Civil Remedy Notice of Insurer Violations
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Filing Number:     793027
Filing Accepted:  11/18/2024
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Complainant
Last/Business Name *  
TABORA   First Name   NORMAN
Street Address * 10401-11 SW 182 STREET
City, State Zip * MIAMI, FL 33157
Email Address * STEPHANY@DUBOFFLAWFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   TABORA   First Name   NORMAN
Policy # * SFLD2006196-04 Claim #* 50226
Attorney
Attorney is Applicable
Last Name* DUBOFF First Name * KENNETH Initial R
Street Address* 680 NE 127TH ST
City, State Zip* NORTH MIAMI , FL 33161
Email Address * STEPHANY@DUBOFFLAWFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SAFEPOINT INSURANCE COMPANY
NAIC Company Code 15341
 
Name of individual responsible for violation (if any):* SURAJ DASWANI
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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)(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)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Coverage D - Fair Rental Value If you rent the described location to others, Coverage D provides for the loss of rent you incur, less any expenses that do not continue, while the building is unfit to live in because of a covered loss. COVERAGE D - Fair Rental Value If a loss to covered property described in Coverage A, B or C by a PERIL INSURED AGAINST under this policy makes that part of the Described Location rented to others or held for rental by you unfit for its normal use, we cover its: Fair Rental Value, meaning the fair rental value of that part of the Described Location rented to others or held for rental by you less any expenses that do not continue while that part of the Described Location rented or held for rental is not fit to live in.
 
* 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. WITH RESPECT TO THE INSUREDS’ CLAIM OF LOSS AS A RESULT OF A VANDALISM LOSS ON AUGUST 26, 2022, THE INSURER, SAFEPOINT INSURANCE COMPANY (HEREINAFTER “SAFEPOINT” OR “INSURER”) BREACHED THE PUBLIC’S TRUST BY ITS ADJUSTMENT OF THAT CLAIM. THIS CLAIM INVOLVES THE INSURED’S LOSS AS A RESULT OF VANDALISM THAT OCCURRED ON OR ABOUT AUGUST 26, 2022. THE INSURANCE FOR THE DWELLING IS BASED ON “ALL RISK” COVERAGE, WHICH PROVIDES COVERAGE FOR ALL OCCURRENCES CAUSING DIRECT PHYSICAL DAMAGE TO THE INSURED PROPERTY, UNLESS THE OCCURRENCE IS EXPRESSLY EXCLUDED. A VANDALISM LOSS IS NOT AN EXCLUDED LOSS UNDER THIS POLICY. THE LOSS WAS TIMELY REPORTED TO THE CARRIER. ON OR ABOUT FEBRUARY 8, 2023 OUR OFFICE RECEIVED PAYMENT IN THE AMOUNT OF $37525.81 FOR COVERAGE A AND $12,070.40 FOR COVERAGE D. THE CARRIER DELIBERATELY UNDERVALUED THIS STRAIGHTFORWARD CLAIM. FOLLOWING THE UNDERPAYMENT, ON FEBRUARY 24, 2023 COUNSEL FOR INSURED INVOKED APPRAISAL AS OUTLINED IN THE POLICY. SURAJ DASWANI ATTEMPTED TO AVOID APPRAISAL BY STILL LOWBALLING THE INSURED. HOWEVER, THE INSURED INSISTED TO PROCEED WITH APPRAISAL. ONCE APPRAISAL WAS INVOKED, IT TOOK SIX (6) MONTHS FOR THE WHOLE PROCESS TO BE COMPLETED. APPRAISAL CHECK WERE FINALLY RECEIVED ON SEPTEMBER 12, 2023. FOLLOWING RECEIPT OF APPRAISAL CHECK, COUNSEL FOR INSURED CONTACTED MR. DASWANI IN ORDER TO RECOVER FOR THE LOSS RENTS. AT THAT POINT, THE APPRAISAL TOOK 6 MONTHS, WHICH MEANT THE INSURED LOSS 6 MONTHS OF RENT, PLUS THERE WAS NEED FOR ADDITIONAL TIME TO COVER THE TIME IT WOULD TAKE TO COMPLETE REPAIRS. MR. DASWANI REFUSED TO PAY THE AMOUNT OF LOSS RENTS DUE AND AS SUCH THE INSURED WAS FORCED TO FILE SUIT. PURSUANT TO DOCUMENTATION PROVIDED TO THE CARRIER, THE AMOUNT OF LOSS RENT IS $2,414.00 A MONTH. IT TOOK A TOTAL OF 13 MONTHS FOR THE CARRIER TO PROPERLY INDEMNIFY THE INSURED. IN ADDITION, THE INSURED WAS INFORMED IT WOULD TAKE APPROXIMATELY 3 MONTHS FOR THE PROPERTY TO BE REPAIRED. THE TOTAL AMOUNT OF LESS RENTS THAT WAS INCURRED IS: $38,624.00. THE CARRIER INITIALLY PAID $12,070.40 IN LOSS RENTS, WHICH MEANS THAT THE BALANCE PENDING IS $26,554. DUE TO THE FACT THAT THE LOSS RENT LIMIT OF COVERAGE D IS $37,600, THE INSURED IS REQUESTING THE REMAINDER OF THE POLICY LIMIT IN THE AMOUNT OF $25,530.00. THE CARRIER HAS MOST RECENTLY TAKEN THE POSITION THAT THEY WILL NOT PAY ADDITIONAL MONIES FOR LOSS OF RENT, UNLESS THE INSURED SHOWS PROOF THAT THE UNDISPUTED PAYMENT WAS INSUFFICIENT TO MAKE REPAIRS. HOWEVER, BY VIRTUE OF THE FACT THAT THE PARTIES WENT TO APPRAISAL, AND THAT PROCESS ALONE DETERMINED THE INSURED WAS INITIALLY UNDERPAID, THE CARRIER IS ACTING IN BAD FAITH IN REFUSING TO PAY THE INSURED THE REMAINING LOSS OF RENTS THAT THEY ARE OWED. IN THIS MATTER THE INSURER IMPROPERLY INVESTIGATED AND UNDERPAID THE CLAIM; AND UNREASONABLY DELAYED THE SUBJECT CLAIM OF LOSS. THE CARRIER HAS FAILED TO PROMPTLY AND FAIRLY