Civil Remedy Notice of Insurer Violations
Login

Filing Number:     793519
Filing Accepted:  11/20/2024
         Print Filing
Complainant
Last/Business Name *  
KREUTZINGER   First Name   JOHN
Street Address * 13541 CHINA BERRY WAY
City, State Zip * FORT MYERS, FL 33908
Email Address * JODI@LAWHUGGINS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   KREUTZINGER   First Name   JOHN
Policy # * FPI231789 Claim #* FPH5345904-01
Attorney
Attorney is Applicable
Last Name* PETERS First Name * JODI Initial
Street Address* 6421 N FLORIDA AVE D-598
City, State Zip* TAMPA , FLORIDA 33604
Email Address * JODI@LAWHUGGINS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FLORIDA PENINSULA INSURANCE COMPANY
NAIC Company Code 10132
 
Name of individual responsible for violation (if any):* DANIEL RIVERA, RAQUEL FOSTER
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* 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 Insurer has not provided a copy of the Policy, despite the Insured’s request. The violations described herein derive from Florida law concerning insurers’ obligations to their insured. See, e.g., Fla. Stat. Chapters 626, 627. Specific policy language that may be relevant to the violations include, but are not limited to, the following: Building Coverage provisions, All Additional Coverages provisions, All Coverages provided by Endorsement or Rider, The Declarations, Page Loss Payment, Settlement provision, and the insurance policy's definition section.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insurer’s adjuster(s) assigned to this claim were/are: Daniel Rivera, Raquel Foster. Hereinafter referred to as the “Adjuster” or “Adjusters”. - The Insured suffered a loss due to Hurricane Ian, which occurred on or about September 28, 2022. The Insured’s covered property was damaged by the loss. - On August 2, 2024, the Insurer admitted that the Property sustained damage from the Loss that was covered by the Insured’s insurance policy (policy number stated above; hereinafter the “Policy”)—for which the Insurer assessed a replacement cost value of $14,614.75 (“Insurer Estimate”), a mere 8% of the Insured’s estimate to repair the property. The Insurer Estimate was prepared and authored by Adjuster Foster. The Insurer Estimate was patently deficient in that it omitted entire categories of damage that would have been visible to and recognizable by any person viewing the damaged Property, let alone a qualified insurance adjuster. It is important to note that some of these damages are not latent; they are patent and easily observable through cursory investigation. Upon review of the Insurer’s estimate, it became clear to the Insured that the Insurer patently undervalued the replacement cost value of the Property by omitting obvious damages and that the Insured would not fully restore the Property to the condition it was in prior to the loss by failing to pay the Insured all the benefits to which the Insured is entitled under the Policy for the loss. In this way, the Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 624.155(1)(b)(2) by making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. Moreover, the Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. And, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - The Insured hired Day Adjusting & Consulting (“DAC”) to assist in the proper administration of the insurance claim. Having conducted thorough investigations and analysis, DAC prepared an estimate of costs to repair the damaged property in the amount of RCV $187,351.95. DAC sent the Insurer a letter of representation on February 21, 2024, providing DAC’s claim file and requesting information—including a copy of the policy, claim payment history, and other claim documents. - Despite the Insured’s February 21, 2024 request for the same, the Insurer has not provided a copy of the Policy, a claim payment history, and other requested claim documents. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon communications with respect to claims. - On August 2, 2024, Adjuster Rivera sent a letter underpaying the claim based upon a report from the insurer’s field adjuster that failed to account for the proper repair of the observed damages. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices as a result. - The roof damage is consistent with hurricane force wind, showing impact from flying debris. Due to the extent of damages and the requirement of a proper repair under Florida law, a full roof replacement would be warranted under the Policy Desirous to avoid this cost, Adjuster Rivera wrongfully underpaid the insurance claim by making the above misrepresentations. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The Insurer violated the provisions of Florida Statute § 624.155(1)(b)(3) by 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 Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - On August 2, 2024, Adjuster Rivera sent the Insured correspondence indicating that $1,198.13 (approximately 0.6%) of the Claim would be paid. However, she provided scant rationale as to how she arrived at this figure/percentage despite the detailed corroborative information provided by the Insured. In this way, the insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 624.155(1)(b)(2) by making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. - Moreover, Adjuster Rivera denied approximately 99.4% of the Claim. However, in this correspondence or at no point did Adjuster Rivera meaningfully explain why 99.4% of the Claim was being denied. Here, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(d) by denying claims without conducting reasonable investigations based upon available information. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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. And, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - The Insurer’s conduct in this case is one instance a pattern of business practice designed to avoid or delay coverage determinations for claims, supplemental claims, and/or additional claims by failing to render a determination when requested, failing to make payments of undisputed amounts of claims, and 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. - To cure the conduct giving rise to the violations described herein, insurer must: (i) pay the total replacement cost value of the Insured’s Claim in the amount of $187,351.95, less prior payments and the deductible; (ii) make payment of any pre-judgment interest owed under Florida law; (iii) make payment for the additional expense incurred by the Insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim.
