Civil Remedy Notice of Insurer Violations
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Filing Number:     798832
Filing Accepted:  1/2/2025
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Complainant
Last/Business Name *  
OMEY   First Name   WILLIAM
Street Address * 4720 NOLAN ROAD
City, State Zip * SANFORD, FL 32773
Email Address * MCKENZIE@GREENLAWGRP.COM
Complainant Type: * Insured
Insured
Last/Business Name*   OMEY   First Name   WILLIAM
Policy # * 2MR07550874128 Claim #* 00104588584
Attorney
Attorney is Applicable
Last Name* GREEN First Name * PAUL Initial
Street Address* 8833 PERIMETER PARK BLVD SUITE 104
City, State Zip* JACKSONVILLE , FL 32216
Email Address * PAUL@GREENLAWGRP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN SECURITY INSURANCE COMPANY
NAIC Company Code 42978
 
Name of individual responsible for violation (if any):* TAYLOR ERDERMAN AND ALL OTHER SUPERVISORS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Unfair Trade Practice
Claim Denial
* 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)(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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

See below
 
* Facts and circumstances giving rise to the violation.
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On or about June 6th, 2024, William Omey (hereinafter “INSURED”), suffered property damage at their property located at 4720 Nolan Road, Sanford, FL 32773. The property suffered extensive damage to the roof. American Security Insurance Company. (hereinafter “ASSURANT”) issued an insurance policy for the Insured’s property, Policy Number 2mr07550874128, which was in full force and effect on the date of the loss. The loss was the result of a significant windstorm. Shortly following the loss, the Insured retained the Law Offices of Paul Green (hereinafter “FIRM”) to help expedite the claim in order to restore the property to its pre-loss condition. FIRM timely notified ASSURANT of the damages sustained to the property and contemporaneously provided an estimate of the damages sought to be recovered. Despite demand of payment, ASSURANT has failed or refused to pay full value to protect and return property to pre-loss ASSURANT’s refusal to adequately and otherwise make INSURED whole, constitutes a breach of contract. As a result of ASSURANT ‘’forementioned breach of contract, it has become necessary for INSURED to retain the services of FIRM. ASSURANT has engaged in a customary business practice and a deliberate course of conduct to hinder resolution of its claims until they enter litigation ASSURANT regularly and consistently “shuffles” desk adjusters when the undersigned attorney calls to discuss claims. One adjuster will imply he can help on the claim but after several minutes states that he does not have the authority to settle the claim and another desk adjuster is needed for that claim. This practice is used solely to insulate ASSURANT in litigation by saying that their adjusters are available to adjust and settle claims and are not avoiding settling. However, all is doing is “passing off” a claim from one adjuster to another in an effort to delay and frustrate the process. ASSURANT regularly and consistently denies justified claims outright, omits or denies specific line items required to properly repair/replace a homeowner’s roof, and uses deceptive tactics, some, aforementioned, to prolong the process in a hope that the homeowner will cancel his retainer with the FIRM. It has become a pattern of practice for ASSURANT to not settle claims when it has the ability to do so and these dilatory tactics serve no purpose other than to increase profits. ASSURANT has violated the following statutory provisions: §642.155(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 regards 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 reasonable clear, under one portion of the insurance policy coverage in order to influence settlement under other provisions of the insurance policy coverage; §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) – Committing or performing with such frequency as to indicate a general business practice any of the following: (a) Failing to adopt and implement standards for the proper investigation of claims; (b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (c) Failing to acknowledge and act promptly upon communications with respect to claims; (d) Denying claims without conducting reasonable investigations based upon available information; (e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured with 30 days after proof-of-loss statements have been completed; (f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement; (g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim; (h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. To remedy this Civil Remedy Notice and to cure the conduct giving rise to the violations described herein, ASSURANT must immediately: (i) tender the full remaining payment to FIRM, on behalf of INSURED; (ii) make payment of any pre-judgment interest owed under Florida law, including §627.70131(5)(a), which is accruing daily; (iii) make payment for the additional expense incurred by the insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim. The aforementioned payments should be tendered to the insured’s attorneys at Law Offices of Paul Green, 8833 Perimeter Park Blvd., Suite 104, Jacksonville, Florida 32216.
Comments
User Id Date Added Comment
Paul@greenlawgrp.com 01-29-2026 This civil remedy notice is hereby withdrawn as all parties have come to a mutual agreement.
