Civil Remedy Notice of Insurer Violations
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Filing Number:     797119
Filing Accepted:  12/17/2024
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Complainant
Last/Business Name *  
ROYAL PELICAN ASSOCIATION, INC.   First Name  
Street Address * 4541-4591 BAY BEACH LANE
City, State Zip * FORT MYERS BEACH, FL 33931
Email Address * CBOE@BECKERLAWYERS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ROYAL PELICAN ASSOCIATION, INC   First Name  
Policy # * AMC-38091-01 Claim #* 4197992
Attorney
Attorney is Applicable
Last Name* BOE First Name * CONNOR Initial
Street Address* 12140 CARISSA COMMERCE COURT #200,
City, State Zip* FORT MYERS , FL 33966
Email Address * CBOE@BECKERLAWYERS.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN COASTAL INSURANCE COMPANY
NAIC Company Code 12968
 
Name of individual responsible for violation (if any):* N/A
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
* 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

A. Coverage We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss. 1. Covered Property Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2., Property Not Covered, if a Limit of Insurance is shown in the Declarations for that type of property. a. Building, meaning the building or structure described in the Declarations, including: (1) Completed additions; (2) Fixtures, outside of individual units, including outdoor fixtures; (3) Permanently installed: (a) Machinery; and (b) Equipment; (4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including: (a) Fire-extinguishing equipment; (b) Outdoor furniture; (c) Floor coverings; and (d) Appliances used for refrigerating, ventilating, cooking, dish- washing or laundering that are not contained within individual units (5) If not covered by other insurance: (a) Additions under construction, alterations and repairs to the building or structure; (b) Materials, equipment, supplies, and temporary structures, on or within 100 feet of the described premises, used for making additions, alterations or repairs to the building or structure; and (6) Any of the following types of property contained within a unit, regardless of ownership, if your Condominium Association Agreement requires you to insure it: (a) Fixtures, improvements and alterations that are a part of the building or structure; and (b) Appliances, such as those used for refrigerating, ventilating, cooking, dishwashing, laundering, security or housekeeping. But Building does not include personal property owned by, used by or in the care, custody or control of a unit-owner except for personal property listed in Paragraph A.1.a.(6) above. . . . . 3. Covered Causes Of Loss See applicable Causes Of Loss Form as shown in the Declarations. . . . . 4. Additional Coverages e. Increased Cost Of Construction (1) This Additional Coverage applies only to buildings to which the Replacement Cost Optional Cover- age applies. (2) In the event of damage by a Covered Cause of Loss to a building that is Covered Property, we will pay the increased costs incurred to comply with enforcement of an ordinance or law in the course of repair, rebuilding or replacement of damaged parts of that property, subject to the limitations stated in e.(3) through e.(9) of this Additional Coverage. (3) The ordinance or law referred to in e.(2) of this Additional Coverage is an ordinance or law that regulates the construction or repair of buildings or establishes zoning or land use requirements at the described premises, and is in force at the time of loss. . . . . B. Exclusions And Limitations See applicable Causes Of Loss Form as shown in the Declarations . . . . C. Limits Of Insurance The most we will pay for loss or damage in any one occurrence is the applicable Limit of Insurance shown in the Declarations. The most we will pay for loss or damage to outdoor signs, whether or not the sign is attached to a building, is $2,500 per sign in any one occurrence. The amounts of insurance stated in the following Additional Coverages apply in accordance with the terms of such coverages and are separate from the Limit(s) of Insurance shown in the Declarations for any other coverage: 1. Fire Department Service Charge; 2. Pollutant Clean-up And Removal; 3. Increased Cost Of Construction; and 4. Electronic Data. . . . . 8. Valuation We will determine the value of Covered Property in the event of loss or damage as follows: a. At actual cash value as of the time of loss or damage, except as provided in b. and c. below. b. If the Limit of Insurance for Building satisfies the Additional Condition, Coinsurance, and the cost to repair or replace the damaged building property is $2,500 or less, we will pay the cost of building repairs or replacement. The cost of building repairs or replacement does not include the increased cost attributable to enforcement of any ordinance or law regulating the construction, use or repair of any property. However, the following property will be valued at the actual cash value even when attached to the building: (1) Awnings or floor coverings; (2) Appliances for refrigerating, ventilating, cooking, dishwashing or laundering; or (3) Outdoor equipment or furniture. c. Glass at the cost of replacement with safety-glazing material if required by law.