Civil Remedy Notice of Insurer Violations
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Filing Number:     794157
Filing Accepted:  11/26/2024
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Complainant
Last/Business Name *  
KANE   First Name   JOANNA
Street Address * 350/352 BELL BLVD S
City, State Zip * LEHIGH ACRES, FL 33974
Email Address * JODI@LAWHUGGINS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   KANE   First Name   JOANNA
Policy # * FL10750220 Claim #* 64424
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*   SAFEPOINT INSURANCE COMPANY
NAIC Company Code 15341
 
Name of individual responsible for violation (if any):* ROBERT REYNOLDS
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 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: Robert Reynolds. Hereinafter referred to as the “Adjuster” or “Adjusters”. - The Insured suffered a loss due to a water loss that occurred on or about July 8, 2024. The Insured’s covered property was damaged by the loss. On August1, 2024, the Insurer denied that the Property sustained damage from the Loss that was covered by the Insured’s insurance policy (policy number stated above; hereinafter the “Policy”). 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. Here, 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 § 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)(2) by making a misrepresentation to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy; the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; 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 or for the offer of a compromise settlement; and the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. - On August 1, 2024, Adjuster Reynolds denied 100% of the insured’s claim, without exception. However, at no point did Adjuster Reynolds meaningfully explain why the Insurer denied any payment on the insured’s claim. 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. Moreover, 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; and 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’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 $39,811.89, 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 03-11-2025 The Insureds hereby withdraw this CRN in its entirety.
jbrookings@safepointins.com 01-23-2025 January 23, 2025 VIA EMAIL: JODI@LAWHUGGINS.COM Jodi Peters, Esq. 6421 N Florida Ave D-598 Tampa, Florida 33604 Re: Insured: Joanna Kane Claim Number: 64424 Policy: FL10750220 Date of Loss: 7/8/2024 CRN Filing Number: 794157 Dear Sir/Madam: This is the formal response of SafePoint Insurance Company (“SafePoint”) to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that was filed on behalf of Joanna Kane (“Complainant”). The Florida Department of Financial Services accepted the Purported Notice, in form only, on November 26, 2024. The Purported Notice was filed in connection with Insureds’ insurance claim for property damage. The Purported Notice names SafePoint and “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(2), 624.155(1)(b)(3) and 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f) and 626.9541(1)(i)(3)(i), Florida Statutes. The Purported Notice is a legal nullity for the four reasons discussed below. SafePoint reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added). The Florida Supreme Court has held that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10- 363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. The Notice fails to meet the requirements of Fla. Stat. § 624.155 on the following grounds: Deficiency #1 Section 624.155(3)(b)(4), Florida Statutes, requires the CRN to reference specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third- party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. The Complainant is the Insured and not a third-party claimant; therefore, the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. It does not. Rather, the Purported Notice states the following vague language without citing specific Policy provisions: “The violations described herein derive from Florida law concerning 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.” General, vague and overbroad references to policy provisions does not satisfy the specificity required by § 624.155(3)(b)(4), Fla. Stat. As such, the Purported Notice is deficient as a matter of law. This deficiency applies to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(2), 624.155(1)(b)(3) and 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f) and 626.9541(1)(i)(3)(i), Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Junior Julien v. United Property and Casualty Insurance Company, No. 4D19-2763. In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Purported Notice fails to “state with specificity” the policy language at issue. Deficiency #2 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply specific facts or circumstances that explain the allegations. Rather, the Purported Notice contains incorrect facts and fails to explain how the purported facts constitute violations of Florida law. The Purported Notice asserts general allegations consisting of conclusory and inaccurate statements rather than specific allegations of fact regarding any alleged misconduct or statutory violations. For example, the Purported Notice states, “… the Insurer denied that the Property sustained damage from the Loss that was covered by the Insured’s insurance policy.” However, these statements are conclusory, inaccurate and without factual basis. This is a claim for interior water damage reported on July 8, 2024, the same day of the alleged date of loss. On July 10, 2024, SafePoint inspected the subject property and documented