Civil Remedy Notice of Insurer Violations
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Filing Number:     797011
Filing Accepted:  12/16/2024
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Complainant
Last/Business Name *  
SANTIAGO   First Name   LUIS AND JENNIFER
Street Address * 1509 W NOON PLACE
City, State Zip * CITRUS SPRINGS, FL 34434
Email Address * JENNYLS24@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SANTIAGO   First Name   LUIS AND JENNIFER
Policy # * 80-BA-T091-8 Claim #* 59-73V1-88M
Attorney
Attorney is Applicable
Last Name* HAMMACK-BARBER First Name * TAMMY Initial
Street Address* 2300 MAITLAND CENTER PARKWAY STE. 106
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * THAMMACK@SERRANOCAGAN.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):* JAREN ROUNDTREE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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.
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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
* 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 – LOSSES INSURED COVERAGE A – DWELLING We will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. However, loss does not include and we will not pay for, any diminution in value. SECTION I – LOSSES NOT INSURED 1. We will not pay for any loss to the property described in Coverage A that consists of, or is directly and immediately caused by, one or more of the perils listed in items a. through m. below, regardless of whether the loss occurs abruptly or gradually, involves isolated or widespread damage, arises from natural or external forces, or occurs as a result of any combination of these: g. wear, tear, decay, marring, scratching, deterioration, inherent vice, latent defect, or mechanical breakdown; h. corrosion, electrolysis, or rust; i. wet or dry rot; k. settling, cracking, shrinking, bulging, or expansion of pavements, patios, foundations (including slabs, basement walls, crawl space walls, and footings), walls, floors, roofs, or ceilings; However, we will pay for any resulting loss from items a. through l. unless the resulting loss is itself a Loss Not Insured as described in this Section. 3. We will not pay for, under any part of this policy, any loss consisting of one or more of the items below. Further, we will not pay for any loss described in paragraphs 1. and 2. immediately above regardless of whether one or more of the following: (a) directly or indirectly cause, contribute to, or aggravate the loss; or (b) occur before, at the same time, or after the loss or any other cause of the loss: a. conduct, act, failure to act, or decision of any person, group, organization, or governmental body whether intentional, wrongful, negligent, or without fault; b. defect, weakness, inadequacy, fault, or unsoundness in: (1) planning, zoning, development, surveying, or siting; (2) design, specifications, workmanship, repair, construction, renovation, remodeling, grading, or compaction; (3) materials used in repair, construction, renovation, remodeling, grading, or compaction; or (4) maintenance; of any property (including land, structures, or improvements of any kind) whether on or off the residence premises; or c. weather conditions. However, we will pay for any resulting loss from items 3.a., 3.b., and 3.c. unless the resulting loss is itself a Loss Not Insured as described in this Section. 8. Loss payment. We will adjust all losses with you, We will pay you unless some other person is named in the policy or is legally entitled to receive payment.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Luis Santiago and Jennifer Louise Santiago submitted a claim for damage to their home to State Farm Florida Insurance Company, after their home sustained a covered direct physical loss due to a storm. Prior to the loss, Insurer issued a policy of insurance, policy number 80-BA-T091-8, which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect when the loss occurred. After sending an adjuster out to inspect, State Farm in its coverage letter acknowledged that they found damage to the home but claimed that this damage is not covered under the policy, and applied inapplicable exclusions. In doing so it has misrepresented pertinent facts or insurance policy provisions relating to coverages at issue in violation of Fl. Stat. 626.9541(1)(i)(3)(b) and issued in writing a material misrepresentation to the insureds 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 in violation of Fl. Stat. 626.9541(1)(i)(2). State Farm fully denied the claim and failed to make any payment. Due to this Insureds had no choice but to retain legal representation, as the Insurer refused to pay the full amount due and owed to its Insureds. Insurer has continually failed to negotiate this claim with Insureds’ attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insureds’ 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 insureds. 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. Insurer can cure its bad faith conduct by: 1) accepting the insureds’ claim as compensable, and agreeing to pay the claim in accordance with its loss settlement provision prior to the expiration of the cure period, or 2) reaching an amicable settlement of the pending claim prior to the expiration of the cure period, or 3) tender payment in the amount of $54,318.25, less any applicable deductible to the Insureds to complete the repairs for the Insureds’ property. By doing any one of these three things, the insurer will cure its bad faith in this case, and extinguish any and all of its liability for all bad faith damages which could be sought pursuant to this Civil Remedy Notice.
