Civil Remedy Notice of Insurer Violations
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Filing Number:     798946
Filing Accepted:  1/2/2025
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Complainant
Last/Business Name *  
KETAN   First Name   GHIA
Street Address * 503/509/511 US ALT 19
City, State Zip * PALM HARBOR, FL 34683
Email Address * BFIZER@FIXITORELSE.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   KEVTAN LLC   First Name  
Policy # * BGFL0021045104 Claim #* UNKOWN
Attorney
Attorney is Applicable
Last Name* FIZER First Name * BRANDON Initial L
Street Address* 5120 CENTRAL AVE
City, State Zip* SAINT PETERSBURG , FLORIDA 33707
Email Address * BFIZER@FIXITORELSE.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CLEAR BLUE INSURANCE COMPANY
NAIC Company Code 28860
 
Name of individual responsible for violation (if any):* UNKOWN
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Unreasonable Investigation
Other : Failure to Communicate
* 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

CLAIMANT IS UNABLE TO INCLUDE POLICY LANGUAGE DUE TO CARRIER FAILURE AND/OR REFUSUAL TO TIMELY PROVIDE CLAIMANT WITH CERTIFIED POLICY AFTER CARRIER’S RECEIPT OF REQUEST FOR SAME.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

CLEAR BLUE INSURANCE HAS COMMITTED THE FOLLOWING IN HANDLING THE SUBJECT CLAIM: 1) CLAIM DELAY 2) NOT CONDUCTING FULL AND PROMPT INVESTIGATION 3) NOT ADJUSTING CLAIMS AND EVALUATING LOSS PROPERLY, PROMPTLY, AND FAIRLY TO PROVIDE FULL AND PROMPT INDEMNITY TO THE ENTITLED PARTIES 4) FAILING TO IMPLEMENT PROPER STANDARDS FOR THE ADJUSTMENT AND INVESTIGATION OF CLAIMS 5) FAILING TO MAKE A COMPLETE AND ACCURATE COVERAGE DETERMINATION FOR ALL DAMAGES 6) FAILING TO TIMELY RESPOND TO COMMUNICATIONS AND REQUESTS MADE BY CLAIMANT. IN FLORIDA THE WORK OF ADJUSTING INSURANCE CLAIMS ENGAGES THE PUBLIC TRUST. THE CARRIER HAS BREACHED THIS DUTY, EVIDENCED BY HOW IT HAS ADJUSTED THE SUBJECT CLAIM OF LOSS. THE CARRIER HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR PROPER INVESTIGATION, REMEDIATION/MITIGATION, CLAIMS EVALUATIONS, CLAIMS HANDLING, AND THE TRAINING AND SUPERVISION OF ITS AGENTS AND EMPLOYEES, RESULTING IN VIOLATIONS AS SET FORTH ABOVE AND FURTHER EXPLAINED BELOW. CLEAR BLUE INSURANCE COMPANY ISSUED A POLICY OF GENERAL LIABILITY INSURANCE ASSOCIATED WITH POLICY NUMBER BGFL0021045104 TO KEVTAN, LLC. SUBSEQUENTLY, WHILE THE SUBJECT POLICY WAS IN FULL FORCE AND EFFECT, KETAN GHIA HIRED KEVTAN, LLC TO REPLACE THE ROOF AT THE PROPERTY LOCATED AT 503/509/511 US ALT 19, PALM HARBOR, FL 34683. KEVTAN, LLC FAILED TO PROPERLY REPLACE THE ROOF AND SUBSEQUENT WATER INTRUSION DAMAGED THE SUBJECT PROPERTY. AS A RESULT OF SAME, A CLAIM WAS REPORTED TO CLEAR BLUE INSURANCE COMPANY ON OR ABOUT AUGUST 15, 2024. DESPITE NOTIFICATION TO THE CARRIER OF THE SUBJECT INSURANCE CLAIM, THE CARRIER HAS DELAYED IN ADJUSTING THE LOSS, ISSUING A COVERAGE DETERMINATION, AND PAYING OR TENDERING TO THE INSURED ALL INSURANCE PROCEEDS DUE AND OWING TO THE CLAIMANT UNDER THE SUBJECT POLICY. AS A RESULT OF THE CARRIER’S MISHANDLING OF THE SUBJECT CLAIM, KETAN GHIA RETAINED THE UNDERSIGNED COUNSEL TO ASSIST IN RESOLUTION OF THE SUBJECT CLIAM. ON OR ABOUT DECEMBER 2, 2024, THE LAW OFFICES OF FIZER FLORES SENT ITS LETTER OF REPRESENTATION TO CLEAR BLUE INSURANCE COMPANY VIA U.S. CERTFIED MAIL. DELIVERY OF SAID LETTER WAS CONFIRMED VIA CERTIFIED MAILED RECEIPT ON DECEMBER 9, 2024. WITHIN THE LETTER OF REPRESENTATION, THE