Civil Remedy Notice of Insurer Violations
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Filing Number:     797629
Filing Accepted:  12/19/2024
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Complainant
Last/Business Name *  
NIMRAH SHAUKAT   First Name  
Street Address * 16300 VANGOGH ROAD
City, State Zip * LOXAHATCHEE, FL 33470
Email Address * SHAHABSHAUKAT@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   NIMRAH SHAUKAT   First Name  
Policy # * 1501-1904-9336 Claim #* FL24-0106180-E723
Attorney
Attorney is Applicable
Last Name* DAVIS First Name * JARED Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * JDAVIS@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* CHRISTOPHER O'BRIEN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Claim Delay
Unsatisfactory Settlement Offer
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

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

The carrier was put on notice of the insured’s property damage sustained due to water infiltrating the premises. The carrier initially attempted to low-ball the claim. Subsequently, the insured prepared a loss package in the amount of $231,679.23 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $19,968.91 only, leaving a remainder in the amount of $211,710.32 to be paid in order to cure the breach, less any applicable policy deductible. The insured has complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About three hundred days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insured’s property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insured’s interests; refusing to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $231,679.23, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Erica De Jesus at (561)-892-9874 if you have any questions or concerns. Sincerely, Jared Davis Attorney at Law
Comments
User Id Date Added Comment
oc1102@universalproperty.com 02-06-2025 February 6, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 797629 Filing Date: 12/19/2024 Complainant(s): Nimrah Shaukat Insured(s): Nimrah Shaukat Policy No.: 1501-1904-9336 Claim No.: FL24-0106180-E723 Re: DFS File No.: 801102 Filing Date: 1/15/2025 Complainant(s): Nimrah Shaukat Insured(s): Nimrah Shaukat Policy No.: 1501-1904-9336 Claim No.: FL24-0106180-E723 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, Jared Davis, on behalf of Complainant, Nimrah Shaukat (also referenced as the “Insured.”) The Notices allege violations of Sections 624.155 and 626.9541, Florida Statutes. Universal denies the allegations contained in the Notices. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notices fail to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notices are deficient as a matter of law as they fail to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Section 624.155(3)(b), Florida Statutes the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language, which the authorized insurer allegedly violated; 2. the facts and circumstances giving rise to the violation; 3. the name of any individual involved in the violation; 4. reference to specific policy language that is relevant to the violation, if any...; 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Department of Financial Services (“DFS”), created form DFS-10-363, which lays out 15 requirements that the Complainant must respond to with specificity. The Florida Supreme Court holds that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant has specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). To begin, the Notices fail to meet the requirements of Section 624.155, Florida Statutes on several grounds. First, the Notices fail to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of Section 624.155, Florida Statutes, the Complainant must name the individual(s) involved with specificity as it relates to the purported violation to allow Universal to properly investigate the allegations. The Notices lack the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Complainant does not identify the person or persons at Universal with the most knowledge of the facts regarding any alleged violation(s), but simply states “Christopher O’Brien,” without more. However, the Notices fail to include any specific facts as to how Mr. O’Brien is knowledgeable of the facts giving rise to any purported allegation(s) and/or what Mr. O’Brien did or failed to do. Therefore, the Notices does not have the requisite specificity as to whom the Complainant is asserting has knowledge as to any allegation to put Universal on Notice of what needs to be cured. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because, the Complainant alleges that Universal misrepresented pertinent facts and/or policy provisions. Thus, the Notices fail to include the requisite specificity as to whom made any misrepresentations, what was misrepresented and/or when any of these alleged misrepresentations occurred. Accordingly, the Complainant’s Notices are insufficient as a matter of law. Second, the Notices fail to satisfy Section 624.155(3)(b)(4), Florida Statutes, in that they fail to reference any specific policy language relevant to any alleged violation. The Notices simply states, “Loss settlement provision.” However, the Notices do not specify any facts regarding how the cited provision applies to the claim at issue and/or how it was allegedly violated. As such, Universal is left to wonder what policy provisions Complainant believes were allegedly violated or breached and why. General, vague, missing, and overbroad references to a policy provision does not satisfy the specificity required by Section 624.155(3)(b)(4), Florida Statutes. As such, the Notices are deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Third, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notices fail to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Complainant lists three (3) reasons for filing the Notice, “Claim Delay,” “Unsatisfactory settlement offer,” and “Unfair Trade Practice.” However, the Complainant’s allegations regarding these “Reasons for Notice” are unsupported by actual facts in the