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On September 28th, 2022 Hurricane Ian made landfall in Southwest Florida, causing extensive damage to the covered property at 4541-4549 Bay Beach Lane, Fort Myers Beach, FL known as the Royal Pelican Condominiums. The Insured submitted a claim to the Insurer for damages related to Hurricane Ian, which has been assigned Claim No. 4197992 (the "Claim” or "Loss") under Commercial Property Policy AMC-38091-01. The damage was reported following the storm. The storm caused extensive damages to all ten (10) buildings at the covered property and insured by American Coastal Insurance Company. After the initial claim was filed the first payment was received by the Insurer on or about June 20th, 2023 for $685,723.91 on an actual cash value basis less the non-recoverable depreciation and deductible. Since that date, the Insurer has not acted in good faith in settling the claims of damage, had delayed the prosecution of the claim, and withheld payment on certain undisputed portions of the claim in order to influence settlement on disputed portions of the claim. First Supplemental Claim On or about, December 12th, 2023, Insurer paid a supplemental claim in the amount of $110,980.71 on an actual cash basis. The supplement was approved in part based on the review of the engineering report provided by the Insured but the review was not completed at the time the First Supplemental Claim was approved. The supplemental claim covered additional payments less the deductible and recoverable depreciation for the following coverage determinations. Building 3 (4531)- $30,960.06 - Roof repairs, roof sheathing, facia, soffit, shutters, stucco repair, pa inting, interiors, lanai screens, window, corridor, doors, fire extinguisher and cabinet, and exit signs Building 4 (4541)- $27,409.16 - Roof, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, screens, windows, corridors, doors Building 6 (4561)- $21,560.38 - Roof, fascia, soffit, gutters, stucco repairs, interiors, screens, window reglaze, corridors, doors, fire extinguisher and cabinet. Building 9 (4591)- $26,965.89 - Roof repairs, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, exit signs, light fixtures, windows Building 10 Pool House- $4,085.22 - Pool house, roof, gutters The remaining locations were determined to remain below the deducible and no payment was processed for those locations and the Insurer continued to contest the outstanding claim. A second supplemental package was issued to Insurer. In February, the Insurer went over the details of the claim with representatives from the Insured. Second Supplemental Claim On or about, February 6th, 2024, Insurer paid a second supplemental claim in the amount of $77,601.72 on an actual cash value basis until the complete repair was completed. The supplemental claim was approved in part related to the field adjuster and the Insured’s retained engineers’ recommendations. The supplemental claim covered additional payments for buildings 3, 4, 6, 9 and the pool house, less the deductible and recoverable depreciation for the following coverage determinations: Building 3 (4531)- $18,318.33 - Roof repairs, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, fire extinguisher and cabinet, exit signs Building 4 (4541)- $18,318.33 - Roof, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, screens, windows, Building 6 (4561)- $18,318.33 - Roof, fascia, soffit, gutters, stucco repairs, interiors, screens, window reglaze, corridors, doors, fire extinguisher and cabinet Building 9 (4591)- $18,318.33 - Roof repairs, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, exit signs, light fixtures, windows Building 10 Pool house- $4,328.40 - Roof, gutters Third Supplemental Claim On or about, April 30th, 2024, Insurer paid a third supplemental claim in the amount of $54,135.98. related to mitigation cost from Dean Mitchell Restoration after a review of the submitted documentation. In the letter, It was specifically alleged that Building Consultant Juan Chanquin retained but Sedgwick was revising estimates to include additional roofing damage and revisions regarding the materials needed to complete the claim. Fourth Supplemental Claim On or about, June 5th, 2024 , Insurer paid a fourth supplemental claim in the amount of $964,041.98 on an actual cash value The claim was readjusted, and supplemental value was provided after reviewing Mr. Chanquin’s revised estimates, TELA Construction Invoices and estimates (Insureds retained contractor), Wareham Construction, Inc’s (Insurers retained contractor) estimate, and performed work invoices to that point. The supplemental claim covered additional payments less the deductible and recoverable