Civil Remedy Notice of Insurer Violations
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Filing Number:     793308
Filing Accepted:  11/19/2024
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Complainant
Last/Business Name *  
BERRY   First Name   JAVONNA
Street Address * 2303 LENNOX RD. E.
City, State Zip * PALM HARBOR, FL 35683
Email Address * NONE. MAY USE KEITH@HERMANWELLS.COM IF NEEDED
Complainant Type: * Insured
Insured
Last/Business Name*   BERRY   First Name   JAVONNA
Policy # * 59-CN-N510-1 Claim #* 59-68F6-20X
Attorney
Attorney is Applicable
Last Name* STAHL First Name * KEITH Initial R.
Street Address* 5701 PARK BLVD. N.
City, State Zip* PINELLAS PARK , FL 33871
Email Address * KEITH@HERMANWELLS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* MATTHEW HORN, OTHER UNKNOWN INDIVIDUALS AT STATE FARM FLORIDA INS. CO.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
* 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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGES A. Coverage A – Building Property 1. Building Property. We cover: a. alterations, appliances, fixtures, and improvements that are part of the building contained within your unit; b. items of real property that pertain exclusively to your unit c. property that is your insurance responsibility under the governing rules of the condominium". SECTION I – ADDITIONAL COVERAGES The following Additional Coverages are subject to all the terms, provisions, exclusions, and conditions of this policy. *** 11. Collapse. We will pay for accidental direct physical loss to covered property involving the abrupt, entire collapse of a building structure or any part of a building structure. a. Collapse means the abrupt and entire falling down, caving in, or falling into pieces of a building structure or any part of a building structure. Collapse does not include any of the following: (1) settling, cracking, crumbling, deterioration, shrinking, bulging, expansion, sagging, bowing, leaning, or bending; (2) substantial structural impairment; (3) imminent or threatened collapse; (4) a building structure or any part of a building structure that is in danger of falling down or caving in; or (5) a part of a building structure that is standing even if: (a) it has been separated from another part of the building structure; or (b) it shows evidence of settling, cracking, crumbling, deterioration, shrinking, bulging, expansion, sagging, bowing, leaning, or bending. b. The collapse must be directly and immediately caused by one or more of the following: (1) perils described in SECTION I – LOSSES INSURED, COVERAGE B – PERSONAL PROPERTY. These perils apply to building structures covered under Coverage A or Coverage B for loss insured by this Additional Coverage; (4) use of defective material or methods in the construction (includes remodeling or renovation) of the building structure, if the collapse occurs during the course of the construction of the building structure. *** 14. Tear Out. If a loss insured to Coverage A property is caused by water, steam, or sewage escaping from a system or appliance, we will also pay the reasonable cost you incur to tear out and replace only that particular part of the building structure or condominium unit owned by you necessary to gain access to the specific point of that system or appliance from which the water, steam, or sewage escaped. SECTION I – LOSSES INSURED COVERAGE A – BUILDING PROPERTY AND COVERAGE D – LOSS ASSESSMENT We will pay for accidental direct physical loss to the property described in Coverage A and Coverage D unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. COVERAGE B – PERSONAL PROPERTY We will pay for accidental direct physical loss to the property described in Coverage B caused by the following perils, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. *** 12. Abrupt and accidental discharge or overflow of water, steam, or sewage from within a plumbing, heating, air conditioning, or automatic fire protective sprinkler system, or from within a household appliance. SECTION I – LOSSES NOT INSURED This entire provision is incorporated by reference as the length of the section is too voluminous to be reproduced herein. This language is included in order to point out the absence of an exclusion applicable to the damage outlined in this Civil Remedy Notice. SECTION I - Loss Settlement Only the Loss Settlement Provisions shown in the Declarations apply. We will settle covered property losses according to the following. However, the valuation of any covered property losses does not include, and we will not pay, any amount for diminution in value. COVERAGE A – BUILDING PROPERTY 1. We will pay the cost to repair or replace with similar construction and for the same use on the premises shown in the Declarations, the damaged part of the building property covered