, FL 32820
Email Address * INTAKE2@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SOSA   First Name   EDGAR
Policy # * 988 904 722 Claim #* 0771285244
Attorney
Attorney is Applicable
Last Name* KADIR First Name * ALI Initial A.
Street Address* 986 DOUGLAS AVE, STE. 102
City, State Zip* ALTAMONTE SPRINGS , FL 32714
Email Address * INTAKE2@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CASTLE KEY INDEMNITY COMPANY
NAIC Company Code 10835
 
Name of individual responsible for violation (if any):* DIASIA BANKS AND ALL CASTLE KEY CLAIMS ADJUSTERS, EMPLOYEES, REPRESENTATIVES, AGENTS, VENDORS, AND/OR ENGINEERS WHO HANDLED THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Misrepresentation
* 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)(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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

“Losses We Cover Under Coverage A: Your policy generally covers sudden and accidental direct physical loss to the property described in Dwelling Protection – Coverage A coverage. . . . Losses We Cover Under Coverage B: Your policy generally covers sudden and accidental direct physical loss to the property described in the Other Structures Protection – Coverage B coverage. . . . Losses We Cover Under Coverage C: Your policy insures covered personal property described in Personal Property Protection – Coverage C against sudden and accidental direct physical losses, except as limited or excluded by your policy, caused by: . . . . - windstorm or hail”
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Edgar Sosa is a homeowner insured with a policy issued by Castle Key Indemnity Company (“Castle Key”). The insured property or home is located at 18211 Bellezza Drive, Orlando, Florida 32820. In September of 2024, a hail and windstorm caused extensive damage to Mr. Sosa’s home. Mr. Sosa timely reported an insurance claim for this damage to Castle Key and fully cooperated with all requests for inspections. He provided all requested documentation, if any, and complied with all post loss policy conditions. After reporting the claim, Castle Key retained an unqualified and biased field adjuster who has a financial relationship with Castle Key. This field adjuster inspected Mr. Sosa’s home in an apparent effort to minimize Castle Key’s losses instead of adjusting the claim in good faith in due regard for Mr. Sosa’s interests. Despite Castle Key finding coverage for his claim, it significantly undervalued Mr. Sosa’s claim at only $700.15. Because this amount is less than the subject policy’s deductible, Castle Key did not issue any payment to Mr. Sosa. Due to such, Mr. Sosa has/have not been able to permanently repair his home. Indeed, an estimate for repair of all damages with respect to his claim was prepared on behalf of Mr. Sosa for $197,681.60 and was submitted to Castle Key; well above the amount from Castle Key. Based on these facts, it is clear Castle Key unreasonably denied full coverage for Mr. Sosa’s claim in bad faith through its extremely low and unreasonable undervaluation of his claim. Had Castle Key conducted a reasonable investigation based upon the available information, it would have been evident that affording greater coverage and issuing a substantially higher payment is warranted. Instead, it failed to adopt and implement standards for proper claim investigation as well as misrepresented pertinent policy provisions/facts rather than act fairly and/or honestly with Mr. Sosa in due regard for his interests. Castle Key also delayed the claim and failed to timely respond to communications. This has become a common business practice of Castle Key. 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 based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Castle Key has breached this duty by refusing to properly and timely adjust the loss. As a result, Mr. Sosa will have no choice but to retain the undersigned counsel to file a lawsuit against Castle Key. Castle Key has more than enough information and is still refusing to accept coverage for this claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Castle Key can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Mr. Sosa based on his $197,681.60 estimate.
Comments
User Id Date Added Comment
dflip@allstate.com 01-10-2025 January 10, 2025 VIA CRN ONLINE SYSTEM Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Building, 200 Gaines Street Tallahassee, FL 32399-0322 Re: Complainant: Edgar Sosa DFS File No.: 792757 Insured: Edgar Sosa Insurance Company: Castle Key Indemnity Company Claim No.: 0771285244 Dear Sir or Madam: This letter is Castle Key Indemnity Company’s (“Castle Key”) response to the above-referenced Civil Remedy Notice. This response is provided on behalf of Castle Key and all of its employees, agents, officers and affiliates. The Department accepted the CRN on 11/15/2024. Therefore, this response has been timely filed within the statutory deadline. As a preliminary matter, Castle Key at all times during the handling of this claim acted fairly and honestly toward its insured. Castle Key fully and fairly considered information in regard to the matters at hand and fully observed its contractual, statutory and administrative obligations. Castle Key has carefully reviewed, considered, and evaluated the alleged violations charged and believes they are completely without merit. Castle Key wholly denies any and all allegations of wrongdoing, claim delay, claim denial, unfair claims handling, unsatisfactory settlement offer, unfair trade practice, misrepresentation or bad faith in connection with the above claim. Additionally, the CRN is defective and either does not sufficiently state the circumstances at hand or does so inaccurately. Accordingly, the CRN should be rejected Complainants’ CRN violates the requirements set forth in the Florida courts’ jurisprudence for civil remedy notices. It fails to meet even the most basic requirements of the statute. Accordingly, Castle Key respectfully requests the Department return the CRN and insist Complainants provide the specific facts required for civil remedy notices. See Section 624.155(3)(c), Florida Statutes. These requirements arise from the provisions of Section 624.155(3)(a) & (b), Florida Statutes. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the statute. Allstate Ins. Co. v. Clohessy, 32 F. Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. Thus, the CRN cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida statutes must be strictly construed. Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1284 (Fla. 2000) (citing Baxter v. Royal Indem. Co., 285 So.2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996). Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. There are requirements for a valid civil remedy notice. Section 624.155(3), Florida Statutes. Section 624.155 mandates Complainants to provide specific facts and circumstances of the alleged violations. This would necessarily include specific facts regarding the method of the investigation, the reasons the investigation was improper or otherwise inadequate, the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. Florida law does not allow an insured, without providing any facts, to allege that the insurer’s only option to avoid bad faith is paying whatever the insured demands. 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008). Complainants’ CRN violates the specificity requirement. As such, Castle Key would like this opportunity to set forth an accurate factual background, and thereby correct omissions in Complainants’ CRN. Castle Key received its first notice of loss on October 3, 2024, for damages allegedly sustained on September 6, 2024, by a wind/hailstorm to the property located at 18211 Bellezza Drive, Orlando, FL 32820. During this claim a prompt investigation was made, and an inspection was done by the appropriate Castle Key representative. Additionally, there was detailed follow up communication by Castle Key during all phases of this claim. Castle Key Indemnity Company has fulfilled and is fulfilling its duties as provided under the terms and conditions of the insurance policy. Castle Key does not consider there to have been any violation of the referenced statutory provisions or otherwise. At all times during the investigation of the subject claim, Castle Key acted diligently and in good faith to resolve same Castle Key reserves all of its rights. If anyone at the Department has any questions concerning this matter, please contact Castle Key at our office for a further response. Sincerely, CASTLE KEY INDEMNITY COMPANY
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