Civil Remedy Notice of Insurer Violations
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Filing Number:     794334
Filing Accepted:  11/26/2024
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Complainant
Last/Business Name *  
BARBARA FRIEDEL AND MICHAEL KNEZEVICH   First Name  
Street Address * 612 ROSE STREET
City, State Zip * ANNA MARIA, FL 34216
Email Address * PACKERKNEZ@SBCGLOBAL.NET
Complainant Type: * Insured
Insured
Last/Business Name*   BARBARA FRIEDEL AND MICHAEL KNEZEVICH   First Name  
Policy # * LCHA-FL-0000696-00 Claim #* LCHA-FL-0000696-00
Attorney
Attorney is Applicable
Last Name* LEONARDIS First Name * RICHARD Initial
Street Address* 925 S. FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * RLEONARDIS@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* CHRISTOPHER BROWN
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 insureds’ water damage claim. The carrier initially attempted to low-ball the claim. Subsequently, the insureds prepared a loss package in the amount of $45,475.00 needed to restore the property back to its pre-loss condition. Whereas, the carrier wrongfully represented the damages to the insureds’ property to be below the policy deductible. 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 insureds. About fifty 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 $45,475.00, 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 at (561)-892- 9760 if you have any questions or concerns. Sincerely, Richard Leonardis Attorney at Law
Comments
User Id Date Added Comment
dania@sselegal.com 01-16-2025 Re: Response to Civil Remedy Notice of Insurer Violations D.F.S. File No.: 794334 Insurer: Certain Underwriters of Lloyd’s London Insured: Barbara Friedel and Michael Knezevich Underwriters Claim No. X12218 Underwriters Policy No. LCHA-FL-0000696-00 Date of Loss: October 9, 2024 Please be advised that our firm represents and is acting on behalf of Certain Underwriters at Lloyds, London Subscribing to Policy No. LCHA-FL-0000696-00 (hereinafter “Underwriters”). Underwriters issued an insurance policy to the insured with effective dates of 07/11/2024-07/11/2025. This will acknowledge receipt of the Civil Remedy Notice of Insurer Violations (“CRN”) No. 794334 served by the insured’s attorney. The claim arises from damage allegedly caused by Hurricane Milton. Underwriters first request that the CRN be rejected as it fails to comply with the requirements set forth in Section 624.155, Florida Statutes, and Florida case law. The CRN generally alleges that Underwriters: failed to attempt in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly towards its insured in violation of §§624.155(1)(b)(1) and624.155(1)(b)(3). The CRN further alleges that Underwriters (a) failed to adopt and implement standards for the proper investigation of claims; (b) misrepresented pertinent facts; (c) failed to acknowledge and act promptly with respect to the claim; and (d) failed 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 has violated various provisions of Florida Statute §626.9541(1)(i). Underwriters vehemently denies any and all statutory violations as alleged by the insured. Underwriters contend that the CRN as filed is deficient as a matter of law as it fails to comply with Section 624.155. 316 Inc. v. Maryland Casualty Insurance Company, 526 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Insurance Corp., 2010 WL 7367059, (S.D. Fla. 2010); Heritage Corporation of South Florida v. National Union Fire Insurance Company of Pittsburgh, PA, 580 F. Supp. 2d 1294 (S.D. Fla. 2008). Pursuant to Section 624.155(3)(b), the notice "shall state with specificity" the following information: 1. The statutory provision, including the specific language, 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; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by the section. First and foremost, the CRN fails to allege any facts to notify Underwriters of any of the specific statutory violations at issue. Therefore, the CRN is insufficient as a matter of law. As such, the CRN lacks the requisite specificity required by Section 624.155(3)(b)(3). Finally, the CRN also fails to satisfy Section 624.155(3)(b)(4) in that it fails to reference any policy language. The CRN does not cite any provision of the policy. The failure to cite any policy language allowing Underwriters to investigate the allegations renders the CRN insufficient pursuant to Florida law. As such, the CRN does not satisfy the specificity required by Section 624.155(3)(b)(4). Also, the CRN fails to specify the policy language and provisions that are relevant or applicable to the alleged facts contained in the CRN. Because the CRN fails to identify any specific statutes that apply to the allegations, Underwriters is unable to properly respond, and the CRN should be rejected and returned. Additionally, the