Civil Remedy Notice of Insurer Violations
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Filing Number:     795921
Filing Accepted:  12/9/2024
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Complainant
Last/Business Name *  
CANDELARIO COLON   First Name   MIGUEL
Street Address * 3266 REDDITT ROAD
City, State Zip * ORLANDO, FL 32822
Email Address * MIGUELCANDELARIO267@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   CANDELARIO COLON   First Name   MIGUEL
Policy # * ATH1074748 Claim #* AH141805
Attorney
Attorney is Applicable
Last Name* LOUIS First Name * PIERRE Initial
Street Address* 290 NW 165TH STREET, SUITE M-500
City, State Zip* MIAMI , FL 33169
Email Address * SERVICE@LOUISLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN TRADITIONS INSURANCE COMPANY
NAIC Company Code 12359
 
Name of individual responsible for violation (if any):* NA
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Governed by the cited authorities, the insurance policy (“Policy”) provides coverage on an “all risk” basis, which clearly, unambiguously and per well-settled Florida Supreme Court case law, requires the insurer to issue full payment for all covered losses and damages that arise during the Policy period as a consequence of a direct physical loss to property. Specifically, the Policy states, “[w]e insure against risk of direct loss to property described in Coverages A and B.” HO 00 03 04 91 pg. 7 of 18. The only exceptions being fraud, intentional damage, and/or the determination that a Policy exclusion or limitation applies. That said, and to lawfully assert any exclusion and/or limitation, the insurer must have a good faith basis to conclude that it can prove the application of the exception or privilege by a preponderance of the evidence gathered during its reasonable and prompt investigation and adjustment of the claim. At a very minimum, the insurer is required to issue full payment for any losses or damages for which such exceptions and/or limitations cannot be promptly verified per the evidentiary considerations referenced, and for an amount that corresponds with the actual cash value of the loss, or the amount necessary to perform repairs in relation to the losses or damages.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Complainants and Insureds, Miguel Candelario-Colon and Waleska Rivera-Quiles, (including their authorized representative, hereinafter “Complainants”), maintained a homeowner’s insurance policy (hereinafter “Policy”) with American Traditions Insurance Company (hereinafter “ATIC”), which generally and broadly provided coverage for any direct physical loss to the residential property, 3266 Redditt Rd., Orlando, FL 32822, (hereinafter “Property”), that occurred during the Policy period. On or about, September 29, 2022, while the Policy was in full force and effect, Complainants suffered a covered loss; to wit: hurricane causing interior and exterior damage to the property (hereafter the “loss”). The interior of the Complainants’ property sustained significant damage, due to a hurricane, to which loss ATIC assigned claim number AH141805. To date, ATIC has refused to remit all proceeds due and owing to the Complainants for their loss, despite Complainants’ compliance with their post loss obligations, and despite ATIC’s receipt of an estimate contradictory to its unilateral assessment of the loss’ value. On December 9, 2024, Complainants, with the assistance of counsel, filed a lawsuit against ATIC. Although hundreds of days have passed since the claims for losses and damages were presented for payment under the Policy, ATIC has refused to remit all proceeds due and owing to Complainants for their loss. Despite Complainants’ compliance with their post loss obligations, despite no express language in the policy excluding damage caused to the Complainants’ property by a hurricane, and despite ATIC receipt of an estimate of damages contradictory to its unilateral assessment of the loss. The Complainants have established that the loss occurred during the policy, but ATIC has failed to meet its burden that all of the damage is caused by a policy exclusion. ATIC has attempted, in bad faith, to close Complainants’ claim by denying coverage for the loss. Since this loss occurred, ATIC’s strategy has been to prolong and delay the fair adjustment of Complainants’ claim. As a result of the deficient adjustment of the loss, Complainants’ property has remained in a state of disrepair, while ATIC has collected a premium on a policy that was designed to protect insureds like the Complainants during their hour of need. Complainants are requesting that ATIC live up to the insurance contract in which ATIC promised to adjust all losses with its Complainants. This promise to adjust all losses with its Complainants is one that ATIC must undertake in good faith, which means it cannot unilaterally determine the value of its Complainants’ losses and remit payment to the Complainants that is grossly insufficient to cover the estimated damages, or, as in this instance, refuse to remit any payment Complainants under the Policy and deny coverage of the loss. Complainants placed their trust in ATIC and has paid all premiums due and owing, and in exchange for said premiums, they are