Civil Remedy Notice of Insurer Violations
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Filing Number:     793214
Filing Accepted:  11/19/2024
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Complainant
Last/Business Name *  
CHALAIRE   First Name   DOUGLAS
Street Address * 1282 THOREAU CIRCLE
City, State Zip * VENICE, FL 34292
Email Address * CDOUG@COMCAST.NET
Complainant Type: * Insured
Insured
Last/Business Name*   CHALAIRE   First Name   DOUGLAS
Policy # * OIC30106195-00 Claim #* 22FLHOV0009511
Attorney
Attorney is Applicable
Last Name* DUNNAVANT First Name * ERIN Initial E
Street Address* 901 W SWANN AVENUE
City, State Zip* TAMPA , FL 33606
Email Address * SERVICE@DANDDLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLYMPUS INSURANCE COMPANY
NAIC Company Code 12954
 
Name of individual responsible for violation (if any):* CLAIMS DEPARTMENT, SUPERVISORS, MANAGEMENT, AGENTS, AND ADJUSTERS, INCLUDING THE FOLLOWING REPRESENTATIVE & ADJUSTER(S): GREGG KNOWLES AND RICHARD BURCHFIELD
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Violation of Code of Ethics
Other : Litigation Strategy and Behavior
* 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)(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.
* 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 Insured believes that the policy language relevant to Olympus’ violations include the following provisions of Policy No. OIC30106195-00, including: From the Declarations: Coverage A – Dwelling Protection $670,000 Coverage B – Other Structures Protection $33,500 Coverage C – Personal Property Protection $268,000 Coverage D – Loss of Use $67,000 Checklist of Coverage (continued) The above Limit of Insurance, Deductibles, and Loss Settlement Basis apply to the following perils insured against: (Items below marked Y (Yes) indicate coverage IS included, those marked N (No) indicate coverage is NOT included) … Y Hurricane … Y Windstorm or Hail (other than hurricane) … Y Any Other Peril Not Specifically Excluded (dwelling and other structures only) … Property – Additional/Other Coverage … Y Debris Removal … SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the “residence premises” shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the “residence premises” used to construct, alter or repair the dwelling or other structures on the “residence premises”. … C. Coverage C – Personal Property 1. Covered Property We cover personal property owned or used by an “insured” while it is anywhere in the world. … SECTION I – PERILS INSURED AGAINST Paragraph A.1. in form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverage A and Coverage B unless the loss is otherwise excluded or limited in this policy. … We insure for sudden and accidental direct physical loss to covered property described in Coverage C caused by any of the following perils unless the loss is otherwise excluded or limited elsewhere in this policy. … E. Additional Coverages 1. Debris Removal a. We will pay your reasonable expense for the removal of: (1) Debris of covered property if a Peril Insured Against that applies to the damaged property causes the loss… … In addition to the above, Olympus referenced the following policy language as pertinent to the claim in prior correspondence to its Insured: SECTION I – CONDITIONS … H. Our Option 1. At our option, in lieu of issuing any loss payment, if we choose to exercise our option: a. For losses settled on an actual cash value basis as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may repair or replace any part of the damaged property with material or property of like kind and quality. b. For losses insured for replacement cost as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may elect to repair or replace any or all of the damaged property with material of like kind and quality without deduction for depreciation. 2. If we choose to exercise our option, we will provide written notice to you no later than 30 days after our inspection of the loss. We may invoke our option to repair within the stated time frame after either a “supplemental claim” or “reopened claim” regardless of whether we invoked our option during the adjustment of the initial claim or a prior “supplemental claim”. 3. If we choose to exercise our option, you must cooperate with and grant us, or any person authorized to act on our behalf, reasonable access to the property in order for repairs to be made. 4. You are responsible for payment of the deductible stated in your Declarations Page. 5. You must comply with the duties described in SECTION I – CONDITIONS, B. Duties After a Loss, paragraph 1.g. 6. As often as is reasonably necessary to effectuate repairs, you must: a. Provide access to the property; b. Execute any necessary city, county, or municipal permits for repairs to be undertaken; c. Execute any work authorizations to allow contractors and related parties entry to the property; d. Otherwise cooperate with the repairs to the property. Our right to exercise our option to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. Any contract entered into between you and any repair person(s), any “assignee(s)”, contractor, other person or company to perform repairs or services except reasonable emergency measures for any loss attributed to a covered peril shall not interfere with this right. … SECTION I – CONDITIONS … E. Mediation Or Appraisal. If you, or any “assignee(s)”, and we fail to agree on the settlement regarding the loss, prior to filing suit, you, or any “assignee(s)”, must notify us of your disagreement in writing as outlined in SECTION I – CONDITIONS, G. Suit Against Us so that either party may: 1. Demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. a. For the purposes of mediation, the term “claim” refers to any dispute between an insurer and a policyholder relating to a material issue of fact. b. The loss amount must be $500 or more, prior to application of the deductible; or there must be a difference of $500 or more between the loss settlement amount we offer and the loss settlement amount that you request. c. The settlement in the course of the mediation is binding only if both parties agree, in writing, on a settlement and, you have not rescinded the settlement within 3 business days after reaching settlement. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided to you. d. We will pay the cost of conducting any mediation conference except when you fail to appear at a conference. That conference will then be rescheduled upon your payment of the mediator's fee for that rescheduled conference. If we fail to appear at a mediation conference, we will pay: (1) Your actual cash expenses you incur in attending the conference; and (2) The mediator's fee for the rescheduled conference. … SECTION I – CONDITIONS … B. Duties After Loss After a loss to which this insurance may apply, you shall see that the following duties are performed: 1. Duties of an “Insured”: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is a failure to comply with any of the following duties. a. Promptly give notice to us or our agent; … (4) Provide us with records, photos, and documents we request and permit us to make copies; (5) In the County where the “residence premises” is located: (a) You and any and all “insureds”; (b) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”, and (c) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in (5)(a) or (b), above; must i. submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”’ ii. provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided, and iii. Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in -person or utilize video and audio technology, or both, as determined by us; (6) Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and (7) Any and all “insureds” must execute all authorizations for the release of information when requested by us. i. promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) as this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. j. to the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us, or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or assisted by a party who provides legal advice, insurance advise, or expert claim advice, regarding and insurance claim under this Policy. An “assignment agreement” does not change your obligation to perform the duties required under this policy. VIII. TO ENABLE THE INSURER TO INVESTIGATE AND RESOLVE YOUR CLAIM, DESCRIBE THE FACTS AND CIRCUMSTANCES GIVING RISE TO THE INSURER'S VIOLATION AS YOU UNDERSTAND THEM AT THIS TIME. In addition of the above statutory provisions alleged to have been violated, see also the following statutes and rules which were violated by Olympus: 624.155(1)(a)1 Any person may bring a civil action against an insurer when such person is damaged: (a) by violation of any of the following provisions by the insurer: (1) Section 626.9541(1)(i), (o), or (x) 69B-220.201(3)(b)(2) An adjuster shall adjust all claims strictly in accordance with the Insurance contract. 69B-220.201(3)(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(k) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. 626.877 Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. 626.878 An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provisions of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. 627.70131(7)(a) Within 90 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer’s claim payment is less than specified in any insurer’s detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. Any payment of an initial or supplemental claim or portion of such claim made 90 days after the insurer receives notice of the claim, or made more than 15 days after there are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured must select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. 624.155(5) No punitive damages shall be awarded under this section unless the acts giving rise to the violation occur with such frequency as to indicate a general business practice and these acts are: (a) Willful, wanton and malicious; (b) In reckless disregard for the rights of any insured; or (c) In reckless disregard for the rights of a beneficiary under a life insurance contract.
 
* Facts and circumstances giving rise to the violation.
