Civil Remedy Notice of Insurer Violations
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Filing Number:     797624
Filing Accepted:  12/19/2024
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Complainant
Last/Business Name *  
MCCLAIN   First Name   AUDREY
Street Address * 21019 KEATON BEACH DRIVE
City, State Zip * PERRY, FL 32348
Email Address * TERRY.MCCLAIN121@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MCCLAIN   First Name   AUDREY
Policy # * CH-0000025700-00 Claim #* HO0524427591
Attorney
Attorney is Applicable
Last Name* KANDELL First Name * SCOTT Initial
Street Address* 2665 S BAYSHORE DRIVE, SUITE 500
City, State Zip* MIAMI , FLORIDA 33133
Email Address * CRNREPLY@KKPFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   MONARCH NATIONAL INSURANCE COMPANY
NAIC Company Code 15715
 
Name of individual responsible for violation (if any):* AGENTS OF MONARCH NATIONAL INSURANCE CO.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I - PROPERTY COVERAGES Coverage A Dwelling Limit $390,500 Coverage B Other Structures Limit $7,810 Coverage C Personal Property Limit $97,625 Coverage D Loss of Use Limit $78,100 Failure to provide specific policy language is not a fatal omission in complying with Fla. Stat. 624.155. Presently, the policy is unavailable to the Insureds. Insureds are unsure and unaware of policy language that applies to the carrier's violation of Florida’s statutes. Insureds reserve the right to add applicable policy language at such time the policy is made available.
 
* 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 September 26, 2024, the insured property located at 21019 Keaton Beach Drive, Perry, FL 32348 (“Property”), owned by Terry and Audrey McClain (“Insureds”), suffered catastrophic damage resulting in a total loss due to Hurricane Helene. Hurricane Helene struck Keaton Beach as a powerful Category 4 storm, leaving behind extensive destruction. The hurricane generated winds near 140 mph, devastating nearly 90% of homes and infrastructure. This event marks one of the most severe impacts on Florida’s Big Bend region in recent history. Specifically, this natural disaster devastated Keaton Beach, which was in the eye of the storm along with the surrounding areas. At the time of loss, the Property was insured under a residential homeowner’s insurance policy, Policy No. CH-0000025700-00 (“Policy”), issued by Monarch National Insurance Company (“Monarch National”). The Policy covers losses due to wind damage, a peril which indisputably affected the Property during Hurricane Helene. Following the Insureds’ prompt reporting of the loss, Claim No. HO0524427591 (“Loss”), Monarch National arranged an inspection and, subsequently, opened coverage for the roof and deck rails. Thus, there is no dispute that the Property sustained intense wind forces from the hurricane, causing damage independently of flood-related forces. Monarch National has failed to acknowledge the total impact of the wind by only opening coverage for the roof and deck rails. Monarch National failed to properly address the severe wind which impacted the entire property in an effort to avoid providing coverage. This approach appears to be part of a pattern and practice of wrongful denial in similar claims to avoid paying for wind damage. The systematic denial of these claims by categorizing them as flood, rather than the wind which caused destruction to the Property first, is an act of bad faith on behalf of Monarch National. Under Florida’s Valued Policy Law (“VPL”), Fla. Stat. 627.702, when a covered peril renders property a total loss, as in this case, the insurer must pay the full policy limits. It is undisputed that the Insureds’ Property is a total loss, and therefore they are entitled to the policy limits. To cure these violations, Monarch National must issue payment under Florida’s VPL for the Policy limits under Coverages A and B, compensating the Insureds fully for the total loss of the insured Property due to wind damage, as well as pay all statutory interest on overdue amounts. Monarch National has made numerous material misrepresentations as to the facts of this Loss with the intent of effecting settlement of this claim on less favorable terms than those provided in the Policy. Monarch National has insisted via communications that it intends on promptly handling and resolving this claim but has substantially delayed said resolution. As a general business practice, Monarch National has demonstrated, both throughout this claim, and others, that it has failed to adopt and implement standards for the proper investigation of claims, frequently delaying its insureds’ claims and leaving them to retain their own adjusters and attorneys to ensure proper handling. It has not