Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 796934

Filing Accepted: 12/16/2024

Print Filing

Complainant

Last/Business Name *

BOWDEN

First Name

AARON BOWDEN & VANESA

Street Address *

2857 VILLAGE GROVE DR N

City, State Zip *

JACKSONVILLE, FL 32257

Email Address *

AARONBOWDEN@ATT.NET

Complainant Type: *

Insured

Last/Business Name*		BOWDEN		First Name		AARON BOWDEN & VANESA
Policy # *		80CD28543		Claim #*		5957P363Z

Attorney

Attorney is Applicable

Last Name*	FOULADI First Name * ANTHONY Initial
Street Address*		2300 MAITLAND CENTER PKWY STE. 106
City, State Zip*		MAITLAND , FL 32751
Email Address *		AFOULADI@SERRANOCAGAN.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		STATE FARM FLORIDA INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10739

Name of individual responsible for violation (if any):* N/A
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)(2)		A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
	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.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	626.9541(1)(i)(3)(e)		Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
	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.
	626.9541(1)(i)(3)(h)		Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.

* 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 COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section).

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

On or about 04/27/2023, AARON BOWDEN AND VANESA BOWDEN ("Insured"), sustained a covered direct physical loss to Insured's property due to wind and hail. Insured reported the loss thereafter to STATE FARM FLORIDA INSURANCE COMPANY("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # 80-CD-2854-3 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # 59-57-P363-Z. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $0 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about 8/13/2024, as the Insurer, specifically Matthew Monroe (FL License #P003400), refused to pay the full amount due and owed to its Insured. Insurer, specifically Matthew Monroe (FL License #P003400), has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 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; 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed; 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. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 626.9541(1)(i)(3)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $54,254.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.

