Civil Remedy Notice of Insurer Violations
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Filing Number:     795399
Filing Accepted:  12/4/2024
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Complainant
Last/Business Name *  
BALLARD   First Name   ANNETTE
Street Address * 13 CIMMARON DR.
City, State Zip * PALM COAST, FL 32137
Email Address * AMJ96.AJ@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BALLARD   First Name   ANNETTE
Policy # * 0688795803 Claim #* 01000117604
Attorney
Attorney is Applicable
Last Name* ALTMAN First Name * ALEXIS Initial
Street Address* 925 SOUTH FEDERAL HIGHWAY, 7TH FLOOR
City, State Zip* BOCA RATON , FL - FLORIDA 33432
Email Address * AALTMAN@KPATTORNEY.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):* BAKIR WILLIAMS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Unsatisfactory Settlement Offer
Claim Denial
* 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)(d) Denying claims without conducting reasonable investigations based upon available information.
* 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.

First Protective Insurance Company d/b/a Frontline Insurance (carrier) has not attempted in good faith to settle the insured’s 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 their interests. The carrier has done everything possible to delay the claim and refuses to pay the complete covered loss amount due under the policy. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). The carrier was put on notice of the insured’s storm claim. Frontline sent an adjuster to inspect the home. Thereafter a letter was sent stating, The inspection revealed the roofing panels were not damaged by wind and/or hail on, or around the reported date of loss. The inspections revealed the damages to the roof coverings were slippage due to gravity, age-related deterioration, construction deficiency and/or foot traffic. It is clear from the coverage letter that the carrier is attempting to relate the damage to any cause possible except for wind as that would be covered under the policy. Frontline continues to certify homes as in good condition collect premiums and wrongfully deny their insured’s claims. The insured retained the assistance of a public adjuster who provided an estimate in the amount of $115,830.76. Despite a myriad of requests to pay the amount that is due and owed to the insureds, they are left with no other option but to seek legal advice and representation to enforce his rights under the policy and Florida law. Under all attendant circumstances described above, the carrier has not engaged in good faith claims conduct. The adjusters handling the claim did not properly evaluate or adjust this loss, specifically related to their failure to tender all sums due and owing for the loss. It is clear that the carrier intentionally sent out its field adjuster with the instructions to deny the claim hoping they will get away with taking advantage of their insured. The carrier has intentionally attributed the damages to exclusions under the policy and denied the claim. The carrier’s actions are in violation of the Loss Settlement provision of the policy as well as the following Florida Statutes: 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)(g): Failing to notify the insured of any additional information necessary for the processing of a claim. This notice is provided in order to perfect a right to pursue the civil remedy authorized by Florida Statute §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay all amounts due and owing to the insured in the amount of $115,830.76 minus any applicable deductible; 2) Pay any emergency services; 3) Pay the statutory interest on the amount of unpaid damages from the date of the loss to the date payment is finally made; and Should you have any questions, please do not hesitate to contact me at 561-892-9988. Thank you for your attention to this matter. Sincerely, Alexis Altman
Comments
User Id Date Added Comment
jsuarez@chartwelllaw.com 01-30-2025 SHAWN DEVENDORF, ESQUIRE Direct Dial: (786) 349-3612 sdevendorf@chartwelllaw.com Reply To: Miami Office 100 SE 2nd Street, Suite 2150 Miami, FL 33131-5322 Phone: (305) 372-9044 Facsimile: (305) 372-5044 January 30, 2025 VIA E-MAIL TO: aaltman@kpattorney.com Alexis Altman, Esq. Kanner & Pintaluga, P.A. and VIA E-FILING: Dept. of Financial Services Civil Remedy Notice Website Florida Department Of Financial Services Consumer Assistance/Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, FL 32399-0322 RE: Annette Ballard / First Protective Insurance Company Date of Loss : February 4, 2024 Claim No. : 01000117604 CRN Filing No. : 795399 Policy No. : 0688795803 Address : 13 Cimmaron Drive, Palm Coast, FL 32137 Our File No. : 890.0113971 To Whom It May Concern: This office has been retained by First Protective Insurance Company d/b/a Frontline