Civil Remedy Notice of Insurer Violations
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Filing Number:     794215
Filing Accepted:  11/26/2024
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Complainant
Last/Business Name *  
LIPSCOMB   First Name   RANDEE AND TRACIE
Street Address * 5247 ANGEL LAKE DR
City, State Zip * JACKSONVILLE, FL 32218
Email Address * N/A
Complainant Type: * Insured
Insured
Last/Business Name*   LIPSCOMB   First Name   RANDEE AND TRACIE
Policy # * 8955415516 Claim #* 01000101137
Attorney
Attorney is Applicable
Last Name* ELIMELECH First Name * REBECCA Initial R
Street Address* 1500 N.E. 162ND ST.
City, State Zip* MIAMI , FLORIDA 33162
Email Address * RELIMELECH@ILGPA.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
Name of individual responsible for violation (if any):* N/A
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Unable to specify language in the policy that is relevant to the violation, as First Protective Insurance Company d/b/a Frontline Homeowners Insurance has refused to provide a certified copy of the policy, in violation of 627.421(1) (A paper copy of the policy shall be provided to the insured or to the person entitled to delivery at his or her request.)
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Randee Lipscomb and Tracie Lipscomb (hereinafter the “Insureds”), paid for a policy of insurance with First Protective Insurance Company d/b/a Frontline Homeowners Insurance (hereinafter, “Insurer”) bearing policy number 8955415516 (the “Policy”). The Policy provides coverage for damage to the Insureds’ property located at 5247 Angel Lake Dr, Jacksonville, FL 32218 (the “Property”), including the significant damage that occurred as a result of a windstorm on or about July 7, 2023 (the “loss”). Specifically, the Insureds’ Property sustained substantial damage to the roof creating an opening that let water into the home, the chimney, exterior of the home, including the windows, front entrance double glass doors, gutter, soffit, fascia, patio screen enclosure, patio screen door, patio entrance glass door, patio double window, the interior of the home, including ceiling and wall damage in the living room fireplace area, frame wood damage in the living room and damage to the carpet, baseboards, and tile flooring in the living room. The Insureds promptly reported their claim to the Insurer. On September 7,2023, the Insurer sent a letter to the Insureds advising that the damages to the Property totaled $989.13, which is less than the policy deductible of $1,000.00. On May 31, 2024, the Insurer issued a letter informing the Insureds that they will send payment in the amount of $14,983.63 for rebuild repairs to the chimney and the living room walls and carpet. In this letter, the Insurer stated that their inspection of the Property on July 25, 2023, revealed that the chimney chase cover was peeled back, and the cap was blown off completely. The Insurer also advises that there was documented water damage to the ceiling and drywall in the living room area. The Insureds contacted the Consumer Law Office, which has subsequently merged with the Insurance Litigation Group, P.A. (hereafter, ILGPA), who conducted a thorough inspection of the property and compiled an estimate of damages. ILGPA, on behalf of the Insureds, forwarded said estimate which fully detailed the Insureds’ damages and total $247,441.40. However, the Insurer refuses to resolve the Insureds’ claim and pay for all damages to the Property. The Insurer’s conduct is in bad faith and violates Florida’s statutes concerning the adjustment of insurance claims. First, Florida Statute § 624.155(1)(B)(1) requires good faith in the settlement of claims. The Insurer is in violation of this Statute for failing to provide a reasonable repair estimate. What is more, the Insurer violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle the claim, when the obligation to settle the claim became reasonably clear. Again, the Insurer failed to make a good faith offer to settle this claim and failed to account for the full scope of the damages. They failed to respond to the estimate provided by ILGPA, on the Insureds’ behalf, in a timely manner. They are obligated to provide coverage for all damages to the Insureds’ Property, and not attempt to resolve this claim with lowball offers. Additionally, the Insurer’s conduct violates Florida Statute § 626.9541, which prohibits unfair settlement practices. More specifically, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. Further, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly with the Insureds and its counsel. ILGPA, on the Insureds’ behalf, emailed the Insurer several times to schedule a re-inspection but have not received a response. As mentioned above, the Insurer failed to account for the full scope of the damages and has additionally failed to respond to the estimate provided by ILGPA, on behalf of the Insureds, in a timely manner, delaying the resolution of this claim. Had the Insurer done so, it would have immediately settled this claim on a fair and reasonable basis and provided full coverage to its Insureds. