Civil Remedy Notice of Insurer Violations
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Filing Number:     796520
Filing Accepted:  12/11/2024
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Complainant
Last/Business Name *  
PAUL A. ELLIOTT AND SUZANN M. ELLIOT   First Name  
Street Address * 25 W HIGH POINT ROAD
City, State Zip * STUART, FL 34996
Email Address * CNSDR@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PAUL A. ELLIOTT AND SUZANN M. ELLIOT   First Name  
Policy # * FPH3-000067299 Claim #* 01000114092
Attorney
Attorney is Applicable
Last Name* GOTTLIEB First Name * MATTHEW Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MGOTTLIEB@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
Name of individual responsible for violation (if any):* CLAIMS DEPARTMENT
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
* 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)(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.
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.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the insureds’ Hurricane Ian claim. Subsequently, the insured prepared a loss package in the amount of $127,472.75 needed to restore the property back to its pre-loss condition. The insureds have attempted to follow-up with the carrier multiple times regarding the status of the claim and have been ignored by the carrier. The insureds have complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insureds. More than seven hundred and eighty-five days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of the damage sustained by the insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $127,472.75, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Idaly Ellis at (561)-892-9674 if you have any questions or concerns. Sincerely, Matthew Gottlieb Attorney at Law
Comments
User Id Date Added Comment
ebrooksherproperty@kpattorney.com 04-03-2025 This filed Civil Remedy Notice is hereby withdrawn pursuant to a settlement agreement between the claimant and the insurance carrier.
jsuarez@chartwelllaw.com 02-07-2025 February 7, 2025 VIA E-MAIL TO: mgottlieb@kpattorney.com Matthew Gottlieb, Esq. Kanner & Pintaluga, P.A. and VIA E-FILING: Dept. of Financial Services Civil Remedy Notice Website Florida Department Of Financial Services Consumer Assistance/Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, FL 32399-0322 RE: Paul A. Elliott & Suzann M. Elliott / First Protective Insurance Company Date of Loss : September 28, 2022 Claim No. : 01000114092 CRN Filing No. : 796520 Policy No. : FPH3-000067299 Address : 25 W. High Point Road, Stuart, FL 34996 Our File No. : 890.0114169 To Whom It May Concern: This office has been retained by First Protective Insurance Company d/b/a Frontline Insurance (hereinafter “Frontline”) in connection with the above referenced claim. Please accept the following as Frontline’s Response to the Civil Remedy Notice (“CRN” or “Notice”) filed on December 11, 2024, by or on behalf of Paul A. Elliott and Suzann M. Elliot (“Insureds”). Frontline specifically denies each and every allegation contained in the Notice and asserts that the Notice fails to comply with the specificity requirements mandated by Florida Statute § 624.155. A civil remedy notice must set forth specific statutory provisions the insurer allegedly violated, the facts giving rise to the violation, the relevant policy language, and a statement that the notice is given to perfect the right to pursue the civil remedy authorized by the statute. See Landers v. State Farm Fla. Ins. Co., 234 So. 3d 856, 858 (Fla. 5th DCA 2018). Similarly, a civil remedy notice must state the facts and circumstances that give rise to an alleged violation with such specificity sufficient to allow an insurer to cure any alleged violation within the 60-day statutory period. See Lane v. Westfield Insurance Company, 862 So. 2d 774 (Fla. 5th DCA 2003). It is Frontline’s position that the CRN filed by the Insureds is deficient pursuant to section 624.155(3)(b), Fla. Stat., which states: The [civil remedy] notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. 2. The facts and circumstances giving rise to the violation. 3. The name of any individual involved in the violation. 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. (emphasis added.) Frontline objects to the filing of the Notice because the Insureds failed to comply with section 624.155(3)(b)(2), Fla. Stat., which requires that the Notice include the facts and circumstances giving rise to each violation. While the Notice contains some statements apparently relating to the loss, there are no facts alleged that support or provide notice to the carrier of the specific violations complained of. Many of the alleged violations appear to be a boilerplate recitation of the statute and general conclusory allegations that do not contain any factual support. For instance, the Notice alleges that the carrier was put on notice of the Insureds’ claim and references how long has passed since the alleged date of loss, but fails to acknowledge that the claim was actually reported one (1) year and ten (10) months after the reported date of loss. Nor does the Notice address the fact that the Insureds failed to provide information and documentation requested by Frontline, including a timely sworn proof of loss, which was required to be submitted within 60 days from the date the claim was reported, as well as in Frontline’s reservation of rights/request for information correspondences dated July 15, 2024, August 14, 2024, September 11, 2024, and October 17, 2024. Additionally, the Notice alleges that the Insureds have attempted to follow-up with the carrier on multiple times regarding the status of the claim, but again fails to provide any factual information to support this allegation. Overall, there are very few statements that even have to do with the subject claim, as the Notice is filled with boilerplate allegations with no factual backing. As such, the Notice is premature, vague and insufficient to put Frontline on notice as to what it allegedly did wrong. Frontline advised that any and all