Insurance (hereinafter “Frontline”) in connection with the above referenced claim. Please accept the following as Frontline’s Response to the Civil Remedy Notice (“CRN” or “Notice”) filed on December 4, 2024, by or on behalf of Annette Ballard (“Insured”). Frontline notes that the subject Notice was only filed on behalf of Annette Ballard, but does not reference Jon D’Amico, who is noted as an additional insured under the policy. Thus, the Notice is deficient in this regard. By virtue of this response, Frontline does not agree that the Notice is proper notice as required by section 624.155, Fla. Stat., and in fact, specifically posits that this Notice is void and should be rejected. Frontline specifically denies each and every allegation contained in the Notice and asserts that the Notice fails to comply with the specificity requirements mandated by section 624.155, Fla. Stat. A civil remedy notice must set forth specific statutory provisions the insurer allegedly violated, the facts giving rise to the violation, the relevant policy language, and a statement that the notice is given to perfect the right to pursue the civil remedy authorized by the statute. See Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856, 858 (Fla. 5th DCA 2018). Similarly, a civil remedy notice must state the facts and circumstances that give rise to an alleged violation with such specificity sufficient to allow an insurer to cure any alleged violation within the 60-day statutory period. See Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). It is Frontline’s position that the CRN filed by the Insured is deficient pursuant to section 624.155(3)(b), Fla. Stat., which states: The [civil remedy] notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 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. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. (emphasis added.) Frontline objects to the filing of the Notice because the Insured failed to comply with section 624.155(3)(b)(2), Fla. Stat., which requires that the Notice include the facts and circumstances giving rise to each violation. While the Notice contains some statements relating to the loss, there are no facts alleged that support or provide notice to the carrier of the specific violations complained of. Many of the alleged violations appear to be a boilerplate recitation of the statute and general conclusory allegations that do not contain any factual support. For instance, the Notice alleges that Frontline was immediately put on notice of the Insured’s claim but fails to acknowledge that the claim was reported seven (7) months after the reported date of loss. Nor does the Notice address the fact that the Insured failed to provide Frontline with requested information and documentation, including a sworn proof of loss, as requested in Frontline’s claim notice letter dated September 25, 2024, as well as in Frontline’s reservation of rights correspondences dated October 2, 2024 and October 14, 2024. As such, the Notice is vague and insufficient to put Frontline on notice as to what it allegedly did wrong because its investigation revealed that there was no coverage for the Insured’s claim under the terms and conditions of the policy, and the Insured has failed to provide any information to the contrary. Rather, the Notice is full of conclusory allegations that are devoid of any factual support, which evidences the generic nature of the Insured’s Notice and how it fails to provide specificity as to the facts and circumstances of the subject claim. Additionally, the Notice alleges that the Insured’s public adjuster prepared an estimate totaling $115,830.76. However, Frontline never received a copy of this estimate prior to the time this Notice was filed on December 4, 2024. This further evidences the generic nature of the Insured’s Notice and how it fails to provide specificity as to the facts and circumstances of the subject claim. Failure to provide such specificity is direct and clear noncompliance with the requirements of Fla. Stat. § 624.155 and renders the Notice deficient on its face as to form and substance. Indeed, the lack of factual specificity leaves uncertainty as to how to cure the alleged bad-faith conduct. See Valenti v. Unum Life Ins. Co. of Am., No. 8:04-cv-1615-T-30TGW, 2006 U.S. Dist. LEXIS 36880, at *7 (M.D. Fla. June 6, 2006) (The purpose of the civil remedy notice is to provide insurers one last opportunity to settle a claim with the insured to avoid unnecessary litigation). The Insured also failed to comply with section 624.155(3)(b)(4), Fla. Stat., which requires references to specific policy language. Notably, the Notice does not list any specific policy provisions. Instead, the Notice broadly states “[l]oss settlement provision,” which is overbroad and fails to provide any specificity as to what specific policy language