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: (1) create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations and avoid this from occurring in the future; (2) immediately tender all insurance proceeds due and owing its Insureds under the Policy in the amount of $247,441.40 (less the deductible and any prior payments), plus all statutory interest; (3) act fairly and honestly towards its Insureds and with due regard for their interests in attempting to settle their Insureds’ claim; (4) hold the claim open in the event that its errors and delay does or may cause the Insureds to suffer either further loss and/or damage; and, (5) stipulate to the Insureds’ entitlement to attorney’s fees and court costs pursuant to Florida Statutes §§ 627.428 and 626.9373. Acknowledgment This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statutes section 624.155, should First Protective Insurance Company d/b/a Frontline Homeowners Insurance fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
Comments
User Id Date Added Comment
relimelech@ilgpa.com 07-14-2026 This Civil Remedy Notice is hereby withdrawn.
hconnolly@sgc-attorneys.com 01-09-2025 January 9, 2025 Via The Department of Financial Services Civil Remedy System Florida Department of Financial Services Division of Consumer Services 200 East Gaines Street Tallahassee, FL 32399-0322 Re: Civil Remedy Notice of Insurer Violations Company: First Protective Insurance Company Complainants: Randee and Tracie Lipscomb Named Insureds: Randee and Tracie Lipscomb Policy No.: 8955415516 Policy Period: 06/07/2023 to 06/07/2024 Claim No.: 01000101137 DFS File No.: 794215 Acceptance Date: 11/26/2024 Dear Sir or Madam: We write on behalf of First Protective Insurance Company (hereafter “First Protective”) to respond to the Civil Remedy Notice of Insurer Violations submitted to the Department of Financial Services (hereafter “DFS”) by Rebecca Elimelech, Esq. on behalf of Randee and Tracie Lipscomb (hereafter “the Insureds”). The DFS accepted the Civil Remedy Notice on November 26, 2024. First Protective issued a homeowners insurance policy to the Insureds, who submitted a claim for insurance benefits under the policy for damage reportedly caused by a storm on July 12, 2023. The alleged violations purportedly arise out of First Protective’s investigation, evaluation, and adjustment of the Insureds’ claim. However, the Civil Remedy Notice is factually and legally deficient, and thus invalid, because it does not comply with the requirements of § 624.155(3)(b), Fla. Stat., and First Protective otherwise denies the blanket and unsupported allegations. To begin, § 624.155(3)(b), Fla. Stat., requires the Civil Remedy Notice to provide “with specificity” each of the following: (1) the statutory provision allegedly violated, including the specific language of the statute; (2) the facts and circumstances giving rise to a violation of the statutes referenced in the Notice; (3) the name of any individual involved in the alleged violation; and (4) the specific policy language that is relevant to the alleged violation. Accordingly, to be valid, the Civil Remedy Notice must be specific enough factually so as to provide First Protective with the opportunity to adequately respond to and, if necessary, timely cure the alleged violations within sixty days. See Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2020) (a civil remedy notice is facially invalid where the insured fails to identify the specific statute and specific policy provisions relevant to the alleged violations); Heritage Corp. of S. Fla. v. National Union Fire Ins. Co. of Pittsburgh, 580 F.Supp.2d 1294 (S.D. Fla. 2008) (insured did not state with requisite specificity the facts giving rise to the specific statutory violation so as to put the insurer on notice of the wrongful acts being alleged). The Civil Remedy Notice submitted on behalf of the Insureds fails to meet these basic requirements. First, the Insureds completely fail to specify the name of any person representing First Protective who is responsible for or has the most knowledge of the “facts” giving rise to the allegations contained within the Notice. This failure to properly identify the person representing the insurer who is most responsible for and knowledgeable of the facts giving rise to the alleged violations alone