Civil Remedy Notice of Insurer Violations
Login

Filing Number:     797609
Filing Accepted:  12/19/2024
         Print Filing
Complainant
Last/Business Name *  
GERGES   First Name   AIHAB AND JENNIFER
Street Address * 2610 NIGHT RAINS DR.
City, State Zip * LUTZ, FL 33559
Email Address * STEVEN@CROSKEYLAW.ORG
Complainant Type: * Insured
Insured
Last/Business Name*   GERGES   First Name   AIHAB AND JENNIFER
Policy # * OIC30026491-05 Claim #* 24FLHOV0014466
Attorney
Attorney is Applicable
Last Name* CROSKEY First Name * STEVEN Initial M
Street Address* 1644 BLANDING BLVD.
City, State Zip* JACKSONVILLE , FLORIDA 32210
Email Address * STEVEN@CROSKEYLAW.ORG
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLYMPUS INSURANCE COMPANY
NAIC Company Code 12954
 
Name of individual responsible for violation (if any):* DARIUS NORFLEET
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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Coverage A – Dwelling: Insurer is required to cover damage incurred by an insured event to the Insured’s dwelling. Insurer is required to cover damage that Insured has claim coverage for.
 
* 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 January 9, 2024, Claimants suffered loss to their Insured Property as a result of a windstorm. The Claimant reported same loss to the Insurer subsequently thereafter, and the Insurer had the insured Property inspected. The Insurer created an estimate, but the Insurer undervalued and denied parts of the claim. Additionally, despite Claimant’s roofing company, public adjuster, and engineer indicating that there is clear wind damage to the roof and covered interior water damage and mold damage from wind driven rain, the Insurer has failed or refused to acknowledge same damage. As a result, Claimant asserts that the Insurer is attempting to undermine the scope of repairs and damage to the Insured Property identified by the Claimant. Moreover, the Insurer is failing or refusing to pay for a replacement of the roof despite the circumstances indicating that more than 25% of the total roof area or roof section of the Property needs to be repaired, replaced or recovered, all within a 12-month period. The Insurer hired SDII Global to perform an inspection of the roof, and SDII found no storm related damages to the roof despite the storm producing 71 mph wind speeds at or around the property on the date of loss, which was included in their report. Furthermore, the inspector for SDII, who was hired by the Insurer, broke 5 roofing tiles in different areas and elevations of the roof during his inspection, and the Insurer has yet to remedy this issue, despite being first made aware of it by the public adjuster on July 12, 2024. Furthermore, Claimants hired Engage Mold Solutions to perform mold testing and provide a mold assessment report. Upon the discovery of mold, which was left out of the Insurer’s estimate, a copy was provided to the Insurer and a request was made to have the Insurer reinspect the damaged property to test for mold. That inspection occurred on September 19, 2024. To date, the Insurer has not provided any updated information or results of their vendor’s testing, leaving the Claimants unaware of the Insurer’s position from their vendor regarding necessary mold remediation. Claimant asserts that all of these things taken into consideration, along with everything described below, and also each one individually, the Insurer acting in bad faith and not fairly towards the Claimant based off of the circumstances. In Florida, the work of adjusting insurance claims engages the public trust. The Insurer breached this duty in the adjustment of this claim, by failing to apply the insurance policy language to its coverage analysis by, inter alia, unreasonably underpaying a claim with knowledge of higher costs being required to restore the property to its pre-loss condition. Accordingly, the Insurer’s conduct as described herein was inappropriate. Furthermore, by failing to justify any of Insurer’s actions and omissions with policy language, the Insurer is actively misrepresenting a fact material to Insured’s claim, materially misrepresenting the policy, prejudicially investigating the claim, and wrongfully denying and/or limiting coverage based upon these misrepresentations. Specifically, the Insurer knew or had cause to know the proposed scope of repairs were insufficient to restore the property to its pre-loss condition; thus the Insurer (1) failed to act in good faith and due diligence to resolve claims; (2) placed the Insurer’s financial interest before that of the Insureds; (3) unfairly looked for ways to reduce Insured’s recovery; (4) failed to adjust the claim to restore the property to its pre-loss condition; (5) misrepresented the insurance policy provision(s) to the Insured; (6) failed to create and implement adequate guidelines for proper investigation of claims handling and for training and supervision of employees resulting in statutory violations as set forth herein; (7) failed to acknowledge or respond to in accordance with Florida law correspondence from the Insured to the Insurer regarding this claim and requesting a certified copy of the applicable policy; and (8) failed to correct its mistake(s) prior to entry of this civil remedy. These actions and omissions are all inherently deceptive and unfair to any person insured by them. Insurer’s misconduct needlessly increasing the likelihood of continued damage to the Insured Property. NOTICE: This notice is given in order to perfect the right to pursue the civil remedy authorized by this section. It appears Insurer has a pattern of violating, at the very least, Florida Statute 624.155(1)(b)(1) and also 627.70131(5)(a), 626.9541(1)(i)(3)(c) and 627.70131(1)(a). Undersigned Counsel is aware of numerous other claims where Insurer failed to act in good faith in resolving residential property and casualty insurance claims. Many of these instances are recorded in the Civil Remedy Notice database which indicates these are general business practices for the Insurer. The Insurer’s refusal to properly and timely adjust this claim will continue increasing those costs and reasonable attorneys’ fees and costs. Insurer’s wrongful conduct and omissions include, but are not limited to those identified above and the following: (1) claim delay; (2) not conducting full and prompt investigation; (3) not treating the Insured with good faith claims conduct; (4) looking for ways to deny, reduce, or delay recovery to Insured; (5) holding back and failing to pay the claim, clearly owed; (6) not adjusting the claim and evaluating the loss property promptly and fairly to provide full and prompt indemnity to the Insured; (7) failing to implement proper standards for the adjustment and investigation of claims; (8) placing the company’s interests before the policyholder’s interests. Failure to cure all defects during the 60-day safe harbor period may result in additional extra-contractual damages.
Comments
User Id Date Added Comment
Steven@croskeylaw.org 02-28-2025 Claimants hereby withdraw this Civil Remedy Notice as the parties have reached an amicable resolution to this claim.
