Civil Remedy Notice of Insurer Violations
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Filing Number:     795784
Filing Accepted:  12/6/2024
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Complainant
Last/Business Name *  
CHANDLER   First Name   KAREN
Street Address * 732 S OCRACOKE SQ SW.
City, State Zip * VERO BEACH, FL 32968
Email Address * KCHANDLER10@ICLOUD.COM
Complainant Type: * Insured
Insured
Last/Business Name*   CHANDLER   First Name   KAREN
Policy # * 3709819197 Claim #* 01000086830
Attorney
Attorney is Applicable
Last Name* STRUBLE First Name * MATTHEW Initial
Street Address* 325 FIFTH AVENUE, SUITE 103
City, State Zip* INDIALANTIC , FLORIDA 32903
Email Address * SERVICE@STRUBLECOHEN.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):* AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE RELATED TO THIS CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
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.
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)(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)(j) Altering or amending an insurance adjuster’s report without: (I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and (II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or (III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

There are no policy provision specifically at issue or in dispute, the policy provides coverage resulting from a pipe leak but First Protective Insurance Company D/B/A Frontline Insurance has failed to extend coverage for repairs needed for the insured property.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Insurer issued an insurance policy bearing policy number 3709819197 which insured the property located at 732 S Ocracoke SQ SW., Vero Beach, Florida 32968. The policy was in effect when the property sustained damage on or about October 28, 2022, when damage was caused by a pipe leak. First Protective Insurance Company D/B/A Frontline Insurance (“Insurer”) received notice of the claim for property damage resulting from a pipe leak, and related damages which occurred on or about October 28, 2022. The damage was reported to Insurer which assigned Claim Number 01000086830 to the claim and investigated the claim. On February 20, 2023, Insurer issued a complete denial of the claim and Insurer failed to retain the experts needed to perform the inspection and needed to address the damage at issue and determine the repairs needed to restore the property. Insurer has been provided with documents establishing that the claim is covered, despite this being apparent from the condition of the property alone. Insurer has failed to extend coverage for payments owed and has refused to attempt to settle the claim with its insured. Insurer’s delay in issuing payment is causing and will cause the insured to sustain extra-contractual damages not covered by the property, including loss of use and enjoyment of the property and related damages, costs associated with hiring adjusters and experts, among other damages and these uninsured damages would not have occurred but for the insurer ’s failure to timely issue payments owed. In this claim and as a business practice, insurer fails to retain experts needed to investigate claims, ignores evidence establishing coverage and avoids covered repairs to attempt to avoid issuing payments owed pursuant to the insurance policy. Insurer can cure these violations by attempting to settle the claim in good faith and issuing payment for the remaining contractual damages owed. As Insurer is aware, issuing payment for contractual damages owed will preclude recovery of extra-contractual damages already incurred, and that will be incurred, and the contractual damages should immediately be paid and be paid within 60 days from the date of this notice. Due to applicable Florida Statutes, and the insurance policy’s payment provisions, the payment issued should also include interest. If insurer contends there is somehow more information needed that was not already provided, it should immediately advise the insured’s attorney what information is needed. Insurer has been provided with information establishing that the claim is covered but has failed to extend coverage for the claim. Insurer’s denial of the claim and refusal to issue payment is a breach of the insurance policy. This notice is being given in order to perfect the right to pursue the civil remedy authorized by this section.
