Civil Remedy Notice of Insurer Violations
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Filing Number:     795540
Filing Accepted:  12/5/2024
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Complainant
Last/Business Name *  
MORGAN   First Name   SUSAN
Street Address * 461 BAYSHORE DR.
City, State Zip * CAPE CORAL, FL 33904
Email Address * SUE.SCHULTE@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MORGAN   First Name   SUSAN
Policy # * OIC30108288-00 Claim #* 22FLHOV0006512
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W
Street Address* 2790 SUNSET POINT RD
City, State Zip* CLEARWATER , FL 33759
Email Address * GRANT@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLYMPUS INSURANCE COMPANY
NAIC Company Code 12954
 
Name of individual responsible for violation (if any):* DAVID HENDERSHOTT, THOMAS ROBINSON, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, OLYMPUS INSURANCE COMPANY, WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Not treating the Insured with good faith claims conduct
Other : Looking for ways to deny full recovery to the Insured
Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
Other : Not adjusting claims and evaluating loss properly
Other : Shifting the burden of insuring the loss to the Insured
Other : Failing to implement proper standards for the adjustment and investigation of claims
Other : Making material misrepresentations
* 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)(2) A material misrepresentation made 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.
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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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.

627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an insured within 15 calendar days after an individual or entity designated by the insurer receives the insured's written request, either: A loss run statement. 627.70131 (d) Within 7 days after the insurer's assignment of an adjuster to the claim, the insurer must notify the policyholder that he or she may request a copy of any detailed estimate of the amount of the loss generated by an insurer's adjuster. After receiving such a request from the policyholder, the insurer must send any such detailed estimate to the policyholder within the later of 7 days after the insurer received the request or 7 days after the detailed estimate of the amount of the loss is completed. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. 627.4137(1)(e) - Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the Insured, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: a copy of the policy. 627.70131 (1)(a) - upon the Insurer receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgement. If the acknowledgement is not in writing, a notification indicating acknowledgement shall be made in the insurer's claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. As used in this subsection, "agent" means any person to whom an insurer has granted authority or responsibility to receive or make such communications with respect to claims on behalf of the insurer. This subsection shall not apply to Insureds represented by counsel beyond those communications necessary to provide forms and instructions. Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Olympus Insurance Company (the "Insurer") has committed the following in handling the Insured's claim: 1) failing to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the Insured; 3) looking for ways to deny benefit payments and otherwise "low ball" or "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; 8) shifting the burden of investigating the loss onto the Insureds; 9) requesting a re-inspection despite no changes to the above-referenced insured property; 10) failing to acknowledge and act promptly upon communications with respect to claims; 11) failing to respond to or acknowledge correspondence within statutory time; 12) failing to provide a loss run statement; and 13) making material misrepresentations. On or about September 28, 2022, while the subject policy was in full force and effect, the insured property suffered a loss caused by Hurricane Ian. The areas impacted include but are not limited to the roofing system, exterior surfaces, overhead garage door, pool, dock, privacy fence, back patio ceiling, great room, foyer, dining room, kitchen, master suite, and master bathroom. The Insured timely submitted a claim to the Insurer for damages caused by Hurricane Ian and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 22FLHOV0006512 to the loss and issued a letter dated October 29, 2022, in which it notified the Insured that it was electing to repair the subject property roof per the policy's "Elite Repair Program." Given the scope and nature of the damage, the Insured retained a public adjuster. After assessing the damage and the true scope of repairs, the public adjuster prepared an estimate identifying $200,009.32 in covered damage to the dwelling and $6,834.30 in damage to other structures. The