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The property located at 1282 Thoreau Circle, Venice, Florida 34292 (“the Insured Property”) was damaged as a result of Hurricane Ian on or about September 28, 2022. Fortunately, prior to the loss, the Insured had obtained an all-risk policy from Olympus Insurance Company (“Olympus”). The Administrative, Home, and Mailing address for Olympus is listed 8375 Dix Ellis Trail, Suite 300, Jacksonville, Florida 32256. The Insured promptly reported the Hurricane loss to his insurer, Olympus. Olympus sent out Richard Burchfield to inspect the Insured Property on or about October 20, 2022. The resulting estimate totaled less than the deductible for the roof to be replaced. Mr. Burchfield prepared his estimate on behalf of Olympus on or about October 23, 2022. The estimate only accounted for damage sustained to the Insured Property’s roofing system. Despite the Insured advising Olympus of interior damage and providing the carrier with photographs of same, Mr. Burchfield failed to include this element of loss in his estimate of damages. On or about October 12, 2022, the Insured retained public adjusting firm, SEPIA Group LLC (“Sepia”) to assist him through the claims process. Sepia provided Olympus with a letter of representation and asked for a copy of the policy. To date, Olympus has not provided a policy. On November 13, 2022, Olympus opened coverage for the Insured’s claim as to the roof damage only. To date, Olympus has never provided a coverage decision as to the interior losses to the Insured Property and has otherwise completely failed to adjust this portion of the claim. As such, this amounts to a constructive denial of that aspect of the Insured’s claim, particularly as the Insured had placed Olympus on notice of the interior damages but chose to ignore them. In any event, in lieu of tendering payment for the roof damage to the Insured Property, Olympus compelled the Insured to submit to its “managed repair” provision of the policy. This provision requires the Insured to use one of Olympus’s chosen contractor(s) for the repairs and/or replacement of the roofing system. As part of this “Olympus Elite Repair Program” the insurer provides “an additional workmanship warranty” as to the work product of its pre-selected contractor. In addition, when Olympus compels an Insured to submit to the “managed repair” provision of the policy, it requires the Insured submit a deductible payment to Olympus for losses sustained to the Insured Property. The Policy for the Insured Property has a hurricane deductible of five (5%) percent of Coverage A. This is an astonishing $33,500 that Olympus demanded the Insured pay them before they would send out one of their “licensed and insured contractors” to repair the damage sustained to the roofing system. In order to mitigate damage to the roofing system, the Insured retained “Roof Tarp Now Inc” to conduct emergency mitigation services and place a tarpaulin on the roofing system until the Insured Property could be properly restored to a pre-loss condition. Olympus assigned Robinson Roofing & Restoration (“Robinson”), “Clayton” and one other individual whom the Insured does not know by name, as their “licensed and insured contractor” through the policy’s “managed repair” program. Due to the significant amount of deductible the Insured was “required” to pay to Olympus, and significant confusion as to whether it was going to allow the Insured to just perform the roof work on his own, or whether it was actually going to follow-through with the elect to repair program, it took months before Robinson came out to “restore” the roofing system to a pre-loss condition. In November of 2023, Robinson began work at the Insured Property. Unfortunately, Robinson completely botched the roof replacement and Olympus refused to honor its “workmanship warranty.” At this point, not only did Olympus fail to pay for the significant interior losses to the home due to Hurricane Ian due to its failure to adjust same, but it actually denied the loss caused by its preferred contractor! These failures by Olympus are breaches of the insurance contract it made with its Insured. Moreover, Robinson never scheduled a time with the Insured to come out and begin the work. They simply showed up one day but hopping over the Insured’s gated electric fence without advising him of their presence. Additionally, Clayton and the other individual were rarely onsite to oversee or supervise their subcontractors. As such, the Insured felt compelled to contact his own general contractor to come out to the Insured Property and inspect the work which had been completed by Robinson at that point in time. Robinson’s workers damaged the existing TPO roofing material and did not use appropriate safeguards to protect the TPO deck. TPO has not been replaced to date and has continued to leak causing additional damages to lower ceilings and structures underneath, including, mildew, warping of wood, rotted mildewed drywall, staircase, etc. There was additional damage to electrical fixtures that were left out in the weather and not removed or protected. None of this has been addressed to date. Robinson’s dump trailers and trucks leaked hydraulic fluids and oils on the driveway of the Insured Property for weeks and they failed to clean and/or remove same. The Insured had to pressure wash the entire driveway which costed him approximately $1,500 out-of-pocket. The Insured advised Clayton of this issue, but he never addressed same. The subcontractors from Robinson also damaged the detached garage carport and gutter system. The carport is dented from the subcontractors walking on it