CRN fails to set forth any specific policy language alleged to have been violated in accordance with Florida Statutes Section 624.155(3)(b)(4). The failure to identify any specific policy provision that is allegedly relevant to the alleged violations prevents Underwriters from addressing any issues regarding the policy and, as a result, the CRN should be rejected. The CRN sets forth various "cures" for the alleged defects. There are also multiple "cures" in the CRN that are improper pursuant to Florida case law, specifically the case of Talat Enterprises, Inc. v. Etna Casualty & Surety Company, 753 So. 2d 1278 (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 insured. Talat also commented that "it 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 the payment are fulfilled...." As a result, the "cures" in the CRN not relating to payment are improper remedies and contrary to Florida law. The CRN also requires the Complainant 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." Instead of providing facts and circumstances, the CRN contains conclusory, unsupported statements as to the claim. The tenor and inferences of the allegations are wholly without merit and Underwriters denies all of the insured’s allegations. Notably, the CRN letter refers to an estimate totaling $45,475. However, this estimate has not been provided to Underwriters. The facts are as follows: On October 14, 2024, Underwriters received notice of the loss that was reported by the insured as wind damage to the roof and water damage to the interior as the result of Hurricane Milton occurring on October 9, 2024. A third-party adjuster appointed by Underwriters, inspected the property on October 18, 2024, in the presence of the insured’s representative, Michael Knezevich. During the inspection of the roof, the field adjuster found no wind damage to any of the four major slopes and the roof was in fair condition. During the inspection of the exterior, the field adjuster observed no wind related damage, but he observed flood lines at all elevations. Additionally, the field adjuster observed damage to the fencing. During the inspection of the interior, the field adjuster observed 3-4’ flood cut throughout the property. During the investigation, Underwriters discovered that the insured had a prior claim for water and flood damage due to Hurricane Helene on September 26, 2024 and handled under claim number X11988. On October 25, 2024, Underwriters issued a denial letter to the insured advising that the field adjuster’s investigation determined that damage to the property occurred as the result of a flood. No wind damage was found to the property at the time of the inspection. The policy does not provide coverage for flood damage. Therefore, the claim was denied and no payment was issued. After reviewing the CRN, Underwriters conducted a thorough review of its decision. Underwriters respectfully submits that it has investigated and adjusted the insured's loss in the utmost good faith. Underwriters further assert that it has fully complied with all statutory requirements with respect to this claim and has acted in good faith toward its insured during the investigation and resolution of this claim. While this response is meant to be comprehensive, Underwriters' response is based upon limited information provided in the CRN and the information Underwriters has to date. If the insured feels that Underwriters is not in possession of all the facts, Underwriters requests that it inform us immediately. Please note that Underwriters' response is not necessarily exhaustive and does not preclude Underwriters from asserting any other valid reason for seeking rejection and return of the CRN. Furthermore, this response or any act or failure to act on the part of Underwriters or any agent or representative of Underwriters should not 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. Thus, the Civil Remedy Notice of Insurer Violation is without merit. Underwriters acted timely and appropriately to adjust the claim. In the event the insured can demonstrate any loss for which it has not been fairly and fully compensated, Underwriters stands ready to fully compensate the insured for such loss, within the terms of the Policy. With respect to the allegations of the CRN, Underwriters submits that it has at all times acted in the utmost good faith in the handling of the claim and, further, has made payment based upon the estimate and documentation presented subject to the Policy’s terms, conditions, exclusions, and endorsements. Please contact us at your convenience in the event we can be of additional assistance to your examination of the Civil Remedy Notice.
ebrooksherproperty@kpattorney.com 12-02-2024 This Filed Civil Remedy Notice is hereby withdrawn due to a filing error.
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