Civil Remedy Notice of Insurer Violations
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Filing Number:     795834
Filing Accepted:  12/9/2024
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Complainant
Last/Business Name *  
CORBIN GARCIA   First Name   LEONCIA
Street Address * 3024 SAN LEO DR
City, State Zip * ORLANDO, FL 32820
Email Address * RLA95@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   CORBIN GARCIA   First Name   LEONCIA
Policy # * 9045751348 Claim #* 01000116568
Attorney
Attorney is Applicable
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):* DERRICK COLLINS AND ALL OTHER FRONTLINE EMPLOYEES, REPRESENTATIVES, AGENTS, AND VENDORS WHO HANDLED THIS CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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.
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PERILS INSURED AGAINST Paragraph A.1. in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded in this policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Leoncia Corbin (“the insured”) is a homeowner insured with a policy issued by Frontline Insurance (“Frontline”). The insured property is located at 3024 San Leo Dr, Orlando, FL 32820. On February 4, 2024, a hailstorm caused extensive damage to the insured’s property, including numerous hail impacts to the roof, damage to other areas of the property, and an interior leak. Weather data supports the occurrence and extent of the storm-related damage. The insured promptly reported the claim and fully complied with all post-loss policy conditions. Despite the timely reporting and cooperation, Frontline failed to meet its statutory obligations under Florida law. Specifically, pursuant to Florida Statute § 627.70131(7)(a), insurers are required to pay or deny a claim within 60 days after receiving notice of the loss unless the failure to pay is due to factors beyond the insurer's control. In this case, Frontline took 83 days to make a coverage decision, exceeding the statutory timeframe by 23 days. Additionally, Frontline listed the incorrect loss location for the claim in the official denial letter, this has not been corrected as of this time. The failure to make a timely coverage decision left the insured unable to mitigate damages or restore the property to its pre-loss condition in a timely manner. The insured’s representative prepared a detailed estimate for repairs totaling $53,744.37, accurately reflecting the cost of addressing the hail damages. Frontline’s failure to timely evaluate and pay this claim has caused unnecessary delays and financial hardship. Florida Statute § 624.02 defines insurance as a contract in which one undertakes to indemnify another based on determinable contingencies. Timely payment is essential so that insureds can mitigate damages and restore their property to its pre-loss condition. By delaying its coverage decision and failing to act in good faith, Frontline has breached this fundamental duty. To cure this civil remedy notice and avoid further action, Frontline must acknowledge its statutory obligations, issue payment based on the insured’s estimate of $53,744.37. Failure to cure these violations will result in additional damages and potential legal action, including a lawsuit for bad faith.
Comments
User Id Date Added Comment
bkelley@wallenkelley.com 02-05-2025 February 5, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainant: Leoncia Corbin Garcia Address: 3024 San Leo Drive, Orlando, FL 32820 Email: RLA95@AOL.com Insured: Leoncia Corbin Garcia Policy #: 9045751348 Claim: 01000116568 Attorney: N/A Address: N/A DOI File #: 795834 Date of Acceptance: December 9, 2024 To Whom It May Concern: Please accept this as the response of First Protective Insurance Company ("Frontline") to the Civil Remedy Notice filed by the Complainant, Leoncia Corbin Garcia. Frontline’s response is specifically in regard to Claim 01000116568, which is related to a claim for the Insured’s property located at 3024 San Leo Drive, Orlando, FL 32820, which was insured by Frontline under Policy #9045751348 with effective dates of that Policy being January 04, 2024 through January 04, 2025 and was in effect on the alleged date of loss, February 4, 2024. Statement of Facts This matter arises from an alleged hailstorm claim at the Insured’s Orlando, Florida residence. For the convenience of the reader, I have broken down the Statement of Facts that will detail Frontline’s handling of the file. 1. Claim: 01000116568 The instant claim was reported to Frontline on August 24, 2024, more than six months after the alleged date of loss, as an alleged result of an alleged hailstorm with a date of loss of February 4, 2024. After receipt of the claim, Frontline assigned a claim number, 01000116568, and, on August 28, 2024, sent an acknowledgment letter to the Insured. In addition, Frontline provided a Homeowners’ Bill of Rights to inform the Insured of his rights under the Policy. Frontline also sent correspondence requesting an executed sworn proof of loss in an effort to ascertain the amount of damages being claimed and a third letter informing the Insured of his right to mediate the claim. The acknowledgement letter stated: “This communication is intended to confirm receipt of the above-captioned claim, filed under your Frontline insurance policy. Your claim will be handled by Frontline’s claim team, who will contact you to discuss the claims process, initiate an investigation and arrange for an inspection of the loss, as needed. As required by your policy conditions, please take the necessary steps to protect covered property from further damage. Additionally, please photograph, document, and save all receipts for any emergency