the Insured is relying upon. Therefore, the Insured’s failure to list any policy language relevant to the alleged violations fails to comply with Fla. Stat. §624.155(3)(b)(4). See Julien v. United Prop. & Cas, Ins. Co., 2020 Fla. App, LEXIS 13520 (Fla. 4th DCA 2020) (citing fox v. Starr Indemn. & Liab. Co., No, 8:16-CV-3254-T-23MAP-2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294, at *2 (M.D. Fla, April 28, 2017)) (an insurer’s listing of whole sections of the insurance policy in a civil remedy notice “appear[ed] to lack specificity”). As such, Frontline was not provided with notice of the specific policy language that it allegedly failed to comply with. The Notice does not provide the contemplated and mandated notice of alleged bad faith that is required as a condition precedent to any civil claim for bad faith pursuant to Fla. Stat. § 624.155. Additionally, as described in detail above, the facts alleged in the Notice are overbroad and conclusory and do not contain any specific factual support for the alleged violations. Frontline, therefore, is unable to ascertain the reasons for the alleged statutory violations from the Notice rendering the Notice deficient. For these reasons, the Notice should be denied and rejected. With regard to the facts of the claim, the subject loss was reported to Frontline on September 25, 2024, with an alleged date of loss of February 4, 2024. In order to adjust the claim, Frontline requested documentation and information, including a sworn proof of loss, and inspected the property with both an independent adjuster and an engineer. Additionally, Frontline issued reservation of rights letters on October 2, 2024 and October 14, 2024 which requested further documentation and/or information to aid in its investigation of the claim. However, the Insured outright failed to provide a sworn proof of loss during the adjustment of the claim. Based on its investigation and adjustment of the claim, Frontline determined that there was no coverage for the Insured’s claim under the terms and conditions of the policy and issued correspondence to the Insured and/or her representatives dated December 2, 2024 explaining the coverage determination. Therefore, in spite of the Insured’s failure to cooperate with the terms and conditions of the policy, Frontline investigated the claim based on all of the information available to it and found that there was no coverage pursuant to the terms and conditions of the policy. The Insured alleges various reasons why this Notice was filed and also alleges multiple statutory violations; however, no specific facts or circumstances are provided to support these allegations. As previously stated, the Notice is simply a recitation of general, and unsupported allegations of bad faith conduct which are not specifically alleged or described. Frontline specifically denies that it has violated any of these sections and denies all other allegations of bad faith or improper claims handling in this matter. However, notwithstanding these allegations, the Insured fails to provide factual support for these alleged violations within the body of the Notice. Nonetheless, Frontline denies the following allegations made by the Insured in the Notice: Unfair Trade Practice: There is no basis for this allegation, thus it is denied. The Insured submits no facts or circumstances to support this allegation. At no time did Frontline, its agents, or its employees employ any unfair business practice during the handling, adjustment, or disposition of this claim. Unsatisfactory Settlement Offer: Frontline denies any allegation pertaining to any unsatisfactory settlement offer with regard to the subject claim. The Insured fails to submit any facts or circumstances in support of this alleged violation. As demonstrated in the factual summary set forth above, Frontline’s investigation of the claim revealed that there was no coverage pursuant to the terms and condition of the policy. The Insured’s assertions to the contrary lack support. Claim Denial: Frontline denies this allegation. The Insured fails to submit any facts or circumstances in support of this alleged violation. As demonstrated in the factual summary set forth above, Frontline promptly investigated the loss and properly sent a coverage determination letter to the Insured in compliance with its duties and obligations under the subject policy of insurance. Fla. Stat. §624.155(1)(b)(1): Denied. Frontline has not failed to attempt to settle this claim in good faith and has always acted fairly and honestly towards the Insured. As shown in the factual summary above, the conduct of Frontline following its receipt of the first notice of the loss has been compliant with all aspects of Florida law. Frontline promptly investigated the claim, made a coverage determination based on the applicable policy language and