Comments

User Id		Date Added		Comment
afouladi@serranocagan.com		03-07-2025		Complainants hereby withdraw this Civil Remedy Notice.
Viktoria.Willette@kubickidraper.com		02-06-2025		February 6, 2025 VIA ELECTRONIC FILING THROUGH WWW.FLDFS.COM – CIVIL REMEDY SYSTEM And by electronic mail to: Aaron Bowden and Vanessa Bowden c/o Anthony Fouladi, Esq. 2300 Maitland Center Pkwy, Ste. 106 Maitland, Florida 32751 afouladi@serranocagan.com CIVIL REMEDY NOTICE RESPONSE DFS File No.: 796934 Complainant(s): Aaron Bowden & Vanessa Bowden Insured: Aaron Bowden & Vanessa Bowden Claim No.: 59-57P3-63Z Policy No.: 80-CD-2854-3 Date CRN filed: December 16, 2024 Dear Sir or Madam: Undersigned counsel and the law firm of Kubicki Draper represent State Farm Florida Insurance Company (“State Farm”) with regard to the above-referenced claim. This shall serve as State Farm’s response to the “Civil Remedy Notice of Insurer Violations” (“CRN”), filed by or on behalf of Aaron Bowden and Vanessa Bowden (hereinafter “Complainants” or “Insureds”), with the Florida Department of Financial Services (“Department”) on December 16, 2024, State Farm responds as follows. The CRN arises from alleged hail damage reported to State Farm on October 13, 2023, following an alleged storm that Complainants allege occurred on April 27, 2023 at Complainants’ property located at of 2857 Village Grove Dr N, Jacksonville, Florida 32257 (the “Property”). Upon receiving notice of the loss, State Farm promptly acknowledged, investigated and issued its coverage determination on Complainants’ claim as more fully described below. In their CRN, Complainants asserts four (4) allegations against State Farm: claim denial, claim delay, unsatisfactory settlement offer, and unfair trade practice. Complainants further allege State Farm has violated various provisions of sections 624.155 and 626.9541, Florida Statutes (2024) in handling his claim. Complainants contend State Farm did not attempt in good faith to settle his claim 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; failed 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; a material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy; failed to adopt and implement standards for the proper investigation of claims; failed to acknowledge and act promptly upon communications with respects to claims; denying claims without conducting reasonable investigation based upon available information; failed to affirm or deny full or partial coverage of claims, and as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed; failed 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; and failed to clearly explain the nature of the requested information and the reasons why such information is necessary. See CRN at 3 (citing §§ 624.155(1)(b)(1); 624.155(1)(b)(3); 626.9541(1)(i)(2); 626.9541(1)(i)(3)(a); 626.9541 (1)(i)(3)(c); 626.9541 (1)(i)(3)(d); 626.9541 (1)(i)(3)(e); 626.9541 (1)(i)(3)(f); 626.9541 (1)(i)(3)(h). This is not so. State Farm has at all times handled this claim in good faith, and thus, respectfully and categorically denies without limitation each and every allegation contained within the CRN, including but not limited to the alleged violations of the cited provisions of Florida law. State Farm further denies any and all stated, implied, and/or unspecified allegations, including but not limited to denying any and all allegations of alleged improper claim handling, inadequate investigation, failure to communicate, misrepresentations, failure to settle in good faith, improper delay or denial, general business practices, and the like, whether or not specifically alleged by the CRN. As will be discussed herein, not only is the CRN riddled with defects and factual errors that render it totally invalid, but also, Complainants’ claims against State Farm are substantively without merit. Addressing first the CRN’s legal sufficiency, State Farm objects to the CRN based on multiple defects, which render the CRN invalid and legally insufficient. Specifically, the CRN fails to comply with section 624.155(3)(b), Florida Statutes, which requires the CRN to specify the facts and circumstances giving rise to the alleged violations, the statutory provisions allegedly violated, as well as the relevant policy language at issue in the alleged violations. All such requirements must be strictly construed and complied with, as a claim for first-party bad faith does not exist apart from the statute creating it. This was confirmed by the appellate court’s decision in Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021) (on rehearing), where the Fourth District affirmed that a CRN is invalid and precludes a future bad faith claim where, as here, it fails to strictly comply with the specificity and other requirements of section 624.155(3)(b). As will be discussed, the instant CRN’s failure to strictly comply with section 624.155(3)(b) likewise renders it invalid. Here, little—if anything—is stated with specificity as required by the statute. The CRN lists nine (9) statutory provisions State Farm allegedly violated; however, it offers no meaningful explanation as to how these provisions were allegedly violated or how they relate to the subject claim or the allegations of the CRN. State Farm responds to each individual violation as follows: • Section 624.155(1)(b)(1), Florida Statutes. 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 his or their interests. • Section 624.155(1)(b)(3), Florida Statutes. 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. • Section 626.9541(1)(i)(2), Florida Statues. Committing or performing with such frequency as to indicate a general business practice any of the following: (2). A material misrepresentation made to an Insured or any other person have an interest in the proceeds payable under such contact or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by such contract or policy. • Section 626.9541(1)(i)(3)(a), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: a. Failing to adopt and implement standards for the proper investigation of claims. • Section 626.9541(1)(i)(3)(c), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: c. Failing to acknowledge and act promptly upon communications with respect to claims. • Section 626.9541(1)(i)(3)(d), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: d. Denying claims without conducting reasonable investigations based upon available information. • Section 626.9541(1)(i)(3)(e), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: e. Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigation, upon the written request of the Insured within 30 days after proof-of-loss statements have been completed. • Section 626.9541(1)(i)(3)(f), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: f. Failing to promptly provide a reasonable explanation in writing to the Insureds 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. • Section 626.9541(1)(i)(3)(h), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: f. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. State Farm responds to each individual violation as follows: • Section 624.155(1)(b)(1), Florida Statutes. Complainants provide no support for their allegation that State Farm did not attempt in good faith to settle the claim, and certainly no factual support that settlement was warranted “under all the circumstances” of this claim. Complainants focus on the coverage decision for the alleged damages. State Farm hired engineering firm Forcon International Corporation to inspect the Complainants’ Property. The inspection of the subject property did not reveal any indications of wind or hail damage to the roof or exterior of the Complainants’ property related to the reported weather event on April 27, 2023. Instead, the overall condition of the roof is consistent with progressive and cumulative wear, tear, deterioration, and exposure to weather over time—none of which are covered under the policy. Accordingly, State Farm had no duty to settle this claim, as its inspection found no accidental direct physical loss. While the Complainant may be dissatisfied with State Farm’s findings, a mere difference in opinion regarding the cause of the damage does not constitute a valid basis for any future bad faith claim against State Farm. • Section 624.155(1)(b)(3), Florida Statutes. Again, Complainants provide no support for the allegation State Farm failed to promptly settle their claim once the obligation became reasonably clear under one portion of the policy so as to influence settlement under other portions of the policy. Complainants have only sought coverage under the policy’s Coverage A provisions, there are no other portions of the policy (i.e. personal property/loss of use) at issue in this claim. Additionally, settlement has not become reasonably clear under any portion of the policy for this statute to apply, anyway, as this is not a covered loss. As such, it is unclear how State Farm could be guilty of trying to improperly influence settlement under different portions of the policy. Complainants certainly provide no explanation facts and circumstances section of their CRN as to how this applies when no settlement was made at all. • Section 626.9541(1)(i)(2), Florida Statutes. Complainants do not identify any “material misrepresentation” made by State Farm, much less do they elaborate what State Farm materially misrepresented to effect settlement “on less favorable terms” than provided by the policy – there was no settlement on any terms here, so this statute is inapplicable. In its coverage correspondence, State Farm clearly explained the inspection findings, outlined the basis for denying coverage for the Complainants’ claim, and cited specific policy language supporting its decision. A determination of no coverage does not constitute a misrepresentation or misstatement—it reflects a difference in inspection findings between State Farm and the Complainants’ representatives and does not provide a valid basis for a bad faith claim. • Section 626.9541(1)(i)(3)(a), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contain no allegations concerning the frequency with which State Farm performs this action and no allegation that it rises to the level of a general business practice. Furthermore, Complainants provide no detail as to how State Farm’s claim investigation standards are lacking or deficient, and indeed, the body of the CRN does not mention State Farm’s investigation standards at all – it only mentions Complainants were dissatisfied with the outcome. Again, a difference in inspection findings is not a basis for a bad faith claim. Complainants do not raise any further issues with the State Farm’s investigation to reach the outcome. This does not constitute a violation of section 626.9541(1)(i)(3)(a). • Section 626.9541(1)(i)(3)(c), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contains no allegations concerning the frequency with which State Farm performs this action and certainly no allegation that it rises to the level of a general business practice. Additionally, the body of the CRN provides no detail as to which communication was unacknowledged or not timely responded to, and indeed, contains no allegations concerning delayed/deficient communication by State Farm whatsoever. There is absolutely no support for this claimed violation of the law. • Section 626.9541(1)(i)(3)(d), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contain no allegations concerning the frequency with which State Farm performs this action and no allegation that it rises to the level of a general business practice. Complainants provide no support for this assertion, and certainly cannot show State Farm denied the claim without conducting a reasonable investigation when they do not address any facts about the investigation and merely the outcome. State Farm and/or its representatives found that the inspection did not reveal accidental direct physical loss, which is required to trigger coverage under the policy. State Farm’s written coverage decision was issued following the inspection of an independent professional engineer, discussions with the Complainants and a review of all available information. • Section 626.9541(1)(i)(3)(e), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show they provided a proof-of-loss statement to State Farm, and State Farm failed to timely affirm or deny full or partial coverage of claims, or failed to provide a written statement that the claim is being investigated. Complainant’s CRN contains no allegations concerning the frequency with