or temporary repairs. Please also retain for our inspection all damaged property. Please be advised that in order to adequately investigate your claim, Frontline is requesting you complete, sign, date, notarize and return to Frontline the enclosed Proof of Loss and Claim for Damaged Property forms within sixty (60) days from the date of this letter. Frontline may also require you and/or any others to submit to an Examination Under Oath to discuss the circumstances of the claim(s). These requests are made pursuant to the policy conditions outlined in SECTION I – CONDITIONS … Duties After Loss., which we encourage you to carefully review in your Frontline policy of insurance. Thank you for insuring with Frontline. We appreciate your business and look forward to working together to solve this matter.” The next day, August 29, 2024, Frontline sent an email to the Insured introducing the handling adjuster, Derrick Collins, and requesting the Insured submit “home purchase contracts, pre-purchase inspection report and sellers’ disclosure,” as well as “any invoices, pictures, estimates, and other documents that relate to the claim.” The email was followed by a phone call the same day, where Frontline confirmed the date of loss and alleged damages with the Insured. On this call, the Insured stated that he contacted a roofer after seeing staining on the interior of the garage ceiling, and the roofer indicated hail damages. Next, Frontline’s Field Adjuster called and scheduled an inspection for September 4, 2024. The inspection occurred as planned when Field Adjuster, Kevin Mitchell, inspected the property on September 4, 2024. The Insured and his roofer were present for the inspection. Following the Field Adjuster’s inspection, on September 13, 2024, Frontline sent the Insured a Reservation of Rights letter, for the inspection raised questions as to whether Frontline was obligated to indemnify the Insured under the policy for the reported loss, mainly citing the fact that the first notice of loss is 206 days following the alleged weather event and that the alleged damages were possibly caused by seepage or normal wear and tear, which such losses are not covered under the policy. Specifically, the letter stated: “We received your claim on August 28, 2024, for storm related damages to your roof and exterior and discoloration on your garage ceiling with a reported date of loss of February 04, 2024. We are issuing this reservation of rights letter to you because there is a question as to whether Frontline is obligated to indemnify you under the policy for the reported loss. Frontline will evaluate every claim which is reported to us and make payment for those losses which are covered under your policy number 9045751348 with effective dates of January 04, 2024 to January 04, 2025; however, we must inform you that based on our preliminary evaluation, we have identified issues that may restrict, limit or exclude coverage, and we will be continuing our evaluation under a Reservation of Rights. Failure to comply with the following "Duties After Loss" may have jeopardized, or may result in prejudice to, Frontline's evaluation of this claim: • It is questionable whether you gave immediate notice of the loss to us or our agent as the claim was reported 206 days after the reported date of loss. In addition, the following policy exclusions may apply to the loss based on the facts provided to Frontline thus far: • It is questionable whether the loss was caused by repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor that occurs or develops over a period of time. • It is questionable whether the loss was caused by wear and tear, marring, deterioration. Your policy, HOMEOWNERS 3 - SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS - FLORIDA FIM 00 23 11 21 , states in relevant part: SECTION 1- PERILS INSURED AGAINST Paragraph A.1. in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we will not pay for, any “diminution in value.” 2. We do not insure, however, for loss: a. Excluded under Section I - Exclusions; c. Caused by: Paragraph 2.c.(5) is deleted and replaced by the following: (5) Repeated seepage or leakage of water or the presence or condensation of humidity, moisture, or vapor, that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. (6) Any of the following: (a) Wear and tear, marring, deterioration; (b) Mechanical breakdown, latent defect, inherent vice or any quality in property that causes it to damage or destroy itself; Paragraph 2.c.(6)(c) is deleted and replaced by the following: (c) Smog, rust, decay or other corrosion; (f) Settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings; SECTION I - EXCLUSIONS A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. 12. Repeated seepage or leakage of water or steam, or the presence or condensation of humidity moisture or vapor that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. B. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. 