Florida law, and promptly advised the Insured of the determination. Frontline asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance policy. Fla. Stat. §624.155(1)(b)(3): Denied. Frontline has not failed to promptly settle this claim. As supported by the above claim facts, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it. Frontline promptly investigated the claim, made a coverage determination based on the applicable policy language and Florida law, and promptly advised the Insured of the determination. The Insured has submitted absolutely no facts or circumstances supporting this allegation. Fla. Stat. §626.9541(1)(i)(3)(a): Denied. This allegation is without basis. Frontline has adopted and implemented standards for the proper investigation of claims at all times. The aforementioned facts demonstrate that Frontline employed proper and customary claims practices in the investigation and adjustment of this claim, and in strict compliance with the statutory requirements imposed upon it. Furthermore, the Insured submitted absolutely no facts or circumstances supporting this allegation. Fla. Stat. §626.9541(1)(i)(3)(b): Denied. Again, there is no showing by the Insured to support this baseless allegation of misrepresentation of pertinent facts or policy provisions relating to the coverages at issue. Frontline has adopted and implemented standards for the proper investigation of claims at all times. The aforementioned facts demonstrate that Frontline employed proper practices in the investigation and adjustment of this claim, and in strict compliance with the statutory requirements imposed upon it. The Insured do not submit any facts or circumstances in support of this alleged violation. Fla. Stat. §626.9541(1)(i)(3)(c): Denied. There is no showing by the Insured to support this baseless allegation of failing to acknowledge or act properly upon communications with respect to the claim. As shown in the detailed factual summary above, Frontline was forthcoming with the Insured at all times material hereto and acted as promptly as possible under the circumstances to advise the Insured of its coverage decision. The Insured does not submit any facts or circumstances in support of this alleged violation. Moreover, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance policy. Fla. Stat. §626.9541(1)(i)(3)(d): Denied. This allegation is without basis. As demonstrated above, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it. Frontline promptly investigated the claim, made a coverage determination based on the applicable policy language and Florida law, and promptly advised the Insured of the determination. The Insured has submitted absolutely no facts or circumstances supporting this allegation. Fla. Stat. §626.9541(1)(i)(3)(g): Denied. There is no showing by the Insured to support this baseless allegation of failing to promptly notify the insured of any additional information necessary for the processing of the claim. As shown in the factual summary above, Frontline issued reservation of rights letters on October 2, 2024 and October 14, 2024 to the Insured and/or her representatives, which included requests for additional information and documentation. The Insured does not submit any facts or circumstances in support of this alleged violation. Moreover, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance policy. Frontline has adjusted the loss and damages claimed by the Insured to the extent possible and determined that there was no coverage under the subject policy based on its investigation and the information available to it, in spite of the Insured’s failure to cooperate. Furthermore, Frontline has acted reasonably in adjusting the loss based on the information available to it and the terms of the subject policy. Frontline conducted a reasonable and diligent investigation to assess the damages in this loss, and promptly communicated with the Insured throughout the investigation—all within the mandates of Florida law. Throughout the handling of the Insured’s insurance claim, Frontline has acted in good faith towards the interests of its Insured. Frontline investigated the loss in accordance with the policy provisions and standard claims handling practices. Frontline, therefore, denies any allegations to the contrary. In further response to the Notice, Frontline denies the allegations therein and denies that it has violated any Florida Statute, rule, law, or other authority in its handling of the Insured’s claim. We trust that the foregoing is sufficient to advise of Frontline’s position with regard to the Civil Remedy Notice filed by the Insured. If any additional information is required, please feel free to contact the undersigned regarding same. Very truly yours, CHARTWELL LAW By: Shawn E. Devendorf Shawn E. Devendorf
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