FOLLOWING INFORMATION WAS REQUESTED: A) THE NAME OF YOUR INSURANCE CARRIER; (B) THE NAME OF EACH INSURED ON YOUR POLICY; (C) THE LIMITS OF LIABILITY COVERAGE; AND (D) A COMPLETE COPY OF THE INSURANCE POLICY AND DECLARATIONS PAGE. PURSUANT TO FLORIDA STATUTE 627.4137, UPON RECEIPT OF SUCH A REQUEST, A CARRIER IS TO PROVIDE THE INFORMATION NO LATER THAN 30-DAYS OF SUCH REQUEST. AS OF THE FILING OF THIS CIVIL REMEDY NOTICE, CLEAR BLUE INSURANCE COMPANY HAS FAILED AND/OR REFUSED TO ACKNOWLEDGE AND RESPOND TO THE AFOREMENTIONED LETTER OF REPRESENTATION. CLEAR BLUE INSURANCE COMPANY KINOWS THAT THE CLAIMAINT CANNOT CONTINUE TO PURSUE RESOLUTION OF THE SUBJECT CLAIM WITHOUT THE REQUESTED INFORMATION AND IT IS TACTFULLY REFUSING TO PROVIDE SAME IN A VEILED EFFORT TO AVOID PAYING MONIES DUE AND OWING UNDER THE SUBJECT LOSS. ULTIMATELY, THE CARRIER HAS FAILED AND/OR REFUSED TO PROPERLY ADJUST THE LOSS. THE CLAIMANT HAS REQUESTED THAT THE CARRIER ADMIT FULL COVERAGE AND PAY FULL DAMAGES; THE CARRIER HAS FAILED AND/OR REFUSED TO DO SO. THE CARRIER CONTINUES TO REFUSE TO INDEMNIFY THE CLAIMANT FOR ITS LOSS AND PAY THE APPROPRIATE AMOUNT OF DAMAGES TO REPAIR THE SUBJECT PROPERTY. THE CARRIER DOES THIS DESPITE KNOWING IT IS REQUIRED TO DO SO, AND DELAYING OR DENYING THE CLAIM WILL ONLY LEAD TO MORE DAMAGE. IN SHORT, THE CARRIER HAS FAILED TO HANDLE THE SUBJECT CLAIM IN GOOD FAITH. FLA. STAT. § 624.02 DEFINES INSURANCE AS A CONTRACT WHEREBY ONE UNDERTAKES TO INDEMNIFY ANOTHER OR PAY OR ALLOW A SPECIFIED AMOUNT OR A DETERMINABLE BENEFIT UPON DETERMINABLE CONTINGENCIES. INHERENT IS THE FACT THAT PAYMENT MUST BE MADE TIMELY AND PROMPTLY SO THAT THE INSURED MAY MITIGATE THEIR DAMAGES AND TO PUT THE INSURED BACK INTO THE POSITION HE WAS PRIOR TO LOSS AS QUICKLY AS POSSIBLE. THE CARRIER HAS BREACHED THIS DUTY. THE ACTIONS TAKEN BY EDISON AND ITS ADJUSTERS IN THE HANDLING/ADJUSTMENT OF THE INSURED’S CLAIM WERE WILLFUL, WANTON, AND IN DISREGARD FOR THE RIGHTS OF ITS INSURED. THEY OCCUR WITH SUCH A FREQUENCY AS TO INDICATE A GENERAL BUSINESS PRACTICE, AND ARE IN VIOLATION OF FLA. STAT. §§ 624.155 AND 626.9541. THE CARRIER’S ACTIONS AMOUNT TO BUT ARE NOT LIMITED TO THE FOLLOWING: 1. CLAIM DELAY 2. NOT CONDUCTING FULL AND PROMPT INVESTIGATION 3. NOT TREATING POLICYHOLDERS WITH GOOD FAITH CLAIMS CONDUCT 4. LOOKING FOR WAYS TO REDUCE RECOVERY TO THE CLAIMANT 5. LOOKING FOR WAYS TO DELAY FULL RECOVERY TO THE CLAIMANT 6. NOT ADJUSTING CLAIMS AND EVALUATING LOSS PROPERLY, PROMPTLY AND FAIRLY TO PROVIDE FULL AND PROMPT INDEMNITY TO THE CLAIMANT 7. FAILING TO IMPLEMENT PROPER STANDARDS FOR THE ADJUSTMENT AND INVESTIGATION OF CLAIMS 8. NOT TRAINING, SUPERVISING OR MANAGING ADJUSTERS PROPERLY SO THAT PROMPT AND FULL PAYMENTS ARE MADE, BUT RATHER PLACING THE COMPANY’S INTERESTS BEFORE THE CLAIMANT’S INTERESTS 9. NOT ESTABLISHING SEVERITY CONTROL INITIATIVES AND OTHERWISE ESTABLISHING A CULTURE OF NOT FULLY AND PROMPTLY PAYING CLAIMS FOLLOWING LOSSES 10. FAILING TO MAKE A COMPLETE AND ACCURATE COVERAGE DETERMINATION FOR ALL DAMAGES 11. FAILING TO PROMPTLY NOTIFY THE CLAIMANT OF ANY ADDITIONAL INFORMATION NECESSARY FOR THE PROCESSING OF THE CLAIM 12. FAILING TO TIMELY RESPOND TO COMMUNCIATIONS AND/OR REQUESTS OF THE CLAIMANT AND/OR ITS REPRESENTATIVES. THEREFORE, TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, EDISON MUST: (1). PROVIDE CLAIMANT WITH ALL REQUESTED DOCUMENTATION AND ADMIT FULL COVERAGE FOR THE CLAIMANT’S LOSS. (2). TENDER ALL INSURANCE MONIES DUE AND OWING TO THE CLAIMANT FOR THEIR LOSS IN AN AMOUNT EQUAL TO ALL DAMAGES UNDER THE SUBJECT POLICY. (3). PAY STATUTORY INTEREST ON THE AMOUNT OF UNPAID CONTRACT DAMAGES FROM THE DATE OF THE LOSS TO THE PRESENT TIME PURSUANT TO FLORIDA STATUTE § 627.70131, AND PAY REASONABLE ATTORNEY FEES AND COSTS INCURRED.