which State Farm performs this action and no allegation that it rises to the level of a general business practice. In this claim, the Complainants have not provided a sworn Proof of Loss statement to State Farm. Under the terms of their policy, Complainants are required to submit a Proof of Loss statement within sixty (60) days of notifying State Farm of the loss. However, to date, State Farm has not received this required documentation. Accordingly, this allegation is entirely without merit. • Section 626.9541(1)(i)(3)(f), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contains no allegations concerning the frequency with which State Farm performs this action. Additionally, the body of the CRN lacks any detail explaining how State Farm allegedly failed to promptly provide a reasonable written explanation to the insured regarding the basis for the claim denial under the policy, in relation to the facts or applicable law. State Farm’s coverage decision letter, dated October 12, 2024, clearly outlines the relevant policy provisions that formed the basis for the denial. Moreover, the CRN’s Facts Section does not reference any specific issues with the denial letter itself but instead disputes the results of the investigation—namely, that Complainants have no covered damages. This fails to meet the specificity requirements outlined in the applicable statutes. • Section 626.9541(1)(i)(3)(h), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contain no allegations concerning the frequency with which State Farm performs this action and no allegation that it rises to the level of a general business practice. In fact there are no allegations specific to this statutory violation at all. This appears to be a boilerplate allegation with no factual support provided within the body of the CRN. State Farm was able to render a decision based on the information it had. The following statutes were improperly included in the Facts Section of the CRN rather than in the Statutory Provisions Alleged section. The statutes and State Farm’s responses are as follows: • Section 626.9541(1)(i)(3)(g), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: g. failing to promptly notify the Insured of any additional information necessary for the processing of a claim. o Section 626.9541(1)(i)(3)(g), Florida Statutes. In order to prove a violation under this provision of the law, Complainants must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ CRN contains no allegations concerning the frequency with which State Farm performs this action and no allegation that it rises to the level of a general business practice. In fact there are no allegations specific to this statutory violation at all. State Farm sent its coverage decision letter dated October 12, 2024 based on the information available. • Section 626.9541(1)(i)(3)(i), Florida Statutes. Committing or performing with such frequency as to indicate a general business practice any of the following: i. failing to pay personal injury protections claims within the time periods required by section 627.736(4)(b). o Section 626.9541(1)(i)(3)(i), Florida Statutes. In order to prove a violation under this provision of the law, Complainant must show State Farm commits this action “with such frequency to indicate a general business practice.” Complainants’ alleged claim pertains to a roof damage dispute, not a personal injury matter. Accordingly, this claim is without merit and is not applicable. In sum, the CRN is replete with conclusory assertions unsupported by any meaningful factual basis. Contrary to the specificity explicitly required by section 624.155(3)(b)2., the facts do not specify any details about the claimed damage. Furthermore, there are no dates, timeframes, or any other specific details concerning State Farm’s investigation of the claim, or its communication with the Complainants and their representatives throughout the claims handling process, to substantiate any recitation of the Florida law cited. Rather the few “facts” that are contained in the CRN comprise an incomplete and inaccurate recitation of what transpired after wind and hail storm allegedly damaged the Complainants’ property. Additionally, the CRN relies on vague and conclusory allegations, the bulk of which merely parrot language from sections 624.155(1)(b) and 626.9541(1)(i)(3) without providing any claim-specific factual basis in support of same. Moreover, the CRN does not comply with Section 624.155(3)(b)3., which requires Complainants to name 'any individual involved in the violation.' In the Notice Against section, Complainants list 'N/A.' However, in the Facts Section, they reference Matthew Monroe without providing any detail or clarity as to his alleged involvement in the claim. The CRN merely states that Mr. Monroe 'failed to negotiate this claim with Insureds’ attorney and/or failed to provide a satisfactory settlement offer to resolve the claim,' without offering any factual basis or specifics. It further alleges—without support—that Mr. Monroe 'refused to pay the full amount due and owed to its Insured[s].' However, the coverage decision letter, dated October 12, 2024, was issued by another claim specialist, Paul Fynnmore, and confirmed that the inspection did not reveal any signs of wind or hail damage to the roof or exterior of the Complainants’ property. Additionally, State Farm retained Forcon International to conduct the inspection, further supporting its findings. This CRN fails to articulate how Mr. Monroe allegedly mishandled the claim. Furthermore, it is contradictory, vague, and non-specific, as it simultaneously asserts that coverage was confirmed by State Farm while also claiming that coverage was denied. For these reasons, the CRN is invalid. Additionally, the subject CRN merely references certain alleged policy contents in a generic, boilerplate manner, which consists of broadly referencing the general insuring agreement of the policy’s property coverage provisions for “Section I – Property Coverage A, Coverage A – Dwelling (Entire Section), Coverage B – Other Structures (Entire Section), Coverage C – Personal Property (Entire Section), and Coverage D- Loss of Use (Entire Section).” The CRN then fails to justify how any provisions of the policy were allegedly breached or how