Civil Remedy Notice of Insurer Violations
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Filing Number:     798834
Filing Accepted:  1/2/2025
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Complainant
Last/Business Name *  
SWAN LAKE CLUB, INC.   First Name  
Street Address * 5435 JAEGER RD., UNIT 4
City, State Zip * NAPLES, FL 34109
Email Address * LORI@WEGMANDESIGNGROUP.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SWAN LAKE CLUB, INC.   First Name  
Policy # * 1492370566 Claim #* 05000001538
Attorney
Attorney is Applicable
Last Name* MCINTYRE First Name * GARRETT Initial W
Street Address* 1520 ROYAL PALM SQUARE BLVD., SUITE 210
City, State Zip* FORT MYERS , FL 33919
Email Address * GARRETT@MBCOUNSEL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FRONTLINE INSURANCE UNLIMITED COMPANY
NAIC Company Code 10074
 
Name of individual responsible for violation (if any):* AARON SCOTT, JOHN MOSES, CAROL CRUMP, KRISTIN FITCH, BETH SPEED
Type of Insurance * Commercial 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)(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.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

A. Coverage We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss. 1. Covered Property Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2., Property Not Covered, if a Limit of Insurance is shown in the Declarations for that type of property. a. Building, meaning the building or structure described in the Declarations, including: (1) Completed additions; (2) Fixtures, outside of individual units, including outdoor fixtures; (3) Permanently installed: (a) Machinery; and (b) Equipment; (4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including: (a) Fire-extinguishing equipment; (b) Outdoor furniture; (c) Floor coverings; and (d) Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering that are not contained within individual units; (5) If not covered by other insurance: (a) Additions under construction, alterations and repairs to the building or structure; (b) Materials, equipment, supplies, and temporary structures, on or within 100 feet of the described premises, used for making additions, alterations or repairs to the building or structure; and (6) Any of the following types of property contained within a unit, regardless of ownership, if your Condominium Association Agreement requires you to insure it: (a) Fixtures, improvements and alterations that are a part of the building or structure; and (b) Appliances, such as those used for refrigerating, ventilating, cooking, dishwashing, laundering, security or housekeeping. But Building does not include personal property owned by, used by or in the care, custody or control of a unit-owner except for personal property listed in Paragraph 1) A.1.a.(6) above. e. Outdoor Property You may extend the insurance provided by this Coverage Form to apply to your outdoor fences, radio and television antennas (including satellite dishes), trees, shrubs and plants (other than "stock" of trees, shrubs or plants), including debris removal expense, caused by or resulting from any of the following causes of loss if they are Covered Causes of Loss: (1) Fire; (2) Lightning; (3) Explosion; (4) Riot or Civil Commotion; or (5) Aircraft. 4. Loss Payment a. In the event of loss or damage covered by this Coverage Form, at our option, we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property, subject to b. below; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality, subject to b. below. We will determine the value of lost or damaged property, or the cost of its repair or replacement, in accordance with the applicable terms of the Valuation Condition in this Coverage Form or any applicable provision which amends or supersedes the Valuation Condition. b. The cost to repair, rebuild or replace does not include the increased cost attributable to enforcement of any ordinance or law regulating the construction, use or repair of any property. c. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. d. We will not pay you more than your financial interest in the Covered Property. e. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the Covered Property. f. We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. g. We will pay for covered loss or damage to Covered Property within 30 days after we receive the sworn proof of loss, if you have complied with all of the terms of this Coverage Part and: (1) We have reached agreement with you on the amount of loss; or (2) An appraisal award has been made. If you name an insurance trustee, we will adjust losses with you, but we will pay the insurance trustee. If we pay the trustee, the payments will satisfy your claims against us. 8. Valuation We will determine the value of Covered Property in the event of loss or damage as follows: a. At actual cash value as of the time of loss or damage, except as provided in b. and c. below. b. If the Limit of Insurance for Building satisfies the Additional Condition, Coinsurance, and the cost to repair or replace the damaged building property is $2,500 or less, we will pay the cost of building repairs or replacement. The cost of building repairs or replacement does not include the increased cost attributable to enforcement of any ordinance or law regulating the construction, use or repair of any property. However, the following property will be valued at the actual cash value even when attached to the building: (1) Awnings or floor coverings; (2) Appliances for refrigerating, ventilating, cooking, dishwashing or laundering; or (3) Outdoor equipment or furniture. c. Glass at the cost of replacement with safety-glazing material if required by law. h. "Fungus", Wet Rot, Dry Rot And Bacteria Presence, growth, proliferation, spread or any activity of "fungus", wet or dry rot or bacteria. But if "fungus", wet or dry rot or bacteria results in a "specified cause of loss", we will pay for the loss or damage caused by that "specified cause of loss". This exclusion does not apply: 1. When "fungus", wet or dry rot or bacteria results from fire or lightning; or 2. To the extent that coverage is provided in the Additional Coverage – Limited Coverage For "Fungus", Wet Rot, Dry Rot And Bacteria with respect to loss or damage by a cause of loss other than fire or lightning. E. Additional Coverage – Limited Coverage For "Fungus", Wet Rot, Dry Rot And Bacteria 1. The coverage described in E.2. and E.6. only applies when the "fungus", wet or dry rot or bacteria is the result of one or more of the following causes that occurs during the policy period and only if all reasonable means were used to save and preserve the property from further damage at the time of and after that occurrence. a. A "specified cause of loss" other than fire or lightning; or b. Flood, if the Flood Coverage Endorsement applies to the affected premises. 2. We will pay for loss or damage by "fungus", wet or dry rot or bacteria. As used in this Limited Coverage, the term loss or damage means: a. Direct physical loss or damage to Covered Property caused by "fungus", wet or dry rot or bacteria, including the cost of removal of the "fungus", wet or dry rot or bacteria; b. The cost to tear out and replace any part of the building or other property as needed to gain access to the "fungus", wet or dry rot or bacteria; and c. The cost of testing performed after removal, repair, replacement or restoration of the damaged property is completed, provided there is a reason to believe that "fungus", wet or dry rot or bacteria are present. 2. Water Damage, Other Liquids, Powder Or Molten Material Damage If loss or damage caused by or resulting from covered water or other liquid, powder or molten material damage loss occurs, we will also pay the cost to tear out and replace any part of the building or structure to repair damage to the system or appliance from which the water or other substance escapes. This Coverage Extension does not increase the Limit of Insurance. 3. Glass a. We will pay for expenses incurred to put up temporary plates or board up openings if repair or replacement of damaged glass is delayed. b. We will pay for expenses incurred to remove or replace obstructions when repairing or replacing glass that is part of a building. This does not include removing or replacing window displays.
 
* Facts and circumstances giving rise to the violation.
