Civil Remedy Notice of Insurer Violations
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Filing Number:     793386
Filing Accepted:  11/20/2024
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Complainant
Last/Business Name *  
ROBERT HAGLER AND DIANE HAGLER   First Name  
Street Address * 12536 GRANDEZZA CIRCLE
City, State Zip * ESTERO, FL 33928
Email Address * BDHAGLER90@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ROBERT HAGLER AND DIANE HAGLER   First Name  
Policy # * PFL374311-05 Claim #* CFL24603034
Attorney
Attorney is Applicable
Last Name* M. MESSINGER First Name * MAX Initial
Street Address* 925 S. FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MMESSINGER@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   PEOPLE'S TRUST INSURANCE COMPANY
NAIC Company Code 13125
 
Name of individual responsible for violation (if any):* SHANTELL HARDIMAN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Unsatisfactory Settlement Offer
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(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.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the as a result of the sudden and accidental discharge of water into the insureds’ property. The carrier initially attempted to low-ball the claim. Subsequently, the insureds prepared a loss package in the amount of $86,332.10 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $5,915.67 only, leaving a remainder in the amount of $80,416.43 to be paid in order to cure the breach, less any applicable policy deductible. Additionally, the carrier did not appropriately address the need for the damaged to the property, allegedly relying on the wrongful findings of a representative who it is believed was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of wind damage to the roof, for the purpose of wrongfully low-balling the claim as a whole. The insureds have complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About one hundred sixty-five days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $86,332.10, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Rebecca Barrett at (561)-892-9746 if you have any questions or concerns. Sincerely, Max M. Messinger Attorney at Law
Comments
User Id Date Added Comment
bfrankel@gmail.com 01-14-2025 On behalf of People’s Trust Insurance Company (hereinafter “PTI”), I am responding to the Civil Remedy Notice filed on behalf of PTI’s insureds, Robert and Diane Hagler. The Civil Remedy Notice of Insurer Violation submitted lacks specificity and merely tracks the language of the bad faith statutes, citing general allegations of misconduct without setting forth the facts and circumstances giving rise to the alleged violations. The Civil Remedy Notice filed on behalf of Robert and Diane Hagler alleges a laundry list of allegations without factual support, and without specificity or telling the insurer how it can “cure” the alleged violations. The carrier maintains that it has not been in violation of the law, and that the above-referenced Civil Remedy Notice filed by Robert and Diane Hagler is defective on its face and does not comply with the specificity requirements set forth in Florida Statute §624.155. A simple review of the facts reveals that there was no “bad faith” in the handling of this claim. The first notice of this loss was reported by the insured via Webform on August 6, 2024, as kitchen damage as a result of a dishwasher leak. No damage to other areas of the home was initially reported but the insured reported that a company called iMold had done a mold assessment. On the same day the claim was reported, PTI issued a Homeowner Bill of Rights letter to the insured, and sent a claim acknowledgment letter, outlining what the insured could expect during the claim process. On August 7, 2024, PTI also received a quote from iMold in the amount of $4,064.60 for mold. On August 11, 2024, a licensed field adjuster inspected the property with the insured. At the inspection, the field adjuster observed water-related damage to the kitchen as the result of a dishwasher leak. The field adjuster created an estimate to repair the damage totaling $8,227.10 (actual cash value). On September 6, 2024, a formal coverage determination letter was sent to the insured, in which coverage was afforded and PTI advised that it was issuing a check in the amount of $5,727.10, which represented PTI’s estimate minus the deductible. During that time, PTI had requested that its preferred contractor, Rapid Response Team (“RRT”), conduct mold testing and create an estimate based on the protocol provided by iMold. RRT conducted mold testing at the property on or about September 18, 2024. Subsequently, PTI made an additional payment under the mold endorsement in the amount of $5,915.67. On November 13, 2024, People’s Trust Insurance Company received the Civil Remedy Notice of Insurer Violation filed on behalf of the insured, which generally asserts allegations of misconduct by the insurer in the handling of the claim. Since the time the Civil Remedy Notice was filed, PTI has sought to do a reinspection of the property in order to resolve the scope dispute with the public adjuster, who has submitted an estimate in the amount of $86,332.10. The reinspection is scheduled to take place on January 15, 2025. As the