bkelley@wallenkelley.com 02-14-2025 February 14, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainants: Aihab and Jennifer Gerges Address: 2610 Night Rains Dr. Lutz, FL 33559 Email: Steven@croskeylaw.org Insureds: Aihab and Jennifer Gerges Policy #: OIC30026491-05 Claim: 24FLHOV0014466 Attorney: Steven Croskey Address: 1644 Blanding Blvd. Jacksonville, FL 32210 Email: Steven@croskeylaw.org DOI File #: 797609 Date of Acceptance: December 19, 2024 To Whom It May Concern: Please accept this as the response of Olympus Insurance Company ("Olympus") to the Civil Remedy Notice filed by the Complainants, Aihab and Jennifer Gerges. Olympus’ response is specifically in regard to Claim 24FLHOV0014466, which is related to a claim for Insureds’ property located at 2610 Night Rains Dr. Lutz, FL 33559, which was insured by Olympus under Policy # OIC30026491-05 with effective dates of that Policy being June 29, 2023 through June 29, 2024 and was in effect on the alleged date of loss, January 9, 2024. Statement of Facts This matter arises from an alleged windstorm claim at the Insureds’ Lutz, Florida residence. For the convenience of the reader, I have broken down the Statement of Facts that will detail Olympus’ handling of the file. 1. Claim: 24FLHOV0014466 The instant claim was reported to Olympus on February 19, 2024, with a date of loss of January 9, 2024. After receipt of the claim, Olympus assigned a claim number, 24FLHOV0014466, and sent the Insureds an acknowledgement email. The next day, on February 20, 2024, Olympus sent an acknowledgment letter to the Insureds. In addition, Olympus provided a Homeowners’ Bill of Rights to inform them of their rights under the Policy. Olympus also sent correspondence requesting an executed sworn proof of loss in an effort to ascertain the amount of damages being claimed, and a another document informing the Insureds of their right to mediate the claim. Specifically, the Claim Information Letter stated: “We hope this letter finds you well. We are writing to provide you with important information regarding the claims process for your recent insurance claim. We understand that this can be a complex and sometimes overwhelming process, and we want to ensure that you are well-informed and supported every step of the way. If you have any relevant photos or claim-related documents that can assist us in assessing your claim more effectively, such as photos, videos, and other supporting documentation. We kindly request that you email them to us at claimsmail@oigfl.com and be sure to include your claim number in the subject line. These additional materials can provide valuable evidence and contribute to a smoother and more efficient claims process. During the claims process, it is common for us to communicate with you via email. As we work on your claim, you may receive multiple emails from us containing copies of your estimate. These emails are intended to keep you updated on the progress and provide you with the necessary documentation for your reference. It is important to note that in certain situations, there might be revisions to the initial estimate. In such cases, we will promptly send you additional emails with the revised estimates. These revisions could be due to various factors, such as unforeseen damages or new information that becomes available during the assessment process. We assure you that any revisions are aimed at accurately reflecting the scope of the claim and ensuring a fair resolution. We understand that filing an insurance claim can be a stressful experience, but please know that our team is dedicated to providing you with the support and assistance you need. Should you have any questions or concerns throughout the process, please don't hesitate to reach out to our claims department. We are here to help and address any queries you may have. Thank you for choosing Olympus, we appreciate your trust and cooperation. Rest assured, we are committed to handling your claim professionally and efficiently.” The acknowledgement letter sent in the group of documents on February 20, 2024, also advised as follows: “This letter acknowledges receipt of the above referenced claim. Your claim will be handled by our Olympus Claims Team, and a team member will contact you to discuss the claims process and arrange for any onsite inspections needed. Olympus Insurance Company ("Olympus") will conduct an investigation and will pay to repair or replace damage to covered property, subject to the terms and conditions of your policy. Under the terms of your policy, Olympus may elect to repair and/or remediate the damaged property pursuant to the policy provisions. Should Olympus exercise its option to repair, no insurance proceeds will be due or payable to you for such repairs because they will be paid directly to the contractor chosen by Olympus to make the necessary repairs. This letter serves as Olympus' express notification to you that it reserves its right to repair and will notify you of any decision to exercise such option as provided for under your policy and as required under any applicable law. Please be advised that in order to adequately investigate any claims, Olympus may require you and/or any others to submit to an Examination Under Oath to discuss the circumstances of the claim(s). Please take a moment to review the Homeowner Claims Bill of Rights and information on the Department of Financial Services' Dispute Resolution Programs. Following are Your Duties After Loss, including the requirement that you complete, sign, date, notarize and return to Olympus the enclosed Sworn Proof of Loss within sixty (60) days after the loss. Nothing contained herein shall preclude any party from availing themselves of any provisions of Florida law providing such party a means of obtaining judgment for their reasonable attorney's fees and costs incurred. If you have any questions, please contact us: (866) 281-2242 during the hours of 8:00 AM to 5:00 PM, EST, Monday- Friday, or feel free to leave a message so we may return your call by the next business day. You can send claim information to us via email: OlympusClaims@oigfl.com; or fax: (800) 634-6892; or mail: P.O. Box 884, Worcester, MA 01613. Please include your claim number on any correspondence provided to us. Thank you for insuring with Olympus Insurance Company. We appreciate your business and look forward to working together to resolve this matter.” Additionally, with this group of February 20, 2024, documents, Olympus cited the following policy language: “SECTION I – CONDITIONS B. Duties After Loss After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. 2. As soon as reasonably possible, notify the police in case of loss by theft or vandalism and provide us a copy of the police report; 3. As soon as reasonably possible, notify the credit card or electronic transfer card or access device company in case of loss as provided in SECTION I – PROPERTY COVERAGES, Additional Coverages, 6., Credit Card, Electronic Fund Transfer Card or Access Device, Forgery and Counterfeit Money; 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, your signed, sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds”, “assignees” if any, and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of the damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or reopened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred: f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (a) You and any and all “insureds”; (b) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (c) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must; i. Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; ii. Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and iii. Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. SECTION I – Property Coverages E. Additional Coverages 2. Reasonable Emergency Measures a. We will pay up to the greater of $3,000 or 1% of your Coverage A limit of liability for the reasonable costs incurred by you for necessary measures taken solely by you to protect covered property from further damage or loss when the damage or loss is caused by a Peril Insured Against. b. If, however, form OL HO 03 52 is part of your Policy and a covered loss occurs during a covered “Hurricane Occurrence” as defined in form OL HO 03 52, the amount that we pay under this additional coverage will be the reasonable cost incurred by you for necessary measures taken solely to protect the covered property from further damage and is not limited to the amount in a. above. c. We will not pay more than the amount in a. above unless you submit a request to us for an increase above this limit of liability and we approve the scope and amount of work to be done. The request may be submitted via: (1) Telephone at (866) 281-2242; (2) Facsimile at (866) 903-3521; or (3) Electronic mail to EMS@oigfl.com. d. The request must include: (1) The date the request is submitted to us; (2) The identity of all Named Insureds; (3) The identity and contact information of any and all “Assignees”; (4) A complete and executed copy of any and all “Assignment Agreements”; (5) The date of loss; (6) The address where the loss occurred; (7) Description of the loss and location of damages; (8) All photographs, videos, moisture readings, and work logs that demonstrate the damage and work performed up to the time of the request; (9) Itemized estimate of the proposed measures to be taken solely to protect, repair, restore, or replace covered property to mitigate against further damage or loss to the covered property; (10) Estimated timeframe of completion; and (11) All other information or documentation reasonably requested. All supporting documentation must be submitted via one of the methods detailed in c.(2) or c.