they relate to the subject claim or alleged bad faith statutory violations. These allegations are too broad because they summarize the policy provision, or just provide the heading of the section, which is improper. Other than a difference in opinion, Complainants have cited to no wrongdoing of State Farm or policy violation. The requirement for Complainants to discuss specific policy provisions is meant to narrow down the applicable policy provisions to give the insurer notice, not simply advise the insurer that broad sections of the policy apply. This is no better than referencing the entire policy, and Complainants provide absolutely no justification for failing to cite the specific policy language relevant to the alleged statutory violations committed by State Farm, as is explicitly required by section 624.155(3)(b). The CRN thereby fails to comply with the specificity requirements of section 624.155(3) (b), especially given the broad, sweeping, and vague nature of the CRN’s reference to certain alleged policy contents. This is prejudicial to State Farm. The CRN offers no basis and no policy provisions that might provide coverage for this claim, and none that might alter State Farm’s decision on this claim or warrant reconsideration. Complainants cannot prevail on a claim for extra-contractual damages without first establishing State Farm breached the insurance contract, yet they would force State Farm to essentially guess what policy provisions they believe were allegedly violated and why. An insurer cannot be forced to guess about these or any other matters. The CRN is therefore invalid. See Julien, 311 So. 3d 875 (holding broad references to policy language do not satisfy the specificity requirements of the civil remedy notice statute; such requirements are not mere technicalities). In addition, Complainants make improper and ambiguous demands which likewise invalidate the CRN. They demand State Farm “immediately tender payment in the amount of $54,254.000 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property.” See CRN at 4. Complainants cannot demand State Farm “immediately” take any action as State Farm has sixty (60) days to cure this CRN. Furthermore, this CRN is premature and invalid as Complainants provided State Farm with new alleged damages the exact same date this CRN was filed. To be clear, State Farm acknowledges that a CRN is not required to state the dollar amount being demanded, but the CRN must provide the insurer with sufficient information and a reasonable basis from which the insurer can determine what amount is being demanded to cure the claim. Similarly, if a CRN does demand a dollar amount, it must do so with specificity and without ambiguity. This CRN does neither. Defects such as these, which create genuine doubt and ambiguity as to what Complainants are seeking to cure the CRN, render the CRN invalid. Furthermore, Florida law does not impose an insurer the obligation to pay whatever the insured or claimant demands, such as the estimate discussed in the CRN. Rather, in a first-party matter such as this, an insurer is only required to pay the contractual amount still owed under the policy—if any. Thus, any demand that the insurer must purportedly pay inferred costs, a subjective amount Complainants seek through their estimate, or any other type of extra-contractual damages renders the CRN a legal nullity. See Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003). The purpose of the CRN is not to force the insurer to engage in a guessing game. Yet that is precisely what this CRN does by virtue of its lack of specificity and other defects. The deficiencies described above deprive State Farm of any meaningful notice and ability to respond. They also render any purported “cure” provisions illusory and render the CRN invalid. Defects such as these thwart the fundamental purpose of the CRN, which is to give the insurer the opportunity to cure the alleged violations within the 60-day statutory period. This CRN is contrary to the purpose and requirements of Florida law, including the notice and cure provisions of section 624.155, which are a necessary prerequisite to any future bad faith action against State Farm. See, e.g., Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000). An invalid CRN, such as this, cannot serve as a condition precedent to any action for alleged bad faith against State Farm under section 624.155 or otherwise under Florida law. As such, this CRN should not be permitted to serve as the legal precursor for a bad-faith lawsuit, or any other action against State Farm. Subject to and without waiving these denials and objections and any other available defenses, State Farm submits that it has not violated any applicable provision of Florida law in handling this claim, in any way related to this claim, or in any litigation related to this claim. FACTS OF CLAIM As noted above, this claim arises from alleged wind and hail damage to the Complainants’ property, purportedly occurring on April 27, 2023, and reported to State Farm on October 13, 2023, by Complainant Aaron Bowden. Upon receiving notice of the loss, State Farm promptly acknowledged the claim in writing, issuing its Homeowner’s Bill of Rights and Duties After Loss correspondence. This correspondence informed the Complainants of the claim process, their obligations under the policy, and their rights as insureds. State Farm made multiple attempts to contact the insureds to discus their claim, but never received any response from the insureds. Therefore, on November 28, 2023, State Farm sent correspondence to the insureds advising of State Farm’s inability to contact the insureds and closing the claim based on the same. On January 9, 2024, a contractor, ELO Roofing, contacted State Farm to inquire whether the claim was still open. State Farm explained that the claim had been closed due to a lack of contact with the Complainants. ELO Roofing confirmed that they were experiencing similar difficulties in reaching the Complainants. On August 21, 2024—more than ten months after the claim was initially reported—Dustin, a contractor from ELO Roofing, contacted State Farm requesting an update on the claim. State Farm informed ELO Roofing that the claim remained closed due to no contact with the