Comments
User Id Date Added Comment
emily@lawhuggins.com 09-26-2025 The Insureds hereby withdraw this CRN in its entirety.
tsalehi@salehiboyer.com 01-14-2025 VIA ELECTRONIC SUBMISSION: civilremedy@myfloridacfo.com Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Re: Complainant: John Kreutzinger Policyholders: John Kreutzinger Filer: Jodi Peters, Esq. Claim #: FPI231789 Policy #: FPH5345904-01 Date of Loss: September 28, 2022 CRN Filing No.: 793519 CRN Filing Date: November 20, 2024 To Whom It May Concern at The Department of Financial Services: With this correspondence, Florida Peninsula Insurance Company (“Florida Peninsula”) responds to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Jodi Peters, Esq. on behalf of John Kreutzinger (the “Complainants” or “Claimant”). After reviewing the CRN, Florida Peninsula conducted a thorough review of its handling of the Complainant’s claim. Florida Peninsula denies that it has violated any of the statutes referenced in the CRN. At all times, Florida Peninsula has acted in good faith, fairly and honestly toward the Complainant and with due regard for their interest. Florida Peninsula also argues that the CRN utterly fails to describe any of the alleged violations and fails to provide any information such as facts and circumstances which would allow Florida Peninsula to identify and correct the alleged violations. The Complainant alleges violations of the following statutory provisions: 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. Florida Peninsula denies the allegation that it violated the above referenced statute. 624.155(1)(b)(2): Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. Florida Peninsula denies the allegation that it violated the above referenced statute. 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. Florida Peninsula denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Florida Peninsula denies this allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Florida Peninsula denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Florida Peninsula denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigation based upon available information. Florida Peninsula denies the allegation that it violated the above referenced statute. 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. Florida Peninsula denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(i): Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). Florida Peninsula denies the allegation that it violated the above referenced statute, specifically, this is not a personal injury protection matter. Florida Peninsula specifically denies each and every one of the Complainant’s allegations that it violated any of the above referenced statutes. In addition to the allegations specifically denied above, Florida Peninsula generally denies all allegations presented in this CRN as Florida Peninsula has not violated any statute or rule. CRN MUST BE DISMISSED The CRN must be dismissed first and foremost because the Complainants failed to allege specific, actual facts in support of any of their statutory allegations. Next, because the Civil Remedy Notice fails to allege specific facts and/or circumstances in support of its allegations, Florida Peninsula is unable to properly respond; as such, the CRN should be rejected and returned. The CRN is completely devoid of any factual allegations relating to the monetary amount of any claims. See Rousso v. Liberty Surplus Ins. Corp., No. 10-cv-20554, 2010 WL 7367059, at *4 (S.D. Fla. Aug. 13, 2010) (“In this case, the Plaintiffs do not explain how or identify which claims or suits the Defendant responded to in a manner that was contrary to good faith, unfair, or dishonest.”). This glaring deficiency fails to apprise Florida Peninsula of the nature of any purported violation and cannot satisfy the statutory standard of “pleading the facts and circumstances” giving rise to the violation with specificity. The CRN first addresses Section 624.155(1)(b)(1), Florida Statutes, which addresses an insurer’s refusal to attempt to settle in good faith. The CRN, however, does not specify does not specify when any settlement opportunity or proposal existed, the details of the settlement proposal, the nature of the underlying claim(s), or the circumstances supporting the conclusion that the unspecified refusal to settle was not in good faith. To the extent the CRN suggests that Florida Peninsula should tender payment due on the claim, the CRN fails to provide any description of the facts and circumstances supporting this contention. Next, the CRN addresses Section 624.155(1)(b)(2), Florida Statutes, which addresses an insurer’s responsibility to make claim payments to insureds or beneficiaries accompanied by statement setting forth the coverage under which payments are being made. The CRN, however, does not include any supporting facts or circumstances supporting the contention that Florida Peninsula failed to perform this obligation, and Florida Peninsula denies any allegation of same. Moreover, as to Section 624.155(1)(b)(3), Florida Statutes, the CRN is completely devoid of any facts to support that Florida Peninsula failed to promptly settle a claim under one portion of the policy in order to influence settlement under other portions of the policy. Regarding the alleged violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, the CRN’s failure to describe any of the facts or circumstances of the claim precludes Florida Peninsula from evaluating what error, if any, allegedly occurred during the investigation of the claim. Complainant cannot possibly support the position that Florida Peninsula failed to adopt and implements standards for the proper investigation of the claim because the CRN provides little to no description of the facts or circumstances of Florida Peninsula’s investigation, the disposition of the claim, or the facts and circumstances indicating Florida Peninsula’s investigation was in some way defective. As to the alleged violation of Section 626.9541(1)(i)(3)(b), Florida Statutes, the CRN is similarly lacking facts or circumstances to support the allegation that Florida Peninsula misrepresented pertinent facts or insurance policy provisions relating to coverages at issue, and Florida Peninsula denies any allegation of same. As to the alleged violation of Section 626.9541(1)(i)(3)(c), Florida Statutes, Florida Peninsula denies the allegations regarding the alleged facts contained in the CRN surrounding the allegation that Florida Peninsula failed to acknowledge and act promptly upon communications with respect to claims. Furthermore, regarding the alleged violation of Section 626.9541(1)(i)(3)(d), Florida Statutes, the CRN does not describe any standards applicable to denying claims without conducting reasonable investigations