Civil Remedy Notice of Insurer Violations
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Filing Number:     797913
Filing Accepted:  12/23/2024
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Complainant
Last/Business Name *  
GRIFFIN   First Name   DIANE RONDINA
Street Address * 15011 PUNTA RASSA RD
City, State Zip * FORT MYERS, FL 33908
Email Address * DIANERGRIFFIN@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GRIFFIN   First Name   DIANE RONDINA
Policy # * 1503-1803-4635 Claim #* FL22-0146796-A322
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial
Street Address* 2501 S TAMIAMI TRL
City, State Zip* SARASOTA , FL 34239
Email Address * ESERVICE@ROSSLEGALFL.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):* HENRY WIMP (A287915), AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
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.
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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Dwelling Coverage provisions Perils Insured Against Loss Payment Loss Settlement
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Universal Property & Casualty Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Diane Rondina Griffin (“INSURED”) claim of loss. Universal Property & Casualty Insurance Company’s mailing address is 1110 W Commercial Blvd, Fort Lauderdale, FL 33309. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. The INSURED immediately reported the loss to INSURER and allowed for inspection. This claim involves the INSURED’S property located at 15011 Punta Rassa Rd, Unit 802, Fort Myers, FL 33908 which sustained significant damage from Hurricane Ian on or about September 28, 2022. The INSURED suffered damage to the interior of the property, and incurred expenses to move and store their contents, as well as additional living expenses. INSURER inspected the property and wrongfully denied coverage for the claim without a good faith investigation into the cause of the observed damages. INSURER failed to properly communicate with the INSURED, and constantly misrepresented the coverages afforded to her under the subject Policy, the information required for further investigation of the claim, and the types of damages that could be submitted for reimbursement. Additionally, multiple requests have been made by the INSURED and her representatives to the INSURER to provide a complete and certified copy of the subject Policy in order to verify the coverages and potential exclusions and endorsements, but those requests have been ignored. The INSURED retained Floridian Public Adjusters to assist with determining the amount of damage sustained to the property. Floridian prepared an estimate in the amount of $95,119.61 in damages to the dwelling, which is above the Policy’s Coverage A limit of $84,670.00. Furthermore, the INSURED incurred $14,036.26 in Additional Living Expenses compensable under Coverage D of the Policy, and $9,691.96 in expenses to move and store the contents contained in the property compensable under Coverage C of the Policy. The INSURED is owed insurance benefits in order to return the property to pre-loss condition and reimburse them for covered damages under the terms of the Policy. Therefore, demand is hereby made as follows: Damages $108,398.22 Less Deductible $6,634.00 TOTAL $101,764.22 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $109,777.74 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: Floridian Adjusters estimate, expense receipts, proposed Complaint
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 08-08-2025 The Insured, Diane Rondina Griffin, hereby provide notice to the Florida Department of Financial Services and Universal Property & Casualty Insurance Company, that the issues outlined in Civil Remedy Notice filing #797913 have been resolved between the parties and Universal Property & Casualty Insurance Company has cured all allegations listed therein. Accordingly, Diane Rondina Griffin, hereby withdrawals Civil Remedy Notice filing #797913 filed on 12/23/24.