renders the Civil Remedy Notice invalid. Second, the Insureds fail to reference any specific policy language in the Notice that is relevant to the alleged violations. Instead, the Insureds claim that they do not possess a copy of the policy. However, a copy of the policy was provided to them and/or their representatives, and the policy is otherwise available to them through their homeowners customer portal access. The failure to include the specific language relevant to the alleged violations also renders the Civil Remedy Notice invalid. Third, the Insureds absolutely fail to specify sufficient facts supporting each of the alleged violations. Indeed, there are no specific facts explaining how First Protective allegedly: (1) did not attempt in good faith to settle the claim; (2) failed to promptly settle the claim under one portion of the policy coverage in order to influence settlements under other portions of the policy coverage; (3) failed to adopt and implement standards for the proper investigation of claims; (4) failed to acknowledge and act promptly upon claim communications; (5) failed to promptly notify them of any additional information necessary for the processing of the claim; and (6) failed to pay undisputed amounts of partial or full benefits owed under the policy within 60 days after receiving notice of the claimed loss. Instead, and in direct contravention of the statutory requirements, the Civil Remedy Notice provides nothing more than bald, broad-brushed, and boilerplate allegations of wrongdoing without setting forth any supporting factual information sufficient to enable First Protective to adequately respond to and/or cure the alleged violations. Moreover, undersigned counsel attempted to contact the Insureds’ counsel on multiple occasions to discuss the alleged violations, to no avail. Absent any factual foundation, no specific statute or violation has been identified as required by § 624.155(3)(b), Fla. Stat. In fact, the allegations set forth in the Civil Remedy Notice are nearly identical to the allegations of statutory violations set forth in at least four other civil remedy notices of insurer violations (DFS Filing Nos.: 740263, 774212, 792558, and 794387) filed by Ms. Elimelech. Each of these Civil Remedy Notices alleges the same three reasons for the notice, the same six statutory provisions allegedly violated, the same generic allegations of wrongdoing, and the same general “cure.” Also, a review of the notices prepared by Ms. Elimelech reveals that if an insurer does not pay an insured’s claim as presented, a civil remedy notice of insurer violation will be forthcoming, regardless of the facts specific to the claim. Given the substantial similarities between this and the other civil remedy notices of insurer violations submitted by Ms. Elimelech, it is abundantly clear that the Civil Remedy Notice here is nothing more than a form letter totally devoid of specific factual information about First Protective’s alleged statutory violations, and absent any factual foundation, no specific statute or violation has been identified as required by § 624.155(3)(b), Fla. Stat. For these reasons, the Civil Remedy Notice filed on behalf of the Insureds fails to comply with the requirements of § 624.155(3)(b), and First Protective respectfully requests the DFS to reject the Civil Remedy Notice as being deficient. Notwithstanding these glaring deficiencies, First Protective categorically denies all allegations of wrongdoing contained in the Notice, and First Protective affirmatively states that it acted in good faith and with due regard for the Insureds’ interests in the investigation, evaluation, and adjustment of their claim. Upon receiving notice of the claimed loss on July 12, 2023, First Protective made immediate contact with the Insureds to obtain pertinent information and documentation, including a sworn proof of loss, and to arrange an inspection of the damages. The initial inspection by an independent field adjuster took place on July 25, 2023, and a subsequent inspection was performed by an independent engineer on September 15, 2023. However, prior to the inspections, sections of the home reportedly damaged by the storm event had already been removed and discarded. Also, the Insureds never submitted a sworn proof of loss to First Protective. As such, First Protective will never know what the condition of the property was shortly after the reported date of loss. Nonetheless, First Protective determined that a covered loss had occurred as represented by the Insureds, but there were questions about the scope of the covered loss. Based on its initial assessment of the covered damages, First Protective estimated the loss to be less than the deductible. The