attempted in good faith to settle this claim when under all the circumstances it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for their interests. It has failed to promptly settle this claim when the obligation to settle has become reasonably clear. As a result of Monarch National’s lack of cooperation, the Insureds have been forced to exercise their only remaining option: retaining counsel and filing a lawsuit, costing them money and reducing their ultimate recovery, preventing them from being fully indemnified and denying them the opportunity to rebuild their Property. Monarch National has acted in bad faith by denying the Insureds’ claim without fully investigating or accounting for the wind damage sustained by the Property. In failing to provide the owed benefits, Monarch National has neglected its duty to act fairly and in good faith toward the Insureds. Monarch National must promptly pay the full policy limits for the total loss of the Insureds’ Property in accordance with Florida’s VPL to cure these violations. In order to remedy these violations, Monarch National must immediately issue an undisputed payment in connection with this claim as well as statutory interest under Fla. Stat. 627.70131 and undertake bilateral adjustment of the claim with the Insureds or their representatives per the terms and conditions of the Policy, at minimum outlining any disputes and setting forth the reasons in support of any position or compromise.
Comments
User Id Date Added Comment
Blair@becklawpa.com 02-14-2025 Department of Financial Services Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: Civil Remedy Notice of Insurer Violation Complainant : Audrey McClain Insured : Audrey McClain Policy Number : CH-0000025700-00 Claim No. : HO0524427591 DFS File Number : 797624 Acceptable Date : December 19, 2024 Insurer : Monarch National Insurance Company To Whom It May Concern: Please be advised that we represent Monarch National Insurance Company (“Monarch”) in the above-referenced matter. Kindly consider this to be Monarch’s report to the Department on the disposition of the alleged violations. Monarch maintains that it has not been in any violation of the law and that the Civil Remedy Notice of Insurer Violation (“CRN”) filed by Audrey McClain (“Insured”) is defective on its face, and fails to comply with the specificity requirements under Florida Statute 624.155. As such, Monarch objects to the Department’s acceptance of the above-referenced CRN. By way of background, this matter stems from reported wind and/or flood damage that occurred on September 26, 2024. Monarch first received notice of the claim on or about September 30, 2024. On or about October 7, 2024, Monarch’s independent field adjuster inspected the property, just one week after Hurricane Helene made landfall in Florida. Based on Monarch’s initial inspection, it was determined that substantial flood and/or storm surge affected the insured property. On or about October 14, 2024, Monarch wrote to the Insured advising it was retaining an independent engineering firm to further assist in Monarch’s investigation of the claim. The engineering inspection occurred on or about October 21, 2024. Monarch’s independent engineer opined the property sustained substantial flood and/or storm surge related damages due to 14-16 foot storm tide and 8-11 foot flooding. The engineer further opined that wind was the likely cause of damage to the property’s roof, soffit and fascia coverings, siding, and balcony guard. Based on Monarch’s investigation of the claim, Monarch wrote to the Insured on or about November 19, 2024, advising that Monarch was affording coverage for the wind-related damages, and denying coverage for the flood and/or storm surge damages pursuant to the clear and unambiguous terms of the policy. On or about December 19, 2024, the Insured, through their legal counsel, filed the instant CRN, a pre-requisite to a bad faith lawsuit under Florida Statute 624.155. The CRN includes three (3) reasons for the notice, including “unsatisfactory settlement offer, unfair trade practice, and claim delay,.” Additionally, the CRN alleges that Monarch has violated numerous Florida Statutes. On its face, this CRN merely contains accusations without any factual specificity to support them. Monarch maintains the CRN filed by the Insured is defective on its face. Florida Statute 624.155 expressly requires factual specificity to support the allegations contained within the Insured’s CRN. However, the Insured’s CRN merely contains blanket accusations without any factual specificity in relation to the Insured’s underlying claim. It is no surprise that in the past year, the Insured’s counsel has filed more than sixty (60) CRNs against various insurance