asking ATIC to pay the damages that it agreed to cover when it issued the insurance policy. The work of adjusting insurance claims in Florida requires insurers to engage the public trust. ATIC has clearly breached this trust with respect to its deficient handling of Complainants’ claim. ATIC is obviously motivated by a desire to protect its own interest to the detriment of its complainants, and has pursued a course, which is only advantageous to itself. ATIC’s general business practice of willful, wanton, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claims has caused the Complainants to suffer further harm and extra-contractual damages that have accrued, and will continue to accrue. The stated misconduct is collectively referred to as “Bad Faith,” and the specific factual and/or legal considerations in relation thereto are further outlined below for its consideration in accordance with Fla. Stat. Sec. 624.155 and the cited legal authorities associated therewith. 1. ATIC insures hundreds of homes throughout the area where the Complainants’ residence is located. That said, it failed to institute the necessary policies, procedures, guidelines, protocol, personnel and contingencies in relation to fully, promptly and equitably indemnify its insureds who are impacted by hurricane losses. Consequently, insureds such as the Complainants were forced to fend for themselves to mitigate damages arising from ATIC’s Bad Faith; absorb the burden, expense, inconvenience and delay associated with an insurer who was not equipped (because it didn’t want to incur the expense associated therewith) to meet their contractual obligations; risk health hazards associated with the presence of moisture and/or mold due to ATIC’s failure to perform pursuant to the Policy; hire experts/professionals/counsel to force ATIC to abide by its fiduciary duty and avoid the consequential damages associated with ATIC’s failure to perform; etc. 2. ATIC knew that hurricane losses are of a nature that a thorough, nuanced and specialized investigation/adjustment of the claim needs to be promptly performed by qualified and prepared personnel in order to protect its insureds, satisfy its fiduciary duties and otherwise not engage in the Bad Faith claim handling practices at issue. That said to the detriment of its insureds and to maximize its financial interests, ATIC disregarded the obvious and known obligations by way of the following: a. Not developing, maintaining and/or instituting policies, procedures, protocol or guidelines to determine whether adjusters/personnel/vendors utilized to protect its insureds were qualified to duly assess the scope and/or value of the loss or damages. b. By way of the cited legal authorities and considerations, ATIC knew that it would have to promptly hire licensed contractors, uniquely qualified adjusters and/or engineers to fully, equitably and honestly assess the scope and/or value of the loss or damages suffered by its insureds. c. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel/vendors to perform moisture meter assessments throughout the insureds property to honestly assess the full extent of damages and losses suffered by its insureds. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. Although ATIC will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, it choose to avoid such expense for self-gain when it knows that the claim is covered. d. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel/vendors to perform thermal imaging assessments throughout the insured property to honestly assess the full extent of damages and losses suffered by its insureds. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. Once again though, and although ATIC will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determine coverage may be in dispute, it choose to avoid such expense for self-gain when it knows that the claim is covered. e. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize personnel/vendors to perform detailed, thorough, reliable and qualified assessments of any air conditioning component of the home in which moisture escaped. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. Once again though, and although ATIC will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, it choose to avoid such expense for self-gain when it knows the claim is covered under the Policy. f. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to retain a licensed mold assessor to determine whether there were concealed conditions within the home which necessitated mold remediation and the need for its insureds to take precautionary measures to preserve their physical health and property interests. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. Once again though, and although ATIC will implement such methods to establish a lack of coverage as it relates to a specific claim in which it determines coverage may be in dispute, it choose to avoid such expense for self-gain when it knows that the claim is covered. g. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to promptly issue payment for professional/qualified moisture assessments and remediation in order to, inter alia, avoid: the development of hazardous/toxic conditions within the residence; preclude the insured from suffering consequential and extra-contractual damages; the development of an uninhabitable residence and various risks that may develop; etc. Such practice is an accepted, reasonable, necessary and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. h. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to utilize a license mold remediator to consider a license mold assessor’s assessments and protocol in order to honestly determine the true scope and value of damages and/or the loss. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. i. By way of the cited legal authorities and considerations, ATIC knew that it would be in it insureds’ interests and its obligation under the insurance policy to carefully consider all policy terms that afford coverage for losses and damages as the obligation to pay was made reasonably clear, and thereafter utilize counsel when an adjuster is in doubt to advise them on a claim-by-claim basis whether in fact it is duly indemnifying its insureds. Such practice is a simple, inexpensive, efficient and industry wide accepted means of protecting its insureds, however, ATIC knows that it does not serve its financial interest since it will increase its financial obligations to insureds such as the Complainants. j. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to carefully evaluate on a claim-by-claim basis whether any amounts appropriated for “depreciation” are based on sufficient facts and data, reliable principles and methods, and/or the application of reliable principles and methods. ATIC knows that it is arbitrarily, capriciously, deceptively, willfully and wantonly appropriating depreciation without any claim/item specific consideration to justify same. In the aggregate, and unbeknownst to its insureds, this sham practice allows ATIC to unjustly avoid millions of dollars in benefits owed to its insureds who are consequently placed in a position wherein they are financially coerced into choosing whether to leave their home in a state of disrepair, or alternatively, searching for a handyman and non-licensed vendors to perform makeshift repairs which create secondary risks and potential damages that ATIC will deny coverage for when they arise. k. By way of the cited legal authorities and considerations, ATIC knew that it would be in its insureds’ interests and its obligation under the insurance policy to carefully evaluate on a claim by claim basis, and only after equitably and fully investigating/adjusting claim, the amounts owed to the insured for: overhead and profit associated with the insured’s reasonable need to utilize a general contractor; taxes associated with the repairs; permit costs associated with the repair; costs associated with various licensed trades that will be needed to effectuate the repairs; whether benefits are owed to the insured for loss of use and/or additional living expenses; personal property that may have been affected by toxic/mold/moisture conditions that developed in the home; costs associated with maintaining the continuity of the finish/appearance for pairs or sets such as cabinets, flooring, roof covering/tile/shingles, walls, ceilings; etc. l. By way of the cited legal authorities and considerations, ATIC knew that it had an obligation to ensure that software programs, data bases and adjusting practices utilized to estimate the scope and value of the loss were being utilized in form that: honestly and fully delineated the line item repairs or costs that needed to be performed; pricing corresponded with licensed professionals - as opposed to handyman or non-licensed professionals; accounted for consideration of actual expenditures incurred by the insureds or otherwise compensable expenses on a repair cost basis; etc. Ultimately, ATIC knows that the adjusting practices are guided to unlawfully depriving its insureds of benefits owed under the insurance policy, which in the aggregate, serves to maximize its profits to the detriment of its insureds. m. By way of the cited legal authorities and considerations, ATIC knew that it had an obligation to treat all insureds equally and honestly. However, and for its own financial interest, it will only start to fully consider its obligations as stated herein if the insured retains legal representation and pursues a legal action which exposes them to liabilities and costs associated with, inter alia, Fla. Stat. Secs. 627.428, 627.70152, 626.9373, 54.071 and 624.155. Even then, ATIC will withhold monies owed in an unjust effort to limit/delay its liabilities in relation to the statutory considerations and otherwise. n. By way of the cited legal authorities and considerations, and even after litigation ensues, ATIC knows that it has a continuous and ongoing duty to not engage in the Bad Faith conduct that is the subject of this Complaint. However, and to advance its own financial interest and avoid the liabilities pursuant to the above cited statutory authorities, ATIC will direct and utilize non-qualified counsel to delay the equitable and prompt payment of the claim via delay tactics and otherwise not implementing policies, procedures and/or guidelines to ensure that its duties are fulfilled during the course of litigation. Moreover, ATIC will insist upon the insured to fulfill its own obligations