(3) above. e. Any request to exceed the limit in a. above may require our agreement to a mutual schedule with you and your permission for us and/or our designated representative(s) to enter the “residence premises” at the address designated in your Declarations as the Insured Location, for the purpose of inspecting any reasonable emergency measures in excess of $3,000 or 1%. f. To the degree reasonably possible, all damaged property must be retained for us to inspect. g. Reasonable emergency measures under this Additional Coverage 2. may include a permanent repair only when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. h. We will respond to you within 48 hours of your request to us to exceed the limit in a. above. i. We will not pay more than the amount in a. above unless we provide approval within 48 hours of your request to us to exceed the limit in a. above. Failure on your part to comply with the provisions outlined in d., e., and f. above may result in the denial of your request to exceed the limit in a. above. In such circumstance, we will pay only up to the additional costs for reasonable emergency measures that we authorize. If we fail to respond to your request within forty-eight (48) hours of such request to us and the damage or loss is caused by a Peril Insured Against, you may exceed the amount in a. above, to perform the reasonable emergency measures taken solely to protect the covered property from further damage or loss, but only up to the reasonable cost. j. This coverage does not: (1) Increase the limit of liability that applies to the covered property; (2) Relieve you of the duties, in case of a loss to covered property, as set forth in SECTION I – CONDITIONS, B.; (3) Pay for property not covered, or for repairs resulting from a peril not covered, or for loss excluded in this policy. SECTION I – CONDITIONS … G. Suit Against Us 1. No action can be brought against us by you unless there has been full compliance with all of the terms and conditions under SECTION I of this policy and the action is started within 5 years after the date of loss. Prior to filing suit, you must provide the Florida Department of Financial Services with written notice to initiate litigation at least 10 business days before filing suit under the policy, in accordance with 627.70152, Florida Statutes.” Later that day, Olympus received documentation for the claim from Robert Wieland of 5 Star Roofing and Construction. Thereafter, Olympus retained the services of Paul Davis Restoration and Baldwin Roofing Company to inspect the property. On February 21, 2024, Olympus’ Desk Adjuster contacted the Insured, Aihab Gerges, about the claim. In that conversation, they discussed the leaks at the property, his hiring of a roofing contractor, and the adjustment process for the claim. On or about February 27, 2024, Lucas Berken of Paul Davis Restoration, inspected the property. He subsequently provided an estimate concerning the scope of damages. Thereafter, Drew Murray of Baldwin Roofing Company inspected the roofing system of the property. During this inspection, he took photographs of the roof and provided a report containing his findings to Olympus. After a review of these materials, on March 11, 2024, Olympus opened coverage for the claim and advised the Insureds that it had invoked its right to repair the property under its “option to repair” right in the Insureds’ Policy. In their correspondence to the Insureds, Olympus explained that: “Based on our investigation, the repair/replacement of your interior damages from the above referenced loss is covered under your policy. Olympus Insurance Company (“Olympus”) has the option to issue payment or to repair or replace the damaged property. Olympus has selected the option to the repair your interior water damages. The repairs to your property will be completed through the Olympus Elite Repair Program. The licensed and insured contractors participating in the program are vetted to ensure that you receive the highest level of quality and customer satisfaction. In addition to the manufacturer’s product warranty, you will receive a one-year workmanship warranty on the repairs. The warranty applies only to work related to damages arising from the covered loss which are not otherwise excluded or the subject of another loss or claim. There is no additional cost to you beyond your deductible for repairs to the covered damage. Paul Davis Restoration has been selected to complete the repairs for you. Founded in 1966, Paul Davis is one of the largest restoration networks and is known in the industry for offering expertise, best-in-class customer service, and being a visionary for innovation. Paul Davis is committed to living by its vision of providing extraordinary care, while serving clients in their times of need. To expeditiously facilitate the repairs: • We request that you promptly pay your deductible to Olympus in the amount of $2,500.00. Payment can be by check or money order made payable to Olympus Insurance or contact the undersigned to request a PayPal link. • A representative from Paul Davis Restoration will contact you to schedule an appointment and will visit your property; • You will be asked to execute the necessary paperwork including documents such as a work authorization, any material color selections, municipal permits and/or notice of commencement; • Paul Davis Restoration will generate a complete scope of repairs after inspecting your property and provide the scope of repairs to you; and • A project manager will be assigned and will be your point of contact with Paul Davis Restoration. • Olympus requests your cooperation to timely complete the above next steps as required by your policy and as outlined in the policy Conditions. You may contract with Paul Davis Restoration for additional work beyond Olympus’ scope of repairs at your own expense. If you choose to do so, please discuss these details directly with Paul Davis Restoration. Also, it is important that you are aware that Olympus' decision to proceed with its Option to repair is limited to the scope of specific designated repairs for which it has exercised the Option to repair under the insurance policy. This may include all damages or portions of the total damage. Olympus will provide you with a scope of repairs once you allow Paul Davis Restoration to inspect the property. Olympus’ Option to repair only applies to the particular damage specified and currently known and reported in this claim. Exercising this Option to repair has no impact any future claims that may be made under your policy. We are unable to pay for the replacement of the roof, stucco, and flooring as your policy excludes coverage for wear and tear, deterioration, repeated seepage, and inadequate maintenance. Based on our investigation of your claimed damage the exterior and roof was determined to be the result of deterioration and not the result of a Peril Insured Against. These excerpts from your policy are for reference only. By this letter, Olympus does not imply that other policy provisions are not applicable as all of the policy terms and Conditions apply to your claim. Your insurance policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 01 23 Special Provisions – Florida endorsement, states within the “Our Option” provision as follows: SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure for sudden and accidental direct physical loss to covered property described in Coverage A and Coverage B unless the loss is otherwise excluded or limited in this policy. However, loss does not include and we will not pay for any “diminution in value”. 2. We do not insure, however, for loss: a. Excluded under Section I – Exclusions; … c. Caused by (5) Constant or repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years, unless such seepage or leakage of water or the presence or condensation of humidity, moisture or vapor: (b) The resulting damage is: i. Unknown to all “insureds”; and ii. Is hidden within the walls or ceilings, or beneath the floors, or above the ceilings of a structure. (6) Any of the following: (a) Wear and tear, marring, deterioration; … (c) Smog, rust or other corrosion; … (f) Settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings; … SECTION I – EXCLUSIONS A. We do not insure under any coverage for any loss which would not have occurred in the absence of one or more of the following excluded events. We do not insure for such loss regardless of: 1. The cause of the excluded event; or 2. Other causes of the loss; or 3. Whether other causes acted concurrently or in any sequence with the excluded event to produce the loss; or 4. Whether the event occurs suddenly or gradually, involves isolated or widespread damage, arises from natural or external forces, or occurs as a result of any combination of these. … B. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. … 3. Faulty, inadequate or defective: a. Planning, zoning, development, surveying, siting; b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; c. Materials used in repair, construction, renovation or remodeling; or d. Maintenance; of part or all of any property whether on or off the "residence premises". SECTION I – CONDITIONS … H. Our Option 1. At our option, in lieu of issuing any loss payment, if we choose to exercise our option: a. For losses settled on an actual cash value basis as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may repair or replace any part of the damaged property with material or property of like kind and quality. b. For losses insured for replacement cost as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may elect to repair or replace any or all of the damaged property with material of like kind and quality without deduction for depreciation. 2. If we choose to exercise our option, we will provide written notice to you no later than 30 days after our inspection of the loss. We may invoke our option to repair within the stated time frame after either a “supplemental claim” or “reopened claim” regardless of whether we invoked our option during the adjustment of the initial claim or a prior “supplemental claim”. 3. If we choose to exercise our option, you must cooperate with and grant us, or any person authorized to act on our behalf, reasonable access to the property in order for repairs to be made. 4. You are responsible for payment of the deductible stated in your Declarations Page. 5. You must comply with the duties described in SECTION I – CONDITIONS, B. Duties After a Loss, paragraph 7. 6. As often as is reasonably necessary to effectuate repairs, you must: a. Provide access to the property; b. Execute any necessary city, county, or municipal permits for repairs to be undertaken; c. Execute any work authorizations to allow contractors and related parties entry to the property; d. Otherwise cooperate with the repairs to the property. Our right to exercise our option to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. Any contract entered into between you and any repair person(s), contractor, other person or company to perform repairs or services except reasonable emergency measures for any loss attributed to a covered peril shall not interfere with this right. … Either you or we may demand a mediation in accordance with the rules established by the Florida Department of Financial Services and stated in your policy. In addition, we ask that you present us with a detailed estimate of the damages you are claiming which should outline any dispute as to scope and/or price. Please refer to the relevant part of your policy which states as follows: SECTION I – CONDITIONS … E. Mediation Or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either party may: 1. Demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. a. For the purposes of mediation, the term “claim” refers to any dispute between an insurer and a policyholder relating to a material issue of fact. b. The loss amount must be $500 or more, prior to application of the deductible; or there must be a difference of $500 or more between the loss settlement amount we offer and the loss settlement amount that you request. c. The settlement in the course of the mediation is binding only if both parties agree, in writing, on a settlement and, you have not rescinded the settlement within 3 business days after reaching settlement. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided to you. d. We will pay the cost of conducting any mediation conference except when you fail to appear at a conference. That conference will then be rescheduled upon your payment of the mediator's fee for that rescheduled conference. If we fail to appear at a mediation conference, we will pay: (1) Your actual cash expenses you incur in attending the conference; and (2) Pay the mediator's fee for the rescheduled conference. … If however, we demanded the mediation and either party rejects the mediation results, you are not required to submit to, or participate in, any appraisal of the loss as a precondition to action against us for failure to pay the loss. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement and intent to file suit in writing as outlined in SECTION 1 – CONDITIONS, G. Suit Against Us to allow us an opportunity to exercise our right to demand mediation or appraisal. … SECTION I – CONDITIONS … G. Suit Against Us. 1. No action can be brought against us by you unless there has been full compliance with all of the terms and conditions under SECTION I of this policy and the action is started within 5 years after the date of loss. Prior to filing suit, you must provide the Florida Department of Financial Services with written notice to initiate litigation at least 10 business days before filing suit under the policy, in accordance with s. 627.70152, Florida Statutes. … Further Florida Statute 627.70152(3)(a) states: As a condition precedent to filing suit under a property insurance policy, a claimant must provide the department with written notice of intent to initiate litigation on a form provided by the department. Such notice must be given at least 10 business days before filing suit under the policy, but may not be given before the insurer has made a determination of coverage under s. 627.70131. Notice to the insurer must be provided by the department to the e-mail address designated by the insurer under S. 624.422. The notice must state with specificity all of the following information: 1. That the notice is provided pursuant to this section. 2. The alleged acts or omissions of the insurer giving rise to the suit, which may include a denial of coverage. 3. If provided by an attorney or other representative, that a copy of the notice was provided to the claimant. 4. If the notice is provided following a denial of coverage, an estimate of damages, if known. 5. If the notice is provided following acts or omissions by the insurer other than denial of coverage, both of the following: a. The presuit settlement demand, which must itemize the damages, attorney’s fees, and costs. b. The disputed amount. … Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Thank you for your attention to the foregoing and your anticipated cooperation as we work through this claim to effectuate repairs. I will continue to be the adjuster assigned to handle your claim until the covered repairs to your property have been completed. Should you have any questions regarding the Olympus Elite Repair Program or your claim, please do not hesitate to contact me.” Olympus also emailed this information to the Insureds, an email that also alerted the Insureds that Paul Davis Restoration would reach out to them as follows, “Your claim of interior damage has been referred to the Elite Repair Program. I am reaching out to you to advise that I am the desk adjuster that has been assigned to your claim for further handling and will be the main point of contact. Olympus has invoked their option to repair your interior under the Elite Repair Program. I have set up an inspection with one of our top vendors Paul Davis Restoration for a date and time to assess the damages to your interior. The vendor will provide Olympus with their inspection report and recommendation for review and approval for your interior. Your policy deductible of $2,500.00 will need to be paid directly to Olympus prior to scheduling of repairs. You can mail a check made payable to Olympus to P.O. BOX 33117 Palm Beach Gardens, FL 33420 (please put claim #24FLHOV0014466 in memo line) or you can pay by credit or with debit card by clicking the secure PayPal link sent to you in a separate email. My direct contact number is listed below. Please contact me if you have any questions or concerns. Please be sure to add your claim # to all correspondence. https://www.paypal.com/invoice/p/#ZDQUPMA2KVGVNHT9 Thank you!” After a request for the scope of the work was made by the Insured, Olympus provided a copy of same that day as well. As payment for the deductible had not been received, Olympus sent a reminder for same on March 28, 2024 to the Insured. Thereafter, Paul Davis advised Olympus that the Insureds had advised them that they did not wish to move forward with interior repairs for the property. On April 8, 2024, Olympus received a letter from Zack Hill of ADR Florida Inc., the Insureds’ Public Adjuster with an attached Letter of Representation. This email additionally requested documents such as the policy, special provisions, and declarations page, which Olympus provided on April 17, 2024. On April 24, 2024, after leaving a voice message on the Insureds’ phone due to no answer, Olympus called the Insureds’ Public Adjuster to discuss the next steps and was advised he would be submitting an estimate for the claim. On May 1, 2024, Olympus received photographs of the property and an estimate of damages from the Insureds’ Public Adjuster. Olympus responded that the estimate was not approved and reminded the Public Adjuster of the approved estimate from the prior correspondence invoking the Option to Repair. Thereafter, the Desk Adjuster spoke to the Public Adjuster and was advised the Insured did not wish to move forward with repairs until there was an agreement over the scope of the work involved with the claim. In its good faith continuance in adjusting the claim, on June 10, 2024, Olympus retained SDii Global, an engineering firm, to inspect the property to further determine the cause, origin, and duration of the reported damage to the interior, exterior stucco, and roof. This inspection took place on June 19, 2024, when Mark Woodard, P.E. inspected the home. During this inspection, Mr. Woodard took pictures, interviewed the Insured, and made observations on the reported damage to the interior, exterior, stucco, and roof. After conducting additional evaluations, his report with his findings and pictures was submitted to Olympus on July 10, 2024. Of note, Mr. Woodard concluded that: Exterior and Roof • The concrete roof tiles, mortar, and/or mod-bit were not damaged by wind and/or hail on or around the reported date of loss. • The dark brown stains, cracks, section loss, dirt, and/or suspected biological growth on the floor and sealant between the floor and architectural band of the balcony along the front side of the residence indicated age-related deterioration, long-term exposure to moisture, and deferred maintenance. Therefore, the causes of damage to the balcony were age-related deterioration, long-term exposure to moisture, and/or deferred maintenance. • The causes of damage to the roof tiles were age-related deterioration, construction deficiencies, and/or foot traffic. Roof Reparability • Roof sections 1, 2, 3, and 4 had zero (0) roof tiles that were damaged by wind, hail, or wind-borne debris on or around the reported date of loss, which equates to zero percent (0%) of the area of the roof sections. This quantity is less than the 25% threshold specified in the Florida Building Code; therefore, the entire existing roof sections 1, 2, 3, and 4 is not required to be repaired, replaced, or recovered to conform to the Code due to storm related damage. • Roof section 5 had zero (0) square feet of mod-bit that were damaged by wind, hail, or wind-borne debris on or around the reported date of loss, which equates to zero percent (0%) of the area of the roof section. This quantity is less than the 25% threshold specified in the Code; therefore, the entire existing roof section 5 is not required to be repaired, replaced, or recovered to conform to the Code due to storm-related damage. Interior Cause and Origin • The interior damage was not a result of wind or hail-related damage to the roof, a storm created opening, or wind-driven rain. • No evidence of moisture-related damage to the bedroom was observed during our site investigation. • The loose and partially separated window seals around the windows of the bedroom and bonus room coincided with the damage due to thermal expansion and contraction of dissimilar materials. • The cause of the cracks on the drywall around the window and on the baseboard and the shoe molding in the bedroom (as observed in the OIC Photo Sheet 2) was relative movement between the building materials as a response to the normal changes in ambient temperature and humidity. • Based on the available evidence and our experience in investigating moisture intrusion through roofs, it is our opinion that the cause of the bubbled paint on the office wall (as observed in the OIC Photo Sheet) was moisture intrusion due to: o An inadequate flashing system (age-related deterioration and/or construction deficiency) at the first-story wall-to-roof facet interface and/or lack of kick-out diverter flashing at the interface of the stucco and the end of the tiled facet above and/or upslope of the office; o The lack of weep screeds along the bottom edges of the second story in the stucco construction (construction deficiencies); and o Unsealed gaps/cracks around the light fixture on the exterior side above the office. • The cause of the cracks/separations with no discolorations on the window stool and/or drywall around the window, on the baseboard and wall-to-baseboard interface (as observed in the OIC Photo Sheet 