Civil Remedy Notice of Insurer Violations
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Filing Number:     796247
Filing Accepted:  12/10/2024
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Complainant
Last/Business Name *  
WOODS   First Name   HARRISON AND JEANNETTE
Street Address * 425 CAPEADOR ST NW
City, State Zip * PALM BAY, FL 32907
Email Address * N/A
Complainant Type: * Insured
Insured
Last/Business Name*   WOODS   First Name   HARRISON AND JEANNETTE
Policy # * SOIH4451163 Claim #* 55396
Attorney
Attorney is Applicable
Last Name* ELIMELECH First Name * REBECCA Initial R
Street Address* 1500 N.E. 162ND ST.
City, State Zip* MIAMI , FLORIDA 33162
Email Address * RELIMELECH@ILGPA.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SOUTHERN OAK INSURANCE COMPANY
NAIC Company Code 12247
 
Name of individual responsible for violation (if any):* N/A
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(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 – PROPERTY COVERAGES COVERAGE A – Dwelling We cover: 1. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and 2. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises." COVERAGE B – Other Structures We cover other structures on the "residence premises" set apart from the dwelling by clear space. This includes structures connected to the dwelling by only a fence, utility line, or similar connection. SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Harrison and Jeannette Woods (hereinafter the “Insureds”), paid for a policy of insurance with Southern Oak Insurance Company (hereinafter, “Insurer”) bearing policy number SOIH4451163 (the “Policy”). The Policy provides coverage for damage to the Insureds’ property located at 425 Capeador St NW, Palm Bay, Florida 32907 (the “Property”), including the significant damage that occurred as a result of Hurricane Ian on or about September 28, 2022 (the “loss”). Specifically, the Insureds’ Property sustained substantial wind damage to the fence, porch screen, sliding door screen and roof. The Insureds promptly reported their claim to the Insurer. On November 27, 2022, the Insurer sent a letter to the Insureds advising that the damages to the Property totaled $5,976.74 for dwelling and $2,118.02 for appurtenant structures. However, the Insurer refuses to resolve the Insureds’ claim and pay for all damages to the Property. In the Insurer’s letter dated November 27, 2022, the Insurer denied coverage for the garage door, stucco, soffit/fascia, and some areas of the fence based on their investigation alleging that these damages were caused by wear and tear and cracking. The Insureds subsequently contacted the Insurance Litigation Group, P.A. (hereafter, ILGPA), who is conducting a thorough inspection of the property and compiling an estimate of damages. ILGPA, on behalf of the Insureds, will forward said estimate which will fully detail the Insureds’ damages. The Insurer’s conduct is in bad faith and violates Florida’s statutes concerning the adjustment of insurance claims. First, Florida Statute § 624.155(1)(B)(1) requires good faith in the settlement of claims. The Insurer is in violation of this Statute for failing to provide a reasonable repair estimate. Repairs have not started as the cost of a new roof exceeds the claim amount. What is more, the Insurer violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle the claim, when the obligation to settle the claim became reasonably clear. Again, the Insurer failed to make a good faith offer to settle this claim and failed to account for the full scope of the damages. The Insurer partially denied coverage and underpaid the Insureds’ claim. They are obligated to provide coverage for all damages to the Insureds’ Property, and not attempt to resolve this claim with lowball offers. Additionally, the Insurer’s conduct violates Florida Statute § 626.9541, which prohibits unfair settlement practices. More specifically, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. Further, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly with the Insureds and its counsel. As mentioned above, the Insurer failed to account for the full scope of the damages, and has additionally underpaid the Insureds for their loss, delaying the resolution of this claim. Had the Insurer accounted for the whole scope of the damages and fully paid the amount due and owing for the loss, it would have immediately settled this claim on a fair and reasonable basis and provided full coverage to its Insureds. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: (1) create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations and avoid this from occurring in the future; (2) immediately tender all insurance proceeds due and owing its Insureds under the Policy (less the deductible and any prior payments), plus all statutory interest; (3) act fairly and honestly towards its Insureds and with due regard for their interests in attempting to settle their Insureds’ claim; (4) hold the claim open in the event that its errors and delay does or may cause the Insureds to suffer either further loss and/or damage; and, (5) stipulate to the Insureds’ entitlement to attorney’s fees and court costs pursuant to Florida Statutes §§ 627.428 and 626.9373. Acknowledgment This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statutes section 624.155, should Southern Oak Insurance Company fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
Comments
User Id Date Added Comment
relimelech@ilgpa.com 03-03-2026 This Civil Remedy Notice is hereby withdrawn.