by imposing upon them the burden to establish their full entitlement to benefits for which it knows, or should know, are owed. o. By way of the cited legal authorities and considerations, ATIC knows that it has to assess the application of the policy deductible on a case-by-case basis and only after the claim is fully adjusted and investigated. This practice is necessary to protect the interests of the insured since, pursuant to binding precedent and the policy, the deductible is subject to being absorbed by losses and/or damages that exceed a limitation of coverage under a certain section of the policy. p. By way of the cited legal authorities and considerations, ATIC knows that it has a duty to duly assess whether benefits are owed to the insured in relation to the costs associated with removing and resetting personal property in relation to repairs and/or remediation work that needs to be performed. This duty is ignored by ATIC in order to maximize its own financial interests. q. By way of the cited legal authorities and considerations, ATIC knows that it has duty to issue payment for interest owed in relation to payments that were untimely issued per governing authorities. With that said, and to the detriment of the insured, it foregoes and/or delays such considerations in order to maximize its financial interests. r. Although ATIC knows that it has a duty to treat all insureds/assignees equally, it will consistently act inconsistently in relation to: the application of policy limits; the manner in which valuations and/or the scope of repair is assessed; the manner in which an insured is required to comply with policy conditions; the application and/or consideration of policy conditions and/or exclusions to bar coverage; the timing and/or circumstances upon which undisputed payments will be made pre-suit and post-suit; etc. The lack of consistency and organization ultimately serves to deprive insureds of their rights under a policy and otherwise creates an inherently dishonest, immoral, and unfair means of adjusting and investigating claim. s. ATIC knows that once the claim is fully and fairly investigated and adjusted, it then has to determine whether certain benefits are owed to the insured for the cost of engineering fees in relation to the construction/repairs that need to be performed. These costs are avoided by ATIC by engaging in the Bad Faith conduct described herein. t. ATIC’s Bad Faith conduct as described places the insured in a position of being forced into incurring expert fees to secure judicial relief by way of a legal action. Moreover, and as part of the Bad Faith practice, ATIC will await the insured’s post-suit retention of an expert to retain a designated/pre-disposed (due to financial biases) experts to further delay its obligations to its insureds and the consequential liabilities that the legislature has imposed to deter ATIC from engaging in the Bad Faith practice. 3. ATIC’s “toolbox” of Bad Faith claims handling practices as described above leaves insureds, the insured’s counsel, the ATIC’s counsel and even the judiciary guessing as to when and how ATIC will duly perform. The continuously vacillating positions and cherry picking of the described Bad Faith conduct not only serves to maximize ATIC’s prospective financial gains by being able to avoid paying benefits, it also serves to minimize ATIC’s lost adjusting expense as it see fit and to the invariable detriment of its insureds, the Complainants, and ultimately the tax paying citizens of this State that bear the expense of the judicial system which needs to unravel the tangled web created by ATIC. 4. To cure the above stated immoral, deceptive, unlawful and collectively defined general business practice of Bad Faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the Complainants’ interests being implemented, ATIC must perform as follows within 60 days of receiving this Complaint. a. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainants in the amount of $97,962.00, for indemnity; b. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainants; c. To the extent verified after duly performing under the policy pursuant to cited authorities and considerations, issuing any and all payments owed to the Complaint for interest on benefits that were untimely paid; d. To the extent verified after duly performing under the policy pursuant to cited authorities and considerations, confess judgment in relation to the pending breach of contract action brought forth by the Complainants; e. Stipulate to the Complainants’ and/or their counsel’s entitlement to attorney’s fees and costs pursuant to, inter alia, Fla. Stat. Sec. 627.428, 627.70152, 626.9373, and 54.071; f. After exercising good faith efforts to resolve the claim, issuing payment to the Complainants’ counsel for any attorney’s fees and/or costs that it cannot dispute are due and owing; g. As it relates to any claims/benefits that may remain in dispute or undetermined, fairly, honestly, specifically, meaningfully and substantively disclosing to the Complainants’ counsel the basis therefor and the means to promptly reach resolution; and/or h. Otherwise fulfilling any and all obligations under the policy that it knows, or should know, remain to be performed.
