Civil Remedy Notice of Insurer Violations
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Filing Number:     794873
Filing Accepted:  12/2/2024
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Complainant
Last/Business Name *  
OFFILOCK INC   First Name  
Street Address * 1601 LEE ST
City, State Zip * FORT MYERS, FL 33901
Email Address * JODI@LAWHUGGINS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   OFFILOCK INC   First Name  
Policy # * CPS8004647 Claim #* 02184670
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*   SCOTTSDALE INSURANCE COMPANY
NAIC Company Code 41297
 
Name of individual responsible for violation (if any):* JEFFREY BISCH, DONNA MIKOVITS
Type of Insurance * Commercial 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 Insureds’ 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: Jeffrey Bisch, Donna Mikovits,. Hereinafter referred to as the “Adjuster” or “Adjusters”. - On December 2, 2024, the undersigned sought to verify that Adjuster Mikovits held a valid Florida adjusting license and appointment, performing a search on https://licenseesearch.fldfs.com for the following terms: ‘mikovits’, and ‘mikovits’ & ‘donna’. No person matching Adjuster Mikovits arose in the search results. Accordingly, it is likely that Adjuster Mikovits lacked a Florida adjusting license and/or was not appointed during the administration of this claim. Here, the Insurer has violated Fla. Stat. § 626.112(1)(a) (“No person may be, act as, or advertise or hold himself or herself out to be an insurance agent, insurance adjuster, or customer representative unless he or she is currently licensed by the department and appointed by an appropriate appointing entity or person. [...] Any person who knowingly transacts insurance or otherwise engages in insurance activities in this state without a license in violation of this section commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.”). Here, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. The insurer also 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. Moreover, 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. On December 2, 2024, the undersigned sought to verify that Adjuster Bisch held a valid Florida adjusting license and appointment, performing a search on https://licenseesearch.fldfs.com for the following terms: ‘bisch’, and ‘bisch’ & ‘jeffrey’. No person matching Adjuster Bisch arose in the search results. Accordingly, it is likely that Adjuster Bisch lacked a Florida adjusting license and/or was not appointed during the administration of this claim. Here, the Insurer has violated Fla. Stat. § 626.112(1)(a) (“No person may be, act as, or advertise or hold himself or herself out to be an insurance agent, insurance adjuster, or customer representative unless he or she is currently licensed by the department and appointed by an appropriate appointing entity or person. [...] Any person who knowingly transacts insurance or otherwise engages in insurance activities in this state without a license in violation of this section commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.”). Here, the insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(i) by conducting unfair claim settlement practices. The insurer also 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. Moreover, 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 Insured suffered a loss due to Hurricane Milton that occurred on or about October 9, 2024. The Insured’s covered property was damaged by the loss. On November 3, 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 $1,959.91 (“Insurer Estimate”), a mere 1% of the eventual cost incurred to repair the property. The Insurer Estimate was prepared and authored by Adjuster Bisch. 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. 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 or about November 14, 2024, the Insurer denied 100% of Infinity Roofing’s estimate, without exception. However, in this correspondence, nor at any point, did the Insurer meaningfully explain why the Insurer denied any payment on Infinity Roofing’s estimate. 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 $199,368.00, 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
dpittman@butler.legal 12-23-2024 Scottsdale Insurance Company has responded to this Civil Remedy Notice in a December 23, 2024 letter sent directly to Jodi Peters, Esq. with Huggins Law Firm.
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