Civil Remedy Notice of Insurer Violations
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Filing Number:     796732
Filing Accepted:  12/13/2024
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Complainant
Last/Business Name *  
GRANT   First Name   KIRK
Street Address * 2099 BRIAN LAKES DRIVE NORTH
City, State Zip * JACKSONVILLE, FL 32221
Email Address * GRANTKIRK400@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GRANT   First Name   KIRK
Policy # * 80-CM-L081-4 Claim #* 59-63Q4-28P
Attorney
Attorney is Applicable
Last Name* ELAZAR First Name * SAPIR Initial
Street Address* 800 E BROWARD BLVD., STE. 510
City, State Zip* FORT LAUDERDALE , FLORIDA 33301
Email Address * SE@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
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
Claim Denial
* 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)(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.

Loss Payment Provision. 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.

Kirk Grant (the "Insured") purchased an insurance policy ("Policy") from State Farm Insurance Company ("State Farm"), with effective coverage on the date of the loss, on or about September 11, 2023, and policy number 80-CM-L081-4 to insure the property located at 2099 Brian Lakes Dr. North, Jacksonville, FL 32221 (the "Property"). On or about September 11, 2023, the Property suffered severe damage as the result of a sudden hail and windstorm which caused ensuing damage to the Property, including but not limited to the roof of the Property (the "Loss"). On or about February 22, 2024, State Farm was notified of the Loss. State Farm acknowledged the claim and assigned claim number 59-63Q4-28P ("Claim") to the Loss. From the onset, it was clear to the Insured that State Farm had one goal - to reduce or eliminate its liability in the claim. State Farm delivered a coverage determination that misrepresented the material facts of the claim and relied on a faulty and disingenuous expert report. State Farm thus denied the Insured the full benefits they are rightfully entitled to without properly evaluating the documentation and proof provided by the insured. Frustrated with State Farm’s denial and confused as to their rights under the policy, the Insured was forced to retain the services of Eco Restore, LLC (“Eco Restore”), and legal counsel. Eco Restore inspected the damage to the property and generated a true and accurate estimate of the damage in the amount of $35,041.93. Despite multiple requests from the Insured pleading that State Farm reconsider their position, State Farm refused to provide the Insured with the funds needed to return the property to its pre-loss condition. The Insured has fully complied with all applicable policy provisions requiring cooperation with the investigation, however State Farm is unjustifiably and unreasonably denying payment to the Insured. Rather than paying the actual damages and/or trying to settle with the Insured, State Farm is delaying a prompt resolution of the claim. Additionally, State Farm has not attempted, in good faith, to settle this claim when, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholder and with due regard to the policyholder’s interests. As a direct consequence of State Farm’s failure to adjust this loss in good faith and make any supplemental payment, the Insured continues to be without adequate compensation for the damages sustained at his property. By stating the above detailed facts, it is clear that State Farm has violated the following Florida 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 Insureds and with due regard for their interest, when State Farm denied coverage on the Insureds’ claim. • 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, by failing to respond to the Insured’s public adjuster, and Insured’s counsel with respect to supplemental requests for payments; • 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 and/or his public adjuster of the basis in the insurance policy, in relation to the facts or applicable law, for the offer of a compromise settlement; • 626.9541(1)(i)(4) Failing to pay any undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer receives notice of a residential property insurance claim, determine the amounts of partial or full benefits, and agree to coverage, when State Farm failed to release any undisputed amount of the claim to the Insureds. To date, State Farm has in bad faith failed to provide a sufficient coverage determination to the Insured. The Insured’s property continues to be in disarray as the Insured is without funds to put his property into its pre-loss condition. As a direct result of State Farm’s denial of coverage and breach of Florida Statutes, the Insured was forced to seek the help of licensed professionals to assist them, including a contractor and legal counsel. Due to the amount of time that has passed since the date of loss, the information discussed above, it is irrefutable evidence that State Farm knowingly and intentionally, and in bad faith delays the claims process to further disadvantage the Insured. The financial detriment caused to the Insured is a direct result of State Farm’s reckless treatment of the claims process. The Insured submitted all documents requested in a timely fashion, made her property available for inspection, submitted supplemental invoices, estimates and requests. However, State Farm failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim. To deny the Insured the benefit clearly due and owing under the Policy, for which they have time and time again been making premium payments for and after they have satisfied all of his obligations is morally and ethically reprehensible, and reeks of Unfair Claims Practice and Bad Faith. Upon information and belief, the aforementioned actions complained of, among others, were made by State Farm so often as to constitute a general business practice, evidencing a motive to enhance State Farm’s profits, and designed to cause a detrimental effect to its policyholders. The above clearly shows that State Farm adjusted this claim in bad faith and that State Farm is in direct violation of Unfair Claims Practices. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should State Farm fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, State Farm must: (1) Immediately tender all proceeds due and owing to the Insured that are fairly owed to the Insured under the insurance policy that would reasonably compensate the Insured in order to put the loss property back to its pre-loss condition; (2) Agree to reimburse the Insured’s reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insured for interest on the amount of benefits that was found to be due and owing to the Insured, relating back to the date of loss.