jbrown@burr.com 02-26-2025 February 26, 2025 Via Upload to DFS Website Florida Department of Financial Services Division of Insurance Regulation Consumer Assistance / Civil Remedy Section Larson Building, 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DOI File No.: 798832 File Date: January 2, 2025 Complainant: William O. Omey Claim No.: 0010488584 Filed By: Paul Green Esq. Date of Loss: June 6, 2024 Response to Civil Remedy Notice of Insurer Violation To Whom This May Concern: Please consider this the formal response of American Security Insurance Company (“American Security”) to the Civil Remedy Notice of Insurer Violation (“CRN”) filed by the homeowner William O. Omey (“Complainant”) on his lender-placed insurance policy (“Policy”). The Florida Department of Financial Services accepted the CRN on January 2, 2025. The CRN relates to an insurance claim regarding the residential real property located at 4720 Nolan Road, Sanford, FL 32773 (“Property”). The Policy was issued to Complainant’s lender Select Portfolio Servicing, Inc. (“Lender”) as the Named Insured, with Complainant designated as a Borrower with rights to file a claim. American Security issued the Policy at the direction of the Lender after Complainant failed to maintain hazard insurance on the Property as required by Lender’s mortgage. A. FACTUAL BACKGROUND The Property was built in 1981 in Seminole County. Complainant bought the Property in 2004 for $49,500, and it’s a three-bedroom, two-bathroom single family home that’s 1,350 sq ft under air in Sanford, FL. According to the Property’s permit history, in 2016, Complainant replaced the twenty-four square shingle roof through contractor Sunrise Roofing Services Inc. with a $6,450.00 valuation. Plaintiff made the subject insurance claim with American Security for alleged property damage resulting from a windstorm or hailstorm with an alleged date of loss of June 6, 2024 (“2024 Windstorm Claim”). Complainant reported the 2024 Windstorm Claim on September 5, 2024, and almost three (3) months after the alleged date of loss. On September 9, 2024, American Security sent a reservation of rights letter to Complainant regarding the late reporting of the 2024 Windstorm Claim due to the delay. American Security promptly assigned the claims examiner Taylor Erdeman to the 2024 Windstorm Claim (“Claims Examiner”). The Claims Examiner then engaged an independent field adjuster from Pilot Catastrophe Services Inc. on the same day to inspect the Property and evaluate the 2024 Windstorm Claim for American Security (“Field Adjuster”). Complainant advised Field Adjuster that he was surprised when his roofer stated that there was damage as the roof as it was only a few years old. Field Adjuster evaluated the Property’s shingle roof and did not observe any storm-created openings, windstorm or hail damage. No interior water damage was claimed by Complainant so the Property’s interior was not evaluated by Field Adjuster. According to the historical weather report from Weather Underground taken from the Sanford Airport on the date of loss, the wind speeds involved gusts up to forty-seven MPH with sustained winds peaking at only thirty-one MPH. These relatively low wind speeds should not have damaged a relatively-new roof. Furthermore, according to the historical aerial photographs of the Property from 2018-2020, the roof was surrounded and covered by large, mature trees. In a historical aerial photograph of the Property in 2022, Complainant removed most of the surrounding trees but Field Adjuster’s photographs taken in 2024 still identify at least one tree and its branches sitting on top of the roof. On October 4, 2024, Claims Examiner sent a denial letter to Complainant on behalf of American Security identifying the policy provisions and grounds for the denial (“Denial Letter”) including without limitation, the wear and tear, and mechanical damage terms. Complainant never provided a report from a roofer or professional to substantiate the claimed damage to the Property in the 2024 Windstorm Claim. Also, no estimate of alleged damage to the Property from the 2024 Windstorm Claim was received by American Security during the claims process. Complainant nor its counsel even made a demand of American Security for a specific sum to resolve the 2024 Windstorm Claim. In a kitchen-sink approach, Complainant filed this CRN on January 2, 2025, citing a multitude of alleged statutory violations and blaming American Security’s process in adjusting the 2024 Windstorm Claim simply because Complainant did not agree with the coverage decision. American Security wholly rejects each of these assertions as explored below. B. RESPONSE TO CRN American Security promptly and fairly investigated and adjusted the 2024 Windstorm Claim. As for the statutes mentioned by Complainant, each of these citations is improper considering the above-referenced facts. Namely, American Security abided by Fla. Stat. § 624.155(1)(b)(1) as it promptly investigated and made a coverage decision. Claims Examiner promptly appointed Field Adjuster to inspect the Property and evaluate the loss. The loss was reported almost three (3) months late such that an immediate evaluation of the Property could not occur here. Claims Examiner, with the assistance of Field Adjuster, concluded that the seven-year-old shingle roof did not experience wind or hail damage as the wind speeds were low on the date of loss and there was no hail damage to the shingles. Also, there was no water intrusion into the Property. Claims Examiner promptly sent the Denial Letter within a month of Complainant initiating the 2024 Windstorm Claim with the applicable policy citations included therein. American Security could not violate Fla. Stat. § 624.155(1)(b)(3) as it did not fail to promptly settle the 2024 Windstorm Claim as no obligation to settle the loss ever became reasonably clear under one portion of the Policy in order to influence settlements under other portion of the Policy as explained above. Complainant’s citation of Fla. Stat. § 626.9541(1)(i)(3)(a) related to the 2024 Windstorm Claim fails as American Security did not make a material misrepresentation to Complainant, let alone for the purpose and intent of effecting the settlement of the 2024 Windstorm Claim on less favorable terms than contemplated by the