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Swan Lake Club, Inc., (hereinafter “Swan Lake”) is comprised of a condominium association located in Naples, Florida. Swan Lake Club, Inc. includes six (6) structures. One (1) of the structures is a pool house, and the remaining five (5) are residential structures that contain eight (8) units per building, for a total of forty (40) residences within the association. The association is governed by a board of directors, which has in turn employed a number of property management companies over the years to handle the day-to-day needs of the association members. This dispute involves a wind insurance claim filed by Swan Lake Club, Inc. in the aftermath of Hurricane Ian. As all Floridians are keenly aware, Ian made landfall as a strong Category 4, almost Category 5, hurricane on September 28, 2022, just ever so slightly north of Naples. This resulted in Naples, FL receiving some of the worst winds associated with the Hurricane. Ian brought with it devastating winds to the entire region, and left many folks, such as my client’s members, with extensive damage. Swan Lake made monumental efforts to quickly report, document, quantify, and remediate the damage caused by the storm. This included taking hundreds of photographs, obtaining reports from numerous experts (including engineers), obtaining estimates for the repair work, engaging remediation companies within hours, and otherwise making sure the damage was addressed in a swift manner. I can candidly say that in my years of litigating insurance related disputes, Swan Lake by far has some of the most well documented and well mitigated damage that can be found anywhere in the State of Florida. This is in large part due to the herculean efforts of its board members. Unfortunately, the effort has not been reciprocated by Frontline Insurance. The insurance carrier for which a policy was in effect at the time of Hurricane Ian was Frontline Insurance Unlimited (“Frontline”). Frontline has acknowledged the initial claim that was filed by Swan Lake and assigned Claim No.: 05000001538 to the same on or about October 17, 2022, or more than two years ago. Swan Lake, its board, and its legal counsel have all submitted significant documentation associated with the loss and otherwise made dozens of well documented requests to Frontline for the funds needed to mitigate the damage, such as the damaged roofs, HVAC systems, windows, doors, building facades, outdoor lighting, and more. Frontline Insurance initially agreed to issue payment for certain portions of the loss, and the same was remitted primarily for the cost of temporary roofing and a minimal amount per residential building to cover the roof replacements. The TPO roofing that has been used as a temporary roof is now severely deteriorated. Along with numerous other systems present on the property, the damaged roofs constitute a clear covered loss. In many regards, Frontline Insurance has initially agreed with this assertion in writing to the legal counsel for Swan Lake and during numerous telephonic meetings with the revolving carousel of third parties and adjusters that have been hired by Frontline, but has woefully failed to provide adequate payment under the initial claim and likewise has failed or refused to address the timely supplements provided to Frontline. After Swan Lake retained the law firm of McIntyre & Bermudez, PLLC, the firm immediately worked to provide Frontline with supplemental documentation and provided an initial series of detailed supporting documents on March 25, 2024. The same included 170 pages of supporting records, such as the previously disclosed engineering report, an updated and detailed Xactimate estimate for all of the wind related damage, updated invoices from an HVAC contractor, updated invoices from an electrical contractor, and other relevant supporting documentation. This submission was in relation to the original claim and was not intended as a formal “supplemental” claim. The March 25, 2024, submission constituted a far more detailed submission that more accurately identified and quantified the damage that was present at the time of the covered loss. The March 25, 2024, submission also made a demand for payment from Frontline for an amount in dispute of $2,268,584.16. The months that followed the March 25, 2024, submission largely consisted of Frontline asking to conduct roof inspections, a singular HVAC inspection by HVACi (a company hired by Frontline) of exactly one (1) HVAC unit (despite Swan Lake claiming damage to well over a dozen HVAC units), a series of interior inspections focused on the ceilings of the second floor units (20 total), a two (2) day long engineering inspection conducted by a licensed engineer hired by Frontline and its adjuster at the time Carol Crump (for which no report has ever been provided to the insured), a follow up site inspection with third party consultants allegedly hired by Frontline and Carol Crump - which also included access to the roof and access to a number of unit interiors, the provision of a Supplemental Sworn Proof of Loss by Swan Lake, and an Examination Under Oath (EUO), which occurred on November 21, 2024. All said, both Swan Lake and the firm they retained attended somewhere between 5-7 onsite inspections of the property, countless conference calls with adjusters, countless conference calls with the consultants allegedly retained by Frontline, responded to dozens and dozens of emails and written requests made by Frontline and its ever revolving carousel of adjusters, and provided every piece of documentation imaginable to support the claim. During that time, Swan Lake also provided estimates, invoices, proofs of payment, ledgers, and other documentation to address, update, or supplement the following: 1) Damage and deterioration to the windows and doors of the units. The buildings sustained significant wind damage, which included damage to the exterior windows and doors. This was evidence by damages seals, abrasive damage to the windows (“sandblasting”), and warping or bowing of some windows and doors. 2) Updated and signed roofing estimates for the replacement of the roofs on the five (5) primary residential buildings present on the property. 3) New estimates for HVAC replacement of numerous units. After Hurricane Ian approaching twenty (20) or more units have failed due to brown outs, stress caused to the compressors by high winds, and other electrical failures directly traceable to the storm. 4) A bid for additional roof strapping, which is required under new ordinances and building codes that have gone into effect since the roof was originally installed. 5) A GAF system certification that outlines the specification of the required roofing systems for the buildings, and which comports with the updated roof estimates. 6) A lighting bid for the outdoor lighting that Swan Lake must maintain. This has been recently updated, and has now required additional engineering such that the same will be compliant with building codes and local ordinances. 7) Invoices / bids for new screens and metal that are necessary for various screen enclosures that have been damaged or destroyed. 8) Paint and stucco invoices / bids for the painting of the exterior and stucco replacement where the building envelope was impacted by debris, high winds, and the sandblasting referenced above. Swan Lake has strictly complied with every post lost request made by Frontline Insurance. They have meticulously documented the costs and estimates associated with the initial remediation / mitigation, tear out efforts, and the required rebuild. Swan Lake has likewise provided Frontline with continuous and unrestricted access to the property since filing the claim in October of 2022. Despite these efforts and careful compliance with the terms of the policy of insurance, and other than an initial confirmation that the supplemental documents were received, Frontline has provided exactly zero (0) payments in response to the March 25, 2024, submission. Adjusters and others working for Frontline have even admitted that they “forgot” they hired HVACi to inspect the HVAC systems, that they forgot the engineer they hired was ever onsite, that they forgot about dozens of pages of invoices that were provided and used at the EUO of Swan Lake, and that they forgot Frontline had previously agreed through its adjuster that the roofs present on the property were indeed "temporary" coverings, and not permanent roofs. How Frontline could conveniently “forget” its own written communications with the insured and years of inspections by numerous parties is an untenable position from which it cannot be permitted to deny the valid claim. Moreover, Frontline has assigned, terminated, and reassigned close to a dozen adjusters, consultants, engineers, and contractors to handle Swan Lake’s claim from October of 2022 to present day. The more recent adjusters have even admitted limited if any familiarity with the claim as a whole and have often exhibited complete ignorance when confronted with simple inquires about the status of the claim and whether or not a supplemental payment is forthcoming to Swan Lake. As a result of this absurdly inappropriate approach to claim handling practices, Swan Lake was left with no option but to file a Notice of Intent to Initiate Litigation (NOI) on September 25, 2024. At the time it was submitted, numerous supporting documents were again re-provided and the amount claimed to be in dispute was $2,268,584.00. Since filing the NOI, Swan Lake has continued to comply with the requests of Frontline and recently attended an EUO on November 21, 2024. In advance of the EUO, the large swath of documentation was again shared with Frontline, which included more updated estimates, mitigation documents, and other bids related to the covered loss. This documentation was uploaded to a Dropbox folder and shared with Frontline's legal counsel. Despite recognizing receipt of the same and even explicitly referring to said documentation during the EUO, Frontline, through its adjuster and legal counsel, is now claiming they have not seen some of the documents. This position is absurd and patently false. After the EUO concluded, Swan Lake has continued to provide current / updated quotes for items such as the paint work needed on the five (5) structures as well as newly revised quotes for the electrical work needed. After carefully reviewing all of the documentation generated by Swan Lake, its contractors and its consultants, Swan Lake has carefully submitted troves of documentation to assert that the total damage it sustained as a result of covered losses under the policy of insurance now exceeds $3,586,699.74. Despite having a valid, well documented, and sound legal claim for damages that are well in excess of $3,500,000.00, Frontline Insurance has in most regards ignored their insured, sought to waste the time and resources of the insured with countless inspections, and has yet sadly failed to address the claim in a timely manner. Despite repeated requests for an additional payment, no funds have been remitted to Swan Lake since April 25, 2023. Swan Lake recently attended mediation in good faith and to negotiate a resolution. However, the mediation resulted in an impasse. Frontline’s continuing breach of their policy of insurance can no longer be tolerated. Swan Lake has a statutory duty to its members and takes that responsibility seriously. It is Swan Lake’s expectation that Frontline will do the same and recognize that a payment is due immediately. Frontline should also be forced to comply with the numerous statutory obligations required of it and should end its deliberate efforts to delay the timely handling of the claim filed by its insured.
