Civil Remedy Notice of Insurer Violations
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Filing Number:     797890
Filing Accepted:  12/23/2024
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Complainant
Last/Business Name *  
ROJAS GALLEGOS   First Name   ENRIQUETA
Street Address * 901 S FEDERAL HIGHWAY
City, State Zip * HALLANDALE BEACH, FL 33009
Email Address * NATHALIEQUINONES@HOTMAIL.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   STRONACH GROUP INC   First Name  
Policy # * TB1-B71-170912-033 Claim #* 190373738
Attorney
Attorney is Applicable
Last Name* RUTIGLIANO First Name * VINCENT Initial
Street Address* 2501 HOLLYWOOD BOULEVARD, SUITE 110
City, State Zip* HOLLYWOOD , FL 33020
Email Address * VRUTIGLIANO@RRPALAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   LIBERTY MUTUAL INSURANCE COMPANY
NAIC Company Code 23043
 
Name of individual responsible for violation (if any):* DANIELLE JOHNSON
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

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

Ms Johnson has refused to engage with the attorney representing the claimant herein. Other than one or two acknowledgements that she is assigned to the instant claim by the insurance carrier she has refused to communicate with the claimant's attorney. The instant claim involves security personnel who while driving a golf cart struck the claimant (who was working at the time) on the insured's premises. Since October 4, 2024 the submitting attorney has attempted to engage with Ms. Johnson to determine their position on liability, whether there was any video that captured what occurred and to address the involvement of certain parties that Ms. Rojas Gallegos' worker's compensation carrier is asking to have released in separate worker's compensation carrier. The following is a list of the communication initiated by the attorney representing the claimant: 10/4/24 - message left for Ms. Johnson on her voice mail asking for a return call. 10/14/24 - message left for Ms. Johnson on her voice mail asking for a return call. 11/4/24 - email sent and message left for Ms. Johnson on her voice mail asking for a return call. 11/5/24 - email to Ms. Johnson asking if she was still assigned to this file. 11/11/24 - Ms. Johnson responded to prior email saying "yes." 11/12/24 - email sent and message left for Ms. Johnson on her voice mail asking for a return call. Reference to prior outreach. 11/18/24 - email sent and message left for Ms. Johnson on her voice mail asking for a return call. 11/20/24 - Ms. Johnson's made a return call and left the attorney representing the claimant a message. When the representing attorney immediately called Ms. Johnson back she did not take the call and instead emailed "Can you state the specifics of your call by email as it may be easier to respond?". The representing attorney in response said "It involves certain basics to a new claim - facts and positions. I always find these to be easier when done by phone. I will be available all morning tomorrow (I am leaving in 5 minutes). Please give me a call. Thank you." 11/22/24 - email sent and message left for Ms. Johnson on her voice mail asking for a return call. 11/25/24 - email sent and message left for Ms. Johnson on her voice mail asking for a return call. 11/26/24 email sent to Ms. Johnson "We have never spoken on this claim. I want to discuss the facts / defenses of the claim. Is there video / what does it show? Are there witnesses? What does the driver of the cart say? I find these conversations to be easier and quicker if done by phone. I just tried you again. Please give me a call." 11/27/24 email sent to Ms. Johnson "I also need to address with you potential releasees related to the companion work comp file. The work comp carrier (on the work comp claim) as part of the work comp settlement is asking for the release of: Released parties: XXXX [names not written here] and also in his capacity as owner/operator/principal/officer of XXX. Can you please advise / confirm that that the release of the foregoing individuals in the work comp claim would have zero impact on our third party claim. I want to make sure that if those individuals are released it will not affect Enriqueta’s ability to assert her claim against those responsible for causing the incident where she was hit by the individual on the golf/security cart. 12/4/24 message left for Ms. Johnson and email sent: What information do you have as far as how the incident occurred? What is your position on liability? Is there video / what does it show? Are there witnesses? What does the driver of the cart say? The work comp carrier (on the work comp claim) as part of the work comp settlement is asking for the release of: Released parties: XXXX [names not written here] and also in his capacity as owner/operator/principal/officer of XXX. Can you please advise / confirm that that the release of the foregoing individuals in the work comp claim would have zero impact on our third party claim. I want to make sure that if those individuals are released it will not affect Enriqueta’s ability to assert her claim against those responsible for causing the incident where she was hit by the individual on the golf/security cart. 12/11/24 - message left for Ms. Johonson with email of "Please advise if you will be substantively engaging with me on this file? Is there some reason why you will not engage with me?" Ms. Johnson's conduct is not in accordance with the ethical requirements she is bound under as set forth in 69B-220.201. Ms. Johnson has failed to put her duty for fair and honest treatment of the claimant above her own interests. Ms. Johnson's refusal to engage is prejudicial to her insured. Ms. Johnson has failed to investigate and make truthful and unbiased reports of the facts. Ms. Johnson has failed to act with honesty and integrity and allow a fair adjustment of the instant claim. Ms. Johnson has failed to act with dispatch and due diligence to acheive a proper disposition of this claim.