SETTLE ITS INSURED’S INSURANCE CLAIM WHEN THE OBLIGATION TO SETTLE THAT CLAIM BECAME REASONABLY CLEAR. AS EVIDENCED BY ITS CONDUCT, THE INSURER HAS TO FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR THE PROPER INVESTIGATION AND EVALUATION OF SUCH CLAIMS - INCLUDING RELATED TO ITS CLAIMS HANDLING AS WELL AS FOR AND REGARDING THE TRAINING AND SUPERVISION OF ITS EMPLOYEES. THOSE FAILURES RESULTED IN THE STATUTORY VIOLATIONS SET FORTH ABOVE. AS A RESULT OF ITS ERRORS, THE INSURER HAS UNREASONABLY PROLONGED THE CLAIM AND HAS AVOIDED TENDERING TO ITS INSUREDS THE FULL INSURANCE POLICY PROCEEDS DUE AND OWING TO THEM IN ACCORDANCE WITH THEIR POLICY. THE INSURER IS MOTIVATED BY THE DESIRE TO PROTECT ITS OWN INTERESTS AT THE EXPENSE OF ITS INSUREDS’ INTEREST AND PURSUED A COURSE WHICH IS ADVANTAGEOUS TO ITSELF WHILE DISADVANTAGEOUS TO THE INSURED. THE REASONS TO WITHHOLD FUNDS WERE AND ARE UNFOUNDED, CAUSING DELAY AND DECEIT CLEARLY EVIDENCING THE INSURER’S EXERCISE OF ANY UNFAIR ADVANTAGE TO PRESSURE THE INSURED INTO A LOWBALL SETTLEMENT OF THE INSURED’S CLAIM. THEREFORE, TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, THE INSURER MUST: 1) PAY THE INSUREDS $25,530, THE AMOUNT INCURRED BY THE INSURED IN CONNECTION WITH LOSS OF RENTAL INCOME
Comments
User Id Date Added Comment
mbakas@safepointins.com 01-17-2025 January 17, 2025 VIA EMAIL: STEPHANY@DUBOFFLAWFIRM.COM Kenneth R Duboff, Esq. 680 NE 127th Street North Miami, FL 33161 RE: Insured: Norman Tabora Claim Number: 50226 Policy: SFLD2006196-04 Date of Loss: 8/26/2022 CRN Filing Number: 793027 Dear Sir/Madam: This is the formal response of SafePoint Insurance Company (“SafePoint”) to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that was filed on behalf of Norman Tabora (“Complainant” / “Insured”). The Florida Department of Financial Services accepted the Purported Notice, in form only, on November 18, 2024. The Purported Notice was filed in connection with Norman Tabora’s insurance claim for property damage. The Purported Notice names SafePoint and alleges “Claim Denial,” “Unsatisfactory Settlement Offer,” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(i)(3)(h), Florida Statutes. The Purported Notice is a legal nullity for the reasons discussed below. ^1 SafePoint specifically denies each and every allegation contained in the Notice. Additionally, SafePoint denies that it violated these or any statutes, Florida law or policy provisions regarding the claim adjustment of this matter. ^1 SafePoint reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, 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. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; 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 statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added); The Florida Supreme Court has held 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). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10-363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. The Purported Notice fails to meet the requirements of Fla. Stat. § 624.155 on the following grounds: Deficiency #1 The Purported Notice lists the Insured as “NORMAN TABORA” and fails to list the additional insured on the property, “ONDINA ORTEGA”. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. This deficiency applies to all allegations in the Purported Notice. Deficiency # 2 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply specific facts or circumstances that explain the allegations. Rather, the Purported Notice contains incorrect facts and fails to explain how the purported facts constitute violations of Florida law. The Purported Notice is riddled with general allegations consisting of conclusory and inaccurate statements rather than specific allegations of fact regarding any alleged misconduct or statutory violations. For example, the Purported Notice states, “Claim Denial” and “THE INSURER HAS TO FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR THE PROPER INVESTIGATION AND EVALUATION OF SUCH CLAIMS”. However, these statements are conclusory, inaccurate and without factual basis. This is a claim for vandalism damage to the property that was late reported on August 29, 2022, three (3) days after the alleged date of loss, August 26, 2022. On September 14, 2022, SafePoint inspected the property and documented any visible damage including damages related to the reported cause of loss. On January 26, 2023, SafePoint opened coverage for the reported loss and notified the Complainant of the coverage decision and issued payment to the Complainant in the amount of $45,420.72 under Coverage A – Dwelling, less recoverable depreciation $5,394.91, less deductible $2,500 for a total net payment to the Insured in the amount of $37,525.81 for the covered