Comments
User Id Date Added Comment
se@weklaw.com 05-23-2025 This CRN is hereby withdrawn pursuant to an agreement of the parties.
jvelazco@butler.legal 01-23-2025 January 23, 2025 Florida Department of Financial Services (FILED ELECTRONICALLY) Divisions of Consumer Services – Civil Remedy Larson Building, 200 East Gaines Street Tallahassee, Florida 32399-0322 Mr. Kirk Grant c/o Sapir Elazar, Esquire (VIA E-MAIL) 800 East Broward Boulevard, Suite 510 Fort Lauderdale, Florida 33301 Re: Civil Remedy Notice of Insurer Violations Complainant: Kirk Grant Insured: Kirk Grant Claim Number: 59-63Q4-28P Policy Number: 80-CM-L081-4 DFS File Number: 796732 Dear Mr. Grant: This correspondence constitutes State Farm Florida Insurance Company’s (“State Farm”) response to the Civil Remedy Notice of Insurer Violation (“Notice”) that was filed on behalf of you (“Complainant”) regarding the claim listed above. State Farm welcomes the opportunity to respond to this Notice and specifically denies each and every allegation contained in the Notice filed in relation to this claim. With that said, State Farm believes the Notice fails to comply with the specific notice and information requirements as set forth in the Civil Remedy Notice of Insurer Violation document provisions, Florida Statute §624.155, and Florida case law. State Farm has acted fairly and with due diligence throughout the handling of the Complainant’s claim. To the extent that this reply does not fully address and respond to the allegations set forth by the Notice, such deficiency is the direct result of the lack of specificity and the overall vague nature of the allegations contained therein. State Farm will address each statutory allegation. Fla. Stat. §624.155(1)(b)(1) State Farm denies any violation of Fla. Stat. §624.155(1)(b)(1), which provides as follows: 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 towards its insured and with due regard for her or his interests. State Farm has acted fairly and honestly towards the Complainant at all times. At no time has State Farm acted dishonestly or unfairly towards the Complainant. All of State Farm’s actions have been performed in good faith and for the purpose of moving the Complainant’s claim towards a just and proper determination of coverage under the subject policy of insurance. Absolutely no facts or circumstances supporting this allegation have been provided by the Complainant in the Notice. As a result, there is no evidence that State Farm violated §624.155(1)(b)(1), Florida Statutes, that it did not act in good faith to settle the Complainant’s claim; or that it did not act fairly and honestly towards the Complainant with due regard for the Complainant’s interests. Fla. Stat. §624.155(1)(b)(3) State Farm denies any violation of Fla. Stat. §624.155(1)(b)(3), which provides as follows: 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. State Farm’s actions have been performed in good faith and for the purpose of moving the Complainant’s claim towards a just and proper determination of coverage under the subject policy of insurance. Absolutely no facts or circumstances supporting this allegation have been provided by the Complainant in the Notice. There is no evidence to substantiate the Complainant’s claim that State Farm has failed to promptly settle the Complainant’s claim, 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. Fla. Stat. §626.9541(1)(i)(3)(a) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(3)(a), which provides as follows: Failing to adopt and implement standards for the proper investigation of claims. This allegation is without basis, and the Notice again fails to allege any facts or circumstances whatsoever that would provide any support for this allegation. State Farm has adopted and implemented standards for the proper investigation of insurance claims and has complied with the same at all times during the investigation of the Complainant’s claim. The standards and methods utilized by State Farm in examining its claims have met and exceeded its obligations and industry standards. State Farm has conducted the handling of this claim according to such standards and the Complainant has failed to allege any factual support or evidence to substantiate the Complainant’s allegation that State Farm has failed to adopt and implement standards for the proper investigation of insurance claims. Florida Statute §626.9541(1)(i)(3)(b) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(3)(b), which provides as follows: Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. The Complainant provided no information as the specific actions of State Farm showing that it allegedly made material misrepresentations in this claim to the Complainant or any other person having an interest in the proceeds for this