Comments
User Id Date Added Comment
thammack@serranocagan.com 12-02-2025 This CRN is withdrawn.
capacheco@mdwcg.com 11-19-2025 The parties have resolved all issues in dispute.
sjpoljak@mdwcg.com 01-07-2025 January 7, 2025 Via Email to thammack@serranocagan.com Luis and Jennifer Santiago c/o Tammy Hammack-Barber, Esquire 2300 Maitland Center Parkway, Suite 106 Maitland, Florida 32751 RE: DFS #: 797011 DFS Acceptance Date: December 16, 2024 Complainant: Luis and Jennifer Santiago Insured: Luis and Jennifer Santiago Insurer: State Farm Florida Insurance Company Policy No.: 80-BA-T091-8 Date of Loss: February 4, 2024 Claim No.: 59-73V1-88M Our File No.: 40977.01172 Dear Ms. Hammack-Barber: We have been retained by State Farm Florida Insurance Company (State Farm) to respond to the above-referenced Civil Remedy Notice of Insurer Violation (CRN) filed by you on behalf of Luis and Jennifer Santiago (Claimants). While State Farm welcomes the opportunity to respond to this CRN and specifically denies each and every allegation contained in the CRN filed in relation to this claim, State Farm asserts that the CRN should be rejected as it fails to comply with several of the requirements of the Civil Remedy Notice of Insurer Violation document provisions, as set forth in Florida Statute §624.155 and Florida case law. THE CRN ALLEGATIONS The CRN asserts the following reasons for the notice: • Claim Denial Further, the CRN alleges State Farm 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 insured and with due regard for her or his interests. 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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. DISCUSSION For a number of reasons, the CRN fails to comply with the requirements of Florida Statutes. First, the CRN should be rejected because although the CRN identifies an individual "representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations" the CRN fails to ascribe any specific act of impropriety or statutory violation to the identified individual or any other specific State Farm employee, representative or agent. It is this failure to ascribe any specific act of impropriety or statutory violation to specific individuals which prohibits State Farm from adequately addressing the issues raised in the CRN and is a reason why the CRN should be rejected. Next the CRN requires the Complainant "pursuant to Section 624.155, Florida Statutes, please indicate all statutory provisions alleged to have been violated." As indicated above, the CRN includes statutory provisions regardless of whether they are relevant or applicable to any alleged facts contained in the CRN. In fact, based upon the facts of this matter, State Farm performed a prompt investigation of the claim required of it under Florida law and the Policy. Further, the facts of this matter evidence that, at all times, State Farm acted in accordance with Florida law and the obligations under its Policy. Therefore, State Farm denies that it violated any of the statutory provisions set forth in the CRN. It is because the CRN contains statutory provisions that are clearly inapplicable, that State Farm is unable to properly respond and the CRN should be rejected. In response to The Department's request for the "specific policy language that is relevant to the alleged violation", the CRN merely list sections of the policy and general policy language. However, simply listing sections of the policy and general policy language regarding coverage without providing any further analysis or discussion of how the policy was violated is in direct contradiction to Florida Statute §624.155(3)(b) and renders the Notice defective. See Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021). Again, it is this failure of the Complainant to comply with the requirements of the Civil Remedy Notice of Insurer Violation document provisions, as set forth in Florida Statute §624.155 and Florida case law, which prohibits State Farm from adequately addressing the issues raised in the CRN and is a reason why the CRN should be rejected. Further, the CRN itself only provides unsupported allegations without setting forth specific facts allegedly evidencing violation of each specific Florida statutes contained in the CRN. Notwithstanding the deficiencies in the CRN, State Farm denies it committed the alleged acts or violated the statutes cited in the CRN and asserts this is another reason why the CRN should be rejected. Additionally, before addressing the allegations set forth in the CRN, the CRN is insufficient on its face. Contrary to the requirements of Section 624.155, Florida Statutes, the CRN does not specifically describe the facts or circumstances giving rise to each statutory violation alleged against State Farm, and as indicated above, many of the alleged statutory violations are clearly inapplicable in light of the allegations contained in the CRN. The CRN simply sets forth the provisions of various statutes and fails to allege any fact or circumstances whereby State Farm's actions may have violated those statute. Therefore, the CRN is inadequate under Florida law and must be rejected. Based upon the foregoing, the CRN is insufficient on its face. See, Talat Enterprises Inc., vs. Aetna Cas. & Sur. Company., 753 So. 2d 1278 (Fla. 2000); Lane v. Westfield Ins. Company, 862 So. 2d 744 (Fla. 5th DCA 2003); Valenti v. Unum Life Insurance Company of