1. Weather conditions. However, this exclusion only applies if weather conditions contribute in any way with a cause or event excluded in A. above to produce the loss. 3. Faulty, inadequate or defective: b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; c. Materials used in repair, construction, renovation or remodeling; or d. Maintenance; of part or all of any property whether on or off the "residence premises". For the reasons set forth herein, and for any other good and valid reasons which may become known during our investigation of this claim, you are hereby notified that any action taken by Frontline or its authorized representatives to investigate the cause of loss, determine the amount of loss or damage, or attempt to adjust any claim arising out of the alleged loss shall not waive any of the terms or conditions of the policy of insurance described above. We request that you provide the following documents and information that are material to Frontline's evaluation of your claim: • Inspection: We have assigned an engineer to inspect the loss. We asked that you attend the inspection. • Recorded interview regarding loss details. • Rebuild Estimates/Invoices: Submit all related estimates, invoices, contracts, work authorizations, photos and supporting documentation from all repair firms and mitigation contractors. • Proof of Loss: Submit a Sworn Statement in Proof of Loss executed by all named insureds. Home Purchase Contracts, Pre-Purchase Inspection Report and Sellers' Disclosure: Provide the Real Estate Contract for Sale and Purchase including all addendums, Pre-purchase Home Inspection report including all color photos and Seller's Disclosure pertaining to your (2023) purchase of the insured location. Also note that your signed Sworn Proof of Loss was required to have been provided to us within 60 days after notification of the loss. Please provide the requested information through the web portal at www.frontlineinsurance.com (Main Menu > File A Claim > Upload documents to an existing claim). Please note the following Duties After Loss in your policy, HOMEOWNERS 3 - SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS -FLORIDA FIM 00 23 11 21, which states in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An “assignment agreement” does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either: 1. " Your" Duties After Loss a. Give immediate notice to us or our agent. Except for Reasonable Emergency Measures taken under Additional Coverage 2., there is no coverage for repairs that begin before the earlier of: (1) 72 hours after we are notified of the loss; (2) The time of loss inspection by us; (3) The time of other approval by us. If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the ear1ier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. b. To the degree reasonably possible, retain the damaged property and any photographs of the damaged property; and Allow us to inspect, subject to the paragraph above, all damaged property prior to its removal from the “residence premises” and make copies of the photographs. e. Protect the property from further damage The following must be performed: (1) Take reasonable emergency measures that are necessary to protect the covered property from further damage. as provided under Additional Coverage 2. A reasonable emergency measure under 5.a. above may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To the degree reasonably possible, the damaged property must be retained for us to inspect. (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person au1horized to act on our behalf, and providing, documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any “insured" seeking, coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. h. As often as we reasonably require: (1) Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under (2) Provide us with records and documents we request and permit us to make copies; (3) You, and any and all ~insureds;" and Any member,. officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity, who is an “insured”-must: (a) Submit to examination under oath and recorded statements at the location insured or other reasonable location designated by us, while not in the presence of each other or any other “insured;” (b) Provide government issued photo identification. If you do not possess government issued photo identification, a signed sworn statement be provided; and (c) Sign any transcript of the examinations under oath and recorded statements; At our request, the examinations will be conducted separately and not in the presence of any other persons except legal representation; Such examinations and recorded statements must either be in person or utilize video and audio technology, or both, as determined by us; (4) Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and (5) Any and all "insureds" must execute all authorizations for the release of information when requested by us, which we deem relevant to the investigation of your loss. (6) Allow us or any person authorized on our behalf: (a) Access to the "residence premises;'" (b) To inspect the "residence premises” and to inspect, subject to 2. above, all damaged property prior to its removal from the "residence premises;" and (c) To require an "insured" or their representative, or both if reasonably possible, to be present at our inspection and to assist in identifying the damaged property during the inspection; (7) At our request, identify the person or persons with knowledge of how the loss occurred and the extent of damage; (8) For losses covered under Coverage A and B, allow us to reinspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any “assignees(s)" or third parties were completed, or following a supplemental or re-opened claim. i. Submit to us, within 60 days after the loss, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of the loss: (3) The interest of all “insureds” ”assignees” if any, and all others in the property involved and all liens on the property; (4) Other insurance which may cover the loss; (5) Changes in title or occupancy of the property during the term of the policy; (6) Specifications of damage to the dwelling and other structures, including; (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; j. Produce any updates to the documents and information described above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) As this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. The duties above apply regardless of whether you, an "insured" seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (877) 744-5224 ext. 1338. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible. Frontline does not intend, by this letter, to waive any policy defense in addition to those stated above, but specifically reserves its right to assert such additional policy defenses at any time. In the interim should you have any questions, please feel free to contact me at 321-249-1338.” On September 18, 2024, Frontline received a letter of representation from Florida Public Insurance Adjusters stating that Public Adjuster David Djukic would be representing the Insured for the claim. This letter requested the file and other documents from Frontline, specifically, a certified copy of the policy. The next day, September 19, 2024, Frontline responded that it received a letter of representation with an email and accompanying letter. It also advised the Public Adjuster that an engineer would be retained to inspect the property shortly. The letter states in full: “This serves to acknowledge our receipt of your Letter of Representation between our policyholder Leoncia Corbin Garcia and Florida Public Insurance Adjusters. These documents were submitted and addressed to Frontline Insurance and received September 18, 2024. As we continue to investigate the claim, we look forward to working with you to discuss the facts and circumstances to determine if the policy covers the loss. Should you have any questions or concerns please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at (877) 744-5224 ext. 1338. Should I not be available when you call, please leave me a detailed message and I will return your call as soon as possible.” As there were questions about the cause and origin of the damages to the house, an engineer was assigned and an inspection date of September 24, 2024 was agreed to by all parties. The engineer inspection took place as scheduled when Serguei Diaz Hernandez, P.E. from Stephens Engineering Consultants inspected the property on September 24, 2024. The Insured and his Public Adjuster were present for the inspection. Following a thorough investigation of the interior and exterior of the property, the engineer came to the following conclusions: • “Evidence of up to approximately 1/4-inch-wide hailfall was observed on the vulnerable elements on the property (detailed herein). • Stephens's inspection revealed no punctures, visible depressions, or randomly patterned, roughly circular areas of missing granules consistent with hailfall in the roofing of the house. • The areas of missing granules on the shingles on all roof slopes over the house were consistent with historical and ongoing heat blisters as well as footfall damage, expected aging and granule bonding failure. • Any hail that had recently and/or historically fallen on the subject property was of insufficient mass and velocity to have caused damage to the roofing. • Stephens's inspection of the house roof revealed no creased, torn, or missing shingles consistent with wind-related damage. • The reported wind speeds on the date of loss were insufficient to have caused wind damage to the roofing. • The moisture-stained wall and ceiling on the front-right corner in the garage was an historical and ongoing condition due to moisture intrusion through hidden deficiencies in the roof-to-wall interface. The condition has been exacerbated by the observed free discharging gutter downspout above. The moisture intrusion was not the result of a storm-created opening in the roofing.” Frontline received the engineer report on October 24, 2024, and altered the Public Adjuster. In an October 31, 2024, email to the Public Adjuster, Frontline also requested a recorded statement pursuant to the policy. The Desk Adjuster provided multiple dates and times he was available. The recorded statement then occurred on November 8, 2024, via telephone. There, the Insured stated the property’s address and when he purchased it. The roof’s age was also discussed, but the Insured wasn’t completely certain, so an estimate was provided. He confirmed that he made no repairs to the roof, neither before nor after the alleged date of loss, before talking about the date of loss. He said he was home that day and claims to have heard impact on the roof and could see marble to golf ball sized hail when he looked outside. He said the hail continued for about 5 minutes. Finally, he claimed the reason for the delay in reporting the claim was because in May 2024, when a roofer originally advised the Insured of hail damage, the Insured did not act until July when he saw a build up of materials on his roof and asked the roofer to come back. Following the recorded statement, on November 14, 2024, Frontline sent an email following up on its request that the Insured send an estimate and sworn proof of loss. Following a lack of response, on November 19, 2024, Frontline again called the Public Adjuster to tell him the claim was being denied. The call was accompanied by a coverage decision letter that advised the Insured that:: “This letter confirms the results of our evaluation and consideration of the applicable coverages, terms, conditions, exceptions, limitations, and exclusions related to your claim. Frontline evaluated the claim you reported on August 28, 2024, for wind and hail damage to the roof and discoloration on the interior of garage. As part of that evaluation, Frontline inspected the insured location on September 04, 2024, the field adjuster was unable to confirm if the residence sustained damage from wind or hail or the cause and origin or duration of interior leak in