depreciation for the following coverage determinations: Building 1 (4511)- $192,000.33 with additional payment of $20,346.93 in undisputed mitigation costs - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors Building 3 (4521)- $64,183.88 with an additional $4,627.50 in undisputed mitigation costs - Roof, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, fire extinguisher and cabinet, exit signs Building 4 (4541)- $103,144.95 with an additional payment of $42,570.41 undisputed mitigation - Roof, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, screens, windows, corridors, doors Building 5 (4551)- $210,157.63 with an additional $1,939.75 undisputed mitigation costs. - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, handrails, light fixtures, exit signs Building 6 (4561)- $60,974.54 with an additional $8,880.00 undisputed mitigation costs. - Roof, fascia, soffit, gutters, stucco repairs, interiors, screens, window reglaze, corridors, doors, fire extinguisher and cabinet Building 7 (4571)- $30,109.53 with additional $7,020.92 undisputed mitigation costs - Roof repairs, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, fire extinguisher and cabinet, exit signs, light fixtures, handrails Building 8 (4581)- $188,675.91 - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, fire extinguisher and cabinet, exit signs, light fixtures, windows Building 9 (4591)- $64,795.21 with additional $3,307.09 undisputed mitigation costs. - Roof repairs, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, exit signs, light fixtures, windows Fifth Supplemental Claim On or about, July 25th, 2024, Insurer paid a fifth supplemental claim in the amount with recoverable depreciation of $101,178.79 at a replacement cost value with the water mitigation total of $9,020.16 and mold remediation policy limits of $50,000. The supplement was approved after additional invoices and documentation was provide for the truss repairs on building three and releasing the recoverable depreciation. Building 1 (4511), $6,296.05 - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors Building 3 (4531), $20,520.89 - Roof repairs, roof sheathing, truss repair, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, fire extinguisher and cabinet, exit signs Building 4 (4541), $16,326.21 - Roof, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, screens, windows, corridors, doors Building 5 (4551), $9,788.00 - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, handrails, light fixtures, exit signs Building 6 (4561), $14,417.37 - Roof, fascia, soffit, gutters, stucco repairs, interiors, screens, window reglaze, corridors, doors, fire extinguisher and cabinet Building 7 (4571), $8,932.68 - Roof repairs, roof sheathing, fascia, soffit, gutters, stucco repairs, painting, interiors, lanai screens, windows, corridors, doors, fire extinguisher and cabinet, exit signs, light fixtures, handrails Building 8 (4581), $7,045.48 - Roof replacement per Wareham estimate, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, fire extinguisher and cabinet, exit signs, light fixtures, windows Building 9 (4591), $15,696.26 - Roof repairs, fascia, soffit, gutters, stucco repairs, painting, lanai screens, corridors, doors, exit signs, light fixtures, windows Building 10 (Pool house), $2,155.85 - Roof, gutters To date Insurer has paid has valued the claim at $3,218,349.41 less the deductible and non-recoverable depreciation and paid $1,993,662.11 to Insured. The insured has outstanding costs and is projected to spend more money to repair damages covered under the policy. Below is a breakdown of all money paid by insurer to date: Replacement Costs Depreciation Cash Value Deductible total Ck amount 06.20.2023 1,369,647.26 66,292.40 1,303,354.86 617,630.95 685,723.91 12.12.2023 1,487,450.72 73,115.15 1,414,335.57 617,630.95 110,980.71 02.07.2024 1,552,547.90 60,610.61 1,491,937.29 617,630.95 77,601.72 04.30.2024 1,606,682.90 60,610.61 1,546,072.29 617,630.95 54,135.00 06.06.2024 3,210,649.99 93,479.37 3,117,170.62 1,224,687.30 964,041.98 07.29.2024 3,218,349.41 - 3,218,349.41 1,224,687.30 101,178.79 Since the final payment was received on July 29th, 2024 there have been no additional payments to the Insured despite the Insured placing the Insurer on notice that there were outstanding shortfall costs related to door and window replacements, roof replacement, engineering report and compliance costs, and soffit Nailers in each building. Invoices and evidence of the costs were provided to Insurer. These damages were discussed in detail with the Insurers representatives as early as February of 2024. The Insurer claims it continues the investigation despite being provide invoices for the work completed, detailed estimates, and engineering recommendations. The Insurers third party administrator, Sedgwick, (“TPA”) continued to claim the additional documentation was not provided and continued to contest shortages outstanding. In September, a demand was sent to Insurer for payment on the shortfalls