Comments
User Id Date Added Comment
sseale@wallenkelley.com 03-03-2025 March 3, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainant: Swan Lake Club, Inc. Address: 5435 Jaeger Road, Unit 4, Naples, Florida 34109 Email: lori@wegmandesigngroup.com Insured: Swan Lake Club, Inc. Policy #: 1492370566 Claim #: 05000001538 Attorney: Garrett W. McIntyre, Esq. Address: 1520 Royal Palm Square Blvd., Suite 210, Fort Myers, Florida 33919 DOI File #: 798834 Date of Acceptance: January 2, 2025 To Whom It May Concern: Please accept this as the response of Frontline Insurance Unlimited Company (“Frontline”) to the Civil Remedy Notice filed by the Complainant. Frontline’s response is specifically in regard to Claim 05000001538. The Insured’s property located at 4140 Crayton Road, Naples, Florida 34103, 4140 Crayton Road, Naples, Florida 34103 (Building 2 / Pool House), 4150 Crayton Road, Naples, Florida 34103, 4160 Crayton Road, Naples, Florida 34103, 4170 Crayton Road, Naples, Florida 34103, and 4180 Crayton Road, Naples, Florida 34103 was insured by Frontline under policy 1492370566 with the effective dates of that Policy being May 9, 2022 through May 9, 2023 and was in effect on the date of loss, September 28, 2022. Statement of Facts This matter arises from a Hurricane Ian claim which resulted in damage to the Insured’s Naples condominium property. For the convenience of the reader, I have broken down the Statement of Facts that will detail Frontline’s handling of the file. I. Claim 05000001538 The instant claim was reported to Frontline on October 17, 2022, as a result of Hurricane Ian. The claim was reported by the Complainant’s counsel, McClenny Moseley & Associates, PLLC, via their Letter of Representation. After receipt of the claim, Frontline assigned a claim number, 05000001538. Frontline immediately sent a Claim Notification Letter which included a blank Sworn Proof of Loss form and requested the Insured execute same. In addition, Frontline also sent another letter informing the Insured of its Right to Mediation. Thereafter, Frontline retained the services of a licensed field adjuster, Scott Fugich of Pilot Catastrophe Services, Inc., to perform an inspection of the Insured’s property. Mr. Fugich scheduled the initial inspection on three (3) separate occasions, October 28, 2022, October 31, 2022, and November 9, 2022, however, no one showed up on behalf of the Complainant for any of the three (3) inspections. As a result, Mr. Fugich was unable to access the property to conduct his inspection. On November 17, 2022, Mr. Fugich was finally able to inspect the property. During that inspection, Mr. Fugich took photographs of the property and noted the damage caused by Hurricane Ian. On November 1, 2022, Frontline sent a Letter of Representation Acknowledgement Letter and a copy of the Policy to the Complainant’s counsel. On November 7, 2022, Frontline sent the Complainant’s counsel a Reservation of Rights and Request for Information Letter. The letter clearly stated that, “On 10/14/2022 you reported a claim for damage due to wind to the following insured locations: 4140 Crayton Road Naples, FL 34103-3100 While it is our desire to investigate every claim which is reported to us and make payment for those losses which are covered under your policy, number 1492370566, with a policy period of 05/09/2022 through 05/09/2023 we must inform you that based upon our preliminary investigation we have identified issues that may restrict, limit, or exclude coverage, specifically flood or surface water. As such, we will be continuing our investigation under a full Reservations of Rights. … Your policy specifically excludes coverage for damages due to flood. In order to assist us in our investigation of your claim, we respectfully request that you provide us with the following documents and/or information. 1. The name and contact information for all person(s) who have serviced the insured property in connection with this loss. 2. Photos of the loss as it was found on the date of loss and photographs of repairs (if any). 3. Repair estimates or proposals in your possession. 4. Signed contracts, Assignment of Benefits, or work authorizations in your possession. 5. Invoices or receipts for any work performed. 6. Properly executed Sworn Statement in Proof of Loss. … Should you have any questions or concerns, please feel free to contact me….” After reviewing the materials from Pilot, Frontline retained the services of a licensed engineer, Robert R. Champagne, P.E. of Root Cause Consulting, to perform a re-inspection of the Insured’s property to determine the cause and origin of the claimed damage. This inspection took place on December 16, 2022. During that inspection, Mr. Champagne took photographs of the property, noted the observed damage, and prepared a report which contained his findings. Thereafter, on January 5, 2023, Frontline sent a status update letter to the Complainant’s counsel. The letter clearly stated that, “On 10/17/2022, Heather Hall Melaas reported a claim for damage due to Hurricane Ian to the following insured locations: 4140 Crayton Rd., Naples, FL 34103 4150 Crayton Rd., Naples, FL 34103 4160 Crayton Rd., Naples, FL 34103 4170 Crayton Rd., Naples, FL 34103 4180 Crayton Rd., Naples, FL 34103 Frontline is sending this letter to provide you with a timely update as to the status of the claim and our continuing investigation and/or evaluation. We are sending you this notification regarding compliance with Florida Statute 627.70131(7)(a), which states in part: (7)(a) Within 90 days after an insurer receives notice of an initial, reopened, or supplemental 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 is caused by factors beyond the control of the insurer which reasonably prevent such payment. As of the date of this letter, Frontline Insurance Company is unable to pay or deny the claim as we lack pertinent information required for us to make a coverage determination or to arrive at a payment amount. Presently Frontline is awaiting the following: • Engineers Report Should you have any questions or concerns, please feel free to contact me….” On April 8, 2023, Frontline sent another status update letter to the Complainant’s counsel. The letter clearly stated that, “On October 17, 2022, a claim was reported for Hurricane Ian damages to the building, which occurred on September 28, 2022. Our goal is to continue to provide you with a prompt and accurate conclusion to your claim… We are currently reviewing the estimate submitted by the field adjuster. Upon completion we will call to discuss the estimate. Should you have any questions or concerns, please feel free to contact me….” On April 12, 2023, the Complainant’s counsel sent Frontline an estimate for mitigation prepared by TAD Recovery Services, LLC. Frontline responded that day and advised that the claimed damage to the interior of the property was not covered because there was no storm created opening. After reviewing the field adjuster’s materials and the engineer’s materials, Frontline sent a coverage and partial denial letter to the Insured on April 25, 2023, that specifically informed them that coverage was being afforded for the loss but that some of the claimed damage was not covered under the Policy. The letter clearly stated that, “Please allow this correspondence to confirm that we are continuing our investigation of the above referenced claim. Your claim was reported on 01/23/2023 as damage to an insured building due to Hurricane Nicole. The loss was inspected by an independent adjuster assigned by Frontline on 02/02/2023. The independent adjuster confirmed covered wind damage to the insured building. Five checks in the total amount of $423,439.62, which represents Frontline’s undisputed payment, are included with this correspondence. These payments do not necessarily constitute a full and final settlement of your claim for damages. You may submit supplemental claim(s) for any additional damage discovered during the covered reconstruction and repair of the above-mentioned property… The independent adjuster did not observe any wind created openings in the roof systems on any of the buildings at the time of his inspection. Please note for interior rainwater damage to be covered the building must first sustain damage by a covered cause of loss to its roof or walls through which the rain enters. In furtherance of our investigation, Frontline retained an expert to opine if the roof systems had suffered damage from a covered cause of loss through which rainwater entered the interior of the buildings. The expert did not observe any openings in the roofing membrane, caused by a covered cause of loss, through which the rain water entered. … Pursuant to the policy language above, we are unable to indemnity you for your interior rainwater damage. The independent adjuster observed cracks in the roof tiles that pre-existed the reported date of loss. In furtherance of our investigation, Frontline hired an expert to opine as to the cause and origin of the cracked roof tile. The expert observed isolated cracked roof tiles throughout all buildings and the broken tile were not the result of hurricane Ian as evidenced by the coloration of the cracks and the fact that most tiles had been previously patched. The expert also observed one cracked tile that was the result of footfall traffic. Please note that pre-existing damage and damage related to wear and tear are specifically excluded from coverage as is the unadhered roofing identified by the expert that was due to inadequate or improper installation. … Pursuant to the policy language above, we are unable to indemnify you for the damage to the roof tile systems. Frontline is requesting that you execute a signed, sworn proof of loss pursuant to the terms of the policy. A sworn proof of loss form is enclosed for your convenience. … WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. If additional damages are discovered, it is your responsibility to inform us of the additional damages and allow inspection before repairs are made. Failure to do so may jeopardize your ability to recover for the full amount of the additional damages. Frontline reserves the right to inspect the property or require additional information prior to the release of any additional funds. … Please further be aware the above-referenced estimate of damages represents Frontline’s initial valuation of the alleged damages. In the event you believe there is additional loss or damage arising from this claim, you may bring a Supplemental Claim in accordance with Florida Statute 627.70132 Should you have any questions or concerns, please feel free to