Civil Remedy Notice of Insurer Violations
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Filing Number:     798285
Filing Accepted:  12/26/2024
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Complainant
Last/Business Name *  
WELL DONE MITIGATION LLC   First Name  
Street Address * 8216 NW 30TH TERRACE
City, State Zip * DORAL, FL 33122
Email Address * SC@WELLDONEMITIGATION.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   NORMANDIA SERRANO   First Name  
Policy # * HPH254092 Claim #* H010022401
Attorney
Attorney is Applicable
Last Name* GONZALEZ ESQ. First Name * ROBERT F. Initial
Street Address* 8950 SW 74TH CT., STE 2267
City, State Zip* MIAMI , FLORIDA 33152
Email Address * INTAKE@FLINSLAW.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):* UNKNOWN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
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.

Section 1 - Perlis Insured Against Section 1 - Property Coverages 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.

Page 1 of 1On August 30, 2023, Normandia Serrano suffered a loss due to covered perils contemplatedunder the Policy; and timely reported the damage to Defendant. Normandia Serrano contractedWell Done Mitigation LLC in order to perform DRYOUT, TARP services to the Insureddirectlyrelating to the loss. In exchange for Well Done Mitigation LLC's services Normandia Serranoexecuted an assignment of benefits. On or about July 24, 2024, Well Done Mitigation LLCprovided Heritage Property & Casualty Insurance Company with notice of the Assignment ofBenefits. Within the statutory period, Well Done Mitigation LLC provide Heritage Property &Casualty Insurance Company with a copy of its invoice, assignment agreement, demand forpayment of insurance benefits and supporting documentation. During the investigation of theclaim, Heritage Property & Casualty Insurance Company sent an unqualified person to makedeterminations of causation of damage in violations of 626.9541(1)(i)(3)(d). After completing itsdeficient investigation Heritage Property & Casualty Insurance Company should have providedcoverage for the loss. Heritage Property & Casualty Insurance Company has unduly delayed fullpayment and coverage over the claim in violation of the insurance contract and has done so in amanner which violates multiple Florida Statutes. Furthermore, Heritage Property & CasualtyInsurance Company failed to promptly provide a reasonable explanation in writing to the insuredof the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claimor for the offer of a compromise settlement.The failure to issue payment when there was no applicable exclusion for the type of service orclaim in relation to the covered claim is a violation of 624.155(1)(b)(1) and 624.155(1)(b)(3).Heritage Property & Casualty Insurance Company has been provided sufficient evidence tosupport coverage for the subject claim and services. Despite making numerous payments in thepast for these types of services which were performed in relation to valid insurance claims,Heritage Property & Casualty Insurance Company has subsequently made it a business practiceto deny these services irrespective of the facts for each claim in direct violation of 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(b).Heritage Property & Casualty Insurance Company has repeatedly and continuously acted in badfaith in this matter and others like it. Despite the fact that these services are directly related tocovered losses and not excluded under the policy of insurance, Heritage Property & CasualtyInsurance Company refuses to pay insurance benefits for same. In order to cure HeritageProperty & Casualty Insurance Company’s continuous acts of bad faith, Heritage Property &Casualty Insurance Company must issue payment for the invoiced amount of $ 25,015.02 andwhich has a current balance of $ 25,015.02; as well as, statutory interest. In addition, HeritageProperty & Casualty Insurance Company must cease its unfair trade practice of citing toirrelevant policy provisions in order to misrepresent the coverages afforded under its policies ofinsurance.PDC24-001129
Comments
User Id Date Added Comment
ncarlisle@heritagepci.com 02-12-2025 February 12, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Well Done Mitigation LLC Insured: Normandia Serrano Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 798285 Claim No: H010022401 Policy No.: HPH254092 Address: 10118 N 10Th St, Tampa, FL 33612 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 798285, filed by Well Done Mitigation LLC (“Complainant”). under the insurance claim filed by Heritage’s insured Normandia Serrano (“Insured”). The Department accepted the Notice on December 26, 2024. As a preliminary matter, Heritage states that the assignment agreement upon which Complainant relies to file this Notice is invalid. If the purported assignment agreement is invalid, Complainant does not have standing to file this Notice. While Heritage welcomes the opportunity to respond to the Notice filed concerning this claim, it 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. The Notice fails to identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notice. Additionally, the Notice failed to inform Heritage whether it had been given to perfect the right to pursue the civil remedy authorized by Florida Statute §624.155 and Florida Case law. 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 “Section 1 – Perils Insured Against Section 1 – Property Coverages Loss Settlement Provision,” without specifying which provisions were violated. Therefore, the Notice failed to provide sufficient notice to Heritage what policy provision was violated. Additionally, 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 the insured’s claim and, therefore, the Complainant’s opinions regarding Heritage’s adjustment of this claim. 