under SECTION I – PROPERTY COVERAGES, COVERAGE A – BUILDING PROPERTY, except for wood fences, subject to the following: a. We will pay only the actual cash value at the time of the loss prior to repair or replacement of the damaged part of the property, up to the applicable limit of liability shown in the Declarations, not to exceed the cost to repair or replace the damaged part of the property. Loss Payment is replaced by the following: Loss Payment. We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable upon the earliest of the following: a. 20 days after we receive your proof of loss and reach written agreement with you; or b. 60 days after we receive your proof of loss and: 1. There is an entry of a final judgment; or 2. There is a filing of an appraisal award with us.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

1) Failure to pay claim in full; 2) claim denial and delay; 3) failure to act in due diligence and good faith to resolve claim; 4) placing financial interest of insurer before that of policy holders and claimants; 5) failure to properly train, evaluate, and manage adjusters and estimators; 8) not treating the policyholders with good faith claims conduct; 6) looking for ways to deny coverage, pay less, delay payment and/or otherwise pay less than what is owed for the claim; 7) looking for ways to repair less, delay repairs and/or otherwise repair less than what is owed for the claim; 8) the reasons for this may be attributed to improper training, supervision, and/or motivation of adjusters and claims supervisors to promptly and fairly investigate, adjust and pay full benefits available to all beneficiaries. State Farm Florida Insurance Company has failed to adopt proper standards of investigation and adjustment of losses, or is otherwise not implementing those standards because full payment and prompt payment for the loss is not occurring; 9) not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; 10) failing to implement proper standards for the adjustment and investigation of claims; 11) not training, supervising or managing adjusters properly so that prompt and full payments or full repairs are made, but rather placing the company’s interests before the policyholder’s interests; 12) establishing severity control initiatives and otherwise establishing a culture of not fully and promptly paying claims or making full repairs following losses. A loss occurred to the insured property on May 26, 2024, in which the condominium unit of Ms. Berry was damaged due to the sudden, direct physical loss caused by the accidental discharge of water. During this time, the condominium units where the insured property is located were being worked on during the construction and renovation of the plumbing fixtures. During this time, some residents at the condominium unit, including Ms. Berry’s upstairs neighbor directly located above her unit, were instructed to not run water in the sinks, only within the bathroom tub to make sure that sediment and dirt did not go down the drain. The unit above Ms. Berry’s ran water into the bathtub and shortly thereafter, the condominium owner next door, Robert Louth, to Ms. Berry’s saw water streaming in through the ceiling of Ms. Berry’s unit. Ms. Berry’s neighbor, Mr. Louth, had been checking the mail for Ms. Berry during her absence from the unit due to Ms. Berry’s medical emergency. During this time, Mr. Louth had known Ms. Berry for over twenty (20) years and had been inside of her condominium unit on many occasions. Furthermore, he had been inside of her condominium unit just weeks in advance of this event that occurred on May 26, 2024. Prior to the event on May 26, 2024, he had not observed any water damage to Ms. Berry’s unit. On May 26, 2024, he observed a substantial amount of water coming down the kitchen ceiling and walls and onto the courter and floors. Thereafter, he saw bubbles full of water on her unit. Despite his personal knowledge of the condition of Ms. Berry’s unit and the observations outlined above, State Farm Florida Insurance Company failed to take into consideration his observations and knowledge of the event and prior condition. Instead, it relied upon an inadequately trained and educated adjuster who presumed that the damage was pre-existing despite the lack of any evidence as to this opinion. Based on this inadequate and deficient investigation, Mr. Matthew Horn, authored a letter on behalf of State Farm Florida Insurance Company and stated that the damaged was “determined to be due to to the continuous/repeated leakage/seepage of water, over a period of time, from a bathtub drain line in the unit above.” Despite this position, State Farm Florida Insurance Company tendered payment to Servpro for mitigation work in the unit but then stated it was made “in error”. Then it represented in writing that it was the responsibility of Jovanna Berry and Madeline Ferzola to forward that payment to Servpro. Based upon this, it is believed that State Farm Florida Insurance Company and Servpro have an ongoing, contractual relationship in nature and that the company routinely tenders payments to Servpro while denying coverage and payment to its insured. By failing to provide coverage for the loss to Ms. Berry’s unit, the following statutes were violated: 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. 