Civil Remedy Notice of Insurer Violations
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Filing Number:     797696
Filing Accepted:  12/20/2024
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Complainant
Last/Business Name *  
GALBRAITH   First Name   RICHARD
Street Address * 14215 QUINTESSA LN
City, State Zip * LITHIA, FL 33547
Email Address * RICHARD.GALBRAITH@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GALBRAITH   First Name   RICHARD
Policy # * 988 892 545 Claim #* 077 296 7963
Attorney
Attorney is Applicable
Last Name* ADAMS First Name * JOHN Initial W
Street Address* 1074 BLOOMINGDALE AVE
City, State Zip* VALRICO , FL 33596
Email Address * JADAMS@ADAMSLAWASSOCIATION.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CASTLE KEY INDEMNITY COMPANY
NAIC Company Code 10835
 
Name of individual responsible for violation (if any):* PAIGE BROOKS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Failure to provide coverage for a covered loss
Other : Failure to investigate claim in consultation with the insured
Other : Failure to issue all payments due and owing
Other : Failure to address concerns of health and safety at the insured property
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Reason for Notice: Claim Delay Unfair Trade Practice Other: Failure to provide coverage for a covered loss Other: Failure to investigate claim in consultation with the insured Other: Failure to issue all payments due and owing Other: Failure to address concerns of health and safety at the insured property PURSUANT TO SECTION 624.155, F.S. please indicate all statutory provisions alleged to have been violated. 624.155(1)(b)(1) -- Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests. 626.9541(1)(i)(3)(a) -- Failing to adopt and implement standards for the proper investigation of claims. 626.9541(1)(i) -- Unfair claim settlement practices. 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)(g) -- Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 627.70131 – (5)(a) Within 90 days after an insurer receives notice of a property insurance claim from a 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. 626.9541(1)(a)(1) -- Misrepresenting the terms of an insurance policy. 626.9541(1)(i)(2) -- Making a material misrepresentation to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy. 69B-220.201(3)(B)(2) – An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(C) – An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(D) – An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(E) – An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties. 69B-220.201(3)(F) – An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(G) – An adjuster shall promptly report to the department any conduct by any licensed insurance representative of this state which violates any provision of the insurance code or department rule or order. Reference to specific policy language… THE POLICY LANGUAGE RELEVANT TO THE VIOLATIONS INCLUDES ALL APPLICABLE POLICY COVERAGES, VALUATION PROVISIONS, AND OTHER TERMS AND CONDITIONS OF THE POLICY. SEE: SECTION I COVERAGES; COVERAGE “A” (DWELLING); COVERAGE “C” (PERSONAL PROPERTY); COVERAGE “D” (LOSS OF USE); THE DECLARATIONS PAGE; LOSS PAYMENT AND SETTLEMENT PROVISIONS; DUTIES IN EVENT OF LOSS POLICY PROVISIONS; ALL TERMS AND CONDITIONS OF THE INSURANCE POLICY; AND ALL ENDORSEMENTS TO THE POLICY, INCLUDING ALL FLORIDA ENDORSEMENTS
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