any visible damage. It was noted, there was extensive decay, degradation, mold, and rot in the cabinets and other areas. The damage appeared to have occurred over time rather than from a single event as claimed. To further assist with the investigation, on July 12, 2024, SafePoint retained American Leak Detection (“ALD”) to inspect the property for the source of the water damage. The ALD report noted, a pressure drop likely due to the master bathroom's mixing valve not fully closing. They identified a localized, intermittent leak at the master shower. The damages observed at the property were the result of constant repeated and leakage and wear and tear, marring, chipping scratches, dents or deterioration, or pre-existing damage, neglect. The Policy does not provide coverage for pre-existing damages and loss caused to the system or appliance from which this water or steam escaped; accidental discharge or overflow which occurs off the described location; caused by constant or repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years. As such, on August 1, 2024, contrary to the Purported Notice erroneous assertion, “However, at no point did Adjuster Reynolds meaningfully explain why the Insurer denied any payment on the claim” the Complainant was notified in writing and provided a detailed explanation as to why there was not a covered peril under the Policy in accordance with the investigation and the Policy terms and conditions. Further, the Notice makes boilerplate recitations of statutes and conclusory statement without the requisite specificity. Specificity is of particular importance for this Notice as Complainant generally alleges that SafePoint “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Notice does not set forth any facts regarding any misrepresentations made by SafePoint and does not identify the person or persons who made such misrepresentations. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. The above noted deficiencies apply to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(2), 624.155(1)(b)(3) and 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f) and 626.9541(1)(i)(3)(i), Florida Statutes. Deficiency # 3 The Purported Notice does not supply necessary information that would allow SafePoint to “cure” the alleged violations without paying benefits which are not due and owing to the Complainant, as required by Florida law. The purpose of a Civil Remedy Notice is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). However, Section 624.155, Florida Statute, does not impose on an insurer the obligation to pay whatever an insured demand. Talat, 753 So. 2d at 1282. To the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. Here, Complainant demands extra contractual damages, “(iii) make payment for the additional expense incurred by the Insured in hiring an attorney” As such, the Purported Notice is deficient as it does not provide SafePoint an opportunity to “cure” the alleged violations without paying extracontractual damages. SafePoint is only obligated to pay contractual amounts owed to cure a civil remedy. See id. at 1278. This deficiency applies to all allegations in the Purported Notice, including but not limited to “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer” and “Unfair Trade Practice” supposedly in violation of Sections 624.155(1)(b)(1), 624.155(1)(b)(2), 624.155(1)(b)(3) and 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f) and 626.9541(1)(i)(3)(i), Florida Statutes. Deficiency # 4 Finally, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity as stated herein, including but not limited to the use of the attorney’s firm’s email address, “JODI@LAWHUGGINS.COM” for that of the Complainant. Therefore, the Notice is insufficient and fails to satisfy the condition precedent to filing a bad faith action. See Julien, 2021 WL 824438. STATUTORY ALLEGATIONS 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests. SAFEPOINT denies the allegation that it violated the above referenced statute. 624.155(1)(b)(2): Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. SAFEPOINT denies the allegation that it violated the above referenced statute. 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. SAFEPOINT denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. SAFEPOINT 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. SAFEPOINT 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). The claim that is the subject of this notice is not a personal injury protection insurance claim and therefore this provision is not applicable. The allegations set forth in the Purported Notice are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and intended solely to tarnish SafePoint’s name and reputation. SafePoint has at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. SafePoint unequivocally denies each and every allegation asserted in the Purported Notice. At no time has SafePoint breached any duty to its Insured. AN INSURER IS NOT REQUIRED TO PAY WHATEVER AMOUNT AN INSURED DEMANDS. Finally, SafePoint retained a field adjuster and leak detection specialist and conducted an inspection of the subject property to investigate the Insured’s claim. Thereafter, Safepoint made a coverage decision pursuant to all applicable Policy language and statutes. Please be advised, by this letter, SafePoint neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, SafePoint hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/ Ari Zeltzer Ari A. Zeltzer, Esq. Staff Counsel SafePoint Insurance Cc: Florida Department of Financial Services
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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