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)(i) Unfair claim settlement practices 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. By failing to provide coverage for the insured’s loss, State Farm Florida Insurance Company violated the coverage provisions of their policy including the following policy provisions: “SECTION I – PROPERTY COVERAGES A. Coverage A – Building Property 1. Building Property. We cover: a. alterations, appliances, fixtures, and improvements that are part of the building contained within your unit; b. items of real property that pertain exclusively to your unit c. property that is your insurance responsibility under the governing rules of the condominium". SECTION I – ADDITIONAL COVERAGES The following Additional Coverages are subject to all the terms, provisions, exclusions, and conditions of this policy. *** 11. Collapse. We will pay for accidental direct physical loss to covered property involving the abrupt, entire collapse of a building structure or any part of a building structure. a. Collapse means the abrupt and entire falling down, caving in, or falling into pieces of a building structure or any part of a building structure. Collapse does not include any of the following: (1) settling, cracking, crumbling, deterioration, shrinking, bulging, expansion, sagging, bowing, leaning, or bending; (2) substantial structural impairment; (3) imminent or threatened collapse; (4) a building structure or any part of a building structure that is in danger of falling down or caving in; or (5) a part of a building structure that is standing even if: (a) it has been separated from another part of the building structure; or (b) it shows evidence of settling, cracking, crumbling, deterioration, shrinking, bulging, expansion, sagging, bowing, leaning, or bending. b. The collapse must be directly and immediately caused by one or more of the following: (1) perils described in SECTION I – LOSSES INSURED, COVERAGE B – PERSONAL PROPERTY. These perils apply to building structures covered under Coverage A or Coverage B for loss insured by this Additional Coverage; (4) use of defective material or methods in the construction (includes remodeling or renovation) of the building structure, if the collapse occurs during the course of the construction of the building structure. *** 14. Tear Out. If a loss insured to Coverage A property is caused by water, steam, or sewage escaping from a system or appliance, we will also pay the reasonable cost you incur to tear out and replace only that particular part of the building structure or condominium unit owned by you necessary to gain access to the specific point of that system or appliance from which the water, steam, or sewage escaped. SECTION I – LOSSES INSURED COVERAGE A – BUILDING PROPERTY AND COVERAGE D – LOSS ASSESSMENT We will pay for accidental direct physical loss to the property described in Coverage A and Coverage D unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. COVERAGE B – PERSONAL PROPERTY We will pay for accidental direct physical loss to the property described in Coverage B caused by the following perils, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. *** 12. Abrupt and accidental discharge or overflow of water, steam, or sewage from within a plumbing, heating, air conditioning, or automatic fire protective sprinkler system, or from within a household appliance. SECTION I – LOSSES NOT INSURED This entire provision is incorporated by reference as the length of the section is too voluminous to be reproduced herein. This language is included in order to point out the absence of an exclusion applicable to the damage outlined in this Civil Remedy Notice.” By representing that the insured was responsible for forwarding the payment to Servpro, they’ve misrepresented the terms of the policy to its insured and attempted to cause the insured to believe that there existed liability should Servpro not receive this payment. Based upon this occurrence, the insureds believe that State Farm Florida Insurance Company has failed to implement proper investigative procedures, has failed to train, supervise to investigate a claim promptly and fairly. This is evidence of the company’s failure to implement proper investigative procedures, failed to train and supervise a claim promptly when coupled with the fact that