bases for the initial adjustment were communicated to the Insureds in writing on September 7, 2023, and a copy of the supporting estimate was sent to them. The Insureds were also informed that First Protective was continuing to evaluate their claim. After its initial assessment, First Protective continued to investigate and evaluate the reported loss by communicating with the Insureds and by evaluating and processing new information provided by them, including statements and representations they made during their examinations under oath on April 11, 2024. As this information was gathered, processed, and evaluated, a payment was issued to the Insureds on or about May 31, 2024. Again, First Protective communicated to the Insureds the basis for the payment and provided a copy of the documents supporting the payment. Thereafter, First Protective and the Insureds engaged in mediation in an effort to resolve their disagreement over the scope and amount of the covered loss. Following First Protective’s payment to the Insureds, First Protective learned that the source of the loss and the damages being claimed by the Insureds may have pre-existed the inception date of the insurance policy and the reported date of loss. Specifically, the Insureds submitted a similar claim to Avatar due to damage caused by Hurricane Irma in 2017. The source of the water intrusion with respect to the Avatar claim and this claim is the same chimney and/or chimney flashing. In addition, the scope of damages being claimed by the Insureds in this matter overlaps significantly with the scope of damages they claimed during the Avatar matter. This new information calls into question the veracity of the Insureds’ claim, including the reported cause of damage, the onset and duration of the damage, and the scope and nature of the damage. These issues have been disclosed to the Insureds and their representatives under a complete reservation of rights, and repeated attempts to discuss these matters with the Insureds’ legal representatives have been made, again to no avail. First Protective is entitled to conduct a meaningful and thorough claim investigation, and to do so, First Protective must rely on the Insureds’ cooperation and compliance with their post-loss obligations, and First Protective can only make a coverage determination and issue payment based on the condition of the property at the time of inspection and the accurate information available to it. Simply put, the actual facts and circumstances of the Insureds’ reported claim clearly demonstrate that First Protective did not commit any of the alleged violations, and it is abundantly clear that, throughout the handling of the Insureds’ claim, First Protective promptly and diligently responded to, investigated, and evaluated the claim in accordance with the provisions, terms, and conditions of the policy. Not only did First Protective make a timely coverage determination and explain to the Insureds the bases for the payment ultimately issued, First Protective constantly communicated with the Insureds and their representatives both verbally and in writing in a continued effort to work towards a final adjustment of the claim. It is simply without dispute that First Protective engaged in open and meaningful discussions with the Insureds and continuously communicated with them in a prompt and timely fashion. First Protective has the right to rely on the provisions and conditions of the policy and to deny portions of a claim that it in good faith believes is not covered under the policy. Vest v. Travelers Ins. Co., 753 So.2d 1270 (Fla. 2000). Furthermore, the Insureds appear to outline nothing more than a disagreement over the scope and amount of payment they received. Without more, the Insureds fail to provide any factual basis for the alleged violations. The mere inability of the parties to agree to a dollar amount does not establish bad faith on the part of First Protective Insurance Company. Dadeland Depot, Inc. v. St. Paul Fire & Marine Ins. Co., 945 So.2d 1216 (Fla. 2006); 316, Inc. v. Maryland Cas. Co., 625 F.Supp.2d 1187 (N.D. Fla. 2008). To conclude, although the Insureds’ Civil Remedy Notice is statutorily deficient, First Protective denies that it violated any of the statutes summarily referred to in the Notice. We trust that this response addresses the “allegations” of insurer violations set forth in the Civil Remedy Notice. Should you have any questions, please contact us at any time. Sincerely yours, HUGH J. CONNOLLY cc: Randee and Tracie Lipscomb c/o Rebecca Elimelech, Esq. Insurance Litigation Group, P.A. 1500 NE 162nd Street Miami, Florida 33162 Via Mail and Email: relimelech@ilgpa.com
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