Civil Remedy Notice of Insurer Violations
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Filing Number:     798372
Filing Accepted:  12/26/2024
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Complainant
Last/Business Name *  
ORESTES MERLO AMADOR AND ANNAREYIS SANTANA ESQUIJARROSA   First Name  
Street Address * 1834 CADILLAC CIR
City, State Zip * TAMPA, FL 33619
Email Address * OMERLO6904@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ORESTES MERLO AMADOR AND ANNAREYIS SANTANA ESQUIJARROSA   First Name  
Policy # * HCPC-HO3-622001-2 Claim #* 943478
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 33156
Email Address * INTAKE@FLINSLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
NAIC Company Code 12944
 
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 September 8, 2024, Orestes Merlo Amador and Annareyis Santana Esquijarrosa suffered aloss due to covered perils contemplated under the Policy; and timely reported the damage toDefendant. Orestes Merlo Amador and Annareyis Santana Esquijarrosa presented evidence toHomeowners Choice Property & Casualty Insurance Company, Inc. that the loss occurred duringthe policy period and coverage for the loss was contemplated under the policy. Orestes MerloAmador and Annareyis Santana Esquijarrosa complied with all required post-loss conditions.Homeowners Choice Property & Casualty Insurance Company, Inc. sent an unqualified person tomake determinations of causation of damage in violations of 626.9541(1)(i)(3)(d). Aftercompleting its deficient investigation Homeowners Choice Property & Casualty InsuranceCompany, Inc. should have provided coverage for the loss. Homeowners Choice Property &Casualty Insurance Company, Inc. has unduly delayed full payment and coverage over the claimin violation of the insurance contract and has done so in a manner which violates multipleFlorida Statutes. Furthermore, Homeowners Choice Property & Casualty Insurance Company,Inc. failed to promptly provide a reasonable explanation in writing to the insured of the basis inthe insurance policy, in relation to the facts or applicable law, for denial of a claim or for theoffer of a compromise settlement.The failure to issue full payment when there was no applicable exclusion for the type of servicerendered in relation to the covered claim is a violation of 624.155(1)(b)(1) and 624.155(1)(b)(3).Homeowners Choice Property & Casualty Insurance Company, Inc. has made it a businesspractice to deny covered claims without proper justification in direct violation of 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(b).Homeowners Choice Property & Casualty Insurance Company, Inc. has repeatedly andcontinuously acted in bad faith in this matter and others like it. Despite the fact that the allegeddamages were related to a covered loss and not excluded under the policy of insurance,Homeowners Choice Property & Casualty Insurance Company, Inc. refuses to pay the fullamount of insurance benefits owed for same. In order to cure Homeowners Choice Property &Casualty Insurance Company, Inc.’s continuous acts of bad faith, Homeowners Choice Property& Casualty Insurance Company, Inc. must issue payment in the amount of $ 46,023.43; as wellas, statutory interest. In addition, Homeowners Choice Property & Casualty Insurance Company,Inc. must cease its unfair trade practice of citing to irrelevant policy provisions in order tomisrepresent the coverages afforded under its policies of insurance.HOS24-000593
Comments
User Id Date Added Comment
pleadings@flinslaw.com 01-07-2026 FLORIDA INSURANCE LAW GROUP LLC WITHDRAWS CIVIL REMEDY NOTICE NUMBER 798372.
Legal@hcpci.com 02-17-2025 This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of Orestes Merlo Amador and Annareyis Santana Esquijarrosa (“Complainants”). HCPCI reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, HCPCI issued payments for it on the information available to HCPCI and the circumstances at the time of such payments. Ultimately, HCPCI handled the claim in accordance with the policy and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Furthermore, the CRN fails to adequately describe the alleged violations and fails to provide sufficient information to have created an opportunity for the alleged violations to be corrected (although no violations exist). Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; failed to offer a valid cure, and relied on inaccurate and conclusory statements. The Complainant’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The CRN cannot serve as the basis of a bad-faith action against HCPCI. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the claim under the insurance contract and the facts of the claim.
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