portion of the loss. An additional payment in the amount of $12,070.40 of Fair Rental Value for the period of restoration September 1, 2022 - September 1, 2023, was made to Complainant in full compliance with the terms and conditions of the Policy. Additionally, as the Purported Notice states both parties consented to an Appraisal, resulting in the issuance of an Appraisal Award (“Award”). On August 31, 2023, Safepoint issued payment to the Complainant based on the Award, totaling $25,716.80. The Complainant did not object to these payments or the Appraisal process, which they initially invoked. Now, the Complainant claims the delay in the appraisal process, which they initiated, resulted in a loss of six months of rental income, plus the time required to complete repairs. However, under the Policy, coverage is for the Fair Rental Value, calculated as the fair rental value less any non-continuing expenses during the unfit period, and is limited to the shortest time required to repair or replace the property. The Policy does not cover rental income losses beyond the shortest necessary repair time, irrespective of the appraisal duration. The Complainant's neglect in making timely repairs further bars them from additional recovery. Additionally, the Complainant executed a Sworn Proof of Loss on February 10, 2023, and provided an estimate that included four months of rental income loss totaling $9,656.00. SafePoint not only met but exceeded this payment. The Complainant failed to make any repairs to restore the property after receiving these funds and has not provided any receipts or invoices indicating repairs were made. Since the funds were provided and the rental income loss was covered, further recovery is not warranted under the Policy. Finally, the Purported Notice makes boilerplate recitations of statutes and conclusory statements without the requisite specificity. Specificity is of particular importance for this Purported Notice as Complainant generally alleges that SafePoint violated, Section 626.9541(1)(i)(3)(b), “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Purported Notice does not set forth any facts regarding any misrepresentations made by SafePoint and does not identify the person or persons who made such misrepresentations. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. This deficiency applies to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Unsatisfactory Settlement Offer,” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(i)(3)(h), Florida Statutes. Deficiency #3 Finally, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity as stated herein, including but not limited to the use of the attorney’s firm’s email address, “STEPHANY@DUBOFFLAWFIRM.COM” for that of the Complainant. Therefore, the Notice is insufficient and fails to satisfy the condition precedent to filing a bad faith action. See Julien, 2021 WL 824438. STATUTORY ALLEGATIONS 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 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. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. SAFEPOINT denies the allegation that it violated the above referenced statute. The allegations set forth in the Purported Notice are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and intended solely to tarnish SafePoint’s name and reputation. SafePoint has at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. SafePoint unequivocally denies each and every allegation asserted in the Purported Notice. At no time has SafePoint breached any duty to the Complainant. AN INSURER IS NOT REQUIRED TO PAY WHATEVER AMOUNT THE INSURED DEMANDS. SafePoint conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. SafePoint promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. SafePoint retained a field adjuster and conducted an inspection of the subject property to investigate the Complainant’s claim. Safepoint made a coverage decision and prepared an estimate for the covered portion of the loss and issued payment as noted. SafePoint participated in appraisal and pursuant to the Award, issued additional payment. All payments were cashed by the Complainant, therefore discharging SafePoint from further liability and barring any additional recovery. Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, SafePoint denies any wrongdoing. It specifically denies that it committed the acts asserted or violated Florida Statutes as alleged in the Purported Notice. Please be advised, by this letter, SafePoint neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, SafePoint hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/ Ari A. Zeltzer Ari A. Zeltzer, Esq. Staff Counsel SafePoint Insurance Cc: Florida Department of Financial Services
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