Comments
User Id Date Added Comment
rjurman@hinshawlaw.com 02-17-2025 February 17, 2025 VIA ELECTRONIC SUBMISSION AND CERTIFIED MAIL Vincent Rutigliano, Esq. Rosenberg & Rosenberg, PA 2501 Hollywood Blvd. Suite 110 Hollywood, FL 33020 vrutigliano@rrpalaw.com Re: Civil Remedy Notice of Insurer Violation Complainant: Enriqueta Rojas Gallegos Insurer: Liberty Mutual Insurance Company Insured: 445327 Ontario Limited DFS Filing No.: 797890 Filing Date: December 23, 2024 Claim No.: 190373738 Policy No.: TB1-B71-170912-033 Date of Loss: June 9, 2024 Our File No.: 1082265 Dear Mr. Rutigliano: By way of introduction, our firm and the undersigned attorneys have been retained as coverage counsel by Liberty Mutual Insurance Company (“Liberty Mutual”) with respect to the above-referenced loss and matter. Please allow this letter to serve as Liberty Mutual’s response to the Civil Remedy Notice of Insurer Violations (“CRN”), File No. 797890, filed by Enriqueta Rojas Gallegos (“Gallegos”), which was accepted by the Department of Financial Services on December 23, 2024. The CRN was filed against Liberty Mutual for alleged violations of Section 624.155(1)(b)(1), Florida Statutes, regarding the alleged damages suffered by Gallegos as a result of an alleged incident in which Gallegos, while riding a bicycle, collided with a golf cart being driven by a security officer at Gulfstream Park in Hallandale Beach, Florida. As will be explained in more detail below, Liberty Mutual denies each and every allegation of bad faith and improper conduct expressly or impliedly alleged in the CRN. First and foremost, Liberty Mutual was never notified of this claim until after the CRN was filed. Since then, Liberty Mutual has handled the underlying claim at all times with utmost good faith. Separately, Gallegos’ claim is a third-party claim and any such allegations of bad faith are premature and not ripe given that there has been no excess judgment or settlement with Liberty Mutual’s insured. Furthermore, the specific allegations raised are directly in reference to actions, or inactions, taken by a “Ms. Johnson” as cited in the CRN. However, it is Liberty Mutual’s belief that the Ms. Johnson referenced is Danielle Johnson, Senior Claims Examiner with Broadspire Services, Inc. (“Broadspire Services”), a third-party administrator, who is handling the underlying claim. There do not appear to be any allegations of wrongdoing by Liberty Mutual. BACKGROUND INFORMATION The Subject Incident This matter arises out of an alleged golf cart incident that occurred on Sunday, June 9, 2024, involving Officer Mynor Parrales (“Parrales”) and Gallegos at Gulfstream Park Racing. Gulfstream is a horse racetrack, casino and outdoor entertainment and shopping destination. Parrales is employed there as a security officer. Gallegos is employed as a hotwalker for Trainer Fernando Abreu. At the time of the accident, Parrales was operating a company golf cart traveling northbound on the east side of the property between Barns 10 and 11. He slowed down between the barns as a precaution for horse movement and then noticed an unknown male operating an electric bicycle traveling toward him and on his side of the road. There were two other bicyclists on the southbound lane. In an effort to avoid a head-on collision, he swerved to the opposite side of the road (southbound lane) and allegedly struck Gallegos’ bicycle which supposedly caused her to fall. After the incident, multiple security officers arrived at the scene and escorted Parrales to Fast Care, where he was instructed to take a urine drug test, which returned a negative result. Parrales also submitted a written statement detailing the incident. Gallegos did not provide a written statement, due to discomfort in her right arm. However, during her interview, she corroborated Parrales' account but also insisted that he was traveling at a high rate of speed, which prevented him from stopping in time to avoid the collision. Gallegos checked into HCA Florida Aventura Hospital, reporting pain in her lower back, wrist, abdomen, and knee. She was discharged a few hours later with a prescription for over-the-counter Tylenol and was advised to avoid strenuous activity. The physician did not recommend orthopedic treatment. The Policy The CRN references a Commercial General Liability policy Liberty Mutual provided for 445327 Ontario Limited, policy #TB1-B71-170912-033 for the policy period of June 30, 2023 to June 30, 2024. The Policy provides an each occurrence