contact me… If you have additional documentation or information concerning this loss which you believe would alter our coverage decision, please submit it to us in writing and we will review it.” On May 5, 2023, Frontline was informed that the Complainant would no longer be represented by its current counsel. On May 8, 2023, Frontline received a letter from McClenny Moseley & Associates, PLLC, confirming that they no longer represented the Complainant. On May 16, 2023, Frontline received a Letter of Representation from the Complainant’s new counsel, Florida Insurance Claims Attorneys, PLLC. Shortly thereafter, the previously issued payments which included the Complainant’s prior counsel were voided and re-issued. On June 22, 2023, the Complainant’s counsel sent Frontline a copy of a contract the Complainant executed with Eco Roofing and Solar, Inc. (“ERS”) for temporary roof repairs and requested payment for the contracted work. In response, Frontline requested proof that the temporary roof repairs had been performed. On July 22, 2023, the Complainant’s counsel sent Frontline ERS’ Contract, Invoice, and Photos for the claim. After reviewing ERS’ materials, Frontline retained the services of a licensed roofer, Jose A. Hernandez of AKG Roofing & Specialty Services, Inc., to perform a re-inspection of the Insured’s property to determine if the work performed by ERS was a temporary repair or replacement. This inspection took place on August 17, 2023. After reviewing all the submitted materials, Frontline sent a supplemental coverage letter to the Complainant’s counsel on October 24, 2023. The letter clearly stated that, “Please allow this correspondence to confirm that we are continuing our investigation of the above referenced claim. The loss was inspected by an independent adjuster on 02/02/2023. The independent adjuster confirmed covered wind damage to the insured building. We have reviewed the invoice submitted for the temporary roof installations after the loss. Five checks in the total amount of $192,035.00, which represents Frontline’s undisputed payments for the temporary roofs, are included with this correspondence. These payments do not necessarily constitute a full and final settlement of your claim for damages. You may submit a supplemental claim(s) for any additional damage discovered during the covered reconstruction and repair of the above-mentioned property… At the time of the inspection, the adjuster also observed what appeared to be flood-related damage to the building. In furtherance of our investigation, Frontline retained an expert to inspection and opine as to the cause and origin of the damages that appeared to be related to flood. The expert met with your public adjuster and the COA president, and the expert was informed that flood water entered the building to an approximate height of 36 inches above the floor finish. A Q-risq report was also obtained which shows that storm surge at the address was 3 feet above ground level. … Please your policy specifically excludes damage related to flooding. The independent adjuster observed cracks in the roof tiles that pre-existed the reported date of loss. In furtherance of our investigation, Frontline hired an expert to opine as to the cause and origin of the cracked roof tile. The expert observed isolated cracked roof tiles throughout all buildings, and the broken tiles were not the result of Hurricane Ian, as evidenced by the coloration of the cracks and the fact that most tiles had been previously patched. The expert also observed one cracked tile that was the result of footfall traffic. Please note that pre-existing damage and damage related to wear and tear are specifically excluded from coverage, as is the unadhered roofing identified by the expert that was due to inadequate or improper installation. … Pursuant to the policy language above, we are unable to indemnify you for the damage to the tile roof systems. Frontline has formally requested that you execute a signed, sworn proof of loss pursuant to the terms of the policy three times. A sworn proof of loss form is enclosed for your convenience. … WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. If additional damages are discovered, it is your responsibility to inform us of the additional damages and allow inspection before repairs are made. Failure to do so may jeopardize your ability to recover for the full amount of the additional damages. Frontline reserves the right to inspect the property or require additional information prior to the release of any additional funds. … Please further be aware the above-referenced estimate of damages represents Frontline’s initial valuation of the alleged damages. In the event you believe there is additional loss or damage arising from this claim, you may bring a Supplemental Claim in accordance with Florida Statute 627.70132 Should you have any questions or concerns, please feel free to contact me… If you have additional documentation or information concerning this loss which you believe would alter our coverage decision, please submit it to us in writing and we will review it.” After reviewing the various reports and materials prepared on behalf of the Complainant and Frontline, Frontline retained the services of a licensed engineer, Carlos Morales, P.E. of Grindley Williams Engineering, to perform a desk review of the respective reports and materials and to provide their opinion on same. On December 22, 2023, Frontline sent the Complainant’s counsel a Reservation of Rights and Request for Information Letter. The letter clearly stated that, “On 10/17/2022, you reported a claim for damage due to Hurricane Ian to the following insured locations: 4140 Crayton Rd, Naples, FL 34103 4150 Crayton Rd, Naples, FL 34103 4160 Crayton Rd, Naples, FL 34103 4170 Crayton Rd, Naples, FL 34103 4180 Crayton Rd, Naples, FL 34103 On May 23, 2023, a payment was issued based on the independent field adjuster’s estimate in the amount of $423,439.62. In addition, another payment has been issued in the amount of $192,035.00. Copies of the estimate and a claim settlement letter were included with the checks. Frontline has received your estimate prepared by Write Loss, Inc. which outlines bid items for roof replacement from Crowther Roofing and Sheet Metal of Florida, Inc. in the amount of $1,319,211.51. Secondly, Frontline was provided an estimate, prepared by ECO Roof and Solar, in the amount of $1,619,568.52. In addition, we were made aware of a claim for exterior lighting, light poles, rewiring, and electrical work. However, no supporting documentation has been provided for these items. Frontline would like to address the newly claimed items and the costs incurred or estimated but have not been provided the supporting documentation so we can property investigate these items. Also, Frontline continues to request the executed sworn proof of loss. Most recently, October 24, 2023, May 22, 2023, and November 7, 2022. To date, we have not received your completed sworn proof of loss. While it is our desire to investigate every claim that is reported to us and make payment for those losses that are covered under your policy, number 1492370566, with effective dates of 5/09/2022 to 05/09/2023 we must inform you that based upon our preliminary investigation we have identified issues that may restrict, limit, or exclude coverage, specifically failure to cooperate in the investigation and settlement of the claim. We have requested supporting documentation for newly claimed items and have also requested that you provide the sworn proof of loss per the loss conditions of the policy. As such, we will be continuing our investigation under a full Reservation of Rights. … In order to assist us in our investigation of your claim, we respectfully request that you provide us with the following documents and/or information. 1. Please provide a properly executed Sworn Proof of Loss. 2. Please provide a list of all damaged contents associated with the referenced loss, with any supporting documents/photos. 3. Please provide your contractor’s contact information and estimate. 4. Invoices and receipts for any work performed. … Should you have any questions or concerns, please feel free to contact me….” On February 8, 2024, the Complainant’s counsel submitted the Complainant’s executed Sworn Proof of Loss. On February 20, 2024, Frontline sent its response to the Complainant’s Sworn Proof of Loss to the Complainant’s counsel. The letter clearly stated that, “On 10/17/2022, you reported a claim for damage due to Hurricane Ian to the following insured locations: 4140 Crayton Rd, Naples, FL 34103 4150 Crayton Rd, Naples, FL 34103 4160 Crayton Rd, Naples, FL 34103 4170 Crayton Rd, Naples, FL 34103 4180 Crayton Rd, Naples, FL 34103 Frontline is in receipt of your Sworn Statement in Proof of Loss (“Proof of Loss”) in the amount of $1,318,721.00 received via Email on February 9, 2024. Frontline received the Proof of Loss, however, our investigation determined that the RCV amount for this loss was $615,474.62 and as such, we are not in agreement with the amount of loss submitted. Accordingly, no payments will be issued based upon the submitted Proof of Loss. Frontline is also in the process of reviewing the signed contracts and invoices that were submitted for the replacement of the HVAC system, roof, and other completed repairs. … Should you have any questions or concerns, please feel free to contact me….” Thereafter, on March 13, 2024, Frontline received a Letter of Representation from McIntyre & Bermudez, PLLC. The letter also stated that the Complainant’s current counsel, Florida Insurance Claims Attorneys, PLLC, had been terminated. On March 20, 2024, Frontline received a letter from the Complainant’s prior counsel, Florida Insurance Claims Attorneys, PLLC, confirming that they no longer represented the Complainant. The letter also stated that, “Please be advised Mitchell E. Jacobs, Esq./Florida Insurance Claims Attorneys PLLC asserts a charging lien and a retaining lien against the files and proceeds belonging to Swan Lake Club, Inc. under the Frontline Insurance Company policy until the Swan Lake Club, Inc.” On March 22, 2024, Frontline sent a Letter of Representation Acknowledgement Letter and a copy of the field adjuster’s estimate to the Complainant’s counsel. On March 26, 2024, the Complainant’s counsel submitted correspondence to Frontline advising that the Complainant was submitting a supplemental claim. Provided with the correspondence were various supporting documents and materials. On May 7, 2024, Frontline advised the Complainant’s counsel that the Complainant would need to execute an updated Sworn Proof of Loss following the submission of its supplemental claim and sent a blank Sworn Proof of Loss form via email. That same day, Frontline retained the undersigned firm, Wallen Kelley, to take an Examination Under Oath of the Complainant. On May 9, 2024, the undersigned sent the Complainant’s counsel a Reservation of Rights and Demand for Examination Under Oath Letter. The letter clearly stated that, “I hope this correspondence finds you well. Please note that Wallen Kelley represents your client’s insurer, Frontline Insurance Unlimited Company (hereafter “Frontline”). Pursuant to the terms of the aforementioned insurance Policy, the Insured’s carrier requires their Corporate Representative to submit to an examination under oath for the above-referenced claim. Per your insurance Policy: BUILDING AND PERSONAL PROPERTY COVERAGE FORM E. Loss Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 3. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to Covered Property: … (4) Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. (5) At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed. EXAMINATION UNDER OATH Frontline is hereby exercising its right to take Your client’s examination under oath. Wallen Kelley represents your insurer, Frontline Insurance Unlimited Company. At this time we are requesting that you please provide three (3) dates of availability for your examination under oath within the next ten (10) days. This examination under oath needs to take place in a timely fashion so we would ask that you please provide dates between today and July 9, 2024. Should we not receive any dates from you in a timely fashion, this examination may be unilaterally scheduled. Your examination under oath will take place at a mutually coordinate date and time via Zoom, and concerns the property damage and loss claim listed above; specifically, the reported loss occurring at the aforementioned properties. PLEASE ADVISE IF A TRANSLATOR IS NEEDED. This examination is being undertaken by Frontline Insurance Unlimited Company to obtain information concerning the above-mentioned property damage claim. YOUR EXAMINATION At the examination, you may be asked about the incident resulting in the property damage and/or loss, the extent of the property damage, the existence and extent of any repairs or replacements, and other related matters. You may also be asked questions about your reporting of the above claim to your insurer, or about any related claims. DOCUMENT REQUEST Per your duties under your insurance policy, please document all initial damage, expenses, values at time of loss, and repairs or replacements. If the extent of the subject damage has increased since your insurer’s inspection, or if you believe the damage to be of a higher value than previously estimated, please secure documentation supportive of those topics prior to your examination. In addition to the aforementioned documentation, PLEASE BRING THE FOLLOWING DOCUMENTS TO YOUR EXAMINATION: • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the installation, repair, or replacement of the roofing system currently in the property. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of the interior since September 28, 2022. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of any part of the interior or exterior of the property, (including any patio, pool cage, pool or yard structures), since September 28, 2022. • Photographs or video showing the areas reported as damaged in this claim at any time since September 28, 2022. • Photographs or video showing any repair or replacement of the roof, interior (including all rooms and interior areas), exterior (including any outside fence, pool/patio area, shed or yard structures) or any other damaged area of the property as reported in this claim, since September 28, 2022. • All receipts, canceled checks, copies of checks, cash withdrawal statements, or any other documentation showing payments made to any persons or companies in relation to the damage claimed, the repair thereof, or any purchase or replacement related thereto. • All financial records, including checking account statements, savings account statements, credit card statements, and any other statements of other lines of credit, which reflect financial accounts you used or had access to from September 28, 2022 to present, and which were involved in any deposit or transfer of insurance proceeds or which pertain to any withdrawal or payment related to a repair or replacement of damaged items or areas related to the subject loss. • All estimates, invoices, reports, or other documents pertaining to inspections of the property made since September 28, 2022. • All documents reflecting your hiring or non-hiring of a public adjuster to represent you as to this claim. • All documents relating to any lawsuit brought by you against an insurer, or by an insurer against you, within the past fifteen (15) years. • An executed Sworn Proof of Loss for Claim 05000001538; • A copy of any estimate(s) prepared by your public adjuster/loss consultant for Claim 05000001538 • Any Assignment of Benefits You signed for 05000001538 • Any water remediation or mold remediation documents for Claim 05000001538 • All documents relating to the adjustment of Claim 05000001538. • Any receipts, invoices, photographs, or supporting documents that show amounts spent on repairs, to date. • Any receipts, invoices, photographs, or supporting documents related to any and all contents damage you are claiming, including preparing an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. • Any receipts, invoices, photographs, or supporting documents related to any and all roof damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all exterior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all interior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all business interruption you are claiming. • Your itemized contractor’s estimate; • Any and all mitigation invoices; • Any and all business personal property inventory; • Any and all payments and documents You received from TAD Recovery Services from September 28, 2017. • Any and all payments and documents You received from Eco Roof from September 28, 2017. • Any and all payments and documents You received from Crowther Roofing from September 28, 2017. • Any and all payments and documents You received from Hartford Insurance Company for the Insured’s pending flood claim. • Any and all payments and documents You received from Aaron Harris, P.E. from September 28, 2017. • Any and all payments and documents You received from Write Loss from September 28, 2017. • Any and all payments and documents You received from LGT Restoration Services from September 28, 2017. • Any and all payments and documents You received from Powerhouse Home Services from September 28, 2017. • Any and all payments and documents You received from General Air & Plumbing from September 28, 2017. • Any permit(s) pulled for repair and/or replacement of the subject property since September 28, 2017. • Any and all documents that support you damages claimed for business loss. RESERVATION OF RIGHTS In furtherance of our investigation, Frontline has not been able to resolve your loss. We must inform you that based upon our continued investigation during the claims process, we have identified issues that may restrict, limit, or exclude coverage, specifically lack of mitigation or repair to the roof damages. As such, we will continue our investigation under a full Reservation of Rights. WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. … You are required to attend this examination under oath pursuant to the terms of the insurance policy under which you are seeking recovery. Your duties after loss also obligate you to provide the requested documents. Pursuant to the terms of the insurance policy and Florida law, if you fail or refuse to attend the examination under oath, you may be denied further recovery under the policy. Your attendance at this examination under oath is a condition precedent to your recovery under the policy - your claim may be denied if you do not attend the examination under oath. Once again, if you have any problems, questions, or concerns regarding the examination under oath or the scheduling of same, please do not hesitate to contact me at your convenience.” On May 13, 2024, the Complainant’s counsel submitted the Complainant’s executed updated Sworn Proof of Loss. That same day, Frontline sent its response to the Complainant’s updated Sworn Proof of Loss to the Complainant’s counsel. The letter clearly stated that, “Frontline is in receipt of the insured’s Sworn Statement in Proof of Loss (“Proof of Loss”) and estimate in the amount of $2,839,126.16 received by email on May 13, 2024. Frontline received the updated Sworn Proof of Loss, however, our investigation determined that the RCV amount for this loss was $762,577.52 and as such, we are not in agreement with the scope of repair and cost submitted. Accordingly, no payments will be issued based upon the submitted Sworn Proof of Loss. Frontline is continuing to evaluate the insured’s claim and it may be necessary for us to engage additional experts to reconcile any scope of repair and cost differences. … Should you have any questions or concerns, please feel free to contact me….” After reviewing the Complainant’s supplemental claim materials, Frontline retained the services of a licensed HVAC technician from HVACi, to perform an assessment of the HVAC units at the Complainant’s property. In addition, Frontline also retained the services of a building consultant, Brian Bailey of Restoration Management Consulting Group, LLC, to perform an inspection of the Insured’s property to determine the scope and cost for the reported property damage. This inspection took place on June 7, 2024. On June 4, 2024, the undersigned sent the Complainant’s counsel a second Reservation of Rights and Demand for Examination Under Oath Letter. The letter clearly stated that, “I hope this correspondence finds you well. Please note that Wallen Kelley represents your client’s insurer, Frontline Insurance Unlimited Company (hereafter “Frontline”). Pursuant to the terms of the aforementioned insurance Policy, the Insured’s carrier requires their Corporate Representative to submit to an examination under oath for the above-referenced claim. Per your insurance Policy: BUILDING AND PERSONAL PROPERTY COVERAGE FORM E. Loss Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 3. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to Covered Property: … (4) Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. (5) At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed. EXAMINATION UNDER OATH Frontline is hereby exercising its right to take Your client’s examination under oath. Wallen Kelley represents your insurer, Frontline Insurance Unlimited Company. At this time we are requesting that you please provide three (3) dates of availability for your examination under oath within the next ten (10) days. This examination under oath needs to take place in a timely fashion so we would ask that you please provide dates between today and July 9, 2024. Should we not receive any dates from you in a timely fashion, this examination may be unilaterally scheduled. Your examination under oath will take place at a mutually coordinate date and time via Zoom, and concerns the property damage and loss claim listed above; specifically, the reported loss occurring at the aforementioned properties. PLEASE ADVISE IF A TRANSLATOR IS NEEDED. This examination is being undertaken by Frontline Insurance Unlimited Company to obtain information concerning the above-mentioned property damage claim. YOUR EXAMINATION At the examination, you may be asked about the incident resulting in the property damage and/or loss, the extent of the property damage, the existence and extent of any repairs or replacements, and other related matters. You may also be asked questions about your reporting of the above claim to your insurer, or about any related claims. DOCUMENT REQUEST Per your duties under your insurance policy, please document all initial damage, expenses, values at time of loss, and repairs or replacements. If the extent of the subject damage has increased since your insurer’s inspection, or if you believe the damage to be of a higher value than previously estimated, please secure documentation supportive of those topics prior to your examination. In addition to the aforementioned documentation, PLEASE BRING THE FOLLOWING DOCUMENTS TO YOUR EXAMINATION: • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the installation, repair, or replacement of the roofing system currently in the property. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of the interior since September 28, 2022. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of any part of the interior or exterior of the property, (including any patio, pool cage, pool or yard structures), since September 28, 2022. • Photographs or video showing the areas reported as damaged in this claim at any time since September 28, 2022. • Photographs or video showing any repair or replacement of the roof, interior (including all rooms and interior areas), exterior (including any outside fence, pool/patio area, shed or yard structures) or any other damaged area of the property as reported in this claim, since September 28, 2022. • All receipts, canceled checks, copies of checks, cash withdrawal statements, or any other documentation showing payments made to any persons or companies in relation to the damage claimed, the repair thereof, or any purchase or replacement related thereto. • All financial records, including checking account statements, savings account statements, credit card statements, and any other statements of other lines of credit, which reflect financial accounts you used or had access to from September 28, 2022 to present, and which were involved in any deposit or transfer of insurance proceeds or which pertain to any withdrawal or payment related to a repair or replacement of damaged items or areas related to the subject loss. • All estimates, invoices, reports, or other documents pertaining to inspections of the property made since September 28, 2022. • All documents reflecting your hiring or non-hiring of a public adjuster to represent you as to this claim. • All documents relating to any lawsuit brought by you against an insurer, or by an insurer against you, within the past fifteen (15) years. • An executed Sworn Proof of Loss for Claim 05000001538; • A copy of any estimate(s) prepared by your public adjuster/loss consultant for Claim 05000001538 • Any Assignment of Benefits You signed for 05000001538 • Any water remediation or mold remediation documents for Claim 05000001538 • All documents relating to the adjustment of Claim 05000001538. • Any receipts, invoices, photographs, or supporting documents that show amounts spent on repairs, to date. • Any receipts, invoices, photographs, or supporting documents related to any and all contents damage you are claiming, including preparing an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. • Any receipts, invoices, photographs, or supporting documents related to any and all roof damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all exterior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all interior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all business interruption you are claiming. • Your itemized contractor’s estimate; • Any and all mitigation invoices; • Any and all business personal property inventory; • Any and all payments and documents You received from TAD Recovery Services from September 28, 2017. • Any and all payments and documents You received from Eco Roof from September 28, 2017. • Any and all payments and documents You received from Crowther Roofing from September 28, 2017. • Any and all payments and documents You received from Hartford Insurance Company for the Insured’s pending flood claim. • Any and all payments and documents You received from Aaron Harris, P.E. from September 28, 2017. • Any and all payments and documents You received from Write Loss from September 28, 2017. • Any and all payments and documents You received from LGT Restoration Services from September 28, 2017. • Any and all payments and documents You received from Powerhouse Home Services from September 28, 2017. • Any and all payments and documents You received from General Air & Plumbing from September 28, 2017. • Any permit(s) pulled for repair and/or replacement of the subject property since September 28, 2017. • Any and all documents that support you damages claimed for business loss. RESERVATION OF RIGHTS In furtherance of our investigation, Frontline has not been able to resolve your loss. We must inform you that based upon our continued investigation during the claims process, we have identified issues that may restrict, limit, or exclude coverage, specifically lack of mitigation or repair to the roof damages. As such, we will continue our investigation under a full Reservation of Rights. WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. … You are required to attend this examination under oath pursuant to the terms of the insurance policy under which you are seeking recovery. Your duties after loss also obligate you to provide the requested documents. Pursuant to the terms of the insurance policy and Florida law, if you fail or refuse to attend the examination under oath, you may be denied further recovery under the policy. Your attendance at this examination under oath is a condition precedent to your recovery under the policy - your claim may be denied if you do not attend the examination under oath. Once again, if you have any problems, questions, or concerns regarding the examination under oath or the scheduling of same, please do not hesitate to contact me at your convenience.” Thereafter, on August 5, 2024, the undersigned sent the Complainant’s counsel a third Reservation of Rights and Demand for Examination Under Oath Letter. The letter clearly stated that, “I hope this correspondence finds you well. Please note that Wallen Kelley represents your client’s insurer, Frontline Insurance Unlimited Company (hereafter “Frontline”). Pursuant to the terms of the aforementioned insurance Policy, the Insured’s carrier requires their Corporate Representative to submit to an examination under oath for the above-referenced claim. Per your insurance Policy: BUILDING AND PERSONAL PROPERTY COVERAGE FORM E. Loss Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 3. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to Covered Property: … (4) Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. (5) At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed. EXAMINATION UNDER OATH Your examination under oath will take place on September 20, 2024 via Zoom, and concerns the property damage and loss claim listed above; specifically, the reported loss occurring at the aforementioned properties. PLEASE ADVISE IF A TRANSLATOR IS NEEDED. This examination is being undertaken by Frontline Insurance Unlimited Company to obtain information concerning the above-mentioned property damage claim. YOUR EXAMINATION At the examination, you may be asked about the incident resulting in the property damage and/or loss, the extent of the property damage, the existence and extent of any repairs or replacements, and other related matters. You may also be asked questions about your reporting of the above claim to your insurer, or about any related claims. DOCUMENT REQUEST Per your duties under your insurance policy, please document all initial damage, expenses, values at time of loss, and repairs or replacements. If the extent of the subject damage has increased since your insurer’s inspection, or if you believe the damage to be of a higher value than previously estimated, please secure documentation supportive of those topics prior to your examination. In addition to the aforementioned documentation, please provide the following documents by September 13, 2024. Failure to do so may result in the postponement of the Examination Under Oath. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the installation, repair, or replacement of the roofing system currently in the property. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of the interior since September 28, 2022. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of any part of the interior or exterior of the property, (including any patio, pool cage, pool or yard structures), since September 28, 2022. • Photographs or video showing the areas reported as damaged in this claim at any time since September 28, 2022. • Photographs or video showing any repair or replacement of the roof, interior (including all rooms and interior areas), exterior (including any outside fence, pool/patio area, shed or yard structures) or any other damaged area of the property as reported in this claim, since September 28, 2022. • All receipts, canceled checks, copies of checks, cash withdrawal statements, or any other documentation showing payments made to any persons or companies in relation to the damage claimed, the repair thereof, or any purchase or replacement related thereto. • All financial records, including checking account statements, savings account statements, credit card statements, and any other statements of other lines of credit, which reflect financial accounts you used or had access to from September 28, 2022 to present, and which were involved in any deposit or transfer of insurance proceeds or which pertain to any withdrawal or payment related to a repair or replacement of damaged items or areas related to the subject loss. • All estimates, invoices, reports, or other documents pertaining to inspections of the property made since September 28, 2022. • All documents reflecting your hiring or non-hiring of a public adjuster to represent you as to this claim. • All documents relating to any lawsuit brought by you against an insurer, or by an insurer against you, within the past fifteen (15) years. • An executed Sworn Proof of Loss for Claim 05000001538; • A copy of any estimate(s) prepared by your public adjuster/loss consultant for Claim 05000001538 • Any Assignment of Benefits You signed for 05000001538 • Any water remediation or mold remediation documents for Claim 05000001538 • All documents relating to the adjustment of Claim 05000001538. • Any receipts, invoices, photographs, or supporting documents that show amounts spent on repairs, to date. • Any receipts, invoices, photographs, or supporting documents related to any and all contents damage you are claiming, including preparing an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. • Any receipts, invoices, photographs, or supporting documents related to any and all roof damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all exterior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all interior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all business interruption you are claiming. • Your itemized contractor’s estimate; • Any and all mitigation invoices; • Any and all business personal property inventory; • Any and all payments and documents You received from TAD Recovery Services from September 28, 2017. • Any and all payments and documents You received from Eco Roof from September 28, 2017. • Any and all payments and documents You received from Crowther Roofing from September 28, 2017. • Any and all payments and documents You received from Hartford Insurance Company for the Insured’s pending flood claim. • Any and all payments and documents You received from Aaron Harris, P.E. from September 28, 2017. • Any and all payments and documents You received from Write Loss from September 28, 2017. • Any and all payments and documents You received from LGT Restoration Services from September 28, 2017. • Any and all payments and documents You received from Powerhouse Home Services from September 28, 2017. • Any and all payments and documents You received from General Air & Plumbing from September 28, 2017. • Any permit(s) pulled for repair and/or replacement of the subject property since September 28, 2017. • Any and all documents that support you damages claimed for business loss. RESERVATION OF RIGHTS In furtherance of our investigation, Frontline has not been able to resolve your loss. We must inform you that based upon our continued investigation during the claims process, we have identified issues that may restrict, limit, or exclude coverage, specifically lack of mitigation or repair to the roof damages. As such, we will continue our investigation under a full Reservation of Rights. WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. … You are required to attend this examination under oath pursuant to the terms of the insurance policy under which you are seeking recovery. Your duties after loss also obligate you to provide the requested documents. Pursuant to the terms of the insurance policy and Florida law, if you fail or refuse to attend the examination under oath, you may be denied further recovery under the policy. Your attendance at this examination under oath is a condition precedent to your recovery under the policy - your claim may be denied if you do not attend the examination under oath. Once again, if you have any problems, questions, or concerns regarding the examination under oath or the scheduling of same, please do not hesitate to contact me at your convenience.” On August 6, 2024, Frontline retained the services of a licensed engineer, Scott A. Schroeder, P.E. of Keystone Experts and Engineers, LLC, to perform an assessment of the fenestrations at the Complainant’s property. This assessment took place on August 27 and 28, 2024. Thereafter, on September 25, 2024, Notice of Intent to Initiate Litigation (Notice No.: 211327) was filed. On October 8, 2024, Frontline sent its response to the Complainant’s Notice of Intent to Initiate Litigation. The letter clearly stated that, “Frontline Insurance Unlimited Company d/b/a Frontline Insurance (“Frontline”) acknowledges receipt of the Property Insurance Notice of Intent to Initiate Litigation (Notice Number: 211327) accepted by the Florida Department of Financial Services on September 25, 2024 (hereafter referred to as “the Notice”). The Notice was submitted on behalf of Swan Lake Club, Inc. (hereafter “the Insured”) and Frontline received the Notice on September 25, 2024. At the outset, the Notice is premature. In the most correspondence sent to the Insured’s counsel, counsel for Frontline notified them that the claim was ongoing, being adjusted, that an Examination Under Oath was pending, and that documents were being requested. At no time has Frontline foreclosed the possibility of additional payments under the policy for the Insured’s covered loss. Moreover, Frontline’s counsel specifically advised on September 19, 2024 that, “I hope this correspondence finds you well. Once more, please note that Wallen Kelley represents your client’s insurer, Frontline Insurance Unlimited Company (hereafter “Frontline”). Pursuant to the terms of the aforementioned insurance Policy, the Insured’s carrier requires their Corporate Representative to submit to an examination under oath for the above-referenced claim. Per your insurance Policy: BUILDING AND PERSONAL PROPERTY COVERAGE FORM E. Loss Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 3. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to Covered Property: … (4) Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. (5) At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed. EXAMINATION UNDER OATH Your examination under oath will take place on I hope this correspondence finds you well. Once more, please note that Wallen Kelley represents your client’s insurer, Frontline Insurance Unlimited Company (hereafter “Frontline”). Pursuant to the terms of the aforementioned insurance Policy, the Insured’s carrier requires their Corporate Representative to submit to an examination under oath for the above-referenced claim. Per your insurance Policy: BUILDING AND PERSONAL PROPERTY COVERAGE FORM E. Loss Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 3. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to Covered Property: … (4) Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. (5) At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed. EXAMINATION UNDER OATH Your examination under oath will take place on October 25, 2024 via Zoom, and concerns the property damage and loss claim listed above; specifically, the reported loss occurring at the aforementioned properties. PLEASE ADVISE IF A TRANSLATOR IS NEEDED. This examination is being undertaken by Frontline Insurance Unlimited Company to obtain information concerning the above-mentioned property damage claim. YOUR EXAMINATION At the examination, you may be asked about the incident resulting in the property damage and/or loss, the extent of the property damage, the existence and extent of any repairs or replacements, and other related matters. You may also be asked questions about your reporting of the above claim to your insurer, or about any related claims. DOCUMENT REQUEST Per your duties under your insurance policy, please document all initial damage, expenses, values at time of loss, and repairs or replacements. If the extent of the subject damage has increased since your insurer’s inspection, or if you believe the damage to be of a higher value than previously estimated, please secure documentation supportive of those topics prior to your examination. In addition to the aforementioned documentation, please provide the following documents by October 15, 2024. Failure to do so may result in the postponement of the Examination Under Oath. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the installation, repair, or replacement of the roofing system currently in the property. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of the interior since September 28, 2022. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of any part of the interior or exterior of the property, (including any patio, pool cage, pool or yard structures), since September 28, 2022. • Photographs or video showing the areas reported as damaged in this claim at any time since September 28, 2022. • Photographs or video showing any repair or replacement of the roof, interior (including all rooms and interior areas), exterior (including any outside fence, pool/patio area, shed or yard structures) or any other damaged area of the property as reported in this claim, since September 28, 2022. • All receipts, canceled checks, copies of checks, cash withdrawal statements, or any other documentation showing payments made to any persons or companies in relation to the damage claimed, the repair thereof, or any purchase or replacement related thereto. • All financial records, including checking account statements, savings account statements, credit card statements, and any other statements of other lines of credit, which reflect financial accounts you used or had access to from September 28, 2022 to present, and which were involved in any deposit or transfer of insurance proceeds or which pertain to any withdrawal or payment related to a repair or replacement of damaged items or areas related to the subject loss. • All estimates, invoices, reports, or other documents pertaining to inspections of the property made since September 28, 2022. • All documents reflecting your hiring or non-hiring of a public adjuster to represent you as to this claim. • All documents relating to any lawsuit brought by you against an insurer, or by an insurer against you, within the past fifteen (15) years. • An executed Sworn Proof of Loss for Claim 05000001538; • A copy of any estimate(s) prepared by your public adjuster/loss consultant for Claim 05000001538 • Any Assignment of Benefits You signed for 05000001538 • Any