Civil Remedy Notice of Insurer Violations
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Filing Number:     796538
Filing Accepted:  12/11/2024
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Complainant
Last/Business Name *  
RODRIGUEZ   First Name   JANET
Street Address * 2120 DELIGHTFUL DR
City, State Zip * RUSKIN, FL 33570
Email Address * JANETRODRIGUEZ8149@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   RODRIGUEZ   First Name   JANET
Policy # * 42PFP263772-01 Claim #* BH01744478
Attorney
Attorney is Applicable
Last Name* LEON First Name * JOSE Initial
Street Address* 2828 CORAL WAY, STE. 410-B
City, State Zip* MIAMI , FLORIDA 33145
Email Address * JLEON@JLEONLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   NATIONAL FIRE & MARINE INSURANCE COMPANY
NAIC Company Code 20079
 
Name of individual responsible for violation (if any):* UNKNOWN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
* Statutory provision(s) which the insurer allegedly violated.
 
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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The damage to the Insured's property is extensive and covered by different subsections of Section I, Property Coverages and Perils Insured Against, and no exclusions apply. Specifically, the sections that provide coverage for the Insured's claim are the following: - Section I, Property Coverages, Coverage A-Dwelling. - Section I, Property Coverages, Coverage B-Other Structures. - Section I, Property Coverages, Coverage C-Personal Property. - Section I, Property Coverages, Coverage D-Loss of Use. - Section I, Property Coverages, Additional Coverages. - Section I, Perils Insured Against, Coverage A-Dwelling. - Section I, Perils Insured Against, Coverage B-Other Structures. - Section I, Perils Insured Against, Coverage C-Personal Property. - Section I, Exclusions: None Apply
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

JANET RODRIGUEZ (THE "COMPLAINANT") submits this notice to NATIONAL FIRE & MARINE INSURANCE COMPANY to perfect her right to pursue a civil remedy action against NATIONAL FIRE & MARINE INSURANCE COMPANY, pursuant to Section 624.155, Fla. Stat. JANET RODRIGUEZ (THE "COMPLAINANT"), as the borrower, has been paying for a lender-placed insurance policy through USDA MORTGAGE COMPANY (THE "MORTGAGE COMPANY") which includes hazard insurance coverage provided by NATIONAL FIRE & MARINE INSURANCE COMPANY (THE "INSURANCE COMPANY") under Policy No. 42PFP263772-01. Despite repeated requests, NATIONAL FIRE & MARINE INSURANCE COMPANY has refused to provide a copy of the lender-placed insurance policy that is in effect on the property located at 2120 Delightful Dr, Ruskin, Florida 33570, which is owned by JANET RODRIGUEZ. Upon information and belief, the Insurance Company has been conducting this strategy in an effort to delay the claim process to avoid fulfilling its obligations under the insurance policy. It is crucial to note that JANET RODRIGUEZ, as the borrower under the lender policy with Shellpoint Mortgage Servicing, is the homeowner affected by the property damage. On or about October 10, 2024, the Complainant’s property located at 2120 Delightful Dr, Ruskin, Florida 33570, sustained a sudden and accidental covered loss, causing wind damage to the roof and water damage to the interior of the Subject Property. The Complainant promptly notified the Insurance Company of the damage, and in return, the Insurance Company opened claim number BH01744478. However, despite this notification, the Insurance Company has not provided any payment or further assistance under the policy to the homeowner. The Complainant has made repeated efforts to engage the Insurance Company regarding the lender-placed insurance policy and seek a determination of coverage, but the Insurance Company has failed to involve the Complainant in the resolution of the claim. The refusal to provide a copy of the lender-placed insurance policy hinders the ability of the Complainant to fully assess her rights and coverage under the policy, especially following a covered loss. This lack of transparency is concerning and constitutes a violation of the rights afforded to insured parties under Florida law. The actions of the Insurance Company demonstrate bad faith, as they have not acknowledged the borrower’s existence or her interests in this matter. Despite repeated attempts to engage the Insurance Company regarding the lender-placed insurance policy, the Insurance Company has chosen to resolve the claim without including the Complainant in the negotiation process. Upon information and belief, NATIONAL FIRE & MARINE INSURANCE COMPANY performs the aforementioned actions as a business practice, including delaying claims, in an attempt to dissuade its insureds from insisting on fair coverage. NATIONAL FIRE & MARINE INSURANCE COMPANY can cure its bad faith actions at this time by providing the requested policy documentation to JANET RODRIGUEZ without further delay or obstruction.
Comments
User Id Date Added Comment
gkelly@butler.legal 01-13-2025 This firm represents National Fire & Marine Insurance Company (“Insurer”) and has been requested to respond to the Civil Remedy Notice of Insurer Violations (“Notice”) submitted by Jose Leon, Esq. on behalf of Janet Rodriguez (“Complainant”), bearing an accepted date of December 11, 2024. As such, this response is timely. The Insurer asserts that the Notice fails to comply with the requirements set forth in the Notice document provisions, as set forth in Florida Statutes § 624.155 and Florida case law. Without waiving the deficiencies and failures to comply, the Insurer responds as follows: In the Notice, the Complainant alleges the Insurer violated various subsections of Florida Statute § 626.9541 with regard to a claim for damage to the property located at 2120 Delightful Drive, Ruskin, FL 33570, reported by the Complainant under a lender-placed policy of insurance issued by the Insurer. The Notice generally alleges that the “Reason for the Notice” is “Claim Delay.” The Insurer categorically denies that the Insurer or any of its representatives, agents, or employees engaged in any prohibited conduct, violated any of the statutes referenced in the Notice, or breached any provision of the subject policy of insurance with respect to this claim. The Notice is vague and deficient in describing the facts and circumstances giving rise to the Insurer’s alleged violations. The Notice is also deficient because it includes several provisions of Florida Statute § 626.9541, regardless of whether they are relevant or applicable to the alleged facts contained in the Notice. Furthermore, the Notice is deficient because (a) it identifies the insured as Janet Rodriguez, when in fact the only insured is United States Department of Agriculture Rural Housing Service; and (b) it identifies the Insurer as an “Authorized Insurer” when in fact the Insurer is a non-admitted surplus lines carrier. Despite the various deficiencies in the Notice, the Insurer acted in good faith, without delay, and with due regard to its insured’s interests at all times during the investigation and handling of the claim. Moreover, the Insurer provided a copy of the subject policy to counsel for the Complainant and thus has “cured” all alleged violations in the Notice. A detailed response to the Notice was sent via e-mail to counsel for the Complainant. If the Department has any questions or requires any additional information, please contact us.
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