based upon available information, much less the facts and circumstances giving rise to the contention that Florida Peninsula denied the subject claim without first conducting a reasonable investigation. Next, as to the alleged violation of Section 626.9541(1)(i)(3)(f), Florida Statutes, the CRN does not describe any standards applicable to the contention that Florida Peninsula failed to promptly provide a reasonable explanation in writing to the Insureds of the basis in the insurance policy, in relation to the facts or applicable law, for denial of the claim or for the offer of a compromised settlement. Finally, as to the alleged violation of Section 626.9541(1)(i)(3)(i), Florida Statutes, which applies to personal injury protection insurance claims, Florida Peninsula contends that the subject matter does not pertain to personal injury protection, and therefore, it is impossible that Florida Peninsula could be in violation of the referenced statute. Moreover, the CRN does not describe any standards applicable to such an allegation. Additionally, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported, conclusory, and incorrect allegations with no basis in fact or circumstance. Aside from the fact that the allegations are devoid of sufficient facts, the tenor and inferences of the allegations are wholly without merit and Florida Peninsula denies each and every one. Additionally, the CRN fails to identify specific policy language relevant to an alleged violation. Blanket references to policy provisions and statutes without specification deems the Civil Remedy Notice deficient. See Julien v. United Property and Casualty Insurance Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The Complainant failed to state any specific policy language or provide the specific facts underlying the basis for alleged policy violations. Instead, the CRN vaguely states “Section 1 – Perils Insured Against; Section 1 – Property Coverage Loss Settlement Provision.” The vague reference in the CRN lacks even minimal specificity. The allegations set forth in the CRN are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and clearly intended solely to tarnish Florida Peninsula’s name and reputation. Florida Peninsula, at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. Florida Peninsula at no time misrepresented any pertinent facts or insurance policy provisions. Florida Peninsula conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. Finally, Florida Peninsula promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. Florida Peninsula retained an independent field adjuster who conducted an inspection of the subject property to investigate the Complainant’s claim. As it relates to the facts of the claim, Florida Peninsula received notice of the subject loss on October 3, 2022, alleged to have occurred September 29, 2022. Specifically, it was alleged that the dwelling had sustained damage as a result of Hurricane Ian. On or about October 8, 2022, an independent field adjuster went to the subject property to conduct an inspection on behalf of Florida Peninsula. After analysis of the subject policy of insurance, and based on the above factual investigation, Florida Peninsula issued a coverage determination to the Policyholders on or about December 16, 2022, extending coverage for damage, pursuant to the terms, conditions, exclusions and limitations of the subject policy and issuing payment for same. Thereafter, upon the Insured’s request, the claim was reopened to address additional alleged damages. On May 17, 2023, a supplemental coverage determination letter was issued to the Insured, explaining that no further coverage would be afforded for the alleged damages, pursuant to the terms, conditions, exclusions and limitations of the subject property. At the Insured’s request, the claim was again reopened and on August 2, 2024, a second supplemental coverage determination letter was sent to the Insured, informing of supplemental payment for alleged damages, as well as policy language relating to damages excluded from coverage. All coverage determination correspondences were in writing, contained applicable policy language, and were timely sent to the Insured. The above demonstrates quite clearly that Florida Peninsula acted in good faith, acted fairly and honestly, acknowledged, and acted promptly upon receipt of the claim, attempted to determine coverage for the claim pursuant to the terms of the policy, took reasonable steps to investigate the claim, communicated reasonably with the Complainant about the claim, and provided the Complainant a reasonable explanation for each of its actions. Additionally, the CRN contains “cures” for the alleged defects; however, the listed “cures” are improper pursuant to Florida case law, specifically the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000). The Talat case provides that the scope of what can be "cured" is limited to the alleged non-payment of the contractual amount due to the insureds. Talat also commented that, “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the insured. In the context of a first-party insurance claim, the contractual amount due the insured is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As a result, only a demanded “cure” relating to the specific amount needed to repair covered damages is proper and legal – any remaining “cures” are improper remedies and contrary to Florida law. In closing, Florida Peninsula first believes that the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute § 624.155, Florida Statute § 626.9541, and Florida case law, and regardless of the rejection, Florida Peninsula denies all allegations contained in the CRN and submits that there are no violations. While this response is meant to be comprehensive, Florida Peninsula based the above-mentioned statements upon the limited information provided in the CRN and the information Florida Peninsula has been provided to date. If the Complainant feels that Florida Peninsula is not in possession of all the facts, please provide such additional information as soon as possible. Please note that Florida Peninsula’s response is not necessarily exhaustive and does not preclude the assertion of other valid reasons for seeking rejection and return of the CRN. Also, nothing in this letter, or any act or failure to act on the part of Florida Peninsula or any agent or representative of Florida Peninsula should be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation alleged in the CRN. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Regards, s/ Donald Lavigne Donald Lavigne, Esquire On behalf of Florida Peninsula 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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




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