they have failed pay the claim in full, issuing payment to a preferred contractor and then failing to pay for any build-back or further necessary remediation. These actions clearly demonstrate that State Farm Florida Insurance Company is not training their adjusters to supervise and investigate a claim fairly. This also shows a complete failure to act in good faith towards the insureds. The insureds have been left partial remediation and no amount to repair the property and properly and fully mitigate the damage to the interior of the property. This failure has caused financial harm and additional damages to the insureds and these damages continue. This conduct violates the following statutes: 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. 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)(i) Unfair claim settlement practices 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. State Farm Florida Insurance Company has delayed a valid claim due to its failure to properly investigate and estimate the claim and have failed to act with due diligence and good faith to resolve this claim. As evidence of their lack of good faith to resolve the claim, one only need to look towards the examiner willfully ignoring the observations of Mr. Louth. State Farm Florida Insurance Company failed to employ an engineer to evaluate the age of the water damage they claim to be pre-existing and remain silent as to whether the original field adjuster has the expertise and training necessary to evaluate the same. Furthermore, by failing to acknowledge Mr. Louth’s observations and provide payment, they’ve wrongfully ignored addressing covered items of property. By withholding money due to the insured during this time, sending the insureds a payment for Servpro and shifting liability to the insured to pay Servpro, State Farm Florida Insurance Company has placed its own financial interest ahead of the insured. State Farm Florida Insurance Company has attempted to ignore their insured in an effort to “make her go away” by becoming frustrated that their insurance company is completely unresponsive. This failure to adjust the claim properly is in violation of the following statutes: 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. 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)(i) Unfair claim settlement practices 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. The failure to adjust the claim properly is in direct violation of the following policy provisions: J. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable upon the earliest of the following: 1. 20 days after we receive your proof of loss and reach written agreement with you; or 2. 60 days after we receive your proof of loss and: a. There is an entry of a final judgment; or b. There is a filing of an appraisal award or a mediation settlement with us. State Farm Florida Insurance Company has not attempted in good faith to settle this claim when, under the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for their interests. The following statutes are violated by this conduct: 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. 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)(i) Unfair claim settlement practices 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. It is clear from this behavior that State Farm Florida Insurance Company has failed to implement proper training and management of its adjusters and have not trained or supervised so that prompt and full payments are made. In failing to properly investigate the cause of the damage, State Farm Florida Insurance Comapny is actively engaged in conduct to pay less because full payment of the loss is not occurring. The insured alleges that based upon their experience in this claim process, State Farm Florida Insurance Company has established a culture of not fully and promptly paying claims. These actions constitute unfair claim settlement practices. These practices are the result of State Farm Florida Insurance Company failing to adopt and implement standards for the proper investigation of claims, which should include timely processing claims, and making full payment needed to address the loss to the insured’s property. A copy of the affidavit of Mr. Louth is attached along with this Civil Remedy Notice. Therefore, to cure the defects outlined in this Civil Remedy Notice, State Farm Florida Insurance Company must afford coverage to the insured’s loss. Failure to cure all defects may result in additional extra-contractual damages. This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statutes including any and all bad faith/extra contractual and punitive damages, should State Farm Florida Insurance Company fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
Comments
User Id Date Added Comment
keith@hermanwells.com 06-04-2025 CRN is withdrawn.