water remediation or mold remediation documents for Claim 05000001538 • All documents relating to the adjustment of Claim 05000001538. • Any receipts, invoices, photographs, or supporting documents that show amounts spent on repairs, to date. • Any receipts, invoices, photographs, or supporting documents related to any and all contents damage you are claiming, including preparing an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. • Any receipts, invoices, photographs, or supporting documents related to any and all roof damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all exterior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all interior damage you are claiming. • Any receipts, invoices, photographs, or supporting documents related to any and all business interruption you are claiming. • Your itemized contractor’s estimate; • Any and all mitigation invoices; • Any and all business personal property inventory; • Any and all payments and documents You received from TAD Recovery Services from September 28, 2017. • Any and all payments and documents You received from Eco Roof from September 28, 2017. • Any and all payments and documents You received from Crowther Roofing from September 28, 2017. • Any and all payments and documents You received from Hartford Insurance Company for the Insured’s pending flood claim. • Any and all payments and documents You received from Aaron Harris, P.E. from September 28, 2017. • Any and all payments and documents You received from Write Loss from September 28, 2017. • Any and all payments and documents You received from LGT Restoration Services from September 28, 2017. • Any and all payments and documents You received from Powerhouse Home Services from September 28, 2017. • Any and all payments and documents You received from General Air & Plumbing from September 28, 2017. • Any permit(s) pulled for repair and/or replacement of the subject property since September 28, 2017. • Any and all documents that support you damages claimed for business loss. RESERVATION OF RIGHTS In furtherance of our investigation, Frontline has not been able to resolve your loss. We must inform you that based upon our continued investigation during the claims process, we have identified issues that may restrict, limit, or exclude coverage, specifically lack of mitigation or repair to the roof damages. As such, we will continue our investigation under a full Reservation of Rights. WE ARE CONTINUING TO EVALUATE YOUR CLAIM INVOLVING YOUR INSURED PROPERTY AND MAY ISSUE ADDITIONAL PAYMENTS. IF YOU HAVE QUESTIONS, CONCERNS, OR ADDITIONAL INFORMATION REGARDING YOUR CLAIM, WE ENCOURAGE YOU TO CONTACT US. … You are required to attend this examination under oath pursuant to the terms of the insurance policy under which you are seeking recovery. Your duties after loss also obligate you to provide the requested documents. Pursuant to the terms of the insurance policy and Florida law, if you fail or refuse to attend the examination under oath, you may be denied further recovery under the policy. Your attendance at this examination under oath is a condition precedent to your recovery under the policy - your claim may be denied if you do not attend the examination under oath.” Moreover, the Notice does not comply with the specificity requirements of §627.70152(3)(a), Fla. Stat. First, it does not appear that the Insured has been put on proper statutory notice of this Notice of Intent to Initiate Litigation as their email address listed (Garrett@mbcounsel.com) is identical to the email address listed for their counsel’s office. If the Insured has not been made aware of this Notice, it is fatally deficient, and an amended Notice must be filed. Next, both the “disputed amount” and “pre-suit settlement demand” are seemingly based on an estimates or bids calculated on a replacement cost basis. Replacement cost benefits are not due and owing until and unless the work necessary to repair or replace the covered property is performed and the expenses are incurred. Next, without waiving the deficiencies with the Notice, and subject to a complete reservation of rights, Frontline selects mediation pursuant to the options available under § 627.70152(4)(b), Fla. Stat. as the parties are already in the process of appraisal pursuant to the insurance contract. This response is based on Frontline’s investigation, review, and evaluation of the claim and the information provided by the Insured and their representatives to date. If there is additional information or documentation pertinent to the Insured’s claim that has not previously been submitted, please submit it now for review and evaluation prior to mediation. By selecting mediation pursuant to § 627.70152 Fla. Stat. as Frontline’s response to this premature Notice, Frontline does not waive any rights under the policy or law, including waiver of the previously requested examination under oath pursuant to the insurance contract. Nothing in this letter shall constitute a waiver of any right or an admission of any obligation under the policy. Nor shall any conduct of Frontline or its agents, attorneys, or employees be construed as an estoppel, waiver, modification, or surrender of the terms, limitations, exclusions, conditions, or agreements of the insurance policy. As such, Frontline reserves all its rights and defenses under the policy and Florida law, as well as the right to investigate, review, and evaluate any properly stated dispute in the event Frontline receives a statutorily compliant notice of intent or new or additional information. A copy of this response was sent to the Insured(s) pursuant to the email address listed within the Notice of Intent to Initiate Litigation. If you have any questions or concerns, please feel free to contact Frontline Insurance Unlimited Company’s representative.” Thereafter, on November 21, 2024, the undersigned took an Examination Under Oath of the Complainant. Throughout the entire claims process, Frontline was in constant communication with the Complainant and its (numerous) representatives regarding the status of the claim. II. Nature of the Complainant’s Civil Remedy Complaint In the Civil Remedy Notice, the Complainant alleges Frontline: (1) denied the claim, (2) delayed the claim, (3) made an unsatisfactory settlement offer, (4) engaged in unfair trade practices, (5) failed to attempt in good faith to settle the claim, (6) failed to promptly settle the claim, (7) failed to adopt and implement standards for the proper investigation of the claim, (8) misrepresented pertinent facts or insurance policy provisions relating to coverage for the claim, (9) failed to acknowledge and promptly respond to communications for the claim, (10) denied the claim without conducting a reasonable investigation based upon the available information, (11) failed to affirm or deny full or partial coverage of the claim, (12) failed to promptly provide a reasonable explanation in writing to the Insured of the basis in the insurance policy for the denial of the claim, (13) failed to promptly notify the Insured of any additional information needed to process the claim, (14) failed to clearly explain the nature of the requested information and the reasons why such information was necessary, (15) failed to pay undisputed amounts of partial or full benefits owed under the Policy within 60 days after receiving notice of the claim, and (16) failed to pay the claim within the time periods required by s. 627.736(4)(b). These boilerplate accusations are misleading, inaccurate, and unfair given the nature of the facts and damages surrounding this claim. Here, the claim was thoroughly processed, the Complainant’s property was inspected multiple times, coverage was afforded multiple times, coverage letters which outlined the pertinent facts and included the reasoning behind the coverage decisions were sent to the Complainant and its representatives, and payments were promptly sent. Moreover, the Complainant has not included a specific cure for their Civil Remedy Notice. Instead, they merely state that, “Swan Lake recently attended mediation in good faith and to negotiate a resolution. However, the mediation resulted in an impasse. Frontline’s continuing breach of their policy of insurance can no longer be tolerated. Swan Lake has a statutory duty to its members and takes that responsibility seriously. It is Swan Lake’s expectation that Frontline will do the same and recognize that a payment is due immediately. Frontline should also be forced to comply with the numerous statutory obligations required of it and should end its deliberate efforts to delay the timely handling of the claim filed by its insured.” In response, Frontline would state that the Complainant has failed to provide a proper “final cure” request in that they failed to list the FINAL amount for all damages, and thus, the insurer would be unable to cure the alleged violation. It should also be noted that the Complainant’s Civil Remedy Notice is deficient in the following aspects: • Section 624.155(3)(b)(2), Florida Statutes, requires that the Civil Remedy Notice state with specificity the facts and circumstances giving rise to the violation. The Purported Notice does not supply facts or circumstances that explain the allegations. Rather, it includes false allegations, incorrect facts, and fails to explain how the purported facts constitute violations of Florida law. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. III. Conclusion As can be seen from the above, Frontline has credible evidence to support its belief that the claim was properly adjusted. The claim was thoroughly processed, the Complainant’s property was inspected multiple times, coverage was afforded multiple times, coverage letters which outlined the pertinent facts and included the reasoning behind the coverage decisions were sent to the Complainant and its representatives, and payments were promptly sent. Furthermore, Frontline believes that the Complainant’s position is untenable due to the facts surrounding the claim. Frontline has spent considerable time (and continues to spend time) and resources in the investigation of this matter and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Complainant’s claim and unfairly paints Frontline in a negative light. Finally, the Civil Remedy Notice is deficient in that it fails to specifically identify a number of highly relevant details concerning this claim, as well as failing to meet the requirements under 624.155. Sincerely, Sheldon A. Seale, Esq. On Behalf of Frontline Insurance Unlimited Company d/b/a Frontline Insurance
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