sm1130@universalproperty.com 02-20-2025 February 20, 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.: 797913 Filing Date: 12/23/2024 Complainants: Diane Rondina Griffin Insured(s): Diane Rondina Griffin Policy No.: 1503-1803-4635 Claim No.: FL22-0146796-A322 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice filed by attorney, Vanessa Ross, on behalf of Complainant, Diane Rondina Griffin (also referenced as “Insured.”) The Notice alleges violations of Sections 624.155, 626.9541, and 624.02, Florida Statutes. Universal specifically denies each allegation contained in the Notice. 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 Notice fails 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 Notice is deficient as a matter of law as it fails 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...; and 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 Florida Department of Financial Services (“DFS”) created form DFS-10-363, which lays out 15 requirements that the Complainant(s) 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(s) 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 Notice fails to meet the requirement of Section 624.155, Florida Statutes, on several grounds. First, the Notice fails 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(s) must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to properly investigate the allegations. The Notice lacks the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Notice states “HENRY WIMP…” however, the Notice fails to include any specificity as to what facts the named individual has knowledge of that gave rise to any purported allegation(s) and/or what, if anything, they did or failed to do as it relates to the claim at issue. The Complainant also attempts a “catch-all” by stating “ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY INVOLVED IN THE CLAIM.” which significantly prejudices Universal, as Universal has not been properly notified by Complainant of the individual(s) that purportedly committed statutory violations or the specific statutory violations any individual purportedly committed. The failure to provide the requisite specificity precludes Universal from taking any corrective action and potentially curing any purported allegation. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because, as noted, the Complainant alleges that Universal “misrepresented the coverages…under the subject policy” in the Notice. The Notice, however, fails to include the requisite specificity as to whom made any misrepresentations or when any of these misrepresentations occurred. Accordingly, the Notice is insufficient as a matter of law. Second, the Notice fails to satisfy Fla. Statute § 624.155(3)(b)(4) in that it fails to reference any specific policy language relevant to any alleged violation. Instead, the Notice states: “Dwelling Coverage provisions Perils Insured Against Loss Payment Loss Settlement” The Notice fails to specify how the referenced sections and/or provisions relate to any alleged violation or how, if at all, they are relevant to the subject claim. Therefore, it is unclear what if anything the insurer did to violate these sections or provisions. General, vague, and overbroad references to policy section titles and/or provisions do not satisfy the specificity required by Section 624.155(3)(b)(4), Fla. Stat. As such, the Notice is 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 Notice fails to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Complainant provides four (4) reasons for submitting the Notice: “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” and “Unfair Trade Practice.” However, the Complainant’s allegations regarding these “Reasons for Notice” have no factual support anywhere in the Notice. In addition, the Notice asserts general allegations consisting largely of conclusory, boilerplate and inaccurate statements rather than specifying facts regarding any alleged misconduct or statutory violations. For example, the Notice alleges “INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages.” The Complainant fails to specify any facts to support these conclusions. Further, the Complainant alleges that Universal has breached Section 624.02, Florida statutes which defines “insurance.” However, there are no facts specified in the Notice to place the carrier on Notice of how this statute was breached. The Notice is replete with vague and generic boilerplate and/or conclusory assertions which are unsupported by facts and does not provide the requisite specificity as to how Universal allegedly violated any policy provision or statute. The Complainant’s failure to specify facts to support her conclusory allegations of misconduct hinders Universal’s ability to appropriately investigate the allegations in the Notice. Moreover, the Notice alleges Universal “misrepresented the coverages…under the subject Policy…” However, the Notice fails to specify any actual facts regarding any misrepresentations made by Universal and does not identify any person or persons who made such misrepresentations nor to whom any alleged misrepresentations were made to. It is evident that the statement of facts falls short of the specificity required by Sec. 624.155, Fla. Stat. As a result, the Complainant failed to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. Lastly, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects. 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). 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. Here, Complainant demands vague and amorphous cures unrelated to payment of contractual amounts due to the Insured. As such, the Notice is deficient as it does not provide Universal an opportunity to “cure” the alleged violations without imposing obligations on Universal not contemplated by the Policy. Universal is only obligated to pay contractual amounts owed to cure a civil remedy notice. See id. at 1278. In summation, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity including, but not limited to, failing to satisfy the requirement to sufficiently identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations, failing to reference specific policy language relevant to any alleged violation, failing to allege specific conduct on the part of Universal that would violate any policy provision or statute and failing to provide a proper cure as proscribed by Florida law. 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 Notice is 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 October 7, 2022, Universal was untimely notified by Brown and Brown of Florida Inc. that the insured location was damaged on September 28, 2022. Universal inspected the property and documented any visible damage. Pursuant to the terms of the Policy, Universal advised the Insured that there was no available coverage for the claim. After receipt of certain documents and information, Universal reopened the Insured’s claim. Pursuant to the terms of the Policy, Universal advised the Insured that the estimated cost of additional living expenses, at that time, fell below the applicable deductible. Subsequently, the Insured submitted additional documentation and an estimate totaling $95,119.61 prepared by Floridian Public Adjusters on her behalf. Universal advised the Insured that based on the facts known to date, it was not in agreement with estimate submitted and advised the Insured of the Policy’s alternative dispute resolution methods. Any supplemental payments due and owing have been issued. At no time has Universal breached any duty to its Insured. An insurer is not required to pay whatever amount its insureds demand. As outlined above, the alleged statutory violations set forth in the Notice lack factual support and are therefore without merit. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjustment of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the Notice filed by the Complainant. Sincerely, /s/ Stephen Methe Stephen Methe
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