carriers. Many of the CRNs contain the same, boilerplate language and accusations. The limited factual support contained within the Insured’s CRN is insufficient to place Monarch on notice of the alleged misconduct. Based on the Insured’s failure to comply with section 624.155 by filing an insufficient CRN, Monarch is unable to properly respond to the allegations. However, Monarch will address the factually devoid allegations based on the facts set forth above. As noted, Monarch promptly acknowledged the Insured’s claim, promptly inspected the property, and properly adjusted the claim pursuant to the terms of the subject insurance policy and Florida law. Despite the foregoing, the Insured’s CRN contains a generic allegation that, “as a general business practice, Monarch National has demonstrated, both throughout this claim, and others, that it has failed to adopt and implement standards for the proper investigation of claims, frequently delaying its insureds’ claims and leaving them to retain their own adjusters and attorneys to ensure proper handling.” However, the CRN does not contain any sufficient information or factual support to justify these allegations. The CRN further fails to identify any factual allegations demonstrating how Monarch violated the numerous statutory provisions included in the CRN. Instead, the CRN identifies four (4) separate statutes, regardless of whether they are relevant or applicable to the alleged facts contained in the Notice. Because the Civil Remedy Notice fails to identify any specific statutes Monarch is unable to properly respond, and the CRN does not comply with section 624.155. In addition, the CRN fails to identify any person or person(s) representing the insurer who are responsible for the alleged violations. Instead, the CRN lists, “AGENTS OF MONARCH NATIONAL INSURANCE CO.” The Insured’s failure to comply with section 624.155’s specificity requirement precludes Monarch from properly addressing the alleged misconduct. Lastly, the Notice fails to set forth with specificity the policy language that is relevant to these alleged violations as required by § 624.155. The CRN merely sites to all Section I – Property Coverages, alleging that the Insured is “unsure and unaware of policy language that applies to the carrier's violation of Florida’s statutes.” This allegation is factually incorrect, as the Insured later references Monarch’s coverage determination which expressly addressed the relevant policy terms. Ultimately, the CRN fails to identify any facts to establish any violations on the part of Monarch. A “civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days.” Valenti v. Unum Life Ins. Co. of Am., 2006 WL 1627276, at 2 (M.D. Fla. June 6, 2006) (citing Lane v. Westfield Ins. Co., 862 So. 2d 774, 777 (Fla. 5th DCA 2003)). The “shotgun” approach to the CRN renders it facially defective. The Insured’s CRN quotes the above-mentioned statutes and policy provisions without making it clear how they relate to the subject claim. Accordingly, the CRN fails to meet the stringent standards that are required so that an insurer is put on notice of exactly what is being alleged, to enable it to cure its actions. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136 (Fla. 5th DCA 2022); Heritage Corp. of S. Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008), aff’d, 361 F. App’x 986 (11th Cir. 2010). On its face, the Insured’s CRN is nothing more than a recitation of alleged statutory violations, without providing any specificity as to the facts of the alleged claim, and thus, is statutorily deficient. The?CRN?merely lists numerous statutes and fails to cite to any applicable policy language.? Accordingly, the?CRN?is defective and unenforceable as a matter of law because it fails to comply with the requirements under section 624.155. Based on the information outlined above, Monarch requests that the DFS re-consider its acceptance of the above-referenced CRN and further requests that the DFS provide Monarch a list of the guidelines and requirements utilized by the DFS in determining to accept this defective CRN. As outlined above, Monarch maintains that it has not acted in bad faith in handling the Insured’s claim, has not been in violation of any law, and has properly adjusted the claim pursuant to the terms, conditions, exclusions, and exemptions of the Policy. Monarch further maintains that the CRN, as filed, is defective on its face as it fails to meet the specificity requirements of Florida Statute 624.155. Should the Department require additional information, please do not hesitate to contact us. Sincerely, JOSHUA S. BECK, ESQUIRE
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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