Civil Remedy Notice of Insurer Violations
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Filing Number:     798223
Filing Accepted:  12/26/2024
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Complainant
Last/Business Name *  
DEJENZANO   First Name   NICOLE
Street Address * 11509 MERIDIAN POINT DR
City, State Zip * TAMPA, FL 33626
Email Address * MDEJEN32@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   DEJENZANO   First Name   NICOLE
Policy # * HOH644545 Claim #* H010032921
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*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* CHRISTY NGUYEN
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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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 HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY; (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 HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY INVESTIGATED THE CLAIM, ENGAGED AN INSURANCE CLAIMS ADJUSTER. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY‘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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY ISSUED ITS ESTIMATE DENYING ALMOST ALL OF THE DAMAGE TO THE PROPERTY WITHOUT ANY EVIDENCE, PROOF, REPORT OR PHOTOGRAPHS. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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 HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY BEING PLACED ON NOTICE AND BEGGED FOR HELP. IT IS UNCONSCIONABLE THAT HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY COULD ACCEPT PREMIUMS, CONDUCT AN INITIAL INVESTIGATION, AND DENY ALMOST ALL LIABILITY WITHOUT ANY ENGINEERING REPORTS, INVESTIGATIONS OR EXPLANATION. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY HAS BEEN GIVEN COMPLETE ACCESS TO THE INSURED PROPERTY, HAS NOTICE OF THE CONDITION OF THE PROPERTY THROUGH THEIR OWN INSPECTION AND PHOTOGRAPHS. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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, HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY HAS INSTEAD IGNORED THE INSURED. ON NOVEMBER 6, 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 HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY HAS BREACHED THIS DUTY BY ITS IMPROPER HANDLING OF THE INSURED’S CLAIM OF LOSS. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY BREACHED THIS DUTY. THE ACTIONS TAKEN BY HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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. HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY’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, HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY 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 $76,805.90. (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: HERITAGE PROPERTY AND CASUALTY INSURANCE COMPANY ATTN: CLAIMS DEPARTMENT AND CHRISTY NGUYEN PO BOX 20947 TAMPA, FL 33622-0947 SENT VIA EMAIL & FAX: CLAIMS@HERITAGEPCI.COM (866) 929-4530
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ncarlisle@heritagepci.com 02-11-2025 February 11, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Nicole Dejenzano Insured: Nicole Dejenzano Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 798223 Claim No: H010032921 Policy No.: HOH644545 Address: 11509 Meridian Point Dr., Tampa, FL 33626 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 798223, filed on behalf of Nicole Dejenzano (“Complainant”). The Department accepted the Notice on December 26, 2024. As a preliminary matter, Heritage states that the claim underlying this Notice was settled between Heritage and the Complainant’s representatives on or about December 17, 2024. The release prepared by Heritage was executed by the Insured on January 16, 2025. As a condition of the settlement, the Complainant was to withdraw CRN 798223. Notwithstanding the settlement, Heritage responds to it specifically denying each and every allegation contained in the Notice. Heritage believes that the Notice should be rejected and returned by the Department of Financial Services as it fails to comply with the specific information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions as promulgated in Florida Statute §624.155 and Florida Case law. First, Florida Statute §624.155(3)(b)(2) requires the Complainant to “describe the facts and circumstances giving rise to the insurer’s violation” to enable the insurer to investigate and resolve the claim. Contrary to the requirement set forth in the statute, this Notice contains overbroad and incorrect allegations, which stem only from the Complainant’s opinions regarding the value of their own claim and, therefore, the Complainant’s opinions regarding Heritage’s adjustment of this claim. The Notice contains a list of violations that Heritage has allegedly committed but fails to provide an adequate basis in support of those allegations and, on that basis alone, fails to satisfy the basic requirements of an otherwise proper Notice. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Fla. Stat. §§ 624.155 and 626.9541. Moreover, Florida Statute §624.155(3)(b)(4) requires the Complainant to refer to specific policy language that is relevant to the alleged violation, if any. The Notice is legally insufficient because it indicates that the specific policy provision includes “all applicable policy coverages, valuation provisions, and other terms and conditions of the policy” and refers to all coverages under the policy, without specifying which provisions were violated. Therefore, the Notice failed to provide sufficient notice to Heritage what policy provision was violated. Additionally, as part of the cure stated in the Notice, the Complainant demands costs without specifying what time of costs are demanded, which is an improper component of the cure. As such, the Notice does not comply with Florida law and is legally insufficient. Notwithstanding the deficiencies, for clarification, Heritage provides a brief history of the claim: Subject to its terms, endorsements, limitations, exclusions, and conditions, the Complainant was issued policy HOH644545 for the property at 11509 Meridian Point Dr., Tampa, FL 33626. The insurance policy applies to direct physical loss of or damage to covered property at the premises described in the policy's declarations or resulting from any covered cause of loss as described in the policy. Upon receiving the Complainant’s first notice of loss on October 16, 2024, claiming damages from Hurricane Milton on October 10, 2024, Heritage promptly assigned claim number H010032921. An acknowledgment letter with a Bill of Rights was submitted to Complainant on the same day. In the meantime, Heritage enlisted the services of a field adjuster to coordinate an inspection of the alleged damage caused by the alleged Hurricane. Complainant requested it to occur on October 21, 2024. The on-site inspection documenting the property's interior and exterior conditions occurred as scheduled with the presence of the Complainant. On October 31, 2024, after conducting a reasonable investigation based on available information to Heritage, and in accordance with its obligations under §627.70131, Fla. Stat., Heritage issued a letter including a written explanation of the coverage decision to Complainant, which included pertinent facts and insurance policy provisions relating to coverages at issue. The letter explained that based on Heritage’s field adjuster inspection estimate repairs to the dwelling did not meet the hurricane deductible, and therefore, no payment would be forthcoming. On December 26, 2024, Complainant filed this Notice, to which Heritage is responding. On the same day, Complainant’s representative filed a Notice of Intent to Initiate Litigation (“NOI”). In response to the NOI, Heritage made an offer for settlement, and the parties engaged in settlement negotiations. After reaching the agreeable amount, the claim was settled, and Complainant executed a release. In accordance with Fla. Stat. §624.155, the Civil Remedy Notice requires Complainant, “to indicate all statutory provisions alleged to have been violated.” The Notice alleges the reasons for the Notice are the following: Claim Delay The Notice fails to state who, how, and when a “claim delay” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. The claim was adjusted in a timely manner, following all statutory requirements. Unfair Trade Practice The Notice fails to state instances of “unfair trade practice” occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Failure to provide coverage for a covered claim The Notice fails to state who, how, and when Heritage failed to “provide coverage for a covered claim” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Failure to investigate claim in consultation with the insured The Notice fails to state who, how, and when Heritage failed to “investigate claim in consultation with the insured” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Failure to issue all payments due and owning The Notice fails to state who, how, and when Heritage failed to “issue all payments due and owning” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Failure to address concerns of health and safety at the insured property The Notice fails to state who, how, and when Heritage failed to “address concerns of health and safety at the insured property” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Further, the Notice filed in this matter alleges Heritage violated the following statutory provisions: 1. 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 toward its Complainant and with due regard for his or her interests. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has timely made a coverage determination affording coverage for the claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. Additionally, the claim was settled after Heritage’s offer for settlement was proposed. Therefore, this is an unsupported, sweeping allegation and is without merit. 2. 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. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage made a coverage determination affording coverage to the claim based on the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The Notice fails to specifically identify the “material misrepresentation[s]” allegedly committed by Heritage. As such, this is an unsupported, sweeping allegation and is without merit. 3. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always acted fairly and honestly. Further, Heritage has timely made a coverage determination affording coverage for the claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. Additionally, Complainants failed to specify the instances where Heritage failed “to adopt and implement standards for the proper investigation of claims.” Therefore, this is an unsupported, sweeping allegation and is without merit. 4. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always acted fairly and honestly. Further, Heritage has timely made a coverage determination affording coverage for the claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. Additionally, Complainants failed to specifically identify the “misrepresenting facts or insurance policy provision” allegedly committed by Heritage. As such, this is an unsupported, sweeping allegation and is without merit. 5. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always promptly acknowledged communications and acted promptly in furtherance of the resolutions of the claim. Further, Heritage has timely made a coverage determination affording coverage for the claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The Notice does not specifically identify instances where Heritage failed "to acknowledge and act promptly upon communications." Therefore, this is a broad allegation without specific support. 6. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Response: Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always promptly acknowledged communications and acted promptly in furtherance of the resolutions of the claim. Further, in contrast to this allegation, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. Therefore, this is an unsupported, sweeping allegation and is without merit. As detailed by the facts stated above, Heritage Property & Casualty Insurance Company did not violate any of the statutes mentioned above sections. Heritage has diligently and thoroughly investigated the subject claim, followed up with Complainant for documents supporting their claim, provided a coverage determination, and settled the claim with Complainant’s representatives. The purpose of the Civil Remedy Notice is to provide the insurer notice of the issue its Complainant has with the claim and what it is seeking to remedy that issue. However, it is important to note that Insurers are not required to pay any amount demanded by their Complainants to avoid a bad-faith claim. Rousso v. Liberty Surplus Ins. Corp., 2010 U.S. Dist. LEXIS 82328, at *14-15 (S.D. Fla. Aug. 13, 2010). The Florida Supreme Court has held that an insurer's appropriate response to a Civil Remedy Notice filed pursuant to Fla. Stat. 624.155 is “based upon the insurer's good-faith evaluation of what is owed on the insurance contract.” Vest v. Travelers Ins. Co., 753 So. 2d 1270, 1275 (Fla 2000). The Court further stated, “What is owed on the contract is . . . governed by whether all conditions precedent for payment contained within the policy have been met.” Id. For its part, an insurer “must evaluate a claim based upon proof of loss required by the policy and its expertise in advance of a determination by a court or arbitration.” Id. at 1275-76. See also Julien. Heritage’s position is that it has complied, in good faith, with these obligations. Furthermore, the Complainant’s Notice seeks cures for the alleged defects. However, the “cures” sought are improper pursuant to Florida Case law. Specifically, the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000), provides that the scope of what can be “cured” is limited to the alleged non-payment of the contractual amount due the Complainant. Talat also commented that “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the Complainant. In the context of a first-party insurance claim, the contractual amount due to the Complainant is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As a result, only the demanded “cures” relating to the payment for covered damages are proper and legal. In short, as in Russo, the Notice reflects “a shotgun-blast effort to hit a lot of targets with a single salvo. This approach is contrary to the purpose of the statute.” The Notice must reflect a good-faith effort to inform Heritage of how it has fallen short of its obligations under the policy and what it can do to fix its shortcomings. Thus, the Notice is insufficient as a matter of law. Under § 624.155, Heritage is entitled not only to a clear proposed solution, but also more and accurate details about how Heritage fell short of its obligations to provide coverage pursuant to the terms of the insurance agreement. As such, the Notice is deficient, and the Complainant has failed to comply with several conditions precedent to bringing a claim under § 624.155. Heritage Property & Casualty Insurance Company believes that the Notice should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Moreover, regardless of the rejection, Heritage denies all allegations contained in the Notice and submits there are no violations. While this response is meant to be comprehensive, Heritage Property & Casualty Insurance Company’s response above is based upon the limited information provided in the Notice and the information we have to date. If the Complainant feels that Heritage does not have all the facts, please inform Heritage immediately. In closing, Heritage denies each and every assertion of bad faith in the Notice. And, notwithstanding the foregoing, nothing in this letter should be construed as a waiver or surrender of the policy terms, limitations, exclusions, conditions or agreements, nor should this letter be considered an exhaustive recitation of the deficiencies in the Notice. Heritage reserves the right to supplement its response at a later time. Should the Department have any questions, concerns, or require any additional information regarding this matter, please feel free to contact the undersigned at your convenience. Sincerely, /s/ Priscila Ferreira Priscila Ferreira, Esq. Claims Counsel Heritage Property & Casualty Insurance Co.
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