2), and on the crown molding of the office (as observed in the OIC Photo Sheet 2) was relative movement between the building materials as a response to the normal changes in ambient temperature and humidity. The cracks/separations were cosmetic in nature and did not affect the structural integrity of the residence. • The cause of the stains, suspected biological growth, and/or cracks on the stool and frame of the window and drywall around the bonus room window was moisture intrusion due to the lack of weep screeds along the bottom edges of the second story in the stucco construction (construction deficiencies) and/or gaps/cracks around the light fixture on the exterior side above the bonus room window. • The cause of the cracks with no discolorations on the crown molding-to-ceiling interface of the bonus room (as observed in the OIC Photo Sheet 2) was relative movement between the building materials as a response to the normal changes in ambient temperature and humidity. The cracks were cosmetic in nature and did not affect the structural integrity of the residence. • The cause of the reported damage or musty odor on the floor planks in the bedroom, office, and bonus room (as observed in the OIC Photo Sheet 2) was moisture vapor transmission (commonly called vapor drive) through the concrete slab-on-grade underneath the flooring due to an inadequate or lack of a vapor barrier system (age-related deterioration and/or construction deficiency), moisture intrusion through the joint between the concrete floor slab and wall due to the lack of (or an inadequate) WRB/flashing system at the interface of the concrete slab and wall/stucco (construction deficiency), and/or the termination of the stucco below the exterior grade (construction deficiency) in conjunction with a site drainage deficiency. The damage was not a result of a sudden, one-time, or accidental event. • The cause of the moisture-related damage in the attic above the bathroom ceiling was moisture intrusion due to a non-storm-related breach(es) (age-related deterioration and/or construction deficiency) in the roofing underlayment above and/or upslope of this area. This damage was not wind related. Duration • Moisture had affected the wood floor planks of the office and bonus room (as observed in the OIC Photo Sheet 2) and office wall (as observed in the OIC Photo Sheet 2) for one or two events prior to February 27, 2024 (date of Mr. Berken’s field visit) (short term). • Moisture had repeatedly affected the bonus room window for more than three months prior to February 27, 2024 (date of Mr. Berken’s field visit) (long term). • Moisture had repeatedly affected the attic side of the bathroom ceiling and the roof framing above the bathroom ceiling for more than six months prior to the date of our site investigation. • Due to the time elapsed since the reported date of loss and based on the available evidence, the exact timeframe of the moisture-related damage in relation to the reported date of loss could not be determined. Olympus, in turn, emailed the report to the Insureds and their Public Adjuster on July 11, 2024. After the Insureds, through their Public Adjuster, alleged Mr. Woodard further cracked 5 tiles on their roof during the inspection, on August 8, 2024, Olympus emailed the Public Adjuster to resolve the problem with the involvement of SDii. On August 21, 2024, Olympus sent the Insureds a Reservation of Rights Letter which advised them that: “This correspondence is meant to provide you with a status of your above referenced claim and to request your cooperation with your post-loss obligations so that our Elite Repair Vendor can begin repairs to your property. As you are aware, Olympus issued insurance policy number OIC30026491-05 with effective dates of coverage from 06/29/2023 to 06/29/2024 for the property located at 2610 Night Rains Dr Lutz, FL 33559-7383. This policy was issued to you as the named insured, and the insurance coverage under the policy is subject to its terms and conditions and the express coverage limitations and exclusions to coverage set forth in the policy forms and endorsements. On 03/26/2024 we notified you that Olympus had exercised its contractual right to invoke its Option to repair the covered loss or damage to the insured property under the terms of the policy and that a preferred contractor was assigned to complete the roof replacement. On 03/11/2024 Olympus notified you that we approved Paul Davis’s proposal, on 3/12/2024 Paul Davis attempted to start the repair process. As of this date, you have not cooperated with the repairs to the property, contrary to your obligations under the insurance contract or paid your $2,500.00 deductible to begin the repairs. Based on the above, Paul Davis cannot begin repairs. Pursuant to the terms of your policy, you have not cooperated with the Option to Repair process. Failing to do so may constitute a material breach of your policy. Your Homeowners Policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 01 23 Special Provisions – Florida endorsement, states in relevant part: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; … 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; … 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; … g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. … H. Our Option 1. At our option, in lieu of issuing any loss payment, if we choose to exercise our option: a. For losses settled on an actual cash value basis as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may repair or replace any part of the damaged property with material or property of like kind and quality. b. For losses insured for replacement cost as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may elect to repair or replace any or all of the damaged property with material of like kind and quality without deduction for depreciation, 2. If we choose to exercise our option, we will provide written notice to you no later than 30 days after our inspection of the loss. We may invoke our option to repair within the stated time frame after either a “supplemental claim” or “reopened claim” regardless of whether we invoked our option during the adjustment of the initial claim or a prior “supplemental claim”. 3. If we choose to exercise our option, you must cooperate with and grant us, or any person authorized to act on our behalf, reasonable access to the property in order for repairs to be made. 4. You are responsible for payment of the deductible stated in your Declarations Page. 5. You must comply with the duties described in SECTION I – CONDITIONS, B. Duties After a Loss, paragraph 7. 6. As often as is reasonably necessary to effectuate repairs, you must: a. Provide access to the property; b. Execute any necessary city, county, or municipal permits for repairs to be undertaken; c. Execute any work authorizations to allow contractors and related parties entry to the property; d. Otherwise cooperate with the repairs to the property. Our right to exercise our option to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. Any contract entered into between you and any repair person(s), contractor, other person or company to perform repairs or services except reasonable emergency measures for any loss attributed to a covered peril shall not interfere with this right. … SECTION I – CONDITIONS … G. Suit Against Us. 1. No action can be brought against us by you unless there has been full compliance with all of the terms and conditions under SECTION I of this policy and the action is started within 5 years after the date of loss. Prior to filing suit, you must provide the Florida Department of Financial Services with written notice to initiate litigation at least 10 business days before filing suit under the policy, in accordance with s. 627.70152, Florida Statutes. … Further Florida Statute 627.70152(3)(a) states: As a condition precedent to filing suit under a property insurance policy, a claimant must provide the department with written notice of intent to initiate litigation on a form provided by the department. Such notice must be given at least 10 business days before filing suit under the policy but may not be given before the insurer has made a determination of coverage under s. 627.70131. Notice to the insurer must be provided by the department to the e-mail address designated by the insurer under S. 624.422. The notice must state with specificity all of the following information: 1. That the notice is provided pursuant to this section. 2. The alleged acts or omissions of the insurer giving rise to the suit, which may include a denial of coverage. 3. If provided by an attorney or other representative, that a copy of the notice was provided to the claimant. 4. If the notice is provided following a denial of coverage, an estimate of damages, if known. 5. If the notice is provided following acts or omissions by the insurer other than denial of coverage, both of the following: a. The presuit settlement demand, which must itemize the damages, attorney’s fees, and costs. b. The disputed amount. … The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Please be advised that your failure to pay the ($2,500.00) deductible or to allow Olympus or its agents to enter your property and complete the necessary repairs may constitute a material breach of the insurance contract and result in your claim remaining open (if pending deductible only) or the closure of your claim. At this time, we have not received the requested deductible payment necessary to move forward with the repairs to your home. As such, if we do not receive a response within 10 days of the date of this letter, we will assume that you do not wish to pursue the claim and will close our file. Should you pay your deductible, we will reopen the claim and proceed with repairs under our contractual Option to repair. Nothing herein shall constitute a waiver of that right. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any further questions, please feel free to call me.” On August 22, 2024, Olympus received a letter stating that Setzler, Croskey, Owens, & Bondaryk was hired to legally represent the Insureds. This Letter of Representation was accompanied by requests for documents, importantly, a certified copy of the Policy. On August 30, 2024, Olympus sent the Insureds’ counsel a certified copy of the Policy with the following acknowledgment letter: “This correspondence acknowledges your letter of representation for Aihab and Jennifer Gerges and dated8/22/2024, regarding the above referenced claim. This letter also acknowledges your request for a copy of the Policy. Enclosed is a copy of the Policy. Should you have any questions, please contact me.” On September 3, 2024, Olympus sent a second Reservations of Rights letter stating: “This correspondence is meant to provide you with a status of your above referenced claim and to request your cooperation with your post-loss obligations so that our Elite Repair Vendor can begin repairs to your property. As you are aware, Olympus issued insurance policy number OIC30026491-05 with effective dates of coverage from 06/29/2023 to 06/29/2024 for the property located at 2610 Night Rains Dr Lutz, FL 33559-7383. This policy was issued to you as the named insured, and the insurance coverage under the policy is subject to its terms and conditions and the express coverage limitations and exclusions to coverage set forth in the policy forms and endorsements. On 3/6/2024 we notified you that Olympus had exercised its contractual right to invoke its Option to repair the covered loss or damage to the insured property under the terms of the policy and that a preferred contractor was assigned to complete the interior repairs. On 3/11/2024 Olympus notified you that we approved the Paul Davis proposal and notified you that Olympus was pending receipt of your deductible payment in the amount of $2,500.00. Based on the above, Paul Davis cannot begin repairs. Pursuant to the terms of your policy, you have not cooperated with the Option to Repair process. Failing to do so may constitute a material breach of your policy. Your Homeowners Policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 01 23 Special Provisions – Florida endorsement, states in relevant part: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. … H. Our Option 1. At our option, in lieu of issuing any loss payment, if we choose to exercise our option: a. For losses settled on an actual cash value basis as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may repair or replace any part of the damaged property with material or property of like kind and quality. b. For losses insured for replacement cost as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may elect to repair or replace any or all of the damaged property with material of like kind and quality without deduction for depreciation, 2. If we choose to exercise our option, we will provide written notice to you no later than 30 days after our inspection of the loss. We may invoke our option to repair within the stated time frame after either a “supplemental claim” or “reopened claim” regardless of whether we invoked our option during the adjustment of the initial claim or a prior “supplemental claim”. 3. If we choose to exercise our option, you must cooperate with and grant us, or any person authorized to act on our behalf, reasonable access to the property in order for repairs to be made. 4. You are responsible for payment of the deductible stated in your Declarations Page. 5. You must comply with the duties described in SECTION I – CONDITIONS, B. Duties After a Loss, paragraph 7. 6. As often as is reasonably necessary to effectuate repairs, you must: a. Provide access to the property; b. Execute any necessary city, county, or municipal permits for repairs to be undertaken; c. Execute any work authorizations to allow contractors and related parties entry to the property; d. Otherwise cooperate with the repairs to the property. Our right to exercise our option to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. Any contract entered into between you and any repair person(s), contractor, other person or company to perform repairs or services except reasonable emergency measures for any loss attributed to a covered peril shall not interfere with this right. … SECTION I – CONDITIONS … G. Suit Against Us. 1. No action can be brought against us by you unless there has been full compliance with all of the terms and conditions under SECTION I of this policy and the action is started within 5 years after the date of loss. Prior to filing suit, you must provide the Florida Department of Financial Services with written notice to initiate litigation at least 10 business days before filing suit under the policy, in accordance with s. 627.70152, Florida Statutes. … Further Florida Statute 627.70152(3)(a) states: As a condition precedent to filing suit under a property insurance policy, a claimant must provide the department with written notice of intent to initiate litigation on a form provided by the department. Such notice must be given at least 10 business days before filing suit under the policy but may not be given before the insurer has made a determination of coverage under s. 627.70131. Notice to the insurer must be provided by the department to the e-mail address designated by the insurer under S. 624.422. The notice must state with specificity all of the following information: 1. That the notice is provided pursuant to this section. 2. The alleged acts or omissions of the insurer giving rise to the suit, which may include a denial of coverage. 3. If provided by an attorney or other representative, that a copy of the notice was provided to the claimant. 4. If the notice is provided following a denial of coverage, an estimate of damages, if known. 5. If the notice is provided following acts or omissions by the insurer other than denial of coverage, both of the following: a. The presuit settlement demand, which must itemize the damages, attorney’s fees, and costs. b. The disputed amount. … The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Please be advised that your failure to pay the $2,500.00 deductible or to allow Olympus or its agents to enter your property and complete the necessary repairs may constitute a material breach of the insurance contract and result in your claim. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any further questions, please feel free to call me.” On September 4, 2024, the Insureds’ counsel responded to the Reservation of Rights letter, largely citing pending mold and engineering reports as the reason for their lack of response to the first Reservation of Rights letter. Thus, pursuant to the Insureds’ request for mold testing, on September 19, 2024, Paul Davis, who was hired by Olympus, tested the house for mold. On September 23, 2024, a third Reservation of Rights letter was sent stating: “This correspondence is meant to provide you with a status of your above referenced claim and to request your cooperation with your post-loss obligations so that our Elite Repair Vendor can begin repairs to your property. As you are aware, Olympus issued insurance policy number OIC30026491-05 with effective dates of coverage from 06/29/2023 to 06/29/2024 for the property located at 2610 Night Rains Dr Lutz, FL 33559-7383. This policy was issued to you as the named insured, and the insurance coverage under the policy is subject to its terms and conditions and the express coverage limitations and exclusions to coverage set forth in the policy forms and endorsements. On 3/6/2024 we notified you that Olympus had exercised its contractual right to invoke its Option to repair the covered loss or damage to the insured property under the terms of the policy and that a preferred contractor was assigned to complete the interior repairs. On 3/11/2024 Olympus notified you that we approved the Paul Davis proposal and notified you that Olympus was pending receipt of your deductible payment in the amount of $2,500.00. Based on the above, Paul Davis cannot begin repairs. Pursuant to the terms of your policy, you have not cooperated with the Option to Repair process. Failing to do so may constitute a material breach of your policy. Your Homeowners Policy, HO 00 03 10 00 Homeowners 3 – Special Form, as amended by OL HO 100 01 23 Special Provisions – Florida endorsement, states in relevant part: SECTION I - CONDITIONS … B. Duties After Loss: After a loss to which this insurance may apply, you shall see that the following duties are performed: In case of a loss to covered property, we have no duty to provide coverage under this Policy to you or any other “insured” seeking coverage, if there is failure to comply with any of the following duties. 1. Promptly give notice to us or our agent; Except for Reasonable Emergency Measures taken under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2., there is no coverage for repairs that begin before the earlier of: a. 72 hours after we are notified of the loss; b. The time of loss inspection by us; or c. The time of other approval by us; If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. Any claim or “reopened claim” under an insurance policy that provides property insurance for loss or damage caused by any covered peril is barred unless notice of the claim was given to us in accordance with the terms of the policy within 1 year after the date of loss. A “supplemental claim” is barred unless notice of the “supplemental claim” was given to us in accordance with the terms of the policy within 18 months after the date of loss. For the purposes of this section, the term “reopened claim” means a claim that we have previously closed, but that has been reopened upon an insured’s request for additional costs for loss or damage previously disclosed to us. “Supplemental claim” means a claim for additional loss or damage from the same peril which we previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. … 4. Protect the property from further damage. The following must be performed: a. Take Reasonable Emergency Measures that are necessary to protect the covered property from further damage, as provided under SECTION I - PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. Keep an accurate record of the reasonable and necessary repairs and any and all expenses for such repairs. To the degree reasonably possible, take photos of the damage and cause of loss, and keep damaged parts, prior to repairs commencing; 5. You must submit to us, within 60 days after our request, signed sworn proof of loss, which sets forth, to the best of your knowledge and belief: a. The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; b. The names of all persons who resided at the insured location at the time of loss; c. The names of all persons with knowledge of how the loss occurred and the extent of the damage; d. The interests of all “insureds” and all others in the property involved and all liens on the property; e. Other insurance which may cover the loss; f. Change in title or occupancy of the property during the term of the Policy; g. Specifications of the damage to the dwelling and other structures; including: (1) Detailed descriptions of the damage to the property; (2) Repair estimates which show the extent of the damage to each item or property; (3) Estimated amount(s) to repair or replace each item of property; and (4) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; h. The inventory of damaged personal property described in SECTION I – CONDITIONS, B.7., below; i. Receipts for additional living expenses incurred and records that support the fair rental value loss; and j. Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; 6. Cooperate with us or any person authorized to act on our behalf, in the investigation of a claim. This includes speaking and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any other “insured” seeking coverage, or a representative of either of these: a. Must cooperate with our investigation; b. Must not act in any manner that unreasonably prevents us or any person authorized to act on our behalf, from investigating the claim; and c. May not act in any manner to obstruct our investigation; 7. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 8. As often as we reasonably require: a. Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; b. You must be present at our inspection and assist in identifying the damaged property during the inspection; c. For losses under Coverage A and Coverage B, allow us to re-inspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any third parties were completed, or following a supplemental or re-opened claim; d. Provide us with the records, photos, and documents we request and permit us to make copies; e. Provide us with receipts for additional living expenses incurred; f. Provide us with records that support the fair rental value loss; and g. In the County where the “residence premises” is located: (1) You and any and all “insureds”; (2) Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity who is an “insured”; and (3) Any agent or representative, including any public adjuster engaged on behalf of you or any “insured”, or any member, officer, director, partner, or similar representative of an association, corporation or other entity, described in g.(1) or (2), above; must: (a) Submit to examinations under oath and recorded statements while not in the presence of each other or any other “insured”; (b) Provide government-issued photo identification. If you do not possess government-issued photo identification, alternative identification with a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements. Such examinations under oath and recorded statements must either be in-person or utilize video and audio technology, or both, as determined by us; h. Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and i. Any and all “insureds” must execute all authorizations for the release of information when requested by us. 9. Promptly produce any updates to the documents and information above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: 10. To the degree reasonably possible, prior to materially altering, destroying, trenching, or excavating any part of the property or structure insured, allow us or any person authorized to act on our behalf, the opportunity to inspect the property. The duties above apply regardless of whether a person retains or is assisted by a party who provides legal advice, insurance advice, or expert claim advice, regarding an insurance claim under this Policy. … H. Our Option 1. At our option, in lieu of issuing any loss payment, if we choose to exercise our option: a. For losses settled on an actual cash value basis as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may repair or replace any part of the damaged property with material or property of like kind and quality. b. For losses insured for replacement cost as outlined in SECTION I – CONDITIONS, C. Loss Settlement, we may elect to repair or replace any or all of the damaged property with material of like kind and quality without deduction for depreciation, 2. If we choose to exercise our option, we will provide written notice to you no later than 30 days after our inspection of the loss. We may invoke our option to repair within the stated time frame after either a “supplemental claim” or “reopened claim” regardless of whether we invoked our option during the adjustment of the initial claim or a prior “supplemental claim”. 3. If we choose to exercise our option, you must cooperate with and grant us, or any person authorized to act on our behalf, reasonable access to the property in order for repairs to be made. 4. You are responsible for payment of the deductible stated in your Declarations Page. 5. You must comply with the duties described in SECTION I – CONDITIONS, B. Duties After a Loss, paragraph 7. 6. As often as is reasonably necessary to effectuate repairs, you must: a. Provide access to the property; b. Execute any necessary city, county, or municipal permits for repairs to be undertaken; c. Execute any work authorizations to allow contractors and related parties entry to the property; d. Otherwise cooperate with the repairs to the property. Our right to exercise our option to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. Any contract entered into between you and any repair person(s), contractor, other person or company to perform repairs or services except reasonable emergency measures for any loss attributed to a covered peril shall not interfere with this right. … SECTION I – CONDITIONS … G. Suit Against Us. 1. No action can be brought against us by you unless there has been full compliance with all of the terms and conditions under SECTION I of this policy and the action is started within 5 years after the date of loss. Prior to filing suit, you must provide the Florida Department of Financial Services with written notice to initiate litigation at least 10 business days before filing suit under the policy, in accordance with s. 627.70152, Florida Statutes. … Further Florida Statute 627.70152(3)(a) states: As a condition precedent to filing suit under a property insurance policy, a claimant must provide the department with written notice of intent to initiate litigation on a form provided by the department. Such notice must be given at least 10 business days before filing suit under the policy but may not be given before the insurer has made a determination of coverage under s. 627.70131. Notice to the insurer must be provided by the department to the e-mail address designated by the insurer under S. 624.422. The notice must state with specificity all of the following information: 1. That the notice is provided pursuant to this section. 2. The alleged acts or omissions of the insurer giving rise to the suit, which may include a denial of coverage. 3. If provided by an attorney or other representative, that a copy of the notice was provided to the claimant. 4. If the notice is provided following a denial of coverage, an estimate of damages, if known. 5. If the notice is provided following acts or omissions by the insurer other than denial of coverage, both of the following: a. The presuit settlement demand, which must itemize the damages, attorney’s fees, and costs. b. The disputed amount. … The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Please be advised that your failure to pay the $2,500.00 deductible or to allow Olympus or its agents to enter your property and complete the necessary repairs may constitute a material breach of the insurance contract and result in your claim. Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. Should you have any further questions, please feel free to call me.” This letter was followed by the Insureds submitting a sworn proof of loss dated September 23, 2024. That same day, Olympus sent this acknowledgment letter: “Olympus Insurance Company (“Olympus”) received your Sworn Statement in Proof of Loss on9/23/2024, in the amount of $781,498.54. • Olympus rejects your Sworn Proof of Loss as Olympus does not agree with the scope and amount of loss claimed. • Olympus rejects your Sworn Proof of Loss, as it was not submitted within sixty (60) days of the date of loss as required by the subject policy. Please refer to the pertinent parts of your Homeowner’s Policy, HO 00 03 10 00 Homeowners 3 – Special Form as amended by OL HO 100 01 23 Special Provisions – Florida endorsement, which state as follows: SECTION I - CONDITIONS … B. After a loss to which this insurance may apply, you shall see that the following duties are performed: … e. You must submit to us, within 60 days after our request, your signed, sworn proof of loss, which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of the loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of loss; (3) The names of all persons with knowledge of how the loss occurred and the extent of the damage; (4) The interests of all “insureds”, “assignees” if any, and all others in the property involved and all liens on the property; (5) Other insurance which may cover the loss; (6) Change in title or occupancy of the property during the term of the Policy; (7) Specifications of the damage to the dwelling and other structures; including: (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of the damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and any other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; (8) The inventory of damaged personal property described in SECTION I – CONDITIONS, B.1.h., below; (9) Receipts for additional living expenses incurred and records that support the fair rental value loss; and (10) Evidence or affidavit that supports a claim under Additional Coverage 6. Credit Card, Electronic Fund Transfer Card or Access Device, Forgery And Counterfeit Money stating the amount and cause of loss; Olympus does not intend to waive any of the rights or defenses it now has or may discover in the future under the above-mentioned policy. All such rights, defenses and privileges afforded the insurer under the policy are hereby expressly reserved on its behalf. The service of this notice upon you does not deprive you of any rights you may have against the company. We also reserve the right to assert all other policy provisions. If you have any questions, please contact me.” On October 1, 2024, pursuant to an email from the Insureds’ counsel, Olympus responded with a status update that the results of the mold testing were still pending and that SDii is the entity to contact regarding the five cracked tiles from the SDii engineer. A similar update on the pending mold report was sent to the Insureds’ counsel on October 18, 2024. After a number of emails concerning the claim were exchanged between the parties, the Insureds’ through their counsel, filed this Civil Remedy Notice on December 19, 2024. In addition, a Notice of Intent to Initiate