and is now consistently leaking during rainstorm events. The estimated cost to repair these issues is approximately $15,000. The paint and stucco were damaged in multiple areas during tear off and falling debris. The cost to repaint the house is approximately $15-20k. Robinson was asked multiple times to make sure they cut new ridge vents per Sarasota code requirements; however, they never did on the main house. They did on the detached building after the fact, and it was poorly done and is still not secured, and they additionally scratched the surface of the new metal. As such, Mr. Chalaire retained the services of the undersigned attorney to assist with the proper adjustment of the insurance claim. As part of the scope of their representation, the undersigned hired experts for further evaluation. Mr. Chalaire, through the undersigned attorney, retained Clay Prescott, P.E., a Florida Licensed Engineer and owner of Prescott Engineering (“Prescott”) on February 6, 2024. Prescott was asked to review photographs, perform an inspection of the Insured Property, and conduct an interview with Mr. Chalaire. Upon doing so, Prescott was able to determine the cause and extent of the damage and provided a report based on those findings. Specifically, in a report issued on April 30, 2024, Prescott (“PE”) concluded as follows: Based on the conditions observed within the provided photos, it was our opinion the Chalaire Property had experienced damages caused by a high wind event on September 28, 2022 (Hurricane Ian) requiring replacement of the roof. It was also our opinion that the replacement of the metal roof and gutter systems evidenced multiple defects of the installation, ventilation, flashing, finishes, and site clean-up resulting in damages to the property and deficiency installed roof system which required removal and replacement to prevent further damages to the subject structure. Specifically, the structure evidenced: 1. Deficient cutting of the metal standing seams; 2. Deficient cutting/detailing at the ends of the metal panels and cap flashings; 3. Deficient installation of the wall to roof flashings around wall openings; 4. Deficient installation of the soffits; 5. Deficient installation of the fascia covers; 6. Deficient installation of the skylights; 7. A lack of installation of proper attic ventilation; 8. Deficient installation and damages to the installed gutter system; 9. Damages to the TPO membranes and tape flashing, and; 10. Damages to the concrete driveway. Given the defects and damages to the roof and TPO systems, these components could not be repaired in-place. As such, it was our determination that the metal roofing, metal flashings, metal guttering, and TPO membranes required removal and replacement to correct the observed damages/deficiencies. The concrete driveway cracking also required removal and replacement of the affected sections. It is important to note, a search of the Sarasota County Building Permit records indicated that no permit was pulled for the recent metal roof installation. The only Roof Permit on file was for the tile roof replacement circa 2009. According to the Florida Building Code, roof replacement requires a building permit and check-inspections by the Authority Having Jurisdiction (local building department.) The lack of a roofing permit on file adds to the list of deficiencies in the metal roof replacement. Proper roof inspections would have identified the lack of attic ventilation, deficient cutting/finishing of the roof panels/flashing (as identified above), and the improper soffit installation. Specifically, the soffit span exceeded the unsupported lengths required by the code resulting in undulations and sagging of the soffit. R704.2.1Vinyl soffit panels. Vinyl soffit panels shall be installed using fasteners specified by the manufacturer and shall be fastened at both ends to a supporting component such as a nailing strip, fascia or subfascia component in accordance with Figure R704.2.1. Where the unsupported span of soffit panels is greater than 12 inches, intermediate nailing strips shall be provided in accordance with Figure R704.2.2 unless a larger span is permitted in accordance with the manufacturer’s product approval specification. Vinyl soffit panels shall be installed in accordance with the manufacturer’s product approval specification and limitations of use. Fascia covers shall be installed in accordance with the manufacturer’s product approval specification and limitations of use. We recommend that the damaged soffit sections and drip-edge/fascia flashing around the perimeter of the roof system be removed and replaced. We recommend that any insulation or interior finishes that were affected by racking or cracking should be removed and replaced or repaired as needed. Mr. Chalaire also retained the services of General Estimating & Contracting (“GEC”), to prepare a comprehensive repair estimate based on its own site inspection, including taking photographs, measurements and reviewing the Engineer’s report. An inspection was conducted and GEC’s estimate dated May 9, 2024 of the damages shows that there is $189,148.87 (ACV) in covered damages to the Insured Property. In sum, the Insured Property was damaged by a covered loss. The Insured timely reported the damage to Olympus. Olympus conducted a deficient investigation and improperly undervalued the covered loss and partially denied it, particularly in light of the evidence it received which identified the cause of the loss and damages and costs required for remediation. Olympus has failed to create and implement adequate guidelines for proper claims investigation, claims evaluation, claims handling, and