America, 2006 WL 1627276, 2 (MD Fla. June 6, 2006); Longpointe Condominium Association v. Allstate Ins. Company, 2005 WL 1315810 (MD Fla. June 2, 2005); Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021).. Setting forth the correct factual background, State Farm issued insurance policy number 80-BA-T091-8, with effective dates of November 9, 2023 to November 9, 2024, to Luis and Jennifer Santiago, for property located at 1509 W. Noon Place, Citrus Springs, Florida 34434-5954 (the Property). The Policy is a Homeowners Policy that includes Coverage A – Dwelling limits of $390,121.00 and Building Ordinance or Law coverage of $97,530.00. On or about September 16, 2024, the Claimants reported the present claim to State Farm that the Property sustained wind and hail damage to the roof on or about February 4, 2024. On September 17, 2024, State Farm sent correspondence to the Claimants acknowledging the claim. After attempting to contact the Claimants by telephone, State Farm sent correspondence dated September 20, 2014 advising that it was unable to speak to the Claimants regarding the claim and requested that they contact State Farm. Also on September 20, 2024, State Farm provided the Claimants with the Home Owners Bill of Rights and advised the Claimants of their duties under the policy. On September 23, 2024, State Farm sent a reservation of rights letter to the Claimants advising of issues that could effect coverage under the policy, such as the late notice of the reporting of the claim for approximately 7 months. On September 23, 2024, State Farm's representative was able to speak with the Claimants and discussed the claim handling process. At that time, an inspection of the Property was by Seek Now was discussed with the Claimants. On September 25, 2024 an inspection was conducted of the exterior of the home by Seek Now. During the inspection, the entirety of the roof system was inspected for storm related damages. Accordingly, Seek Now reported the following: Roof Findings No wind or hail damage was found on any slope. No storm related tree damage was found on any slope. No non-storm related tree damage was found on any slope. Other damage was found on the Back and Left slopes. No damage was found on any hip & ridge. No damage was found to the roof accessories. No damage was found to the valleys. All accessory counts can be found in the tables below. Exterior Findings An exterior inspection was performed. No damage found to the Front, Left, Back, and Right elevations. No damage found to the Front soffit. No damage found to the Front gutter system. As a result of the Seek Now inspection, on October 9, 2024, a denial letter was sent to the Claimants. Additionally, on October 11, 2024, State Farm discussed the coverage determination letter with the Claimants and also sent correspondence to Claimants advising them of their rights to mediation as required by Florida statute. On October 24, 2024, State Farm received a letter of representation from the Claimants' attorney. On November 9, 2024, State Farm sent correspondence acknowledging receipt of the letter of representation and advising that it had requested a certified copy of the policy. On November 15, 2024, a copy of the policy and a copy of the denial letter were sent to the Claimants' attorney. On December 16, 2024, State Farm received the instant CRN and a Notice of Intent to Litigate. Therefore, State Farm denies it failed to perform a proper, prompt investigation and evaluation of the claim and takes exception with the allegations in the CRN which suggests the contrary. Accordingly, as reflected above, State Farm has acted within the terms of its Policy and Florida Statutes. State Farm asserts there is no basis for the claims made by Claimants in the CRN that State Farm has failed to act in good faith in the handling of the claim. Likewise there is no basis or factual support for the claims made in the CRN that State Farm improperly delayed the claim; improperly denied the claim; failed to conduct a full and fair investigation of the claim; looked for ways to deny recovery to Claimants; looked for ways to delay recovery to Claimants; failed to adjust the claim and failed to evaluate the loss properly, promptly, and fairly so as to provide full and prompt indemnity to Claimants; failed to implement proper standards for the adjustment and investigation of insurance claims; failed to train, supervise, or manage adjusters and independent contractors properly so that prompt and full payments are made; placed the company's interests before the policyholders' interests by attempting to deny or minimize payments owed; or that its actions were willful, wanton and malicious in nature. In closing, State Farm first requests the CRN be rejected due to its failure to comply with Florida Statute §624.155 and Florida case law. Regardless of the rejection, as demonstrated above, State Farm has, at all times, acted in good faith, with due diligence, and in accordance with the terms of its insurance policy and Florida Statutes with respect to the handling of the Claimants claim. State Farm denies the allegations contained in the CRN. We trust this response adequately addresses the allegations of violation alleged in the CRN. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very truly yours, /s/ Stephen J. Poljak Stephen J. Poljak
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