covered damages fell below the policy deductible based on its investigation. The Insureds have not provided any information to the contrary despite Frontline’s requests for same. Failure to provide such specificity is direct and clear noncompliance with the requirements of section 624.155 and renders the Notice deficient on its face as to form and substance. Indeed, the lack of factual specificity leaves uncertainty as to how to cure the alleged bad-faith conduct. See Valenti v. Unum Life Ins. Co. of Am., No. 8:04-cv-1615-T-30TGW, 2006 U.S. Dist. LEXIS 36880, at *7 (M.D. Fla. June 6, 2006) (The purpose of the civil remedy notice is to provide insurers one last opportunity to settle a claim with the insured to avoid unnecessary litigation). Frontline also objects to the filing of the Notice as the Insureds failed to comply with section Fla. Stat. §624.155(3)(b)(3), as the Insureds failed to list “[t]he name of any individual involved in the violation.” No information is provided by the Insureds as to the specific identity of any persons alleged to have caused or contributed to the violations. Instead, the Insureds state “claims department,” which entirely fails to identify any person representing the insurer. Clearly, the Insureds have failed to list anyone allegedly involved in the violation on the insurer’s behalf. This information is readily available to the Insureds and/or their representatives, but they have failed to include it in the Notice in violation of Fla. Stat. §624.155(3)(b)(3). The Insureds also failed to comply with section 624.155(3)(b)(4), Fla. Stat., which requires references to specific policy language. Notably, the Notice does not list any specific policy provisions. Instead, the Notice broadly lists “loss settlement provision,” which outright fails to provide any specificity as to what specific policy language the Insureds are relying upon in support of the purported violations. Therefore, the Insureds’ failure to list any policy language relevant to the alleged violations fails to comply with section 624.155(3)(b)(4), Fla. Stat. See Julien v. United Prop. & Cas, Ins. Co., 2020 Fla. App, LEXIS 13520 (Fla. 4th DCA 2020) (citing fox v. Starr Indemn. & Liab. Co., No, 8:16-CV-3254-T-23MAP-2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294, at *2 (M.D. Fla, April 28, 2017)) (an insurer’s listing of whole sections of the insurance policy in a civil remedy notice “appear[ed] to lack specificity”). As such, Frontline was not provided with notice of the specific policy language that it allegedly failed to comply with. The Notice 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 Fla. Stat. § 624.155. Additionally, as described in detail above, the facts alleged in the Notice are overbroad and conclusory and do not contain any specific factual support for the alleged violations. Frontline, therefore, is unable to ascertain the reasons for the alleged statutory violations from the Notice rendering the Notice deficient. For these reasons, the Notice should be denied and rejected. With regard to the facts of the claim, subject loss was reported on July 1, 2024 with an alleged date of loss of September 28, 2022. That means that the claim was reported more than one (1) year and ten (10) months after the alleged date of loss. In order to adjust and investigate the claim, Frontline requested documentation and information including a sworn proof of loss, which was required to be returned within 60 days from the date it was requested on July 1, 2024. In fact, it wasn’t until October 17, 2024 that the Insureds submitted their untimely sworn proof of loss, which is well past the 60-day deadline pursuant to the terms and conditions of the policy. Frontline also had the property inspected by an independent adjuster on July 5, 2024, as well as by an engineer on July 26, 2024. Additionally, Frontline issued reservation of rights/request for information correspondences on July 15, 2024, August 14, 2024, September 11, 2024, and October 17, 2024, which requested additional documentation and information supporting the Insureds’ claim for damages. However, the Insureds failed to provide all of the requested information and documentation. The Insureds also provided a recorded statement on July 11, 2024 in which they confirmed repairs were performed prior to the inspection of the property and prior to the time the claim was reported to Frontline. Based on its adjustment and the information received at the time, it was determined that the covered damages fell below the applicable policy deductible and that the roof replacement and interior damages were not covered under the policy. Therefore, despite the Insureds’ failure to cooperate with the terms and conditions of the policy, Frontline investigated the claim based on all of the information available to it and no payment was owed because any and all covered damages fell below the policy deductible. However, Frontline continued to provide the Insureds the ability to supplement their deficient responses by subsequently asking for an examination under oath and making additional requests for documentation. As of the writing of this response, the examinations under oath have not been able to be taken, nor have the additional document requests been responded to by the Insureds. The Insureds allege various reasons why this Notice was filed and also allege multiple statutory violations; however, no specific facts or circumstances are provided to support these allegations. As previously stated, the Notice is simply a recitation of general, and unsupported allegations of bad faith conduct which are not specifically alleged or described. Frontline specifically denies that it has violated any of these sections and denies all other allegations of bad faith or improper claims handling in this matter. However, notwithstanding these allegations, the Insureds fail to provide factual support for these alleged violations within the body of the Notice. Nonetheless, Frontline denies the following allegations made by the Insureds in the Notice: Unfair Trade Practice: There is no basis for this allegation, thus it is