for training and supervision of employees and independent contractors handling its claims resulting in statutory violations as set forth above. Olympus has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insured’s claim for damages. The concept of insurance is that it is the insurer's granting of timely and prompt indemnity or security against a contingent loss. Fla. Stat. §624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment is 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. Olympus has failed to comply with its duty to fully indemnify its Insured. Olympus has refused and/or failed to pay the full insurance proceeds owed to the Insureds as required by the policy and law. Refusal and/or failure to settle the Insured’s claim when under all the circumstances it could have and should have done so had it acted fairly and honestly towards the Insureds is wrong. The actions taken by Olympus in the handling and adjustment of its Insured’s claim was willful, wanton, and in complete disregard for the rights of its Insureds and occurs with such a frequency as to indicate a general business practice, and further, is in violation of Florida Statutes §624.155 and §626.9541. Based on the foregoing actions and omissions, Olympus has engaged in wrongful conduct. That wrongful conduct includes, but is not limited to, the following: 1. Improper claim delay. 2. Improper partial claim denial. 3. Improper constructive denial. 4. Not conducting a full and fair investigation of its Insured’s claim. 5. Looking for ways to deny recovery to its Insured. 6. Looking for ways to delay recovery to its Insured. 7. Not adjusting the claim and not evaluating the loss properly, promptly, and fairly so as to provide full and prompt indemnity to its Insured. 8. Failing to implement proper standards for the adjustment and investigation of insurance claims. 9. Making misrepresentations to the Insured. 10. Not training, supervising, or managing adjusters and independent contractors properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests by attempting to deny or minimize payments owed. 11. Establishing severity control initiatives and otherwise establishing a culture of not fully and promptly paying claims following losses. 12. Ignoring submitted claim documentation and information from the Insured. 13. Refusing to properly re-evaluate its claim decision upon receipt of new information and documentation from the Insured and/or his representative(s). Therefore, to cure the defects outlined in this Civil Remedy Notice, Olympus must: (1) Tender all insurance monies owed to the Insured for the losses to the Insured Property. A copy of this form has been submitted to the FDFS and has been printed out and mailed to the following parties providing them notice of the filing of the Civil Remedy Notice: Olympus Insurance Company, via Certified Mail R.R.R. Mr. Gregg Knowles, Olympus Insurance Company, via Certified Mail R.R.R Claims Department, Olympus Insurance Company, via U.S. Mail. Lauren Belloni, SEPIA Group LLC, via email Douglas Chalaire, via email
Comments
User Id Date Added Comment
mshifrin@bressler.com 12-23-2024 Complainant(s): Douglas Chalaire Policy #:OIC30106195-00 Claim #:22FLHOV0009511 DFS Filing # 793214 Dear Ms. Dunnavant: Please accept this response on behalf of Olympus Insurance Company (hereinafter “Olympus”) to the Civil Remedy Notice of Insurer Violations (hereinafter “CRN”) No. 793214, filed on behalf of Douglas Chalaire (hereinafter, the “Complainant” or the “Insured”), and accepted by the Florida Department of Financial Services on November 19, 2024. The Civil Remedy Notice (“CRN”) alleges that Olympus violated the following statutes: • 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)(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. Please accept this as Olympus’s response to the above-referenced CRN filed with the Department of Financial Services by the Complainant, Douglas Chalaire. To summarize the below, Olympus hereby denies any allegation of not attempting to settle claims in good faith when it could and should have done so; failing to promptly settle claims when the obligation to settle a claim has become reasonably clear; failing to adopt and implement standards for the proper investigation of claims; denying claims without conducting reasonable investigations based upon available information; and failing to provide an explanation in writing to the insured of the basis for denial of a claim, and states that it has at all times handled and adjusted the Complainant’s claim with utmost good faith. Simply put, Olympus denies any acts or omission that could be construed or found to be deemed bad faith and/or a violation of Florida Statutes § 624.155 and § 626.9541, whether expressly stated in the Civil Remedy Notice or implied. Any and all allegations of bad faith are hereby denied and rejected in their entirety by Olympus. Beyond Olympus’s adamant belief that it acted with the utmost good faith, the CRN is deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. As an initial matter, Olympus denies and rejects the instant CRN as it fails to comply with the requirements of Florida Statute § 624.155. The CRN is therefore deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. Florida Statute § 624.155 requires a complainant to file with the Department of Financial Services a Civil Remedy Notice which shall be “on a form provided by the [Department] and shall state with specificity…such other information as the Department may require.” The Department created a CRN form, Form DFS-10-363, which lays out 15 requirements, including in part, the Complainant’s e-mail address, Complainant