foregoing estimate, photographs, and a letter of representation from the public adjuster were sent to the Insurer who subsequently issued a coverage determination letter, dated May 17, 2023, in which it notified the Insured that it was electing to invoke its option to repair the Insured's roof. The letter additionally detailed the Insurer's decision to deny coverage for damage sustained to the interior dwelling. The Insurer misrepresented the loss and issued a wrongful partial denial. The Insurer denied coverage for interior damage based on the rationale that " photos from inspection show no damage." Although the Insurer and Insured are in dispute about the interior damage, the Insurer knows or should know that when independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine. Sebo v. Am. Home Assurance Co., 208 So. 3d 694, 697 (Fla. 2016). The concurring cause doctrine states that coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause. Id. at 698. A covered peril that meets with an uncovered peril may still provide for coverage under a policy when the covered peril triggered the events that eventually led to the loss. Id. at 697. Given the nearly $20,000.00 in out-of-pocket expenses paid by the Insured to repair their property without indemnification from the Insurer, the Insured retained legal counsel who provided the Insurer with a letter of representation, dated March 30, 2023. Within the letter, legal counsel requested a copy of a loss run statement, a certified copy of the subject policy, and documentation regarding the subject claim which the Insured is owed. The Insurer and its agents failed to comply with Fla. Stat. 627.444 by not providing the Insured and the Insured's representatives with a loss run statement. The Insurer and its agents have not acknowledged the request for a loss run statement nor has a loss run statement been provided. Upon an Insurer receiving a written request for a loss run statement, the Insurer is required, within fifteen (15) calendar days, to provide either a loss run statement or information on how to obtain a loss run statement at no charge through a consumer reporting agency. There has been no response within fifteen (15) calendar days of the Insured's written request and the Insurer has not provided information on how to obtain a loss run statement at no charge through a consumer reporting agency. This Insurer has breached its duty to settle claims in good faith when, under all the circumstances, it could and should have done so. The Insurer and its agents have not acted fairly and honestly toward the Insured and the Insured's representative and have moreover failed or refused to promptly acknowledge the Insured's communications in an attempt to frustrate and delay the resolution of the Insured's claim. The Insurer additionally failed to timely provide its estimate of damage sustained to the interior dwelling. The Insurer then requested information from its Insured in a letter dated April 6, 2023. The Insured complied, providing the requested documentation in a letter dated April 13, 2023. The Insured's representatives issued subsequent requests for a coverage determination and estimate on July 28, 2023, August 4, 2023, August 15, 2023, and August 22, 2023. It was not until September 1, 2023, forty-two (42) days after the Insurer completed its reinspection, that the Insurer provided the Insured with its estimate of damages. By waiting longer than seven days from the time the estimate was made to provide an estimate of the damage to the policy holder, the Insurer has gone against Florida Statute 627.70131(3)(e), which states "The insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by an insurer's adjuster. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation." By not providing an estimate to the policy holder within the seven days mentioned by the above statute, the Insurer has violated the statute and lengthened the claims process, therefore frustrating the efforts of the policy holder to repair their property. Moreover, the Insured's multiple requests for a coverage determination and estimate were not responded to within seven (7) days. This shows that Insurer has failed to acknowledge the receipt of communications within seven (7) days in violation of Florida Statute 627.70131(1)(a). Upon an Insurer's receiving a communication with respect to a claim, the Insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the Insurer which reasonably prevents such acknowledgement. The Insurer finally issued a coverage determination letter to the Insured, dated September 1, 2023, in which it notified them that it was extending coverage for interior damage. However, the Insurer wrongfully determined that the amount of covered damage did not exceed the policy deductible, resulting in no payment being issued to the Insured. The Insurer's lowball estimate is that of a classic under scope and under value of the claim. Upon receiving notice of the loss, the Insurer had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return the home to its pre-loss