Notices. The Notices contain general allegations consisting largely of conclusory and inaccurate statements, rather than specific allegations of facts regarding any alleged misconduct or statutory violations. For example, the Notices state, “the insured prepared a loss package in the amount of $231,679.23 needed to restore the property back to its pre-loss condition… The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insured’s property and has not taken any meaningful ensuing action.” However, the Complainant fails to specify any facts to support these conclusory statements. Universal investigated the Insured’s claim and advised the Insured of its coverage decision, pursuant to the terms of the policy. Moreover, at the time the instant Notices were filed, Universal had not been provided the “loss package” referenced in the Notices. Additionally, the Notices alleges: “It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insured’s interests; refusing to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days.” However, Complainant provides no facts or examples to support these boilerplates and/or conclusory allegations. In addition, the Complainant makes a general reference to an alleged violation of the Policy “requiring payment of a claim within 90 days.” Universal asserts as phrased, this is misleading, and Universal relies on the actual Policy language itself. Further, there are no facts asserted to support this allegation. Furthermore, the Notices state, “[a]ll the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida.” However, the Complainant fails to specify any facts to support this conclusory statement nor provides any specific examples of how Universal violated the Insured’s rights. Moreover, the Complainant alleges that Universal violated Section 626.9541(1)(i)(3)(b), Florida statutes, by “[m]isrepresenting pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Notices do not set forth any facts regarding any misrepresentations made by Universal and do not identify the person or persons who made such misrepresentations. The Notices do not state sufficient specific facts to support the Complainant’s misrepresentation allegations or any of the allegations contained therein. The Notices are repleted with conclusory statements and supposition rather than specific facts to support any of the alleged misconduct or statutory violations to support its conclusory allegations. The failure to provide specific facts to support the conclusory allegations of misconduct hinders Universal’s ability to appropriately investigate the allegations in the Notices. A written notice which is vague and “shotgun” in nature or is written in general terms fails to satisfy the specificity requirement of the statute. See Heritage Corp. of South Fla., 580 F. Supp. 2d at 1300; 316, Inc., 625 F. Supp. 2d at 1193; see also Rousso, 2010 WL 7367059 at *3-6; Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). It is evident that the statements of facts fall short of the specificity required by Section 624.155, Florida Statutes. As a result, the Complainant fails to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. Lastly, the Notices do not provide a proper means whereby Universal can “cure” the alleged defects, without paying benefits which are not due and owing to the Insured. The purpose of a Civil Remedy Notice is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). However, Section 624.155, Florida Statutes, does not impose on an insurer the obligation to pay whatever an insured demands. Talat, 753 So. 2d at 1282. To the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. Notably, Universal asserts that when the Insured initiated litigation before the expiration of the Notices, it prejudiced Universal's ability to cure any purported allegation in the Notices as there is no actual cure period wherein Universal could cure without paying extra-contractual damages. In summary, as outlined above, the Complainant fails to respond to each of the fields set forth on the DFS Form with the requisite specificity including, but not limited to, the failure to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations, the failure to reference specific policy language relevant to the alleged violation, the failure to allege any specific conduct on the part of Universal that would violate any policy provision or statute, and the failure to provide a proper means whereby Universal can “cure” the alleged defects, without paying benefits which are not due and owing to the Insured. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notices are deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with the facts and circumstances regarding this claim, which shall demonstrate that Universal has not violated any Policy terms or statutory provisions. On March 14, 2024, Universal received notice from the Insured’s public adjuster, Alpha Claims Consultants, the insured location had damage which occurred on August 29, 2023. Universal inspected the property and documented any visible damage. Universal issued its undisputed payment to the Insured in the full amount of its estimate less the applicable policy deductible and the recoverable depreciation, pursuant to the terms of the Policy. Under the terms of the Policy, Universal will initially pay at least the actual cash value of the insured loss, less any applicable deductible. It will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. On January 22, 2025, the Insured initiated litigation against Universal in Circuit Court of Palm Beach County under case No. 0-2025-CA-000604-XXXA-MB. Thus, at this time the parties continue to litigate their dispute to determine what, if any additional coverage exists under the terms of the Policy. As outlined above, the alleged statutory violations set forth in the Notices lack factual support and are without merit. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully respond to the alleged violations in the Notices filed by the Complainant. Sincerely, /s/ Ozzy Cudila Ozzy Cudila, Esq. Associate General Counsel
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