jshanholtzer@tlsslaw.com 01-24-2025 Ryan S. Parker, Esquire, on behalf of Southern Oak Insurance Company, responded to the Civil Remedy Notice in letter format on January 24, 2025 via electronic mail to: Harrison and Jeannette Woods c/o Rebecca R. Elimelech, Esq. 1500 N.E. 162nd Street Miami, Florida 33162 relimelech@ilgpa.com RE: Insureds : Harrison and Jeannette Woods Claim Number : 55396 Date of Loss : September 28, 2022 Policy Number : SOIH4451163 DFS File Number : 796247 Filing Accepted Date : December 10, 2024 Dear Ms. Elimelech, This firm has the pleasure of representing Southern Oak Insurance Company (“Southern Oak”) in connection with the above-referenced matter. Southern Oak is in receipt of the above-referenced Civil Remedy Notice of Insurer Violations (“Notice”) filed against Southern Oak Insurance Company (“Southern Oak”). The Florida Department of Financial Services assigned Filing Number 796247 and an acceptance date of December 10, 2024. Southern Oak’s response to the Notice will follow. The Notice alleges “Claim Delay,” “Unsatisfactory Settlement Offer, and “Unfair Trade Practice,” as well as violations of Sections 624.155(1)(b)(1) & (3), and 626.9541(1)(i)(3)(a), & (c), Florida Statutes. The allegations contained in the Notice constitute generic, boilerplate accusations against Southern Oak, are wholly without merit, and lack sufficient legal and factual support. Accordingly, Southern Oak denies each and every alleged violation of Florida law. As an initial matter, the Notice is deficient because it fails to comply with the requirements of the Florida Statutes. Section 624.155(3)(b), Florida Statutes, requires that a Civil Remedy Notice “state with specificity” the statutory provisions allegedly violated, the facts and circumstances giving rise to the violation, the name of any individual involved in the violation, and the specific policy language relevant to the violation. Rather than include the specifics required by Statute, when asked to identify the specific policy language relevant to the alleged violations, the Notice references the insuring clause and property coverages sections for Coverages A and B. The Notice does not explain how Southern Oak failed to comply with the specific terms of the policy with specific factual support or specific language in the policy pertaining to the alleged incident. The failure to include the information required by Florida Statute §624.155(3)(b) renders the Notice defective. See Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021); and Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136 (Fla. 5th DCA 2022). Additionally, the Civil Remedy Notice is defective as a matter of law. As stated by the Florida Supreme Court, the purpose of a Civil Remedy Notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). The purpose of Fla. Stat. §624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003). Further, a Civil Remedy Notice must be sufficiently specific to provide the insurer with an opportunity to cure the alleged violations. This would include i) identifying the specific policy provision(s) at issue, ii) citing specific language of the statutory provision(s) the insurer allegedly violated, and iii) specifically identifying what actions the insurer must take to remedy the alleged violations. Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. Aug. 13, 2010); Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299-1300 (S.D. Fla. 2008). Further, the “facts and circumstances” section of the Notice is not in compliance with Florida law. Contrary to the requirements of Florida Statutes, the Notice makes false, boilerplate accusations, and does not contain any specific facts supporting the violations alleged. For example, the Notice alleges that Southern Oak violated Florida Statute §626.9541(1)(i)(3)(a) – Failing to adopt and implement standards for the proper investigation of claims. However, the body of the Notice does not explain how Southern Oak allegedly failed to properly investigate the claim. Instead, the Notice includes vague allegations without any factual support. Similarly, the Notice does not provide factual support for various allegations listed above, including but not limited to how Southern Oak’s investigation was conducted in bad faith or how Southern Oak has engaged in unfair trade practices. As more fully discussed below, the allegations contained within the Notice are untrue, and the Notice contains