dbarnes@simonreedlaw.com 01-17-2025 Diane Barnes-Reynolds, Esq. dbarnes@simonreedlaw.com January 17, 2025 Via Email to: Keith@hermanwells.com Keith R. Stahl, Esq. 5701 Park Blvd., N Pinellas Park, FL 33871 Re: Complainant: Javonna Berry Insured: Javonna Berry Date of Loss: May 26, 2024 Policy No.: 59-CN-N510-0 Claim No.: 59-68F6-20X Property Address: 2303 Lennox Rd. E., Palm Harbor, FL 35683 Filing No.: 793308 Notice Accepted: November 19, 2024 Dear Mr. Stahl: This office represents State Farm Florida Insurance Company (“State Farm”) with regard to the above-referenced matter. Please accept this letter as State Farm’s response to the Civil Remedy Notice of Insurer Violation dated November 19, 2024 (the “CRN”) filed by you on behalf of Javonna Berry (the “Complainant”). State Farm has filed a copy of this response on the Department of Financial Services website. State Farm denies the allegations contained within the CRN filed in this matter and finds them to be without merit. The CRN sets forth insufficient facts and factually incorrect information to support that a violation has occurred. The Civil Remedy Statute requires that a Civil Remedy Notice provide the insurer with notice of the circumstances giving rise to the violation so that the insurer has an opportunity to cure any deficiencies during the 60-day cure period. Talat Enterprises Inc. v. Aetna Casualty & Surety Co., 753 So. 2d 1278 (Fla. 2000). The CRN while lengthy in its duplicative citations to policy provisions, is lacking in specifics and misrepresents the facts and circumstances of the claim. The limited facts that are stated are misleading. As a result, the notice does not comply with the specificity requirement under the statute. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla.4th DCA 2021). The Complainants’ limited, and unsupported allegations are all contested. The CRN states that in order for State Farm to cure the alleged defects it must “afford coverage to the insured’s loss” without indicating the amount Complainant claims will accomplish such a cure and provides absolutely no information as to how to cure any alleged non-monetary violations. Mr. Keith R. Stahl, Esq. January 17, 2025 Page 2 As outlined above, the CRN makes a variety of allegations unsupported by ultimate facts in the face of a claim, and misstates the facts of the claim. Based upon the vague nature of the cure demanded, even if State Farm were to guess the amount Claimant seeks as a cure, it has no guarantee it would serve to cure the CRN to the satisfaction of the Claimant. It is therefore impossible for State Farm to cure the alleged violations. The CRN is therefore noncompliant with Florida Statute §624.155. State Farm has acted and continues at all times to act in good faith. Without waiving its objections to the deficiencies of the instant CRN, State Farm provides herein a brief summary setting forth facts which specifically contradict the allegations contained in the CRN such that same is unwarranted. On May 28, 2024, it was reported that water damage had occurred on May 26, 2024 to the Complainant’s condominium unit located at 2303 Lennox Rd. E., Palm Harbor, Florida 35683 from the bathtub of the unit above. The insured was represented in the claim by a friend with power of attorney. State Farm acknowledged the claim, forwarded the Homeowner Claims Bill of Rights, notified the insured through her representative, of the Duties After Loss, and made a request for information and documentation, including: the plumber’s report from the neighboring unit where the leak occurred, photos of the damages, the ServPro invoice, and the repair invoice. The insured’s representative engaged a mitigation company to mitigate the water damages. No plumber’s report was ever provided to State Farm. After receipt of the photographs and report of the damage from the mitigation company, State Farm determined there were conditions that were non-indicative of a one-time water event. Rather, the photos of the pre-mitigation damage displayed characteristics of a loss that resulted from seepage or leakage of water over a period of time. State Farm provided a detailed explanation, in writing, of the reasons for denial on June 12, 2024, citing the applicable policy provisions to the claim. Notwithstanding this coverage determination, State Farm issued payment for the water mitigation invoice, which had been incurred prior to the coverage determination. Subsequently, the insured was represented by a public adjuster and later, by counsel. Neither provided any additional documentation that refuted the claim determination, but only produced their letters of representation, public adjusting contract, repair estimate, and proof of loss based upon the same estimate. On November 19, 2024, nearly six months after the purported date of loss, the Civil Remedy Notice was filed and attached an affidavit by a neighbor of the Complainant. The affidavit indicated the neighbor witnessed the water damage to the Complainant’s unit on May 26, 2024, and had been in the condominium unit “on numerous occasions.” The affidavit gave no information that would lead State Farm to the conclusion that the loss had not occurred as a result of seepage or leakage over a period of time. Mr. Keith R. Stahl, Esq. January 17, 2025 Page 3 State Farm therefore timely investigated this claim; responded to all inquiries; evaluated the information submitted; and made payment for Complaints’ mitigation expenses incurred