type, claim number, attorney’s name, attorney’s address, attorney’s e-mail address, type of insurer, the person with knowledge of the facts giving rise to the allegations, and the reason for notice. According to § 624.155, these mandates are required by the Department, and they must be stated with specificity. The instant CRN fails to provide the specificity required by § 624.155 and fails to comply with the form requirements as a whole. Therefore, the instant CRN is facially deficient. See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Specifically, the instant CRN filing lists the entire claims department from Olympus, including all supervisors, management, agents, and adjusters, when asked to identify the person(s) representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the CRN. Although the Department prompted the Complainant to provide the names or titles of specific individuals, the instant CRN generically states that the entire claims department of Olympus is most responsible for/knowledgeable of the facts giving rise to the allegations within the CRN. Due to this intentional withholding of mandated information, the CRN is facially deficient as it fails to comply with the form requirements set forth in Florida Statute § 624.155, and specifically § 624.155(3)(b)(3). See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Furthermore, the CRN’s attempt to identify the specific policy language relevant to the violation is woefully deficient. “Courts have found that listing whole sections of the insurance policy constitutes insufficient specificity.” See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294 at *2 and Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020).” When prompted to reference the policy language that is relevant to the alleged violation, the Complainant makes minimal effort to provide the relevant policy language. Instead, the Complainant states generic headings of entire policy sections, including, “SECTION I – PROPERTY COVERAGES,” “SECTION I – PERILS INSURED AGAINST,” and “SECTION I – CONDITIONS” followed by subheadings under each section and limited selective language thereafter. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith that is required as a condition precedent to any civil claim for bad faith pursuant to Florida Statute § 624.155. Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020). Failure to provide specific reference to any relevant policy language is direct and clear noncompliance with the requirements of Florida Statute § 624.155, and therefore renders the CRN deficient on its face as to form and substance. For these reasons alone, the CRN fails at its inception. Moreover, in the space where the Complainant was directed to provide policy language relevant to the alleged violation(s), they included a list of statutory provisions alleged to have been violated by Olympus. Though relevant to the CRN as a whole, the litany of statutory provisions is not appropriate to incorporate within the section seeking policy language. The Complainant’s disregard for the clearly stated request from the Department for policy language and with no mention of statutes, again, renders the instant CRN deficient per the Department’s standards. Additionally, the CRN fails to provide a complete description relating to the facts and/or circumstances which give rise to the alleged statutory violations, thus, prejudicing Olympus from providing any meaningful or complete response. In summary, the CRN is hardly more than a recitation of a number of Florida statutory provisions, with minimal factual allegations in support of the conclusory statutory recitations. A Civil Remedy Notice must state the facts and circumstances that give rise to an alleged violation with specificity sufficient to allow an insurer to cure the alleged violation within the sixty-day statutory period. Lane v. Westfield Insurance Company, 862 So.2d 774 (Fla. 5th DCA 2003). The instant CRN therefore fails to comply with the requirements of Florida Statute § 624.155(3), which requires that a CRN of insurer violation “state with specificity,” inter alia, the facts and circumstances giving rise to the violation and the “specific” language of the subject insurance policy that is relevant to the violation. The CRN fails to specify what was lacking in Olympus’s investigation and fails to specify facts which support that its investigation was unfair or merits additional steps. The CRN further lacks any specificity, facts, or rationale which indicate that Olympus’s coverage determination should have been different. Generally, the CRN lacks the requisite facts and/or specificity, as ruled on numerous times and cited to throughout this Response, to put Olympus on notice as to the allegations against it. Moreover, the few facts that are stated in the CRN are contrary to the facts of the underlying claim or are at best misleading. The CRN states that “Olympus conducted a deficient investigation and improperly undervalued the covered loss and partially denied it, particularly in light of the evidence it received which identified the cause of the loss and damages and costs required for remediation.” However, this statement is blatantly untrue. Rather, Olympus enlisted an independent, licensed field adjuster to inspect the property, and to report his findings and observations back to Olympus. Thereafter, Olympus determined that the damages to the subject property’s roof were covered, and notified the Insured Complainant that it had invoked their contractual right to repair or replace the roof via written correspondence dated November 13, 2022. The Complainant has provided no facts or evidence to