discussed and requesting replacement cost’s associated with buildings 2 and 7 per the engineering reports and the recommendations of the Insurers retained Building Consultant. The Insured was advised that the Building Consultant was no longer working on the file despite showing that buildings 2 and 7 needed complete replacement. The Insured has incurred significant costs related to the damage at the property that is covered by the Commercial package. As of October 24th, 2024 the Insurer had failed to pay or provide satisfactory explanation as to the $2,127,929.80 shortfall for costs incurred and estimated to be incurred by the Association. The Insurer has provided different valuations for what appear to be the same work on different buildings in the complex with little to no explanation for the discrepancies. For example, as it relates to the roof claims, Insurer has paid or valuated the roof claims as follows: Building #1 - $245,374.40 Building #2 - $ 54,174.38 Building #3 - $325,907.20 Building #4 - $330,112.34 Building #5 - $250,250.96 Building #6 - $325,567.32 Building #7 - $ 79,316.01 Building #8 - $244,919.51 Building #9 - $329,952.97 There is a roughly $80,000 variance between buildings 4 and 5 with little to no explanation as to the variance in the claim value despite the damage being similar. The original buildings received a higher valuation with no data or evidence to explain why the Insurer had made that decision. It was communicated that coverage on buildings 2 and 7 were reopened yet no payment has been issued. On or about October 31st, 2024 The Insurer sent a final Reservation of Rights and Request for Information in response to the Insureds demand for payment, neither accepting or rejecting said demand. In this letter, Insurer requested the following items. 1. A revised Proof of Loss, invoices, receipts, your contractors final estimates/invoices per building and contracts for work performed or to be performed in relation to the damage reported for this claim not previously provided. To include but not limited to the window and corridor invoices. 2. Any other documentation which supports the Association’s contention that the claimed damage was due to a covered cause of loss. The TPA appointed employee, Corey Mitchell, had direct communication with the President of the Association regarding the September demand. Mr. Mitchell had claimed one of the main areas of contention related to the thickness of plywood required on the roofs. Part of the claim included this thickness of plywood as it was required by the Town of Fort Myers Beach in order to pass inspection. This information was provided to Mr. Mitchell via an Email from the Town Inspector. The form of communication was not accepted by Mr. Mitchell. The reopened coverage on buildings, 2 and 7, were at a significantly lower price that was provided on other buildings in the complex with similar damage. In fact, the Insurer had provided payment for 5/8th inch plywood on buildings 3 and 4 and then subsequently claimed that the payment and calculation was made in error. It was further discussed with the TPA that all the final invoices for the replacement of windows and doors had been submitted. The TPA acknowledged a coverage determination had been reopened by the carrier on all the doors replaced except for building 2. However, there was never a supplemental payment and there is no explanation as to why they have not been paid on the remaining wind driven damaged doors. There have been multiple increasing offers to settle the claim since the September demand with no justification to the Insured how these costs are calculated. The settlement offers do not cover the costs associated with the covered damage and provide no insight as to how the Insurer is making its cost determinations. To date the Association has complied with the Insurers requests for information, inspections, additional requirements and all terms and conditions under the policy. The insurer has not provided a partial denial letter or any further explanation regarding the settlement offer. The Insurer continues to delay the claim or withhold payment on certain portions of the claim when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage to influence settlements under other portions of the insurance policy coverage. As of the date of this filing, now over twenty-seven months since Hurricane Ian, the Insurer has failed to pay the amounts necessary to make the Association whole under the provisions of the policy, has undervalued the claim, has failed to pay all the undisputed amounts, and has failed to act diligently in performing its investigation. The insurer can cure the above-described deficiencies by (1) immediately paying any and all undisputed sums; (2) identifying any and all disputed sums and the basis for the dispute; (3) agreeing to an appraisal of any disputed sums under the terms of the policy; or (4) paying the remaining amount of included in the Insured’s demand within 60 days of receipt of this Notice.