condition. However, when the Insurer conducted its inspection of the insured property, the Insurer's adjuster failed to conduct a thorough and adequate investigation, or the adjuster intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after investigating. As a result, the Insurer breached the policy by failing to fully indemnify the Insured for the covered loss. The Insurer has presented the Insured with the declarations page for their renewal policy which reflects an inflated policy premium. The Insured's policy is set to be renewed on September 4, 2024. As outlined in the new declaration page, the Insurer has doubled the Insured's annual premium. The Insured did not request any changes to the subject policy that would account for the unreasonable inflation in the annual premium. Upon information and belief, the Insurer has employed this tactic to compensate for the monies it will likely be required to pay to the Insured after the course of the pending litigation. Inflating policy premiums and deductibles to offset and limit the amount of recovery the Insured is entitled to is a clear attempt by the Insurer to avoid its duty under the subject policy. Furthermore, the Insurer is more concerned with determining how it can offset the cost of claims and expenses incurred therefrom because maintaining a favorable ratio of claims/expenses relative to premiums earned/written means that the Insurer can make an underwriting profit. The Insurer is clearly placing its financial interests over those of the Insured and it is disregarding the difficult financial position it has forced upon the Insured. This is clearly a business tactic used by the Insurer commonly, which indicates the Insurer's bad faith conduct. The Insurer, despite itself invoking its right to repair the property, has failed to fully indemnify the contractor that repaired the property. The Insurer retained services including but not limited to lighting specialists, which have sent all repair invoices to the Insurer who has, to date, failed to indemnify the contractors for the work done. The Insurer's chosen contractor, Lighting First, completed repairs to the property during the week of August 30, 2024. Lighting First contacted the Insurer multiple times, including but not limited to email correspondence on October 18, 2024, requesting payment that has, to date, remained without response by the Insurer. This shows that Insurer has failed yet again to acknowledge the receipt of communications within seven (7) days in violation of Florida Statute 627.70131(1)(a). Upon an Insurer's receiving a communication with respect to a claim, the Insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the Insurer which reasonably prevents such acknowledgement. Moreover, the Insurer has continually refused to indemnify the contractor for the work completed, neglecting its obligation to the Insured and failing to ensure the necessary work is done and paid for in a timely manner pursuant to the subject policy. Additionally, Insurer shifted the burden and cost of investigating and insuring the loss onto the Insured. During their investigation, the insurer's adjuster did not use a moisture meter, despite the presence of interior water damage. A moisture meter can be purchased online from Amazon for around $40 before tax. The Insurer could purchase a moisture meter and assess thousands of properties with one meter. Instead, the Insurer would rather place its financial interests over those of the Insured by failing to provide the adjuster with the necessary tools to correctly inspect the loss. As a result of the inadequate investigation and surrounding circumstances it is apparent that the Insurer significantly underestimated the scope of the loss to the Insured's property. The Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. The conduct outlined above is done within the Insurer's routine course of the business. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer's claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured's interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully continues to delay resolution of the subject claim by undervaluing the amount required to restore the insured property to its pre-loss condition. Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer's actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer's actions amount to but are not limited to the following: 1. Claim delay 2. Not treating the Insured with good faith claims conduct 3. Looking for way to reduce recovery to the Insured 4. Looking for ways to deny recovery to the Insured 5. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 6. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the Insured's' interests 7. Placing the financial interest of the Insurer over that of the health and safety of the Insured 8. Failing to provide an estimate that complies with the Florida Building Codes 9. Shifting the burden of investigating onto the Insured 10. Conducting inadequate investigations 11. Failing to render a written claims determination to the Insured within 90 days pursuant to Florida Statute 627.70131 12. Failing to pay interest on a claim that is older than ninety (90) days 13. Requesting a re-inspection despite no changes to the above-referenced insured property 14. Treat represented and unrepresented Insured differently 15. Failing to provide a loss run statement 16. Making material misrepresentations Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1). Admit full coverage for the Insured's loss. (2). Tender full benefits owed to the Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via E-mail: Olympus Insurance Company P.O. Box 33117 Palm Beach Gardens, FL 33420 olympusclaims@oigfl.com