support these allegations in support of the instant CRN or in any other context throughout the entirety of their claim. Olympus promptly and thoroughly investigated the subject claim and reached its coverage determination based upon its complete understanding of the facts surrounding this claim. However, the instant CRN makes vague and unsupported allegations while the fact of the matter is that it is the Complainant who is not complying with the policy’s terms and who is continuing to make unsupported allegations in an attempt to deceive Olympus to issue unwarranted payments and/or additional benefits. The subject CRN makes egregious and baseless allegations that “Olympus has failed to create and implement adequate guidelines for proper claims investigation, claims evaluation, claims handling, and for training and supervision of employees and independent contractors handling its claims…,” and “The actions taken by Olympus in the handling and adjustment of its Insured’s claim was willful, wanton, and in complete disregard for the rights of its Insureds and occurs with such a frequency as to indicate a general business practice…” These are serious blanket allegations made without one scintilla of factual evidence in support of any of such claims. As demonstrated by the facts outlined above, Olympus diligently investigated the subject loss, determined that the property’s roof was damaged by a covered peril, repeatedly and routinely communicated with the Complainant, and at all acted accordingly based upon the facts it discovered throughout its investigation of the claim and according to the terms of the insurance contract which provides rights to both the Complainant as well as the insurer for scenarios just like this one. Contrary to the allegations set forth in the CRN, at no time did Olympus fail to maintain adequate guidelines nor purposefully disregard the rights of the Insured Complainant. The facts of the subject claim prove that the exact opposite remained a top priority throughout Olympus’s assessment of the claim. The Complainant’s cure demand is indiscernible and as such Olympus is not given a fair opportunity to cure the CRN. First, the CRN fails to state the amount of damages which must be paid to cure the CRN. The CRN states “Therefore, to cure the defects outlined in this [CRN], Olympus must: (1) Tender all insurance monies owed to the Insured for the losses to the Insured Property.” This is the functional equivalent of “Pay me everything I’ve asked for.” Rousso v. Liberty Surplis Ins. Co., 2010 WL 736059, *5 (S.D. Fla. 2010). “Insurers are not required to pay any amount demanded by their insureds to avoid a bad-faith claim.” Id. (citing 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008)). However, regardless of its legitimacy, the CRN itself contains a cure in the form of an admission of liability and Olympus cannot even begin to attempt to cure the instant CRN on such unclear terms. The Complainant provides no specified amount nor basis for calculating an amount to determine “all insurance monies owed to the Insured.” Moreover, it remains Olympus’s position that all due insurance monies have been paid to the Insured Complainant, and therefore none are owed. Given the unclear cure demand, Olympus affirmatively asserts that the CRN is deficient. Since no other distinct basis for a cure has been set forth by the Civil Remedy Notice, Olympus was not provided with a reasonable opportunity to purge any alleged violations. See Kafie v. NorthWestern Mut. Life Ins. Co., 834 F. Supp. 2d 1354, 1359 (S.D. Fla. 2011) (“In order to demonstrate good faith, ‘[t]he insurer must investigate the facts, [and] give fair consideration to a settlement offer that is not unreasonable under the facts…’”). Based on the facts provided, it is impossible for Olympus to satisfy the Complainant without guessing and/or significantly prejudicing itself, and therefore the CRN fails to provide a true and feasible cure method. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith that is required as a condition precedent to any civil claim for bad faith pursuant to Florida Statute § 624.155. Similarly, for these reasons, the CRN fails. As outlined above, contrary to the allegations made by the CRN, Olympus sufficiently and diligently investigated the loss. Olympus maintains that it has acted fairly and honestly toward the Complainant, and any other person having an interest in the subject policy or assisting the Complainant in connection with the instant claim. Olympus consistently and promptly communicated with the Complainant and/or their agents throughout all stages of the investigation and conducted a thorough investigation in good faith. To the extent that the instant CRN is intended to address any other facts or circumstances which purport to establish additional coverage for the reported losses, the CRN provides insufficient identification of any such facts or circumstances and therefore prevents Olympus from addressing any other aspect herein. Notwithstanding, Olympus believes that the above facts demonstrate beyond dispute that it has at all times acted in good faith with regard to its investigation of the subject claim, and further believes that the facts provided to date fail to establish that it has not adjusted the reported loss in accordance with the express terms, provisions, limitations and exclusions contained within the policy. If we can provide any additional information, or be of any further assistance, please do not hesitate to contact us at your earliest convenience. Very truly yours, /s/ Michael A. Shifrin _ Michael A. Shifrin, Esq.
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