Comments
User Id Date Added Comment
ccambo@camboferry.com 02-14-2025 February 14, 2025 Via E-Mail Only Royal Pelican Association, Inc. c/o Becker Poliakoff Attn: Connor Boe, Esq. 12140 Carissa Commerce Court #200, Fort Myers, FL, 33966 VIA EMAIL: CBOE@BECKERLAWYERS.COM RE: Insured: Royal Pelican Association, Inc. Claim Number: 4197992 Policy Number: AMC-38901-01 DFS Filing Number: 797119 Location: (Various) Bay Beach Ln., Fort Meyers Beach, FL, 33931 Cause of Loss: Wind/Hurricane Ian Dear Royal Pelican Association, Inc., As you know, my firm has been retained to represent American Coastal Insurance Company (“American Coastal”) in the above-referenced matter. Please allow this letter to acknowledge that American Coastal is in receipt of the Civil Remedy Notice of Insurer Violations bearing Filing No. 797119 (the “Notice”) filed on behalf of Royal Pelican Association, Inc. (“Complainant” or “Insured”). The Notice is void because it is legally invalid. Beyond that, the allegations in the Notice have no merit. I. The Civil Remedy Notice is legally invalid. The filing of a valid Civil Remedy Notice is a condition precedent to an action brought pursuant to section 624.155, Florida Statutes. Talat Enter., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Because the statute is in derogation of the common law, it must be strictly construed. Id. “[A]ny statute in derogation of the common law requires strict compliance with its provisions by one seeking to avail himself of its benefits.” Florida Steel Corp. v. Adaptable Devs., Inc., 503 So. 2d 1232, 1234 (Fla. 1986). Section 624.155, Florida Statutes, requires a civil remedy notice to provide specific information to put the insurer on notice of the alleged violation. Additionally, a civil remedy notice must be “specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days.” Valenti v. Unum Life Ins. Co. of Am., 8:04CV1615T-30TGW, 2006 WL 1627276, at *2 (M.D. Fla. 2006). Here, the Notice is invalid because it does not contain all of the information required by section 624.155. Also, it is invalid because it lacks sufficient specificity to provide notice to American Coastal of the alleged wrongdoing, as discussed below. First, the Notice fails to relate the specific policy language to the alleged violation as required by Fla. Stat. §624.155(3)(b)4. With regard to the policy language relevant to the alleged violation, the Notice cites to numerous provisions and sections of the subject policy of insurance but does not relate these provisions and sections of the subject policy to the alleged violation in any way. Pursuant to Fla. Stat. §624.155(3)(b)4, the Notice must cite to the specific policy language that is relevant to the alleged violations. However, the failure to relate any of the cited policy provisions or sections to the alleged violations in dispute prevents American Coastal from addressing any issues regarding the policy the Complainant alleges to have been violated, which is the underlying purpose of Fla. Stat. §624.155(3)(b)4. The Notice, therefore, is statutorily deficient because it does not comply with the requirements set forth in Fla. Stat. §624.155(3)(b)4. Second, the Notice lacks sufficient specificity to provide notice of the alleged bad-faith conduct. The Notice lists three (3) different statutes which American Coastal allegedly violated. However, the Notice fails to provide any relevant facts supporting the alleged violations or relating these alleged violations to the three (3) cited statutes. Because the Civil Remedy Notice fails to identify any specific statutes or any facts to support why the Insured believes American Coastal violated the statutes, American Coastal is unable to properly respond, and the Notice is invalid and should be rejected and returned. Moreover, the Notice does not list the Complainant’s e-mail address instead it provides the email of counsel for the Complainant, cboe@beckerlawyers.com. See Pin-Pon Corp., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Additionally, the CRN does not identify the person or persons who are most knowledgeable of the facts giving rise to the allegations in the CRN. Therefore, the notice is invalid and should be rejected. See Julien v. United Prop. & Cas. Ins. Co. 311 So. 3d 875 (Fla. 4th DCA 2021); Fonollosa v. Am. Integrity Ins. Co of Fla, 2021 Fla. Cir. LEXIS 5 (Fla. 11th Cir. Ct. 2021); Pin-Pon Corp. v. Landmark Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Finally, the Notice is invalid because it does not list a specific cure for the alleged violations. In Talat, the Florida Supreme Court said that to “cure” a Notice, an insurer must pay the amount owed pursuant to the express terms and conditions of the policy.” However, the Notice states that, to cure the alleged defects in the Notice, the insurer must: “1) immediately paying any and all undisputed sums; (2) identifying any and all disputed sums and the basis for the dispute; (3) agreeing to an appraisal of any disputed sums under the terms of the policy; or (4) paying the remaining amount of included in the Insured’s demand within 60 days of receipt of this Notice.” However, no specific cure amount of any kind is provided. It is improper for a civil remedy notice to not contain a specific cure; therefore, the Notice is invalid. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002). Because the Notice fails to comply with the information requirements promulgated by the Department of Financial Services, it is legally invalid. See Pin-Pon Corp. v. Landmark Ins. Co., 2020 U.S. Dist. LEXIS 100072, *7 (S.D. Fla., June 5, 2020); Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021). Again, in serving this response, American Coastal reserves all rights under Florida law to be served with a properly completed and statutorily compliant Notice. As the Notice fails to strictly comply with the requirements of section 624.155, Florida Statutes, it is legally insufficient and should be rejected. II. The Civil Remedy Notice Lacks Merit. The Notice also lacks merit. American Coastal issued a commercial policy bearing policy no.: AMC-38091-01 (the “Policy”) to Complainant to provide certain coverage for the nine Condominium buildings and Clubhouse at various addresses at Bay Beach Ln., Fort Myers Beach, FL, 33931, for the period of June 30, 2022 through June 30, 2023. The policy provides coverage for ten buildings subject to a 5% Hurricane deductible per building. On September 29, 2022, the Complainant reported a claim as having occurred as a result of Hurricane Ian with a date of loss of September 28, 2022. American Coastal assigned claim number 4197992 to the loss. American Coastal has adjusted and investigated the subject claim in accordance with Florida Law and the subject policy of insurance. American Coastal has issued multiple payments over the course of its investigation of the subject claim totaling $1,993,662.11. American Coastal’s coverage decision and the issued payments are supported by the investigation of the subject claim, the opinion of an independent engineer, and the evaluation of an independent General Contractor. Below is a portion of the claims handling timeline for the subject claim representing and summarizing American Coastal’s investigation and coverage decision. On October 26, 2022, American Coastal, through a field adjuster, inspected the insured property’s nine condo buildings and one clubhouse and documented the observable damages for American Coastal’s review. All inspections throughout this claim were coordinated through representatives of the Insured on an agreed upon date and time. On March 6, 2023 and March 7, 2023, J.S. Held LLC, an independent engineering firm, performed inspections of the Subject Property on behalf of American Coastal. This engineering firm took photos of the observable damages and subsequently prepared an Engineering Report documenting their findings and conclusions. On June 15, 2023, American Coastal issued a Coverage Determination letter. This letter described American Coastal’s continued investigation of the subject claim including inspections by Field Adjuster Gilbert Baran and Engineer Ilan Caballero with J.S. Held. This letter noted that after consideration of the applicable deductibles payment in the amount of $685,723.91 was being issued to the Insured. This letter informed the Insured that the policy does not afford coverage for certain other portions of damage that are excluded by the policy as the investigation revealed that some of the damages to the interiors and exteriors were due to flood and the some of the roofing had signs of deterioration as well as installation related issues. This letter also stated, “Your policy allows for reimbursement for those depreciated items not exceeding the total cost to repair or replace, subject to policy limits. Once the repairs are completed, please submit your proof of completion of these, repairs or replacement.” The Insured and/or their representatives subsequently provided documentation for repairs as they proceeded evidencing the completion of the repairs and American Coastal issued further payments due to the same as noted below. On September 22, 2023, the Complainant provided American Coastal a Sworn Statement in Proof of Loss executed on September 22, 2023 with a Whole Loss Total of $8,000,000.00. Notably, no