Litigation was filed with the Department of Financial Services that day. In response to same, Olympus responded on January 8, 2025, with the following response letter: “The following response is provided pursuant to Section 627.70152, Florida Statutes. Olympus Insurance Company acknowledges receipt of the Property Insurance Notice of Intent to Initiate Litigation (Notice Number: 222379) accepted by the Florida Department of Financial Services on December 19, 2024 (hereafter referred to as "the Notice"). Olympus Insurance Company received the Notice on December 19, 2024, and this shall serve as Olympus Insurance Company's response. As an initial matter, please be advised that there is a question as to whether the Notice of Intention to Initiate Litigation document (“the Notice”) is compliant with the statutory requirements of F.S. 627.70152. First, it appears that the only line item included is an estimate that has been calculated on a replacement cost basis. Replacement cost benefits are not due and owing until and unless the work necessary to repair or replace the covered property is performed and the expenses are incurred. To date, Olympus has not received proof of repairs or invoices for the work done to the roof or the interior that was allegedly performed. Accordingly, the claim should be limited to the actual cash value of the direct physical loss to covered property. Because the estimate is incomplete, the Notice does not place Olympus on sufficient notice of the specific damages in dispute. Second, a formal demand amount has not been listed within the Notice. The Notice does not place Olympus on sufficient notice of the specific facts regarding any alleged act or omission that serve as the alleged basis for the Notice. For these reasons, the Notice is noncompliant with § 627.70152(3)(a), Fla. Stat. The lack of specificity inhibits Olympus’ right to promptly investigate, review, and evaluate the “dispute” stated in the Notice. Olympus requests that a proper and statutorily compliant written notice of intent to initiate litigation be submitted before suit is filed under the policy. Moreover, without waiving the deficiencies with the Notice, and subject to a complete reservation of rights, Olympus Insurance Company demands mediation for this matter. By selecting mediation pursuant to § 627.70152 Fla. Stat. as Olympus’ response to this premature Notice, Olympus does not waive any rights under the policy or law, including waiver of the previously requested examination under oath pursuant to the insurance contract. Nothing in this letter shall constitute a waiver of any right or an admission of any obligation under the policy. Nor shall any conduct of Olympus or its agents, attorneys, or employees be construed as an estoppel, waiver, modification, or surrender of the terms, limitations, exclusions, conditions, or agreements of the insurance policy. As such, Olympus reserves all its rights and defenses under the policy and Florida law, as well as the right to investigate, review, and evaluate any properly stated dispute in the event Olympus receives a statutorily compliant notice of intent or new or additional information. Counsel for Olympus Insurance Company, Brian Kelley, Esq. of Wallen Kelley (BKelley@WallenKelley.com) will contact you to coordinate same. By selecting mediation pursuant to § 627.70152 Fla. Stat. as Olympus’ response to this Notice, Olympus does not waive any rights under the policy or law, including waiver of the previously requested examination under oath pursuant to the insurance contract. Nothing in this letter shall constitute a waiver of any right or an admission of any obligation under the policy. Nor shall any conduct of Olympus or its agents, attorneys, or employees be construed as an estoppel, waiver, modification, or surrender of the terms, limitations, exclusions, conditions, or agreements of the insurance policy. As such, Olympus reserves all its rights and defenses under the policy and Florida law, as well as the right to investigate, review, and evaluate any properly stated dispute in the event Olympus receives a statutorily compliant notice of intent or new or additional information. This response is based on Olympus Insurance Company's investigation, review, and evaluation of the claim and the information provided by the Insureds to date. If there is additional information or documentation pertinent to the Insureds’ claim that has not previously been submitted, please submit it now for review and evaluation. To date, there has been no new documentation provided that would change Olympus’ coverage position on this matter. A copy of this response was sent to the Insureds via the email address listed within the Notice. If you have any questions or concerns, please feel free to contact Olympus.” Although a Civil Remedy Notice and Notice of Intent to Initiate Litigation have been filed, Olympus, in good faith, continues to adjust the claim. Mediation of the claim is pending. 2. Nature of the Complainants’ Civil Remedy Complaint In the Civil Remedy Notice, the Complainants allege Olympus violated: Section 624.155(1)(b)(1)—Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for her or his interests. Section 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. Section 626.9541(1)(i)(3)(a)—Failing to adopt and implement standards for the proper investigation of claims. Section 626.9541(1)(i)(3)(b)—Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Section 626.9541(1)(i)(3)(c)— Failing to acknowledge and act promptly upon communications with respect to claims. Section 626.9541(1)(i)(3)(d)— Denying claims without conducting reasonable investigations based upon available information. Section 626.9541(1)(i)(3)(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)(g)—Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Section 626.9541(1)(i)(3)(h)—Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. In the body of the Civil Remedy Notice, the Insureds additionally cited an alleged violation of section 627.70131(5)(a)-Within 90 days after an insurer receives notice of a property insurance claim from policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay such claim or a portion of the claim is caused by factors beyond the control of the insurer which reasonably prevent such payment; and section 627.70131(1)(a)- Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer’s claim file and dated. A communication made to or by a representative of an insurer with respect to a claim shall constitute communication to or by the insurer. These accusations are unfair given the nature of the facts and damage surrounding this claim. Here, the claim was processed, the Insureds’ property was inspected on numerous occasions, numerous status letters were sent to the Insureds, Olympus came to a coverage determination to open coverage, and invoked its right to repair the interior of the property. Specifically, first, Olympus asserts that it did act in good faith, fairly, and honestly towards the Insureds by taking all necessary steps to decide coverage all while keeping in constant communication with the Insureds. Second, Olympus asserts that not only did it come to a coverage determination, but it continues to adjust the claim and is actively participating in upcoming mediation. Third, Olympus asserts that it does have standards for the proper investigation of claims, standards that it used during the evaluation of this claim, including sending Paul Davis, Baldwin Roofing, and Sdii Global Corporation to inspect the property in person in addition to requesting paper documents for Desk Adjusters to evaluate, requesting a sworn proof of loss, and maintaining communication with the Insureds, their public adjuster, and their counsel. Fourth, Olympus again asserts that has made no misrepresentations on any facts or Policy provisions in its adjustment of this claim. Fifth, Olympus asserts that it always acted promptly, never more than a few days, and often following up with the Insureds when they did not respond promptly to Olympus’s communications. Sixth, Olympus asserts that it did conduct reasonable investigations, both in person and on paper, and any lack of available information stems from the Insureds not completing Olympus’ requests for additional information and documents as required under the policy. Seventh, Olympus sent numerous written communications to the Insureds explaining its bases, while using direct policy language, and thus, did not violate section 626.9541(1)(i)(3)(f). Eighth, Olympus asserts that promptly asked for additional information from the Insureds from its first communication with the Insureds in February 2024 and continues to do so through the filing of this Civil Remedy Notice. Ninth, Olympus asserts that it does explain the nature of the requested information, detailing the requests in writing, and explaining why the information is necessary using language directly from the Policy. Finally, any delay in Olympus’s response to the Insureds’ estimate stems from the Insureds failure to promptly provide Olympus with requested materials within a reasonable time, as required by the policy. Olympus has, at all time, acted within timeframes required by statutes and the Policy Moreover, and extremely importantly, the Complainants have failed to ask for a proper cure of their Civil Remedy Notice. In fact, they request no cure at all, which goes to show that this Civil Remedy Notice is premature, as the adjustment process is ongoing. Conclusion Olympus asserts that there was no misconduct in the adjustment of the Insureds’ claim. As can be seen from the above, Olympus has credible evidence to support its belief that the claim was properly adjusted. The claim was processed, the Insureds’ property was inspected, letters requesting documentation and information were sent, and Olympus has continued its adjustment of the claim through this very moment, especially given the pending mediation. Olympus has spent considerable time and resources in the investigation of this matter and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Insureds’ claim and unfairly paints Olympus in a negative light. Moreover, the lack of documentation provided by the Insureds/Complainants and their counsel during the pendency of this cure period (as well as the lack of specificity within the Civil Remedy Notice, especially due to the lack of a requested cure) has not given Olympus the ability to conclude its adjustment or “cure” the allegations contained herein. Sincerely, Lee Alhanti Lee Alhanti, Esq. On Behalf of First Protective Insurance Company
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