Comments
User Id Date Added Comment
Pierre@louislawgroup.com 01-27-2026 This CRN has been withdrawn.
cwahab@bressler.com 02-07-2025 Dear Mr. Louis: Please accept this response on behalf of American Traditions Insurance Company (hereinafter “American Traditions”) to the Civil Remedy Notice of Insurer Violations (hereinafter “CRN”) No. 795921, filed on behalf of Miguel Candelario Colon (hereinafter, the “Complainant” or the “Insured”), and accepted by the Florida Department of Financial Services on December 9, 2024. The Civil Remedy Notice (“CRN”) alleges that American Traditions 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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. • 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. • 626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial or for the offer of a compromise settlement. Please accept this as American Traditions’ response to the above-referenced CRN filed with the Department of Financial Services by the Complainant, Miguel Candelario Colon. To summarize the below, American Traditions 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; failing to adopt and implement standards for the proper investigation of claims; denying claims without conducting reasonable investigations based upon available information; and failing to promptly provide a reasonable explanation in writing to the insured for denial of a claim or for the offer of a compromise settlement, and states that it has at all times handled and adjusted the Complainant’s claim with utmost good faith. Simply put, American Traditions 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 American Traditions. Beyond American Traditions’ 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, American Traditions 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). Specifically, the instant CRN filing makes no attempt to respond to one of the Department’s prompts, and lists “NA” when asked to “Please identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in this notice.” The Complainant’s failure to comply with the baseline requisite form requirements, insofar as to entirely dismiss one of the Department’s mandated sections, is insufficient under Florida law to support any action for bad faith against American Traditions without speculation on its part. Due to this intentional withholding of mandated information, the CRN is facially deficient as it fails to comply 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 absolutely no effort to provide the relevant policy language. Instead, the Complainant provides its own interpretation of the Complainant’s position and the policy language associated with same. The Complainant, however, entirely fails respond to the Department’s prompt, again dismissing the requisite information needed to submit a valid CRN against an insurer. The only policy language which the Complainant includes in its irrelevant response to the prompt is, “[w]e insure against risk of direct loss to property described in Coverages A and B.” This sentence is the vaguest and least relevant one throughout the entire policy when “[r]eferenc[ing] to specific policy language that is relevant to the violation,” as mandated by the Department. 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 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. Additionally, the CRN fails to provide a complete description relating to the facts and/or circumstances which give rise to the alleged statutory violations, thus, prejudicing American Traditions from providing any meaningful or complete response. In summary, the CRN is hardly more than a recitation of a number of Florida statutory provisions, with minimal factual allegations in support of the conclusory statutory recitations. A Civil Remedy Notice 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). The instant CRN therefore fails to comply with the requirements of Florida Statute § 624.155(3), which requires that a CRN of insurer violation “state with specificity,” inter alia, the facts and circumstances giving rise to the violation and the “specific” language of the subject insurance policy that is relevant to the violation. The CRN fails to specify what was lacking in American Traditions’ investigation and fails to specify facts which support that its investigation was unfair or merits additional steps. To American Traditions’ knowledge, the instant claim for insurance benefits has been adjusted and/or repaired properly. The CRN further lacks any specificity, facts, or rationale which indicate that American Traditions’ coverage determination should have been different. Generally, the CRN lacks the requisite facts and/or specificity, as ruled on numerous times and cited to throughout this Response, to put American Traditions on notice as to the allegations against it. Moreover, the few facts that are stated in the CRN are contrary to the facts of the underlying claim or are at best misleading. The CRN states that “To date, [American Traditions] has refused to remit all proceeds due and owing to the Complainants for their loss, despite Complainants’ compliance with their post loss obligations, and despite [American Traditions’] receipt of an estimate contradictory to its unilateral assessment of the loss’ value.” However, these statements are untrue and unfounded. Also, the CRN claims that, “The Complainants have established that the loss occurred during the policy, but [American Traditions] has failed to meet its burden that all of the damage is caused by a policy exclusion.” Again, these statements are untrue and unfounded. Rather, American Traditions did inspect the property through an independent licensed field adjuster who found no evidence of storm-related damage, or any storm created