denied. The Insureds has not provided any facts or circumstances to support this allegation. At no time did Frontline, its agents, or its employees employ any unfair business practice during the handling, administration, or disposition of this claim. Claim Delay: Frontline denies any delay on its part in the claim handling and processing of the loss, as is evident from the facts outlined above. Frontline promptly acknowledged the Insureds’ claim and timely initiated its investigation of the loss. Frontline’s investigation of the claim revealed that the covered damages fell below the applicable policy deductible. Frontline then immediately sent a coverage determination letter to the Insureds. At all times throughout the handling and adjustment of this claim, Frontline acted in accordance with its duties and obligations pursuant to the policy of insurance and acted as promptly as possible under the circumstances to advise the Insureds of the determination as to coverage for the alleged loss. Furthermore, as noted above, the Insureds’ own failure to comply with the Policy’s terms has also affected the timeline for the adjustment of the claim. Fla. Stat. §624.155(1)(b)(1): Denied. Frontline has not failed to attempt to settle this claim in good faith and has always acted fairly and honestly towards the Insureds. As shown in the factual summary above, the conduct of Frontline following its receipt of the first notice of the loss has been compliant with all aspects of Florida law. Frontline promptly investigated the claim, made a coverage determination based on the applicable policy language and Florida law, and promptly advised the Insureds of the determination. Frontline asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance policy. Fla. Stat. §624.155(1)(b)(3): Denied. Frontline has not failed to promptly settle this claim. As supported by the above claim facts, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it. Frontline promptly investigated the claim, made a coverage determination based on the applicable policy language and Florida law, and promptly advised the Insureds of the determination. The Insureds have submitted absolutely no facts or circumstances supporting this allegation. Fla. Stat. §626.9541(1)(i)(3)(a): Denied. This allegation is without basis. Frontline has adopted and implemented standards for the proper investigation of claims at all times. The aforementioned facts demonstrate that Frontline employed proper and customary claims practices in the investigation and adjustment of this claim, and in strict compliance with the statutory requirements imposed upon it. Furthermore, the Insureds submitted absolutely no facts or circumstances supporting this allegation. Fla. Stat. §626.9541(1)(i)(3)(b): Denied. Again, there is no showing by the Insureds to support this baseless allegation of misrepresentation of pertinent facts or policy provisions relating to the coverages at issue. Frontline has adopted and implemented standards for the proper investigation of claims at all times. The aforementioned facts demonstrate that Frontline employed proper practices in the investigation and adjustment of this claim, and in strict compliance with the statutory requirements imposed upon it. The Insureds do not submit any facts or circumstances in support of this alleged violation. Fla. Stat. §626.9541(1)(i)(3)(c): Denied. There is no showing by the Insureds to support this baseless allegation of failing to acknowledge or act properly upon communications with respect to the claim. As shown in the detailed factual summary above, Frontline was forthcoming with the Insureds at all times material hereto and acted as promptly as possible under the circumstances to advise the Insureds of its coverage decision. The Insureds do not submit any facts or circumstances in support of this alleged violation. Moreover, Frontline asserts its full and strict compliance with the statutory requirements imposed upon it and all duties and obligations set forth in the subject insurance policy. Fla. Stat. §626.9541(1)(i)(3)(f): Denied. Again, there is no showing by the Insureds to support this alleged violation. As set forth above, Frontline promptly informed the Insureds of its coverage determination and referenced relevant policy provisions supporting its determination. The conduct of Frontline following its receipt of the first notice of the loss demonstrates compliance with all aspects of Florida law. At all times throughout the handling, adjustment and settlement of this claim, Frontline acted in strict compliance with the statutory requirements imposed upon it. Frontline has adjusted the loss to the extent possible despite the Insureds’ non-compliance with the policy’s post-loss duties, including failure to promptly report the claim, failure to provide documents requested, and failure to show the damaged property, amongst other failures. Furthermore, Frontline has acted reasonably in adjusting the loss based on the information available to it and in accordance with the terms of the subject policy. Frontline conducted a reasonable and diligent investigation to assess the damages in this loss in light of the Insureds’ failure to comply with their post-loss duties and promptly communicated with the Insureds throughout the investigation—all within the mandates of Florida law. In fact, Frontline continues to seek information and documentation in its continued adjustment of the claim to determine if any changes are warranted. Throughout the handling of the Insureds’ insurance claim, Frontline has acted in good faith towards the interests of its Insureds. Frontline investigated the loss in accordance with the policy provisions and standard claims handling practices. Frontline, therefore, denies any allegations to the contrary. We trust that the foregoing is sufficient to advise of Frontline’s position with regard to the Civil Remedy Notice filed by the Insureds. If any additional information is required, please feel free to contact the undersigned regarding same. Very truly yours, CHARTWELL LAW By: Joseph A. Suarez
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