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. Moreover, 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. Lastly, the Notice failed to provide the insurer’s address, as specifically required by Florida Law. As such, the Notice does not comply with Florida law and is legally insufficient. For clarification, Heritage provides a brief history of the claim: Subject to its terms, endorsements, limitations, exclusions, and conditions, the Insured was issued Policy HPH254092 (“Policy”) for property located at 10118 N 10Th St, Tampa, FL 33612 (“Property”). The Policy of Insurance applies to direct physical loss of or damage to covered property at the premises described in the Declarations of the Policy or resulting from any covered cause of loss as described in the Policy. Upon receiving the Insured’s first notice of loss on July 23, 2024, claiming damages from Hurricane Idalia on August 30, 2023, Heritage promptly assigned claim number H010022401. On the same day the loss was reported, Heritage issued its acknowledgment letter and Bill of Rights to the Insured. Since the claim was filed by the Insured’s attorney, Heritage also received a letter of representation from The Florida Insurance Law Group, LLC. on the same day. Heritage acknowledged the Letter of Representation soon after. On July 24, 2024, upon receiving a purported Assignment of Benefits from the Complainant, Heritage responded advising the Complainant’s request to exceed the policy cap was being denied at that time. Heritage further informed that should “coverage be afforded, the client’s insurance policy has limitations for payment for mitigation and/or remediation services. The next day, July 25, 2024, the Complainant submitted a “general” invoice for mitigation services as they were still ongoing. On August 2, 2024, the insured's attorney, also on behalf of Complainant, submitted a “privileged settlement negotiation correspondence” with a demand for payment on behalf of Complainant. On the same day, Heritage issued a Reservation of Rights letter with a certified policy copy and a blank sworn proof of loss form. Moving forward, Heritage was set to inspect the property with a field adjuster on August 5, 2024. However, the insured’s attorney and representatives of Complainant requested the inspection be moved to August 21, 2024. The inspection documented the exterior and interior condition at the property. Meanwhile, Complainant continued to provide services related to tarping, re-tarping, and shrink-wrapping the property despite Heritage’s notice to Complainant that their request to exceed the policy cap was denied. In addition to the investigation, Heritage retained Haag Engineering to reinspect the property. The inspection occurred on September 10, 2024, and was conducted by Mr. George J. Stepanchak, P.E. In his report, Mr. Stepanchak concluded that there was no wind or hail damage to the shingle roof. He further opined that any water intrusion into the dwelling could be reasonably attributed to build up water on the roof that infiltrated imperfections in roofing material or infiltrated around fasteners placed to attach the solar panels to the roof deck. On September 19, 2024, after conducting a reasonable investigation based on available information to Heritage, in accordance with its obligations under §627.70131, Fla. Stat., Heritage issued a letter including a written explanation of the coverage decision to the Insured, which included pertinent facts and insurance policy provisions relating to coverages at issue. Due to several prior claims filed by the insured as related to this Property, Heritage reviewed prior claims to investigate overlapping damages. Heritage explained in the coverage determination letter that “no coverage was found for the interior damage as there was no storm created opening as well as issues attributed to faulty, inadequate or defective design, workmanship and maintenance. Additionally, no coverage was found for the roof due to no evidence of wind or covered peril related damage.” Heritage further supported its finding on the field adjuster inspection and engineer’s inspection and policy language for excluded causes of loss related to the property's damage. On October 1, 2024, Insured’s attorney, also representing Complainant, submitted a 10 days pre-litigation notice demanding $25,015.02. The attached invoices included services for mitigation, installation of tarp, remove and reset tarp, and shrink warp the roof. On October 3, 2024, Insured’s attorney filed a Notice of Intent to Initiate (“NOI”) on behalf of the insured, and demanded payment of $95,396.00, including the amount for the estimates described above. Heritage responded to the insured’s NOI advising about its decision to maintain its prior decision of denial of the claim. Moving forward, the insured’s attorney, also representing Complainant, filed this Notice on December 26, 2024, to which Heritage has responded. 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 Denial The Notice fails to state who, how, and when a “claim denial” practice occurred; therefore it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Claim Delay The Notice fails to state instances of “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. Unsatisfactory Settlement Offer The complainant failed to state who, how, and when an unsatisfactory settlement offer was made; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. 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. 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 conducted a reasonable investigation based on available information and made a coverage determination in reference to Insured’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. 2. 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. 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 conducted a reasonable investigation based on available information and made a coverage determination in reference to Insured’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, 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 at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Insured’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Additionally, the Notice fails to specifically identify how Heritage fails “to adopt and implement standards for the proper investigation of claims.” Heritage has conducted an inspection and reinspection of the property and reviewed several prior claims filed by the insured. 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 at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Insured’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information do not support a covered loss as demanded by Complainant. Further, the Notice fails to specifically identify the “misrepresenting facts or insurance policy provision” allegedly committed by Heritage. Therefore, this is an unsupported, sweeping allegation and is without merit. 5. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. 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 conducted a reasonable investigation based on available information and made a coverage determination in reference to Insured’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Further, the Notice fails to specifically identify instances where Heritage did not conduct “reasonable investigations based upon available information.” 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, extended coverage based on the Policy. 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 failed to provide any cure for the alleged defects as required by 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, similarly to Rousso, 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 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