Comments
User Id Date Added Comment
dwinningham@bressler.com 01-03-2025 Via U.S. Mail, Certified Mail and E-mail: GRANT@KRAPFLEGAL.COM Grant W. Krapf, Esq. Krapf Legal 2790 Sunset Point Rd. Clearwater, FL 33759 Complainant(s): Susan Morgan Policy #: OIC30108288-00 Claim #: 22FLHOV0006512 DFS Filing #: 795540 Dear Mr. Krapf: Please accept this response on behalf of Olympus Insurance Company (hereinafter “Olympus”) to the Civil Remedy Notice of Insurer Violations (hereinafter “CRN”) No. 795540, filed on behalf of Susan Morgan (hereinafter, the “Complainant” or the “Insured”), and accepted by the Florida Department of Financial Services on December 5, 2024. The Civil Remedy Notice (“CRN”) alleges that Olympus violated the following 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)(2) A material misrepresentation made 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. • 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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. • 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). • 627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an insured within 15 calendar days after an individual or entity designated by the insurer receives the insured's written request, either: A loss run statement. • 627.70131 (d) Within 7 days after the insurer's assignment of an adjuster to the claim, the insurer must notify the policyholder that he or she may request a copy of any detailed estimate of the amount of the loss generated by an insurer's adjuster. After receiving such a request from the policyholder, the insurer must send any such detailed estimate to the policyholder within the later of 7 days after the insurer received the request or 7 days after the detailed estimate of the amount of the loss is completed. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. • 627.4137(1)(e) - Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the Insured, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: a copy of the policy. • 627.70131 (1)(a) - upon the Insurer receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevent such acknowledgement. If the acknowledgement is not in writing, a notification indicating acknowledgement shall be made in the insurer's claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. As used in this subsection, "agent" means any person to whom an insurer has granted authority or responsibility to receive or make such communications with respect to claims on behalf of the insurer. This subsection shall not apply to Insureds represented by counsel beyond those communications necessary to provide forms and instructions. Please accept this as Olympus’s response to the above-referenced CRN filed with the Department of Financial Services by the Complainant, Susan Morgan. To summarize the below, Olympus hereby denies any allegation of not attempting to settle claims in good faith when it could and should have done so; failing to promptly settle claims when the obligation to settle a claim has become reasonably clear; making any material misrepresentation to an insured or any other person having an interest in the proceeds payable under such contract or policy; failing to adopt and implement standards for the proper investigation of claims; failing to acknowledge and act promptly upon communications with respect to claims; failing to affirm or deny full or issue partial coverage of claims or failing to provide a written statement that the claim is being investigated; and failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b), and states that it has at all times handled and adjusted the Complainant’s claim with utmost good faith. Simply put, Olympus denies any acts or omission that could be construed or found to be deemed bad faith and/or a violation of Florida Statutes § 624.155 and § 626.9541, whether expressly stated in the Civil Remedy Notice or implied. Any and all allegations of bad faith are hereby denied and rejected in their entirety by Olympus. First, Olympus specifically responds to the additional allegation contained in the instant CRN which was not previously included in the prior CRN filed by Complainant in regard to this claim (See Civil Remedy Notice No. 778860, accepted by DFS on August 19, 2024). This CRN includes new language relating to Complainant’s allegation that Olympus “despite itself invoking its right to repair the property, has