documentation was included with the Sworn Statement in Proof of Loss Letter that justified this Whole Loss Total. Although subsequently in response to Request for Documentation letters, the Insured or their Representative/Counsel provided an Application and Certification for Payment dated November 3, 2023 from their contractor, TELA Construction, with an Original Contract sum of $876,732.76 and a Contract Sum to Date of $3,570,827.03, but no documentation provided to date evidences a Whole Loss Total of $8,000,000.00. On or about September 28, 2023, American Coastal issued a Response to Sworn Statement in Proof of Loss Letter advising that it neither accepted nor rejected the Sworn Statement in Proof of Loss, that it did not agree to statements made in the Proof of Loss pertaining to the amount of Whole Loss Total or to the Amount Claimed, and that it was continuing with the investigation of the subject claim. On September 13, 2023 and September 14, 2023, J.S. Held LLC, an independent engineering firm, performed a reinspection of the Subject Property on behalf of American Coastal to further evaluate the damage after receipt of additional documentation from the Insured requesting additional items of repair as well as the ongoing repairs. This engineering firm again took photos of the observable damages and subsequently prepared a Supplemental Engineering Report documenting their findings and conclusions for American Coastal’s review. On December 12, 2023, American Coastal issued an additional Supplemental Coverage Determination letter describing its further investigation into the subject claim. Based in part upon the Supplemental Engineering Report and documentation from the Insured, this letter noted an additional payment in the amount of $110,980.71 was being issued to the Insured after consideration of the applicable deductibles. On February 7, 2024, American Coastal issued an additional Supplemental Coverage Determination letter describing its continued investigation into the subject claim and this letter noted an additional payment in the amount of $77,601.72 was being issued to the Insured after consideration of the applicable deductibles. On February 13, 2024, Wareham Construction, Independent General Contractor, performed an inspection of the Subject Property on behalf of American Coastal as part of the continued investigation of the subject claim and documented their findings for American Coastal’s review. On April 26, 2024, American Coastal issued an additional Supplemental Coverage Determination letter. This letter noted that after review of documentation submitted by the Insured, American Coastal issued an additional payment in the amount of $54,135.00 for repairs/mitigation completed by Dean Mitchell Restoration. This letter also requested Dean Mitchel Restoration provide additional documentation to support some of the charges on their invoice/estimate. On June 5, 2024, American Coastal issued an additional Supplemental Coverage Determination letter. This letter noted, “We also retained Building Consultant (BC) Juan Chanquin with Sedgwick Claims Management Services, Inc. to assist with the investigation as well as General Contractor, Wareham Construction, Inc. (Wareham) to perform a re-inspection of the metal roofing. The BC completed revising his estimates to include additional roofing damages and revisions regarding the roofing material. We reviewed the post test invoices and included them in our determination. Juan Chanquin estimated this damage at $3,151,629.83 at replacement cost value with the water mitigation at $9,020.16 and the mold remediation at $50,000.00 (policy limits) and $3,117,170.62 at actual cash value. A copy of the estimate is enclosed.” This letter also noted that payment in the amount of $964,041.98 was being issued to the Insured after consideration of the applicable deductibles.. On July 25, 2024, American Coastal issued an additional supplemental coverage determination. This letter states, “We have completed our review of your submitted documentation and will be issuing a supplement payment for the truss repairs on building three and releasing the recoverable depreciation.” This letter noted that American Coastal’s replacement cost valuation of the damage is $3,218,349.41, and further payment in the amount of $101,178.79 was being issued to the Insured. On October 31, 2024, American Coastal issued a Reservation of Rights and Request for Documentation Letter noting it is continuing to investigate the Subject Claim pursuant to a full reservation of rights. This letter also requested: (1) A revised Proof of Loss, invoices, receipts, your contractor’s final