no facts to support them. Contrary to the allegations in the Notice, Southern Oak acted promptly, responsibly, and in good faith at every opportunity in connection with this claim. The failure to provide any factual support for the alleged violations of Florida law renders the Notice deficient and in violation of Florida Statute §624.155(3)(b). A summary of the pertinent facts regarding the investigation and handling of this claim will follow. On or about October 25, 2022, Southern Oak was notified of a claim for Hurricane damage at the property located at 425 Capeador Street NW, Palm Bay, Florida 32907, with an alleged date of loss of September 28, 2022. It was reported that shingles were missing and RRCA (Roofing & Reconstruction Contractors of America) went over and told the Insured that he needs to replace the whole roof. It was also reported that the fence was damaged by strong winds. Southern Oak immediately began investigating the claim and sent the Insureds a copy of the Homeowner Claims Bill of Rights. Thereafter, Southern Oak set up an inspection of the property. Southern Oak, through its field adjuster, inspected the property on or about November 1, 2022. Following the inspection, Southern Oak prepared an estimate to repair the covered damages. Thereafter, Southern Oak issued payments in the amount of $5,976.74 under Coverage A and $2,118.02 under Coverage B. Contemporaneously, Southern Oak sent a letter to the Insureds, discussing its investigation of the claim. The letter discussed the payments and the Insureds’ ability to recover replacement cost benefits in the amount of $9,205.24 upon the completion of repairs. The letter also advised that Southern Oak’s investigation revealed wear and tear and cracking to the garage door, stucco, soffit/fascia, and some areas of the fence, and that those causes of loss are excluded. The letter cited to the following policy language: SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure for sudden and accidental direct physical loss to property described in Coverages A and B only if that loss is a physical loss to property. We do not insure, however, for loss: . . . 2. Caused by: . . . e. Any of the following: . . . (1) Wear and tear, marring, deterioration; . . . (6) Settling, shrinking, bulging or expansion, including resultant cracking of bulkheads, pavements, patios, footings, walls, floors, roofs or ceilings; . . . 3. Excluded under Section I – Exclusions. . . . Under items 1. and 2., any ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered. * * * * On December 7, 2022, Southern Oak received correspondence from RRCA providing a copy of its contract with the Insureds and photographs of the property. RRCA sent subsequent and similar correspondence thereafter. Thereafter, Mr. Woods contacted Southern Oak about whether or not he intended to proceed with using RRCA as his contractor. Thereafter, he called in and advised that he intended to use Hippo Roofing. On or about November 20, 2024, Southern Oak received a letter of representation from your law firm, which included a request for a copy of the subject policy of insurance. Subsequent requests for the policy were received on November 25, 2024 and November 27, 2024. On November 27, 2024, Southern Oak sent correspondence to your office enclosing a certified copy of the policy. Southern Oak received additional requests for documents thereafter. Southern Oak responded by providing the estimate and payment letter. Then, on December 10, 2024, you filed the Notice. Subsequently, Southern Oak, through the undersigned responded to a request from your office for Southern Oak’s photographs. Without waiving its rights to contest the validity of the subject defective and improper Notice, as the facts clearly demonstrate, Southern Oak has, and continues to comply with both Florida law and the applicable policy of insurance throughout the entire handling of this claim. As outlined above, with regard to the investigation and handling of this claim, Southern Oak’s actions were prompt, thorough, and conducted in good faith. Therefore, Southern Oak specifically denies each and every violation alleged in the Notice. I trust this response addressed all concerns raised by the Notice. However, please do not hesitate to contact the undersigned should you require additional information. Sincerely, RYAN S. PARKER TYLER T. CALEY cc: Southern Oak 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