failed to fully indemnify the contractor that repaired the property.” This allegation has no basis in fact. The subcontractors of the relevant contractor retained to perform repairs to the Complainant’s property confirmed to Olympus following the filing of the most recent CRN that, despite Complainant’s allegation to the contrary, all invoices have been paid for all work completed at the property. As this is the only “new” allegation contained in this CRN, the CRN should be withdrawn based on the fact that the alleged information regarding the (non-existent) unpaid invoices was inaccurate at the time of filing and remains inaccurate at the time of this response. Put simply, the contractor confirmed they have been paid in full for all work completed at the property. There is simply no basis for Complainant’s stating otherwise. Beyond Olympus’s adamant belief that it acted with the utmost good faith, the CRN is deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. As an initial matter, Olympus denies and rejects the instant CRN as it fails to comply with the requirements of Florida Statute § 624.155. The CRN is therefore deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. Florida Statute § 624.155 requires a complainant to file with the Department of Financial Services a Civil Remedy Notice which shall be “on a form provided by the [Department] and shall state with specificity…such other information as the Department may require.” The Department created a CRN form, Form DFS-10-363, which lays out 15 requirements, including in part, the Complainant’s e-mail address, Complainant type, claim number, attorney’s name, attorney’s address, attorney’s e-mail address, type of insurer, the person with knowledge of the facts giving rise to the allegations, and the reason for notice. According to § 624.155, these mandates are required by the Department, and they must be stated with specificity. The instant CRN fails to provide the specificity required by § 624.155 and fails to comply with the form requirements as a whole. Therefore, the instant CRN is facially deficient. See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Due to this failure to provide the mandated information, the CRN is facially deficient as it fails to comply unquestionably with the form requirements set forth in Florida Statute § 624.155, and specifically § 624.155(3)(b)(3). See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Furthermore, the CRN’s attempt to identify the specific policy language relevant to the violation is woefully deficient. “Courts have found that listing whole sections of the insurance policy constitutes insufficient specificity.” See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294 at *2 and Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020).” When prompted to reference the policy language that is relevant to the alleged violation, the Complainant makes no effort at all to provide the relevant policy language. Instead, the subject CRN makes a fatal error from the start, claiming that “the violations alleged are statutorily based and do not rely on any specific policy language.” However, the CRN goes on to describe allegations of breach of contract, which stem directly from the contractual relationship established by the subject insurance policy, and the policy language of same. Without the policy, there is no relationship between the two parties, nor any reason for the insurer to be obligated to cover the insured’s loss. Despite claims to the contrary, the Complainant relies on policy language as the basis of the claim of breach. Failing to include the Policy language as mandated by the Department and which allegedly obligates the insurer to cover the Complainant’s claim is a violation of the requirements set forth in Florida Statute § 624.155. The Complainant copied and pasted various statutes, without providing any reference as to which policy sections are relevant to their purported allegations against Olympus nor which sections the Complainant is asserting Olympus has arguably violated, causing any purported breach of the statutes listed. Accordingly, the CRN 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 Florida Statute § 624.155. Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020). Failure to provide specific reference to any relevant policy language to the Complainant’s allegations contained within the instant CRN is direct and clear noncompliance with the requirements of Florida Statute § 624.155, and therefore renders the CRN deficient on its face as to form and substance. For these reasons alone, the CRN fails at its inception. Furthermore, Fla. Stat. § 624.155(1)(b)(1) requires that a CRN “state with specificity”, inter alia, the facts and circumstances giving rise to the violation(s) alleged. To say that this CRN fails to do so is an understatement. For instance, at no point does the CRN allege facts supporting their allegation that Olympus made a “material misrepresentation” to Insured. The allegation is made but remains unsupported by any facts. The