Department knows, a Civil Remedy Notice of Insurer Violation is a prerequisite to bringing a bad faith lawsuit against People’s Trust. The November 13, 2024 Civil Remedy Notice contains broad accusations and conclusions without any factual support and fails to meet the specificity requirement set forth in Florida Statute §624.155. Based on these broad allegations, People’s Trust is not aware of the facts surrounding the alleged statutory violations or what the insured believes People’s Trust must do in order to “cure” these allegations within the sixty day safe harbor period. The Civil Remedy Notice alleges that People’s Trust Insurance Company committed, inter alia, the following violations: • Not attempting in good faith to settle all claims when, under all the circumstances, it could and should have done so had it acted fairly and honestly toward the insured and with due regard for her or his interests. With regard this alleged violation, the Notice includes no specific facts as to how PTI has failed to negotiate and settle claims. • Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a clam 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 notice contains no particularity as to what portions of the policy under which PTI is unreasonably withholding settlement in order to influence settlement under another. • Failing to adopt and implement standards for the proper investigation of claims. PTI denies this alleged statutory violation and advises that Claimant has not provided any facts to sustain such an allegation. PTI advises that this allegation requires specific facts regarding the method of the investigation; the reasons the investigation was improper or otherwise inadequate; the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. To allege an inadequate investigation, the Notice must include specific facts regarding the method, rather than merely the results. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). • Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. The Notice contains no facts to tell the carrier how it misrepresented facts or policy provisions to the insureds or their representatives, when such a misrepresentation occurred, by whom, or the means of communication through which the alleged misrepresentation was made.. • Failing to acknowledge and act promptly upon communications with respect to claims. The Notice fails to identify what communications (who sent, how sent, when, or to whom) to which PTI failed to respond. • 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. With regard to the seventh alleged violation, the Notice does not explain how PTI failed to explain the basis for its coverage determination and in fact the coverage determination did explain the claims decision and attached the estimate pursuant to which payment was made. The above recitations are nothing more than a laundry list of accusations and conclusions without any factual support. Florida Statute §624.155(3)2 requires that a Civil Remedy Notice state with specificity the facts and circumstances that give rise to the alleged violations. A Civil Remedy Notice is not intended to be a guessing game. If the insureds maintain that People’s Trust committed the above-listed violations, they must provide specificity as to the facts and circumstances giving rise to these alleged violations. Based on these broad accusations People’s Trust does not know what is being alleged and/or how the insured believes People’s Trust can “cure” all of the alleged violations. Florida Statute §624.155 is not a notice statute. It is intended to advise the carrier of any alleged violations so that it can “cure” them within the statutory “cure period”. A Civil Remedy Notice must be made with sufficient specificity to allow the insurer to understand and to cure any purported violation. Longpoint Condominium Assn. v. Allstate Ins. Co., 2005 WL 1315810 (N.D. Fla.2005). The Civil Remedy Notice filed by Robert and Diane Hagler is factually insufficient because there is no specificity regarding the allegations against People’s Trust. Here, the allegations concerning the claim have no nexus with the bad faith statutes listed in the Civil Remedy Notice, thereby presenting a situation that precludes the insurer from understanding what the actual improper conduct in the claims handling may be, and precluding the insurer from adequately or timely responding. Nonetheless, the repairs are currently underway and lines of communication open between counsel for the parties. As shown, PTI has not acted in bad faith but has observed the terms and conditions of the Policy. As discussed above, People’s Trust Insurance Company maintains that it has not been In violation of the law and that the Civil Remedy Notice filed by Robert and Diane Hagler is defective on its face and does not comply with the specificity requirements set forth in Florida Statute §624.155. We trust the foregoing fully explains the facts and circumstances of the claim and addresses any concerns raised. If we can provide other information or clarification of information concerning the claim, please do not hesitate to contact the undersigned. Very truly yours, Arielle Molinet Peters Corporate Counsel, Claims/Legal People’s Trust Insurance Company
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008