before the coverage determination was made, notwithstanding the denial of the claim. Complainants’ CRN nevertheless cites to a variety of statutes alleging they have been violated without related supporting facts. Each statute is addressed more specifically below: • 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. As stated above, State Farm timely investigated and made a coverage decision on the claim. It paid mitigation expenses incurred prior to the coverage determination, notwithstanding denial of the claim. No information or documentation has been provided that refutes State Farm’s coverage determination, therefore it has no further obligation to Complainant. The CRN is thus devoid of ultimate facts to support the allegation that State Farm failed to act in good faith. State Farm denies any violation has occurred. • 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. The CRN similarly lacks factual support for the allegation that State Farm failed to settle or otherwise make payment due and owing to Complainant when it has become clear that such payment is owed. As above, State Farm made payment to Complainant for mitigation expenses incurred prior to the coverage determination, notwithstanding denial of the claim, despite no obligation to do so. No documentation or information has been provided to refute the coverage determination reached by State Farm. State Farm has no further obligation to Complainant, and the CRN misrepresents these facts to the perceived benefit of the Complainant. State Farm denies any violation has occurred. • 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Complainant makes this sweeping and conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. State Farm timely investigated this claim and made a coverage determination based upon the information and documentation of the damages provided. While the CRN makes accusations and assumptions as to the experience and training of one adjuster, it expresses no facts in support of same, only assumptions based upon dissatisfaction with the coverage Mr. Keith R. Stahl, Esq. January 17, 2025 Page 4 determination. The CRN is therefore deficient. State Farm denies any violation has occurred. • 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. The CRN is devoid of any fact supporting this allegation – no identification of any misrepresentation of policy coverages, no identification of facts opposing a representation made that would render it a misrepresentation, no information about the when, where, how, and by whom any such representation was made. The CRN is therefore deficient as it relates to this allegation. The CRN does point to the payment made by State Farm for mitigation services as a misrepresentation of the terms of the policy without making any connection between this statement and any specific policy language. It further misrepresents the contract signed between the Complainant and ServPro, which states, “If, for any reason, Customer receives a check from the Insurance Company made payable to Customer, Customer agrees to pay Provider immediately upon receipt of the check.” State Farm denies any violation has occurred. • 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. While the timeline of circumstances in the CRN would have one believe that State Farm was in possession of the affidavit by Complainant’s neighbor prior to the CRN being filed, the date on the affidavit confirms such an inference is incorrect. Moreover, while the circumstances in the CRN assert that the affiant neighbor, Mr. Louth was in the Complainant’s apartment just “weeks” before the reported date of loss, this misrepresents the contents of the affidavit, which makes no such representation. Furthermore, such explanation does nothing to refute the condition of the unit and damages observed after the loss was reported. Additionally, while State Farm requested the plumbing report concerning the leak, it was never provided. State Farm, made its coverage determination, utilizing the information provided to it by and on behalf of the Complainant. State Farm therefore denies any violation has occurred and asserts the allegations of the CRN misrepresent the content of the affidavit it attaches in support. State Farm denies any violation has occurred. • 626.9541(1)(i)(3)(i) Unfair claim settlement practices. The CRN cites to no specific “practices” the Complainant alleges to be “unfair” other than the “believed” assertion without further support that State Farm denies claims to the benefit of ServPro and to the detriment of its insureds. Claimant has no support whatsoever for such a claim. ServPro was retained by Claimant’s representative. Claimant benefited from State Farm’s payment of ServPro’s invoice, which it made in good faith as it was incurred prior to the coverage determination being made. Claimant now accuses State Farm of being unfair for conferring a benefit Mr. Keith R. Stahl, Esq. January 17, 2025 Page 5 upon her on an otherwise denied claim. State Farm denies any violation has occurred. We believe that the above establishes that State Farm has at all times acted in the utmost good faith in handling this claim. State Farm denies committing any alleged violations referenced in the CRN and reserves all rights. If you have any questions or would like to discuss this matter, please do not hesitate to contact me. Very truly yours, SIMON, REED & SALAZAR, P.A. Diane Barnes- Reynolds
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