Policy. Complainant simply refutes American Security’s coverage decision without any evidence that the roof experienced damage covered by the Policy other than some self-serving statement of Complainant’s roofer, and fails to cite the actual alleged misrepresentation(s) in the CRN itself. American Security met its obligations promulgated by Fla. Stat. § 626.9541(1)(i)(3)(a) as it implemented proper standards for its investigation and communications related to the 2024 Windstorm Claim by promptly assigning the Claims Examiner that promptly engaged the Field Adjuster as explored above. The investigation and coverage decision occurred shortly after Complainant made the 2024 Windstorm Claim, and all letters and communications for the 2024 Windstorm Claim were sent to both Complainant and his Lender. Complainant does not articulate how American Security violated Fla. Stat. § 626.9541(1)(i)(3)(b), but the carrier did not misrepresent facts or policy provisions during the adjustment process as explained above. The wear and tear and mechanical damage exclusion terms of the Policy, and other grounds for the denial, including the findings of the Field Adjuster, were cited in the Denial Letter. Again, Complainant does not explain in the CRN how American Security violated Fla. Stat. § 626.9541(1)(i)(3)(c), but the carrier did not fail to acknowledge and act promptly upon communications with respect to 2024 Windstorm Claim. As explored above, American Security promptly adjusted the 2024 Windstorm Claim, and Complainant failed to provide any documentation in support of the loss during the claims process that American Security failed to evaluate. Complainant also cites Fla. Stat. § 626.9541(1)(i)(3)(d), claiming that American Security denied the 2024 Windstorm Claim without conducting a reasonable investigation based upon available information. Despite this assertion, as explored above, American Security coordinated a reasonable investigation into the 2024 Windstorm Claim before making its coverage decision. American Security did not need to meet its obligations promulgated by Fla. Stat. § 626.9541(1)(i)(3)(e), and to make claim payments to insureds or beneficiaries with a statement setting forth the coverage under which payments are being made, or by failing to affirm or deny full or partial coverage of claims or respond to a proof of loss, because the carrier correctly denied the 2024 Windstorm Claim and Complainant never served a proof of loss. Furthermore, American Security met its obligations promulgated by Fla. Stat. § 626.9541(1)(i)(3)(f) as it promptly provided a reasonable explanation in writing to Complainant regarding the grounds for the denial of the 2024 Windstorm Claim with the relevant Policy citations in the Denial Letter. Fla. Stat. § 626.9541(1)(i)(3)(g) does not apply to the 2024 Windstorm Claim and American Security as it did not require any additional information necessary for the processing of a 2024 Windstorm Claim and never requested it. Similarly, Fla. Stat. § 626.9541(1)(i)(3)(f) does not apply as American Security did not request additional information for the 2024 Windstorm Claim from Complainant such that it failed to clearly explain the nature of the requested information and the reasons why such information was necessary. Complainant, next, cites a few general statements without citing facts in support, such as American Security failed to properly investigate the 2024 Windstorm Claim or implement proper guidelines to investigate. The adjustment occurred in accordance with the Policy terms and Florida law. The Claims Examiner exercised integrity in denying the 2024 Windstorm Claim. In the CRN, Complainant fails to mention the late reporting of the 2024 Windstorm Claim, the prior removal of mature trees around the Property that affected the roof, the relatively low wind speeds on the date of loss and a host of other inconvenient facts relevant to the loss. Complainant’s efforts to seek a new roof based on its age and after a low windspeed event without any wind, hail or debris damage exhibited, show the Complainant’s lack of awareness here. Moreover, the CRN lacks the specificity required by s. 624.155(3) (a), Florida Statutes. The CRN provides nothing more than vague, ambiguous and conclusory allegations regarding what Complainant believes to be American Security's motivations, positions and business practices – none of which are true or supported by any facts. Florida law is clear that a Complainant is required to state with specificity the “facts and circumstances giving rise to the violation,” to allow the insurer to understand and cure any purported violation. Longpoint Condo. Assn. v. Allstate Ins. Co., 2005 WL 1315810 (N.D. Fla. 2005). A written CRN which is vague and “shotgun” in nature or is written in general terms fails the specificity requirement of the statute. See Heritage Corp. of South Fla. v. National Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. 2010); Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The very purpose of the civil remedy notice, pursuant to Chapter 624, is to inform the insurer of alleged violations with specific information to encourage settlement of the subject claim. “The sixty-day window [as provided for in F.S. §624.155] is designed to be a cure period that will encourage payment of the underlying claim and avoid unnecessary bad faith litigation.” Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1278 (Fla. 2000). Notice sent to the Department of Insurance concerning settlement violation(s) is intended to serve as a basis for the Department to assist in the settling of claims and to monitor the insurance industry. Id. However, whenever a complainant provides little in the way of adequate notice, the statutory intent of the CRN is frustrated. To the contrary of the assertions in the CRN, at all times material to the 2024 Windstorm Claim, American Security promptly and diligently investigated the loss and adjusted same in accordance with the terms of the Policy and Florida law. American Security has acted reasonably and in good faith at all times in adjusting the 2024 Windstorm Claim and believes that Complainant’s allegations stated in the CRN are without merit. Sincerely, /s/ Jonathan Brown Jonathan Brown, Esq. cc: Paul Green Esq.
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