matter. Moreover, the facts outlined herein clearly contradict the aforementioned allegations, and nothing within this Civil Remedy Notice supports or justifies the alleged statutory violations. Clearly, the Complainant’s Notice does not place State Farm on Notice of any violation of the cited statute or conduct that may constitute bad faith here. State Farm has represented the facts of its investigation accurately per the policy and has made determinations allowed of it per applicable statute and within the cure period of this notice. State Farm is unclear as to the allegations of the Complainant and would seek additional information in order to provide further response to same. Fla. Stat. §626.9541(1)(i)(3)(c) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(3)(c), which provides as follows: Failing to acknowledge and act promptly upon communications with respect to claims. Following the Complainant’s notice of the loss to State Farm (approximately five months after the alleged date of loss), State Farm, performed an investigation to assess the cause and extent of the reported conditions. Thereafter, State Farm promptly sent correspondence to the Complainant and Complainant’s representatives regarding its investigation. As a result, there is no evidence to substantiate the Complainant’s claim that State Farm has failed to acknowledge or act promptly in response to communications from the Complainant regarding this insurance claim. Florida Statute § 626.9541(1)(i)(3)(d) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(3)(d), which provides as follows: Denying claims without conducting reasonable investigations based upon available information. The Complainant provided no information as the specific actions of State Farm showing that it allegedly failed to perform a reasonable investigation based upon available information with respect to the claim. In fact, the facts outlined herein clearly contradict the aforementioned allegations based on the multiple inspections performed at the property including its constant evaluation of the information and conditions presented, and nothing within this Civil Remedy Notice supports or justifies the alleged statutory violations. Clearly, the Complainant’s Notice does not place State Farm on notice of any violation of the cited statute or conduct that may constitute bad faith here. State Farm has performed its investigation based on the information available to it at the time received and has made determinations allowed of it per same and the applicable statutes. State Farm is unclear as to the allegations of the Complainant and would seek additional information in order to provide further response to same. Florida Statute § 626.9541(1)(i)(3)(f) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(3)(f), which provides as follows: 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 compromised settlement. State Farm reiterates is assertions above that the Complainant provided no facts whatsoever or circumstances in connection to this matter that would support these allegations. Moreover, the facts outlined herein clearly contradict the aforementioned allegations, and nothing within this Civil Remedy Notice supports or justifies the alleged statutory violations. Again, the allegation that State Farm failed to promptly provide a reasonable explanation in writing to the Complainant of it decision is wholly inaccurate. It was not only communicated reasonably but it was in writing and well within the statutory and policy timeframe required. Florida Statute § 626.9541(1)(i)(4) State Farm denies any violation of Fla. Stat. §626.9541(1)(i)(4), which provides as follows: Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer received notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). The Complainant provided no information as to the specific actions of State Farm supporting this allegation. State Farm’s coverage determination and evaluation was based on its investigation, including an inspection performed at the property, and was provided to the Complaint not only within 90 days after receiving notice of the claim but well under 60 days from the reporting of the claim. Nothing within this Civil Remedy Notice supports or justifies the alleged statutory violations. Clearly, the Complainant’s Notice does not place State Farm on notice of any violation of the cited statute or conduct that may constitute bad faith here. State Farm has performed its investigation based on the information available to it at the time received and has made determinations allowed of it per same and the applicable statutes. State Farm is unclear as to the allegations of the Complainant and would seek additional information in order to provide further response to same. Also, State Farm will delineate other deficiencies with the Notice. First, §624.155(3)(b)(4), Florida Statutes, requires: (b) The 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: . . . 