limit of $2,000,000. The policy includes a self-insured retention of $500,000. The Claim against Insured On June 18, 2024, your firm sent a letter of representation through the registered agent for Gulfstream Park Racing, Inc., CT Corporation System, advising that they represent Gallegos with regard to personal injuries allegedly sustained as a result of the June 9, 2024 accident. It alleges that Gallegos was injured due to the negligence of Gulfstream Park. It thereafter requests that the registered agent contact Gulfstream Park and advise them to notify their insurance carrier of this matter and to have an insurance representative contact their office as soon as possible to discuss this claim. On August 5, 2024, a second letter, containing the exact same allegations and requests, was sent by your firm through the registered agent. At this time Liberty Mutual has been provided no further information as to the actual allegations made against the insured. It is aware of medical records from HCA Florida Aventura Hospital wherein Gallegos reported pain in her lower back, wrist, abdomen, and knee. She was discharged a few hours later with a prescription for over-the-counter Tylenol and was advised to avoid strenuous activity. The physician did not recommend orthopedic treatment. Gallego’s CRN On December 23, 2024, you filed the instant CRN against Liberty Mutual, citing “Claim Delay” and “Unfair Trade Practice” as the reason for the filing. According to the CRN, Liberty Mutual has violated the following statute: Fla. Stat. § 624.155(1)(b)(1). As more fully detailed below, Liberty Mutual categorically denies each and every allegation set forth in the CRN of purported bad faith conduct. The allegations of the CRN are unfounded and unwarranted. Liberty Mutual’s response to the CRN is due by February 21, 2025. By virtue of this response, Liberty Mutual’s response is timely within the 60-day notice period and is submitted in advance of the deadline. Liberty Mutual has also filed a response to the CRN through the Florida Department of Financial Service’s portal, denying the allegations of statutory violations and advising that Liberty Mutual has separately provided you with a response. RESPONSE TO CIVIL REMEDY NOTICE The Civil Remedy Notice is Deficient The CRN fails to comply with the requirements of Fla. Stat. § 624.155(3)(b) in that it fails to set forth the specific facts and circumstances giving rise to the list of alleged violations stated therein. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Rousso v. Liberty Surplus Ins. Corp., No. 10-cv-20554, 2010 U.S. Dist. LEXIS 82328 (S.D. Fla. Aug. 13, 2010). Pursuant to Fla. Stat. § 624.155(3)(b), the CRN “shall state with specificity” the following information: 1. The statutory provision, including the specific language of the statute, 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; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The CRN does not substantially comply with this specificity standard. The CRN alleges Liberty Mutual’s violation of Fla. Stat. § 624.155(1)(b)(1) which alleges it did not attempt in good faith to settle claims when it should have done so. The CRN does not provide any facts showing any settlement attempts or demands sent by you on behalf of your client to Liberty Mutual, or even to Broadspire Services. The facts provided merely outline communication attempts with Broadspire Services, wherein Gallegos’ counsel is requesting information from Broadspire. There are no allegations showing Liberty Mutual, or Broadspire, had an opportunity to settle the claim. Furthermore, the CRN makes no assertion that Liberty Mutual was ever put on notice of this claim prior to the CRN being filed. Additionally, the CRN references no specific policy provisions that govern. The letter also fails to establish that Liberty Mutual has any responsibility for this matter given the Policy’s previously noted self-insured retention, which the insured has yet to meet. At its core, the CRN is unclear as to specific instances of bad faith conduct in connection with Liberty Mutual for Rojas’s claim. The crux of the CRN is merely that Liberty Mutual supposedly engaged in bad faith by not responding to multiple communications and by not responding to multiple requests for additional information despite supposed follow-up communications by your firm. However, the CRN solely cites to communications with third-party administrator Broadspire Services and fails to provide any basis whatsoever