garage. Frontline then sent out an engineer who inspected the property on September 24, 2024. The engineer opined there were no punctures, visible depressions, or randomly patterned, roughly circular areas of missing granules consistent with hailfall in the roofing of the house. Missing granules found on all slopes of the roof were consistent with historical and ongoing heat blisters as well as footfall damages, expected aging and granule bonding failure. The engineer also opined there was no creased, torn, or missing shingles on the roof that was consistent with wind damage. The engineer did find 1 /4-inch-wide spatter marks consistent with hailfall on the off-ridge metal roof vents on the back facing roof slope with no corresponding indentations (cosmetic; not hail damage). Moisture intrusion found in the garage was found to be historical and ongoing. The moisture intrusion came through hidden deficiencies in the roof-to-wall interface. The condition was exacerbated by the observed free discharging gutter downspout above. The moisture intrusion was not the result of a storm-created opening on the roof. This claim was presented to Frontline Insurance ("Frontline") on August 28, 2024, more than two hundred and six (206) days after the reported date of loss. The loss report included a claim for wind and hail damage to the roof and discoloration on the interior of garage. Failure to notify Frontline of the loss as soon as possible prejudiced Frontline's ability to independently confirm the cause, origin, date of loss and duration of the reported damages. Your policy does not provide coverage for damages due to repeated seepage or leakage of moisture starting from the first day and instant the repeated seepage or leak occurs. Such loss is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss. In addition, your policy excludes damages resulting from wear and tear, marring, and deterioration, poor workmanship and construction deficiencies, and deferred maintenance related damages. As such, based upon the terms and conditions of your insurance policy, and the documentation received to date, Frontline must respectfully deny your claim in its entirety. Your policy, HOMEOWNERS 3 - SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS - FLORIDA FIM 00 23 11 21 , states in relevant part: SECTION 1- PERILS INSURED AGAINST Paragraph A.1. in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we will not pay for, any “diminution in value.” 2. We do not insure, however, for loss: a. Excluded under Section I - Exclusions; c. Caused by: Paragraph 2.c.(5) is deleted and replaced by the following: (5) Repeated seepage or leakage of water or the presence or condensation of humidity, moisture, or vapor, that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. (6) Any of the following: (a) Wear and tear, marring, deterioration; (b) Mechanical breakdown, latent defect, inherent vice or any quality in property that causes it to damage or destroy itself; Paragraph 2.c.(6)(c) is deleted and replaced by the following: (c) Smog, rust, decay or other corrosion; (f) Settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings; SECTION I - EXCLUSIONS A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. 12. Repeated seepage or leakage of water or steam, or the presence or condensation of humidity moisture or vapor that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. B. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. 1. Weather conditions. However, this exclusion only applies if weather conditions contribute in any way with a cause or event excluded in A. above to produce the loss. 3. Faulty, inadequate or defective: b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; c. Materials used in repair, construction, renovation or remodeling; or d. Maintenance; of part or all of any property whether on or off the "residence premises". SECTION I - PROPERTY COVERAGES Your policy with Frontline form HO 00 03 05 11 HOMEOWNERS - 3 SPECIAL FORM is further modified by your LIMITED FUNGI, WET OR DRY ROT, OR BACTERIA COVERAGE – Florida FIM 00 13 06 21. ADDITIONAL COVERAGES The following Additional Coverage 13. is added: 13. Fungi Wet Or Dry Rot Or Bacteria b. The coverage described in 13.a. only applies when such loss or costs are a result of a Peril Insured Against that occurs during the policy period and only if all reasonable means were used to save and preserve the property from further damage at and after the time the Peril lnsured Against occurred. SECTION I-PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES Paragraph 2.c.(5) is deleted and replaced by the following: (5) Repeated seepage or leakage of water or the presence or condensation of humidity, moisture, or vapor, that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. Paragraph 2.c.(6)(c) is deleted and replaced by the following: (c) Smog, rust, decay or other corrosion Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert additional policy defenses at any time. Please note the following Duties After Loss in your policy, HOMEOWNERS 3 - SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS -FLORIDA FIM 00 23 11 21, which states in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An “assignment agreement” does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either: 1. " Your" Duties After Loss a. Give immediate notice to us or our agent. Except for Reasonable Emergency Measures taken under Additional Coverage 2., there is no coverage for repairs that begin before the earlier of: (1) 72 hours after we are notified of the loss; (2) The time of loss inspection by us; (3) The time of other approval by us. If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the