opening throughout the subject property, and who did document evidence of damage caused by foot traffic on the roof, wear and tear, prior repairs, and damage caused by lack of maintenance. In written correspondence to the insured Complainant dated September 23, 2024, American Traditions explained the field adjuster’s observations and their resulting position as to the Complainant’s claim. That letter explained, “Unfortunately, because the direct force of a covered peril did not damage the exterior of your home causing an opening in your roof or wall allowing rain to enter, there is no coverage for this claim. Additionally, maintenance, wear and tear, mechanical damage, faulty, inadequate or defective repairs, and existing damage is specifically excluded by the policy.” The Complainant has provided no facts or evidence to support these allegations in support of the instant CRN or in any other context throughout the entirety of their claim. Despite the timing of the claim – the claim was reported to American Traditions nearly two years after the purported date of loss, American Traditions promptly and thoroughly investigated the subject claim and reached its coverage determination based upon its complete understanding of the facts. It is the Complainant who is not complying with the policy’s terms and who is continuing to make unsupported allegations in an attempt to deceive American Traditions to issue unwarranted payments and/or additional benefits. The subject CRN makes egregious and baseless allegations that “[American Traditions] has attempted, in bad faith, to close Complainants’ claim by denying coverage for the loss,” and “Since this loss occurred, [American Traditions’] strategy has been to prolong and delay the fair adjustment of Complainants’ claim.” These are serious blanket allegations made without one scintilla of factual evidence in support of any of such claims. As demonstrated by the facts outlined above, American Traditions diligently investigated the subject loss even after it was reported exceedingly late insofar as to warrant a plausible denial, repeatedly and routinely communicated with the insured Complainant, and acted accordingly based upon the facts it discovered throughout its investigation of the claim and according to the terms of the insurance contract which provides rights to both the Complainant as well as the insurer for scenarios just like this one. American Traditions’ investigation of the subject claim was swift and routine: American Traditions received a claim for damages, American Traditions sent a representative to inspect the property, American Traditions reviewed the representative’s observations and applied the relevant policy language thereto, ultimately resulting in a claim denial based on the relevant information. Had their investigation revealed that the insured Complainant’s property sustained covered damages, then the claim determination would have been different. The Complainant’s cure demand is indiscernible and as such American Traditions is not given a fair opportunity to cure the CRN. The CRN states: “… [t]o cure the above stated… [American Traditions] must perform as follows within 60 days of receiving this Complaint. a. Take corrective action… by way of… issuing payment for all benefits owed to the Complainants in the amount of $97.962.00, for indemnity; b. … issuing payment for all benefits owed to the Complainants; c. … issuing any and all payments owed to the Complaint for interest on benefits that were untimely paid; d. … confess judgement in relation to the pending breach of contract action brought forth by the Complainants; e. Stipulate to the Complainants’ and/or their counsel’s entitlement to attorney’s fees and costs… f. … issuing payment to the Complainants’ counsel for any attorney’s fees and/or costs… g. … disclosing to Complainaints’ counsel the basis therefor and the means to promptly reach resolution; and/or h. Otherwise fulfilling any and all obligations under the policy that it knows, or should know, remain to be performed.” 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 American Traditions cannot even begin to attempt to cure the instant CRN on such unclear terms. In addition to demanding “everything I’ve asked for,” the cure is unclear as to what it’s asking for beyond the stated monetary amount. The cure provides no basis for American Traditions to even attempt to calculate what it seeks when demanding several unclear payments and reimbursements to both the insured Complainant as well as their attorneys, and then interest purportedly owed on top of those indeterminate payments. Rather, the cure demand is merely an attempt to deceive American Traditions into issuing some ambiguous payment rather than defending itself against a threat of bad faith when no bad faith is remotely existent anywhere throughout the instant claim. Given the cure, American Traditions affirmatively asserts that the CRN is deficient. Since no other distinct basis for a cure has been set forth by the Civil Remedy Notice, American Traditions 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 American Traditions 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. As outlined above, contrary to the allegations made by the CRN, American Traditions sufficiently and diligently investigated the loss. American Traditions 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. American Traditions 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. 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 American Traditions from addressing any other aspect herein. Notwithstanding, American Traditions 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/ Chafic R. Wahab _ Chafic R. Wahab, 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