as to how Liberty Mutual has any obligation for this matter. As you know, and as your firm has always known, this matter is being handled directly by Broadspire Services. All prior communications regarding the claim previously proceeded through Broadspire Services, not Liberty Mutual. None of the communications noted in the CRN were addressed at any time to anyone at Liberty Mutual. In fact, Liberty Mutual was not notified of this claim until after the CRN was filed. Based upon the foregoing, the CRN fails to satisfy the specificity requirement demanded by Fla. Stat. § 624.155(3)(b). Further, as noted, the CRN misidentifies the correct insured. Accordingly, the CRN is deficient and should be rejected by the DFS. Notwithstanding the deficiencies of the CRN, and without waiving any objections thereto, or remedies or defenses available to Liberty Mutual because of those deficiencies, among others, all allegations of bad faith as set forth in the CRN are denied. To the extent that Liberty Mutual owes Gallegos or its insured any duty under Sections 624.155 and 626.9541 of the Florida Statutes, based upon the facts known to date, Liberty Mutual has complied with all Florida Statutes applicable to this matter. Substantive Response to the CRN A. Alleged Violation(s) of Fla. Stat. § 624.155(1)(b)(1) Gallegos alleges that Liberty Mutual violated Fla. Stat. § 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured and with due regard for her or his interests. The Florida Supreme Court has expressly held that a claim for bad faith pursuant to Section 624.155(1)(b)(1) is founded upon the obligation of the insurer to settle the claim when liability is clear and when all conditions under the policy would require an insurer exercising good faith and fair dealing towards its insured to settle the claim. This obligation on the part of an insurer requires the insurer to investigate claims made in good faith, to evaluate the claim in light of all of the evidence, and—when liability is clear—to initiate settlement negotiations. Liberty Mutual denies any violation of Fla. Stat. § 624.155(1)(b)(1). Liberty Mutual’s first notice of this claim was on December 26, 2024, which is after the CRN was filed. Prior to this, all communications and claim handling had been completed by Broadspire Services. Additionally, all allegations of improper claims handing asserted in the CRN are against the third-party administrator Broadspire Services. Furthermore, until the Policy’s self-insured retention is met, Liberty Mutual has no coverage obligation for Gallegos’ claim. The CRN wholly fails to allege any supposed improper or inadequate actions taken by Liberty Mutual. The CRN fails to provide any specific facts and circumstances in which Liberty Mutual was provided with an opportunity to settle this matter and failed to do so. Liberty Mutual did not fail to attempt in good faith to settle Gallegos’ claim when it could and should have done so. Nothing in the CRN provides evidence, facts, or circumstances to support Gallegos’ naked allegations of bad faith against Liberty Mutual. CONCLUSION Based on the foregoing, Liberty Mutual denies all statutory and substantive allegations of bad faith asserted in the CRN. Liberty Mutual submits that it was not provided notice of this claim until after the CRN was filed. It further asserts that until the Policy’s self-insured retention is met, Liberty Mutual has no coverage obligation for Gallego’s claim. To the extent that this response does not address any of the allegations or assertions of bad faith contained in the CRN, whether express or implied, Liberty Mutual hereby categorically denies each and every one of Rojas’s allegations. Liberty Mutual expressly reserves all, and does not waive any, of its rights, whether or not mentioned above, under the subject policy, law, public policy, or equity. Nothing in Liberty Mutual’s response to this CRN should be construed as an admission by Liberty Mutual in connection with this claim, or as a waiver, estoppel, or modification of any of the subject policy and/or contract terms, exclusions, privileges, powers, and conditions. All of Liberty Mutual’s rights, remedies, and defenses remain reserved, whether expressly mentioned herein or not. If we may provide you with any additional information, or if you have any questions, please do not hesitate to contact us. Very truly yours, HINSHAW & CULBERTSON LLP Rory Eric Jurman Matthew David Chamoff
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