Comments
User Id Date Added Comment
npazos@bushross.com 02-04-2025 February 4, 2025 Via E-MAIL Matthew Struble, Esquire 325 Fifth Avenue, Suite 103 Indialantic, Florida 32903 Re: Insured: Karen Chandler Complainant: Karen Chandler DFS File Number: 795784 Date of Acceptance: December 6, 2024 Claim Number: 01000086830 Policy Number: 3709819197 Dear Mr. Struble, This is the formal response of First Protective Insurance Company d/b/a Frontline Insurance (“Frontline”), to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that you filed, ostensibly, on behalf of Karen Chandler. The Florida Department of Financial Services accepted the Purported Notice, only in form, on December 6, 2024. You filed the Purported Notice in connection with your client’s first-party insurance claim for property damage. It names Frontline and alleges “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” and other nebulous wrongdoing, all supposedly in violation of section “624.155(1)(b)(1), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(d), 626.9541(1)(i)(3)(f), 626.9541(1)(i)(3)(j),” Florida Statutes. The Purported Notice is a legal nullity for no less than five different reasons. First, section 624.155(3)(b)(3), Florida Statutes, requires: (b) The 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: . . . 3. The name of any individual involved in the violation. . . . In the space provided on the form, the Purported Notice names no one. Instead, the Purported Notice vaguely asserts “[a]nd all adjusters, supervisors, management and individuals associated with or retained by First Protective Insurance Company d/b/a Frontline Insurance related to this claim.” To be valid, it must “state with specificity. . . [t]he name of any individual involved in the violation.” Therefore, the Purported Notice fails to comply with section 624.155(3)(b)(3). Second, section 624.155(3)(b)(4), Florida Statutes, requires: (b) The 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: . . . 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. . . . Your client is not a third-party claimant. Hence, to be valid, the Purported Notice must “[r]eference [the] specific policy language that is relevant to the violation.” Here, no specific policy provisions are listed, and, the Purported Notice specifically states that “[t]here are no policy provisions specifically at issue or in dispute. …” Thus, it fails to comply with section 624.155(3)(b)(4). Third, section 624.155(3)(b)(2), Florida Statutes, requires: (b) The 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: . . . 2. The facts and circumstances giving rise to the violation. . . . The Purported Notice does supply a few supposed scant facts, and, supposed circumstances. But, it does not explain how the supposed scant “facts,” and, supposed “circumstances,” correspond to the alleged statutory violations. To be valid, the Purported Notice must “state with specificity . . . [t]he facts and circumstances giving rise to the violation.” Thus, it fails to comply with section 624.155(3)(b)(2). Fourth, the Purported Notice does not supply necessary information that would allow Frontline the opportunity to “cure” the alleged violations. The Supreme Court of Florida, in Talat Enter., Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000), announced that alleged statutory violations may be “cured,” in the context of a first-party insurance claim, by payment of “the contractual amount due the insured” within the 60 days following the acceptance of a valid notice. See also, Lane v. Westfield Ins. Co., 862 So. 2d 774 (Fla. 5th DCA 2003); Longpoint Condo. Ass’n v. Allstate Ins. Co., 2005 WL 1315810 (N.D.Fla. 2005); and, 316, Inc. v. Maryland Cas. Co., 2008 WL 3926863 (N.D.Fla. 2008). Here, the Purported Notice does not fulfill the intended statutory purpose of giving Frontline the chance to avoid litigation and resolve disputes. Lane, 862 So. 2d at 779. The Purported Noticed does not tell Frontline what specific contractual amount allegedly is due, and, that your client would accept as a “cure.” Fifth, instead of supplying necessary information that would allow Frontline the opportunity to “cure” the alleged violations, the Purported Notice demands that Frontline pay unspecified amounts for interest. This demand completely ignores the clear legal precedent that the only valid and legitimate “cure” of a valid notice is the insurer’s payment of “the amount owed pursuant to the express terms and conditions of the policy,” and, that the “cure” cannot be conditioned upon the payment of unspecified amounts of interest. Talat Enter., Inc., 753 So. 2d 1278. This improper demand deprives Frontline of a legitimate opportunity to “cure” the purported violations. The Purported Notice is nearly identical to the purported notice in Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D.Fla. 