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. . . . The Complainant is not a third-party claimant. Hence, to be valid, the Notice must “[r]eference [the] specific policy language that is relevant to the violation.” It does not. The Notice simply references “Loss Payment Provision” Loss Settlement Provision”, which is not sufficient. Thus, it fails to comply with §624.155(3)(b)(4). Second, section 624.155(3)(b)(2), Florida Statutes, requires: (b) The 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: . . . 2. The facts and circumstances giving rise to the violation. . . . The Notice fails to supply the facts and circumstances giving rise to the alleged violations. It does not explain how the scant, supposed “facts,” and, scant, supposed “circumstances,” correspond to the alleged statutory violations. To be valid, the Notice must “state with specificity . . . [t]he facts and circumstances giving rise to the violation.” Thus, it fails to comply with §624.155(3)(b)(2). Third, the Notice requires the Complainant, pursuant to §624.155(3)(b)(5), Fla. Stat., to supply an amount to “cure” the supposed violations. The Notice does not supply a total amount to “cure” all the supposed violations. The Notice completely ignores the clear legal precedent that the only valid and legitimate “cure” of a valid notice is the insurer’s payment of “the amount owed pursuant to the express terms and conditions of the policy." See also, Talat Enter., Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000); Julien v. United Prop. and Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Thus, it fails to comply with §624.155(3)(b)(5). The Notice vaguely refers to “all proceeds due and owing to the Insured and fairly owed to the Insured under the insurance policy that would reasonably compensate the Insured in order to the loss property back to its pre-loss condition” as well as fees, costs and interest without providing a monetary amount related to same. For the aforementioned reasons, State Farm believes the Notice does not comply with §624.155, Fla. Stat. Notwithstanding the deficient Notice, State Farm denies it committed any of the alleged acts or violated the statutes and/or administrative rules cited in the Notice. State Farm hereby denies each and every allegation contained in the Notice, either explicitly or implicitly, and denies any wrongdoing in the handling of the Complainant’s claim. FACTS This matter arises out of a claim for loss and alleged damage that occurred at the insured property located at 2099 Brian Lakes Drive N., Jacksonville, Florida, 32221, on or about September 11, 2023. However, the Complainant did not report the claim to State Farm until five months later. Following the notice of the loss to State Farm, State Farm performed an investigation into the damage allegedly caused by the loss, including inspecting the property. State Farm then provided the Complainant its coverage determination and reasoning for same, including specific reasons for its denial of the claim in correspondence dated March 28, 2024. State Farm’s coverage determination was provided to the Complainant well within the timeframe prescribed by applicable law and the subject policy. Throughout the claim, State Farm sent correspondence to the Complainant and the Complainant’s representatives based on the information it had in its possession. State Farm has acted fairly and with due diligence throughout the handling of the Complainant’s claim. To the extent that this reply does not fully address and respond to the allegations set forth by the Notice, such deficiency is the direct result of the lack of specificity and the overall vague nature of the allegations contained therein. Nevertheless, State Farm disputes all facts alleged by the Complainant, denies all allegations by the Complainant, and relies upon the facts cited above and throughout its response to the Notice in opposition to the same. Additionally, State Farm asserts that all actions it has taken in response to the Complainant’s claim has been done entirely in good faith and for the purpose of fair, just and timely disposition of the same. This letter or any act or failure to act on the part of State Farm or any agent or representative of State Farm should not be construed as a waiver of any rights or defenses, including but not limited to proper Notice and service, available to State Farm by contract or at law as all such rights and defenses are specifically reserved. Please contact me if you have any questions. Sincerely, BUTLER WEIHMULLER KATZ CRAIG LLP Jennifer Velazco, Esquire jvelazco@butler.legal
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