Complainants and provided the contact information for the previous contractor. On August 23, 2024, Serrano, Cagan, and Cagan submitted a letter of representation, a W-9, and a request for a copy of the policy, along with correspondence and documents related to the claim. On August 26, 2024, Dustin from ELO Roofing contacted State Farm to request a status update and mentioned that the Complainants believed their claim had been denied. State Farm clarified that the claim had not been denied and explained that it had not yet conducted an inspection of the property. That same day, State Farm issued a Reservation of Rights letter to the Complainants. On August 30, 2024, State Farm retained Forcon International Group to inspect the Complainants’ property. The inspection did not reveal any indications of wind or hail damage to the roof or exterior of the property related to the reported weather event on April 27, 2023. Instead, the overall condition of the roof was found to be consistent with progressive and cumulative wear, tear, deterioration, and prolonged exposure to weather over time—none of which are covered under the policy. On October 11, 2024, ELO Roofing re-tarped the roof using a poly tarp with cap nails and furring strips, which resulted in additional damage to the shingles. On October 12, 2024, State Farm issued its coverage determination correspondence, explaining its coverage decision. Complainants and/or their representative were also provided with a copy of the engineer’s findings. State Farm informed Complainants of the mediation option available through Department of Financial Services (“DFS”) should they dispute the determination and further encouraged them to submit any additional information relevant to the claim. Later that day, ELO Roofing provided photographs of the roof before and after tarping, along with a tarping estimate of $487.68 and a repair estimate totaling $28,380.00. On October 21, 2024, Complainants’ attorney filed a Notice of Intent to Initiate Litigation ("NOIL") on behalf of Complainants, alleging damages totaling $54,254.00 (and included new areas of alleged damage). Attached to the NOIL was an estimate from Serrano, Cagan, and Cagan in the amount of $46,562.57. On October 23, 2024, State Farm sent a request for information to the Complainants, asking for copies of any photographs taken prior to the installation of the tarp or waterproof membrane. On October 29, 2024, having received no response, State Farm sent a follow-up request for the same information. On November 4, 2024, State Farm issued a NOIL response, requesting a re-inspection of the property. On November 12, 2024, State Farm again sent a request for pre-installation photographs. That same day, Complainants’ attorney responded, stating that the requested photographs had been sent on prior occasions and provided additional photographs for State Farm’s consideration. On November 14, 2024, Complainants’ attorney advised that they would arrange for the tarp to be removed prior to the scheduled re-inspection on November 20, 2024. On November 20, 2024, State Farm conducted a re-inspection of the property with both Complainants present. The inspection revealed water stains on the living room ceiling, garage ceiling, and separation of wallpaper in the den. On November 25, 2024, State Farm issued a second coverage determination letter, advising that while there was no covered damage to the Complainants' roof, there was covered damage to the garage ceiling. However, State Farm’s estimate for the covered repairs totaled $2,201.51, which did not exceed the $5,788.00 policy deductible. Accordingly, no payment was issued. On December 2, 2024, Complainants’ counsel submitted a formal demand for appraisal. On December 4, 2024, State Farm responded, advising that under the terms of the policy, only State Farm has the right to demand appraisal. Accordingly, the demand for appraisal was rejected. On December 16, 2024, Complainants’ counsel filed this CRN. State Farm has at all times acted in good faith, promptly, fairly, honestly, and with due diligence in its handling, investigation, and/or determination of what is owed on the claim and in any related litigation. State Farm is ultimately bound by the terms of the policy—just as the Complainants are. Pursuant to the insurance contract, State Farm has a duty to extend coverage for “accidental” losses that are covered by the policy, and no duty to extend coverage for losses that are not. Even so, State Farm remains willing to review and consider any additional information Complainants believe to be relevant to this matter. State Farm will evaluate any additional information or documentation it receives in good faith, like it has already done thus far. As the foregoing demonstrates and confirms, State Farm has at all times handled this claim in good faith and is continuing to handle it in good faith. These are intended as examples and are not exhaustive. State Farm objects to and denies the allegations of the CRN. The objections and denials herein are not necessarily exhaustive and this response shall not prevent State Farm from asserting any other appropriate objections, denials, and/or defenses related to this claim and/or CRN. Moreover, due to the objections and defects discussed herein, the Department should strike and/or reject the CRN as invalid. As a final matter, it should be emphasized that any policy issued by State Farm is governed by the policy’s terms, conditions, and exclusions together with any endorsements. This CRN response does not waive any such provisions of the policy. Furthermore, any action taken by or on behalf of State Farm or its authorized representative(s), whether in the past or future, to investigate the alleged loss, to adjust any claim or request for payment, or in any way related to or arising out of the subject claim or loss, shall not waive any of the terms, conditions, or any other provisions of the policy. Thank you for your time and attention in this matter. Please contact us if you have any questions or require additional information. Sincerely, /s/ Ashley L. Palmer Christopher M. DelBene, Esq. Ashley L. Palmer, Esq. cc: State Farm

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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008