ear1ier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. b. To the degree reasonably possible, retain the damaged property and any photographs of the damaged property; and Allow us to inspect, subject to the paragraph above, all damaged property prior to its removal from the “residence premises” and make copies of the photographs. e. Protect the property from further damage The following must be performed: (1) Take reasonable emergency measures that are necessary to protect the covered property from further damage. as provided under Additional Coverage 2. A reasonable emergency measure under 5.a. above may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To the degree reasonably possible, the damaged property must be retained for us to inspect. (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing, documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any “insured" seeking, coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. h. As often as we reasonably require: (1) Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under (2) Provide us with records and documents we request and permit us to make copies; (3) You, and any and all ~insureds;" and Any member,. officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity, who is an “insured”-must: (a) Submit to examination under oath and recorded statements at the location insured or other reasonable location designated by us, while not in the presence of each other or any other “insured;” (b) Provide government issued photo identification. If you do not possess government issued photo identification, a signed sworn statement be provided; and (c) Sign any transcript of the examinations under oath and recorded statements; At our request, the examinations will be conducted separately and not in the presence of any other persons except legal representation; Such examinations and recorded statements must either be in person or utilize video and audio technology, or both, as determined by us; (4) Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and (5) Any and all "insureds" must execute all authorizations for the release of information when requested by us, which we deem relevant to the investigation of your loss. (6) Allow us or any person authorized on our behalf: (a) Access to the "residence premises;'" (b) To inspect the "residence premises” and to inspect, subject to 2. above, all damaged property prior to its removal from the "residence premises;" and (c) To require an "insured" or their representative, or both if reasonably possible, to be present at our inspection and to assist in identifying the damaged property during the inspection; (7) At our request, identify the person or persons with knowledge of how the loss occurred and the extent of damage; (8) For losses covered under Coverage A and B, allow us to reinspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any “assignees(s)" or third parties were completed, or following a supplemental or re-opened claim. i. Submit to us, within 60 days after the loss, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of the loss: (3) The interest of all “insureds” ”assignees” if any, and all others in the property involved and all liens on the property; (4) Other insurance which may cover the loss; (5) Changes in title or occupancy of the property during the term of the policy; (6) Specifications of damage to the dwelling and other structures, including; (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; j. Produce any updates to the documents and information described above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) As this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. The duties above apply regardless of whether you, an "insured" seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert additional policy defenses at any time. WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at (321) 249-1338. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” This denial letter was also sent via email to the Insured’s public adjuster as well. Moreover, after a request for the engineer’s report was made by the public adjuster, it was provided on November 21, 2024. On December 6, 2024, the Insured submitted a sworn proof of loss to Frontline. That same day, Frontline responded with the following letter: “We acknowledge receipt of your Sworn Statement in Proof of Loss ("Proof of Loss") December 06, 2024. However, the Proof of Loss fails to comply with the requirements set forth in your policy as follows: 1. The Proof of Loss was not submitted within 60 days after the loss. 2. The Proof of Loss was not signed by all named insureds. 3. You have not provided the interest of all insureds, assignees if any, and all others in the property involved and all liens on the property. 4. You have not stated if there is other insurance which may cover the loss. 5. You have not provided specifications of damage to the dwelling and other structures including detailed descriptions of the damage to the property, repair estimates which show the extent of damage to each item or property, estimated amounts to repair or replace each item of property, amount(s) of payment made for any temporary or permanent repairs and, to the extent it is reasonable and practical to obtain, photographs and other supporting documentation. Your policy, HOMEOWNERS 3 - SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS - FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An "assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an “insured" seeking coverage, or a representative of either: i. Submit to us, within 60 days after the loss, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of the loss; (3) The interest of all “insureds,” "assignees" if any, and all others in the property involved and all liens on the property; (4) Other insurance which may cover the loss; (5) Changes in title or occupancy of the property during the term of the policy; (6) Specifications of damage to the dwelling and other structures, including; (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; (7) The inventory of damaged personal property described in C.7. above; The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Additionally, based upon the terms and conditions of your insurance policy, Frontline denied your claim for wind-hail damages to the roof. Please refer to the enclosed letter dated November 19, 2024, while coverage has been denied, Frontline will evaluate and consider any new information that you submit in support of your claim. Please feel free to submit new information for our consideration through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents). Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at (877) 744-5224 ext. 1338. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” Seemingly in response to same, the Insured filed this Civil Remedy Notice on December 9, 2024. 2. Nature of the Complainant's Civil Remedy Complaint In the Civil Remedy Notice, the Complainant alleges Frontline violated: Section 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. Section 624.155(1)(i)(3)(b)—Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Section 624.155(1)(i)(3)(c)—Failing to acknowledge and act promptly upon communications with respect to claims. However, in the body of its CRN, the Complainant goes further and states: “Despite the timely reporting and cooperation, Frontline failed to meet its statutory obligations under Florida law. Specifically, pursuant to Florida Statute § 627.70131(7)(a), insurers are required to pay or deny a claim within 60 days after receiving notice of the loss unless the failure to pay is due to factors beyond the insurer's control. In this case, Frontline took 83 days to make a coverage decision, exceeding the statutory timeframe by 23 days. Additionally, Frontline listed the incorrect loss location for the claim in the official denial letter, this has not been corrected as of this time.” These accusations are unfair given the nature of the facts and damage surrounding this claim. Here, the claim was processed, the Insured’s property was inspected on multiple occasions, numerous requests for information and a sworn proof of loss were sent, and Frontline received virtually nothing in response to same that would assist it in coming to a coverage determination, nor did Frontline’s own investigations lead to the discovery of covered damages. Specifically, Frontline asserts that it did act in good faith, fairly, and honestly towards the Insured by taking all necessary steps to decide coverage all while keeping in constant communication with the Insured. Next, Frontline asserts that it did not misrepresent facts or policy provisions, in fact, Frontline, in almost all of its communications with the Insured, used exact, photocopied pages of the policy when asserting its rights. Third, Frontline asserts that it always acted promptly, never more than a few days, and often following up with the Insured when the Insured did not respond promptly to Frontline’s communications. Finally, Frontline asserts that the only delay was attributed to the Insured’s delay in reporting the loss and responding to Frontline’s communications and requests, as required by the policy. Moreover, the Complainant has failed to ask for a proper cure of their Civil Remedy Notice. Instead, they have asked for the following cure(s): “To cure this civil remedy notice and avoid further action, Frontline must acknowledge its statutory obligations, issue payment based on the insured’s estimate of $53,744.37. Failure to cure these violations will result in additional damages and potential legal action, including a lawsuit for bad faith.” This is not a cure request, but rather an improper threat to sue, including a suit for bad faith, where there is no basis for it. Additionally, Frontline does acknowledge its statutory obligations, however, as explained above, it has not only acknowledged but has followed those obligations at every moment. Finally, requesting an estimate is not a definite, final cure, and thus, does not save the Insured’s improper cure plan. The Insured has failed to list the FINAL amount for all damages, and thus, the Insurer would be unable to cure the alleged violation. Conclusion In conclusion, Frontline asserts that there was no misconduct in the adjustment of the Insured’s claim. As can be seen from the above, Frontline has credible evidence to support its belief that the claim was properly adjusted. The claim was processed, the Insured’s property was inspected on multiple occasions, letters requesting documentation and information were sent (often without a response), and Frontline has timely determined that there are no covered damages, thus, denial of coverage is proper. Frontline has spent considerable time and resources on the investigation of this matter and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Insured’s claim and unfairly paints Frontline in a negative light. Moreover, the lack of documentation provided by the Insured/Complainant and their counsel during the pendency of this cure period (as well as the lack of specificity within the Civil Remedy Notice) has not given Frontline the ability to conclude its adjustment or “cure” the allegations contained herein. Sincerely, Lee Alhanti Lee Alhanti, Esq. On Behalf of First Protective Insurance Company
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