FACTS OF THE CASE: THIS IS THE FIRST CIVIL REMEDY NOTICE FILED IN AN ATTEMPT TO PLEA FOR THE PROPER ADJUSTMENT OF THIS CLAIM. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS COMMITTED THE FOLLOWING IN INTERACTIONS WITH THE CLAIM: 1) FAILURE TO ACT IN DUE DILIGENCE AND GOOD FAITH TO RESOLVE CLAIMS; 2) PLACING THE FINANCIAL INTEREST OF INSURER BEFORE THAT OF POLICYHOLDERS AND CLAIMANTS; 3) FAILURE TO PROPERLY TRAIN, EVALUATE, AND MANAGE ADJUSTERS RETAINED TO REPRESENT THE POLICIES AND PROCEDURES OF ALLSTATE INSURANCE COMPANY (CASTLE KEY); (4) LOOKING FOR WAYS TO DELAY BENEFIT PAYMENTS AND OTHERWISE OR “STONE WALL” CLAIMS; (5) THE REASONS FOR THIS MAY BE ATTRIBUTED TO IMPROPER TRAINING, SUPERVISION, AND/OR MOTIVATION OF OUTSIDE ADJUSTERS AND CLAIMS SUPERVISORS TO PROMPTLY AND FAIRLY ADJUST AND PAY FULL BENEFITS AVAILABLE TO PARTIES WITH AN INSURABLE INTEREST IN THE PROPERTY. (6) MAKING MATERIAL MISREPRESENTATIONS OF FLORIDA LAW TO THE INSUREDS. ULTIMATELY, THE INSURER FAILED TO ADOPT PROPER STANDARDS OF INVESTIGATION AND ADJUSTMENT OF LOSSES OR IS OTHERWISE NOT IMPLEMENTING THOSE STANDARDS BECAUSE A PROPER ADHERENCE TO THE REQUIREMENTS OF FLORIDA STATUTES CHAPTER 624, 626 AND 627 IS NOT OCCURRING. ON OCTOBER 10, 2024 THE INSURED’S HOME WAS DAMAGED BY WIND AND WINDSTORM EVENT AND THE INSURED SUFFERED A SUBSTANTIAL LOSS REGARDING THE REAL PROPERTY AND PERSONAL PROPERTY. THEREAFTER THE INSURED CALLED ALLSTATE INSURANCE COMPANY (CASTLE KEY) TO REPORT THE CLAIM FOR PROPERTY DAMAGE TO THE PROPERTY AND REQUEST MUCH NEEDED HELP AND DIRECTION AFTER THE INSURED’S LIFE HAD BEEN TURNED UPSIDE DOWN. ALLSTATE INSURANCE COMPANY (CASTLE KEY) INVESTIGATED THE CLAIM, ENGAGED AN INSURANCE CLAIMS ADJUSTER. ALLSTATE INSURANCE COMPANY (CASTLE KEY)‘S ADJUSTER OR THIRD-PARTY CLAIMS ADMINISTRATOR TOOK PHOTOGRAPHS, INTERVIEWED THE INSUREDS BY TAKING STATEMENTS, AND VISITED AND INSPECTED THE PROPERTY. UPON INFORMATION AND BELIEF, THE CARRIER NOR THEIR THIRD-PARTY CLAIMS ADMINISTRATOR ENGAGED ANY ENGINEERS TO CONDUCT AN INVESTIGATION AT THE PROPERTY IN LIGHT OF THE CLEAR STRUCTURAL DAMAGE. ADDITIONALLY, UPON INFORMATION AND BELIEF, THE CARRIER NOR THEIR THIRD-PARTY CLAIMS ADMINISTRATOR PRODUCED ANY REPORT AS A BASIS OF THEIR CLAIMS DECISION. ALLSTATE INSURANCE COMPANY (CASTLE KEY) ISSUED ITS ESTIMATE DENYING ALMOST ALL OF THE DAMAGE TO THE PROPERTY WITHOUT ANY EVIDENCE, PROOF, REPORT OR PHOTOGRAPHS. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS YET TO EXPLAIN AT ALL WHY IT HAS CHOSEN TO DENY THE DAMAGE OR EXPLAIN WHY DAMAGES ARE SUBJECT TO EXCLUSIONS OR EXCEPTIONS WITHOUT ANY BASIS OR FACTUAL EXPLANATION. ALLSTATE INSURANCE COMPANY (CASTLE KEY) CONTINUES TO STALL AND BALK AT THE INSURED’S CONTINUOUS ATTEMPTS FOR HELP AS THEY ARE LEFT IN A DANGEROUS CONDITION AND LEFT ONLY TO THEIR OWN VERY LIMITED RESOURCES TO REPAIR THE DAMAGE. MEANWHILE, THE INSURED CONTINUES TO BE TREATED LIKE A SECOND-CLASS CITIZEN FORCED TO REPAIR WHAT IS CLEARLY A DANGEROUS CONDITION AFTER THE WINDSTORM AND WATER DAMAGE INSPITE OF ALLSTATE INSURANCE COMPANY (CASTLE KEY) BEING PLACED ON NOTICE AND BEGGED FOR HELP. IT IS UNCONSCIONABLE THAT ALLSTATE INSURANCE COMPANY (CASTLE KEY) COULD ACCEPT PREMIUMS, CONDUCT AN INITIAL INVESTIGATION, AND DENY ALMOST ALL LIABILITY WITHOUT ANY ENGINEERING REPORTS, INVESTIGATIONS OR EXPLANATION. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS BEEN GIVEN COMPLETE ACCESS TO THE INSURED PROPERTY, HAS NOTICE OF THE CONDITION OF THE PROPERTY THROUGH THEIR OWN INSPECTION AND PHOTOGRAPHS. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS ALSO BEEN PLACED ON NOTICE THROUGH THE REPEATED CALLS FROM THE INSURED ASKING FOR UPDATES AND REQUESTING FULL PAYMENT TO RETURN THE PROPERTY TO ITS PRE-LOSS CONDITION. INSTEAD OF RE-INSPECTING THE PROPERTY AND ISSUING PAYMENT UNDER THE POLICY, WHICH WAS IN FULL FORCE, ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS INSTEAD IGNORED THE INSURED. ON OCTOBER 18, 2024, THE ADAMS LAW ASSOCIATION, RETAINED BY THE INSURED IN ORDER TO BEG AND PLEA FOR THE CARRIER TO PROPERLY ADJUST THE LOSS, PREPARED A NOTICE OF CLAIM, REQUEST TO RE-OPEN AND RE-ADJUST CLAIM AS WELL AS REQUESTED COPIES OF ALL ADJUSTER REPORTS, ENGINEER REPORTS, ESTIMATES, PHOTOGRAPHS AND DOCUMENTS WHICH SUPPORT THEIR DENIAL. IN THE CORRESPONDENCE, THE LAW FIRM REQUESTED AND DEMANDED THE CARRIER ASSIGN AN ADJUSTER, REVIEW THE CLAIMS FILE AND RE-INSPECT THE PROPERTY TO FULLY AND PROPERTY ADJUST THE LOSS. UNFORTUNATELY, THE CARRIER HAS NOT PRODUCED ANY DOCUMENTS. THE INSURED, THROUGH ITS ATTORNEY, HAS REPEATEDLY REQUESTED THE CARRIER FOR DOCUMENTS WHICH SUPPORT ITS CONTENTION THAT THE DAMAGE WAS CAUSED BY EXCLUSIONS OR EXCEPTIONS OF THE POLICY. AT THIS TIME, THE CARRIER STILL HAS NOT PROVIDED ANY REASON FOR THE CONTINUED CLAIMS DELAY AND HAS OUTRIGHT REFUSED TO EXPLAIN ITS CLAIMS DECISION WITHOUT ANY CLARITY OR DIRECTION. AT THIS POINT, THE CARRIER HAS REFUSED TO PROPERLY ADJUST THE LOSS AND REFUSES TO COMMUNICATE WITH ITS INSURED THROUGH EITHER FORMAL MEANS OR INFORMAL MEANS. THIS INACTION IS PRIMA FACIE EVIDENCE THAT THE CARRIER HAS REFUSED TO ADJUST THE LOSS BY REFUSING TO ISSUE FULL PAYMENT. THE INSURER’S FEIGNED ATTEMPTS TO ADJUST THE LOSS ARE NOTHING MORE THAN TO WRONGFULLY DENY OR DELAY THIS CLAIM. THE ACTIONS TAKEN BY ALLSTATE INSURANCE COMPANY (CASTLE KEY) IN THE HANDLING/ADJUSTMENT OF THE HOMEOWNER’S CLAIM WERE WILLFUL, WANTON, IN BLATANT DISREGARD FOR THE RIGHTS OF THE HOMEOWNERS, AND OCCUR WITH SUCH A FREQUENCY AS TO INDICATE A GENERAL BUSINESS PRACTICE IN VIOLATION OF FLA. STAT. §§ 624.155 AND 626.9541. IN FLORIDA THE WORK OF ADJUSTING INSURANCE CLAIMS ENGAGES THE PUBLIC TRUST. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS BREACHED THIS DUTY BY ITS IMPROPER HANDLING OF THE INSURED’S CLAIM OF LOSS. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR PROPER INVESTIGATION TO EVALUATE CLAIMS HANDLING AND FOR TRAINING AND SUPERVISION OF EMPLOYEES RESULTING IN STATUTORY VIOLATIONS SET FORTH ABOVE. ALLSTATE INSURANCE COMPANY (CASTLE KEY) HAS FAILED AND/OR REFUSED TO THOROUGHLY, ACCURATELY, AND COMPLETELY INVESTIGATE AND EVALUATE THE INSURED’S INSURANCE CLAIM FOR DAMAGES. FLA. STAT. § 624.02 DEFINES INSURANCE AS A CONTRACT WHEREBY ONE UNDERTAKES TO INDEMNIFY ANOTHER OR PAY OR ALLOW SPECIFIED AMOUNT OR A DETERMINABLE BENEFIT UPON DETERMINABLE CONTINGENCIES. INHERENT IS THE FACT THAT PAYMENT MUST BE MADE TIMELY AND PROMPTLY SO THAT THE INSURED MAY MITIGATE HIS/HER DAMAGES AND TO PUT THEM BACK INTO THE POSITION THEY WERE PRIOR TO LOSS AS QUICKLY AS POSSIBLE. ALLSTATE INSURANCE COMPANY (CASTLE KEY) BREACHED THIS DUTY. THE ACTIONS TAKEN BY ALLSTATE INSURANCE COMPANY (CASTLE KEY) IN THE HANDLING OF THE INSURED’S CLAIM WERE WILLFUL, WANTON, AND IN DISREGARD OF THE RIGHTS OF ITS INSURED AND OCCUR WITH SUCH A FREQUENCY AS TO INDICATE A GENERAL BUSINESS PRACTICE, AND ARE IN VIOLATION OF FLA. STAT. §§ 624.155 AND 626.9541. ALLSTATE INSURANCE COMPANY (CASTLE KEY)’S ACTIONS AMOUNT TO BUT ARE NOT LIMITED TO THE FOLLOWING: 1. FAILURE TO RECOGNIZE A CLAIM 2. FAILURE TO RESPOND TO AN INSURED’S REQUEST TO ADJUST THE LOSS 3. FAILURE TO ASSIGN AN ENGINEER TO INSPECT THE DAMAGE 4. FAILURE TO COMMUNICATE TO AN INSURED AFTER A CLAIM WAS MADE 5. CLAIM DELAY 6. NOT CONDUCTING FULL AND PROMPT INVESTIGATION 7. FAILING TO PROVIDE REPORTS REQUESTED 8. NOT TREATING POLICYHOLDERS WITH GOOD FAITH CLAIMS CONDUCT 9. NOT ADJUSTING CLAIMS AND EVALUATING LOSSES PROPERLY, PROMPTLY AND FAIRLY TO PROVIDE FULL AND PROMPT INDEMNITY TO THE INSURED 10. FAILING TO IMPLEMENT PROPER STANDARDS FOR THE ADJUSTMENT AND INVESTIGATION OF CLAIMS 11. NOT TRAINING, SUPERVISING OR MANAGING ADJUSTERS PROPERLY SO THAT PROMPT AND FULL PAYMENTS ARE MADE, BUT RATHER PLACING THE COMPANY’S INTERESTS BEFORE THOSE OF THE POLICYHOLDER. 