estimates/invoices per building and contracts for work performed or to be performed in relation to the damage reported for this claim not previously provided. To include but not limited to the window and corridor invoices. (2) Any other documentation which supports the Association's contention that the claimed damage was due to a covered cause of loss. Notably, a properly executed Proof of Loss has not been received at this time. On December 17, 2024, the subject Civil Remedy Notice of Insurer Violation with Filing Number 797119 was filed with the Florida Department of Financial Services. On January 3, 2025, American Coastal, through the undersigned counsel, sent correspondence to the Complainant’s counsel acknowledging receipt of the Notice and advising that additional information was required in order to determine what the Complainant’s concerns were with American Coastal’s handling of the subject claim, and requesting additional documentation specifically proof of payment related to repairs from the Insured to their Contractor for the subject claim. On January 21, 2025, American Coastal, through the undersigned counsel, sent correspondence to the Complainant’s counsel following up on the January 3, 2025 correspondence. On January 21, 2025, Complainant’s counsel provided documentation responsive to the carrier’s requests for documentation, the January 3, 2025 correspondence, and January 21, 2025 correspondence. On January 31, 2025, American Coastal, through the undersigned counsel, noted some of the requested documentation was missing from the produced materials and specifically requesting materials evidencing proof of payment again. On February 3, 2025, Complainant’s counsel provided documentation responsive to the carrier’s requests for documentation and January 3, 2025 and January 21, 2025 correspondence from American Coastal’s Counsel as well as discussions between Counsel for Complainant and Counsel for American Coastal. To date, American Coastal has not received any documentation evidencing proof of payment from the Complainant to their Contractors/Vendors. The subject policy of insurance states that the insurer will pay no more than the least of: “(1) The Limit of Insurance applicable to the lost or damaged property; (2) The cost to replace the lost or damaged property with other property, …or (3) The amount actually spent that is necessary to repair or replace the lost or damaged property.” As a result, American Coastal has requested documentation that reflects the amount actually spent by the Complainant for the relevant repairs. Additionally, many of the repairs requested by the Complainant for the subject claim were damaged by flood and are potentially already covered under their flood claim with National Flood Insurance Program. For example, the original contract from TELA Construction totaled $876,732.76 and most of the items for repair including related to the doors, the drywall repairs, and the clubhouse repairs were damaged by flood which is excluded by American Coastal’s policy and likely covered by Complainant’s Flood Carrier’s policy. American Coastal continues to request all documentation requested but not received to date including proof of payment from the Insured to their Contractors and a properly completed Sworn Statement in Proof of Loss. Based upon all information to date, American Coastal has properly adjusted and investigated the subject claim in accordance with Florida Law and the Subject Policy of Insurance. American Coastal does not, by this letter or otherwise, waive any rights or defenses relating to the existence of coverage or liability for the alleged loss. American Coastal also reserves the right to rely upon any other policy defenses, limitations, exclusions and conditions that are warranted but not mentioned herein. All rights and defenses are specifically and expressly hereby reserved. As outlined above, American Coastal has abided by the Subject Policy of Insurance and stands by its decision and payments on this claim. As such, American Coastal has complied with all policy provisions and applicable Florida law regarding the subject claim. In light of American Coastal’s investigation, coverage was properly accepted under the subject claim and payments were properly issued, pursuant to the terms, conditions, exclusions, limits and deductibles of the subject policy. Accordingly, American Coastal denies any and all allegations of bad faith in connection with the subject claim. If you have any questions, please do not hesitate to contact me. Sincerely, /s/ Michael J. Neusaenger, Esq. Michael J. Neusaenger, Esq.
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