2010). There, District Court Judge Paul C. Huck properly noted: In short, the civil remedy notice reflects a shotgun-blast effort to hit a lot of targets with a single salvo. This approach is contrary to the purpose of the statute. The civil remedy notice must reflect a good-faith effort to inform the insurer of how it has fallen short of its obligations under the policy and what it can do to fix its shortcomings. The civil remedy notice is not the place for posturing or advocacy, and an effort to overstate a claim in a civil remedy notice may end up undermining it. Rousso, 2010 WL 7367059, *5. In an impermissible “shotgun-blast effort” condemned by Judge Huck in Rousso, the Purported Notice not only levels accusations which are boilerplate and overly broad, it makes representations that are undeniably false. Notwithstanding all of the deficiencies in, and the invalidity of, the Purported Notice, Frontline denies that it has done anything wrong. It specifically denies that it committed the acts asserted, or violated the statutes referenced, as alleged in the Purported Notice. Frontline did not breach any of the provisions of the policy. What is more, on January 28, 2025, a jury rendered a full defense verdict in favor of Frontline. The jury specifically found that Mrs. Chandler had violated the Fraud or Concealment provision of the insurance policy, thereby voiding coverage. (Copy of Jury Verdict attached as Exhibit “A”) If you have any questions or concerns with this response, or, regarding any other matter, please contact me, kindly in writing for the protection of all. Please be advised, by this letter, Frontline neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, Frontline hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. [Footnote 1: See also, § 627.426(1), Fla. Stat.; Rodrigo v. State Farm Florida Ins. Co., 144 So. 3d 690 (Fla. 4th DCA 2014); Exotic Furniture, Inc. v. Am. Cas. Co. of Reading, 173 So. 3d 894 (Fla. 2d DCA 2015); and, Universal Prop. & Cas. Ins. Co. v. Horne, 314 So. 3d 688 (Fla. 2d DCA 2021).] Sincerely, BUSH ROSS, P.A. Nicolas G. Pazos, Esquire cc: First Protective Insurance Company d/b/a Frontline Insurance [EXHIBIT A] IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT IN AND FOR INDIAN RIVER COUNTY, FLORIDA CASE NO: 31-2023-CA-000691 KAREN CHANDLER, Plaintiff, v. FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE, Defendant. _____________________________/ VERDICT FORM 1. Did Defendant prove by the greater weight of the evidence that Plaintiff violated the fraud or concealment provision of the policy? YES __[X]__ NO _______ If the answer is “yes,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “no,” proceed to Question Two. 2. Did Plaintiff prove by the greater weight of the evidence that the damage(s) claimed occurred during the policy period from August 2, 2022, through August 2, 2023? YES ______ NO _______ If the answer is “no,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “yes,” proceed to Question Three. 3. Did Defendant prove by the greater weight of the evidence that Plaintiff breached the contract by failing to provide a valid sworn proof of loss, as required by the policy? YES ______ NO _______ If the answer is “yes,” proceed to Question Four. If the answer is “no,” proceed to Question Five. 4. Did Plaintiff rebut the presumption that Defendant was prejudiced by the failure to provide a valid proof of loss to Defendant? YES ______ NO _______ If the answer is “no,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “yes,” proceed to Question Five. 5. Did Defendant prove by the greater weight of the evidence that the damages claimed were excluded and/or not compensable under the terms and conditions of the policy? YES ______ NO _______. If the answer is “yes,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “no,” proceed to Question Six. 6. Did Plaintiff prove by the greater weight of the evidence that Defendant breached particular term(s) of the policy? YES ______ NO _______ If the answer is “no,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “yes,” proceed to Question Seven. 7. Did Plaintiff prove by the greater weight of the evidence that she was damaged by Defendant’s breach of particular term(s) of the policy? YES ______ NO _______ If the answer is “no,” your verdict is for Defendant. Proceed no further, have the foreperson sign the verdict form, and return the verdict form to the bailiff. If the answer is “yes,” proceed to Question Eight. 8. The total amount of damages owed under the insurance policy as a result of Defendant’s breach of the particular term(s) of the policy is: $_________________ Please sign this verdict form and return it to the courtroom. SO SAY WE ALL this _____ day of January, 2025. _/s/____________________________________ Jury Foreperson
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