12. FAILING TO OFFER ALL COVERAGES AVAILABLE IN SPITE OF THE CLEAR EVIDENCE OF WINDSTORM AND WATER DAMAGE. THEREFORE, TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, ALLSTATE INSURANCE COMPANY (CASTLE KEY) MUST: (1) ADMIT FULL COVERAGE FOR THE INSURED’S LOSS; (2). TENDER COVERAGE APPLICABLE FOR THE DAMAGE CAUSED BY THE WIND AND WATER DAMAGE IN THE AMOUNT OF $118,635.59. (3). PAY STATUTORY INTEREST ON THE AMOUNT OF UNPAID CONTRACT DAMAGES FROM THE DATE OF THE LOSS TO THE PRESENT TIME PURSUANT TO F.S. §627.70131, AND PAY REASONABLE COSTS INCURRED. A COPY OF THIS FORM SUBMITTED TO THE FDFS HAS BEEN SENT TO THE FOLLOWING PARTIES PROVIDING THEM NOTICE OF THE FILING OF THE CIVIL REMEDY NOTICE: ALLSTATE INSURANCE COMPANY (CASTLE KEY) ATTN: CLAIMS DEPARTMENT AND PAIGE BROOKS PO BOX 660636 DALLAS, TX 75266 SENT VIA EMAIL & FAX: CLAIMS@CLAIMS.ALLSTATE.COM (866) 447-4293
Comments
User Id Date Added Comment
tkelb@allstate.com 02-10-2025 Please allow this correspondence to serve as Castle Key Indemnity Company (hereafter, "Castle Key")s initial response to your Civil Remedy Notice of Insurer Violations, filing number 797696. . Castle Key Indemnity Company specifically denies the allegations set forth in the Civil Remedy Notice of Insurer Violations. At all time, Castle Key Indemnity Company has acted in good faith. Castle Key does not consider there to have been any manner of violation and questions the validity of the Notice as it fails to meet the requirements set forth in Section 624.155, Florida Statutes and Florida law and thus fails to perfect the insured's right to pursue civil remedies. The potential statutory violations and information submitted are nothing more than unsupported, baseless allegations. Castle Key notes the CRN fails to reference the specific policy language relevant to the alleged violations or set forth facts in support of each of the alleged violations. This information is required to be included and be correct on the statutory Civil Remedy Notice form. . At this time, after review of the two adjuster inspections and an engineering inspection that have taken place regarding the damages to this property, Castle Key Indemnity Company feels that this loss has been addressed accordingly. From the first two inspections, there was minimal damage found to the shingles or roofing components, no damage to the elevation items nor to the other structures surround the dwelling at the time of the inspection. . At this time, there is no new information that has been presented with regards to your client's loss on October 10, 2024, which would change our claim determination. We are standing on position as stated in the letter dated as of February 5, 2025. . Nothing herein constitutes, nor should be construed by you or your client as a waiver of the rights of Allstate under the policy of insurance, nor is it the purpose of this letter to waive any of the policy terms or conditions. Further, no action or inaction by Castle Key should be construed as a waiver of any of its legal defenses, including but not limited to the right to be served with a compliant Notice. . At all times, Castle Key Indemnity Company has acted in good faith in investigating and handling the claim. Castle Key Indemnity Company has not breached any duty owed to you. . If you have additional documentation that you would like Castle Key to consider, please submit it to claims@claims.allstate.com . Be sure to include the claim number and policyholder name within the subject line of all email communications.
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