CRN also alleges that Olympus failed to address personal injury policy claims – of which there are none. The CRN includes some facts from the claim investigation and repair process which are true, but intentionally leaves out descriptions of Insured’s many failures to cooperate, or the many attempts required to reach Complainant’s counsel at various points in the process. Not once does the CRN address the payments made by Olympus for repairs and mitigation relating to Complainant’s claim. Furthermore, in this section, Complainant alleges that Olympus is in violation of 627.444(2)(a), regarding the insurer’s obligation to provide a “loss run statement” within 15 days of a request for same. At no point during the investigation was a loss run statement requested by Complainant or her counsel. By way of background, Insured reported a claim for damage to her property caused by Hurricane Ian on September 28, 2022. Olympus sent Field Adjuster James Andrews to the property for an initial inspection on October 4, 2022. Mr. Andrews inspected the property with Insured, who explained to him that the storm damaged the roof, boat dock, and back walkway/fence, and advised that water ran all the way up to the entry of the garage and bathroom before flood waters receded. FA Andrews observed wind damage to the roof and damage to the boat dock area (including walkways, fencing) and water damage to the interior bathroom door jamb related to storm surge. Insured advised FA Andrews that she had already called her flood insurance company to report the damage. On October 29, 2022, Olympus sent a letter to Insured invoking its Option to Repair the Insured’s roof. The letter requested that she pay her hurricane deductible and cooperate with the contractor who would be contacting her. Olympus selected JA Edwards of America (JAEA) to handle the repair. On December 12, 2022, Complainant’s public adjuster prepared an estimate for a complete roof replacement, new gutters/downspouts, new garage doors, a new back privacy fence, replacement light fixtures and shutters, significant exterior and back patio repairs, as well as interior repairs to the great room/foyer, dining room, kitchen, master suite, master bathroom. The Complainant’s estimate, as discussed further below, was well beyond the scope of the original damage claimed and included repairs and remodeling unrelated to the Hurricane Ian damage. In other words, Complainant’s estimate reflects an attempt to unjustly enrich herself by asking Olympus to pay for more work than is necessary to restore the property to its pre-loss condition, which is Olympus’ only obligation when it comes to the scope of work. JAEA subsequently prepared a proposed work authorization/scope of work for complete roof replacement. Later, around January 30, 2023, when JAEA called Insured to schedule another inspection of the property, she told them that she wanted to use Peck Roofing for the repair. When JAEA relayed this to Olympus, the adjuster explained to JAEA that because Olympus had invoked its option to repair, it would not allow another contractor to do the work and advised JAEA to contact the Insured’s public adjuster for scheduling. This instance began Insured’s failure to cooperate with Olympus’s option to repair in violation of her obligations under the Policy, which would continue indefinitely. Olympus and JAEA struggled to get the Insured to complete the necessary paperwork for the roof work to begin. On March 9, 2023, her public adjuster emailed Olympus a package of documents including their estimate for repairs and a sworn proof of loss, and requested payment be submitted as soon as possible “so the insureds may begin restoring their property.” This was the first occasion Insured submitted this additional, extensive interior and exterior damages as part of the instant claim. On March 21, 2023, Insured submitted directly to Olympus receipts and invoices for out-of-pocket expenses she incurred for power cleaning, portable generator gas, pump/pool repairs, water to refill the pool, landscaping repairs, and loss of food during power outage, totaling over $10,000. On May 17, 2023, Olympus sent a partial denial letter to Insured denying coverage for estimated damaged items claimed to the interior, as the photos from inspection showed no damage, and the Insured failed to submit any photos showing the claimed damage. The letter reiterated Olympus’ intention to continue with the roof replacement. In the months that followed, Insured failed to cooperate with JAEA and Olympus. Once Fall arrived, Insured advised Olympus that she did not want to proceed with the roof replacement until January 2024 due to hurricane season risks. Finally, Insured and JAEA scheduled a pack out of interior on May 31, 2024, work to begin June 1, and an estimated completion of the project on June 14, 2024. Propack sent its invoice to Olympus on June 4, 2024 requesting payment. On or about June 12, 2024, Olympus issued the following payments: Coverage A Payment to Rescom X for interior repairs: $17,291.50 Coverage A Payment to ProPack for storage/packing: $1,092.12 ProPack supplemented its invoice on June 27, 2024 for packing/moving items back in, requesting an additional $995.52. Around July 10, 2024, Olympus received a revised estimate from RescomX for $31,912.86 for interior repairs and $13,738.79 for lighting. On July 15, 2024, RescomX sent photos it received from Insured of further damages to the roof soffit, despite the original date of loss having occurred nearly two years prior to noticing this alleged damage. Eventually, Insured permitted JAEA to proceed with the roof replacement, which was completed in April 2021. Later, in September 2024, RescomX completed the other repairs to the property as set forth in its scope of work, bringing the property back to its pre-loss condition. The CRN discusses events that allegedly occurred in 2023 relating to communications and response times. There have been many developments since that time; namely, extensive repairs and a complete roof replacement. Specifically, the CRN does not mention that the damage addressed in Complainant’s estimate was beyond the scope of the original claim report and the original inspection – delaying Olympus’ ability to adjudicate the claim quickly. Indeed, even in 2024, the Complainant was supplementing her claim with additional damage (which turns out, had already been denied in 2022 due to policy exclusion for flooding) and content losses. The CRN also fails to address the fact that the landscaping invoice submitted as part of the supplemental claim was from June 2022 – before Hurricane Ian. The CRN includes allegations relating to Insured’s policy renewal, which they say is set to renew on September 4, 2024. They allege that Insured’s premium has been inflated to account for the money lost to Insured’s claim. They claim this is a common practice of Olympus, but does not provide any evidence. Without evidence to support the allegation, Olympus is unable to substantively respond. The CRN also alleges that the investigation was insufficient because Olympus’ representatives did not use a $40 moisture meter found on Amazon. It is unclear how this is relevant to the statutory allegations included in the CRN. Lastly, the CRN contains a cure with non-monetary conditions that are illusory and unascertainable due to the lack of specificity in the non-monetary demands. Instead, they make the following generalized demand: must “admit full coverage… tender full benefits owed.” This does not pass muster as a sufficient cure per the relevant statute. Since the CRN fails to acknowledge payments already made to vendors relating to the instant claim, and also fails to mention that repairs and a roof replacement have already been completed, Olympus is unable to ascertain what dollar amount is sought by the Complainant. The cure also states that the “full benefits owed to the Insured under the insurance contract,” but failed to include any language from the “contract” entitling the Insured to coverage for each category of damage submitted at some point in the claim handling process as alleged Ian damage. Furthermore, this directly contradicts Complainant’s allegation that there is no policy language relevant to the instant CRN, but instead it relies entirely on statutory language. In short, the CRN does not state with specificity the facts and circumstances giving rise to the violation and the specific policy language at issue. The inclusion of only conclusory statements without the requisite specificity renders the CRN facially deficient. Notwithstanding these deficiencies, Olympus expressly denies the allegations contained within the CRN. To conclude, the Complainant posits the aforementioned conduct and alleged statutory violations without stating specific supporting facts to each and every statutory violation alleged. Instead, the few facts stated in support of the alleged statutory violations are wholly conclusory in nature. A CRN must state the facts and circumstances that give rise to an alleged violation with specificity sufficient to allow an insurer to cure the alleged violation within the sixty-day statutory period. Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). Merely stating a litany of alleged wrongful conduct and statutory violations in a conclusory manner is insufficient without stating supporting facts specific to the insurance claim. On these grounds, the CRN is deficient on its face, and thus, in invalid. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). As previously discussed, the cure demanded in the CRN is deficient as it is entirely broad, ambiguous, vague, and improper. First and foremost, the cure demands that Olympus issue payment for “full benefits owed,” in addition to statutory interest and attorney’s fees and costs. This is the functional equivalent of “Pay me everything I’ve asked for.” Rousso v. Liberty Surplis Ins. Co., 2010 WL 736059, *5 (S.D. Fla. 2010). “Insurers are not required to pay any amount demanded by their insureds to avoid a bad-faith claim.” Id. (citing 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008)). However, regardless of its legitimacy, the CRN itself contains a cure in the form of an admission of liability and Olympus cannot even begin to attempt to cure the instant CRN on such unclear terms. The CRN does not include a specific amount nor does it include enough factual information for Olympus to reasonably ascertain the cure on its own through implication or inference. Given the cure, Olympus affirmatively asserts that the CRN is deficient and is otherwise unclear, ambiguous, deficient and deems the CRN invalid. The purpose of the statute’s requirement is to allow an insurer against which such a notice is filed to both understand and effectively be allowed to cure any purported violations. See Longpoint Condo. Assoc. v. Allstate Ins. Co., 2005 U.S. Dis. LEXIS 43917, *7 n. 3 (N.D. Fla. June 1, 2005) (citing Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1281-82 (Fla. 2000)). Since no other distinct basis for a cure has been set forth by the CRN, Olympus was not provided with a reasonable opportunity to purge any alleged violations. See Kafie v. NorthWestern Mut. Life Ins. Co., 834 F. Supp. 2d 1354, 1359 (S.D. Fla. 2011) (“In order to demonstrate good faith, ‘[t]he insurer must investigate the facts, [and] give fair consideration to a settlement offer that is not unreasonable under the facts…’”). Based on the facts provided, it is impossible for Olympus to satisfy the Complainant without significantly prejudicing itself, and therefore the CRN fails to provide a true and feasible cure method. Accordingly, the CRN 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 Florida Statute § 624.155. Similarly, for these reasons, the CRN fails. In sum, Olympus denies any failure to handle, investigate and properly adjust the claim, and all of the allegations contained in the CRN are hereby denied. To the extent that this response does not address each and every allegation of bad faith conduct made by the Complainant, Olympus hereby expressly denies any and all allegations of bad faith conduct or omission set forth in the CRN, and/or any alleged violation of Florida Statutes or any other statutory section set forth therein. Again, Olympus insists it has acted, at all times, in utmost good faith. Olympus expressly denies all allegations against it. The Complainant’s cure demand is indiscernible and as such Olympus is not given a fair opportunity to cure the CRN. First, the CRN fails to state the amount of damages which must be paid to cure the CRN. The CRN states “[Olympus] may cure this CRN by issuing payment for the indemnity damages to the insureds $1,639,000.00 (New Money) inclusive of any attorney’s fees and costs.” This is the functional equivalent of “Pay me everything I’ve asked for.” Rousso v. Liberty Surplis Ins. Co., 2010 WL 736059, *5 (S.D. Fla. 2010). “Insurers are not required to pay any amount demanded by their insureds to avoid a bad-faith claim.” Id. (citing 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008)). Moreover, the cure does not provide any basis for how the Complainant calculated this vague demand nor for Olympus to determine the amount of attorney’s fees and costs which it seeks. However, regardless of its legitimacy, the CRN itself contains a cure in the form of an admission of liability and Olympus cannot even begin to attempt to cure the instant CRN on such unclear terms. Given the cure, Olympus affirmatively asserts that the CRN is deficient. As outlined above, contrary to the allegations made by the CRN, Olympus maintains that it has acted fairly and honestly toward the Complainant, and any other person having an interest in the subject policy or assisting the Complainant in connection with the instant claim. Olympus consistently and promptly communicated with the Complainant and/or their agents throughout all stages of the investigation and conducted a thorough investigation in good faith. Olympus’s coverage determinations were made based upon its understanding of the claim’s facts, and with no bias towards the Insured Complainant. To the extent that the instant CRN is intended to address any other facts or circumstances which purport to establish additional coverage for the reported losses, the CRN provides insufficient identification of any such facts or circumstances and therefore prevents Olympus from addressing any other aspect herein. Notwithstanding, Olympus believes that the above facts demonstrate beyond dispute that it has at all times acted in good faith with regard to its investigation of the subject claim, and further believes that the facts provided to date fail to establish that it has not adjusted the reported loss in accordance with the express terms, provisions, limitations and exclusions contained within the policy. If we can provide any additional information, or be of any further assistance, please do not hesitate to contact us at your earliest convenience. Very truly yours, s/ Donald F. Winningham III, Esq. Donald F. Winningham III, Esq.
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