Comments
User Id Date Added Comment
karend@fwcrum.com 03-03-2025 To Whom It May Concern: FrankCrum General Agency, Inc. (“FCGA”) is the managing general agent handling claims on behalf of Clear Blue Insurance Company (“CBIC”), including a claim made against its insured Kevtan, LLC (incorrectly referenced in the Civil Remedy Notice of Insurer Violation as Kvetan LLC). Please accept this as CBIC’s report to the Department on the disposition of the alleged violations. CBIC maintains it has not been in violation of the statutory provisions Claimant alleges and that the CRN is legally insufficient. As an initial matter, CRN fails to allege facts and circumstances supporting each of the five statutory provisions allegedly violated by Clear Blue. For example, Complainant does not allege any facts to support its claim that Clear Blue violated section 626.9541(1)(i)(3)(c) for “[f]ailing to adopt and implement standards for the proper investigation of claims.” In response to Claimant’s allegation that she has not received a copy of the Policy after a request for same, a copy of the Policy along with an Affidavit pursuant to Florida statute section 627.4137 has now been provided to Claimant, through her counsel. This claim is about alleged resultant damages following a roofing job. Claimant states that CBIC’s insured, Kvetan LLC, failed to properly replace the roof and subsequent water intrusion damaged the subject property. Claimant is seeking damages related to the roofing and water intrusion and as a result, reported the claim. CBIC has previously properly denied this claim to its insured, Kevtan, LLC, and notified Claimant. The bases for denial are discussed below. The claim investigation has revealed that in or about August 1, 2024, Claimant entered into a contract to replace the roof at property located at 503-511 US ALT 19 in Palm Harbor, Florida. However, the Claimant’s contract for this work was with an entities called Matrix Capital Ventures LLC dba Fix Roofing and A&R Rubio, not Kevtan, LLC. Relative to the time of the contract and work, Clear Blue Insurance Company issued commercial general liability insurance policy number BGFL0021045104 to Kevtan LLC with policy period of April 15, 2024 to April 15, 2025, with a $1,000,000.00 per occurrence limit, a $2,000,000 general aggregate limit, and a $2,000,000 products/ completed operations aggregate limit. The Policy provides that Clear Blue “will pay those sums that the insured becomes legally obligated to pay as damages because of . . . ‘property damage’ to which this insurance applies. We will have the right and duty to defend the insured against any ‘suit’ seeking those damages.” The Policy provides coverage to entities that qualify as insureds, subject to the policies limitations, conditions, exclusions, and endorsements. Neither Matrix Capital Ventures LLC dba Fix Roofing nor A&R Rubio, the entities with whom Claimant entered into the roofing contract, are named insureds nor are they endorsed as insureds on the Policy. Further, for limited liability companies, such as Kevtan, LLC, the Policy defines and insured as follows: SECTION II - WHO IS AN INSURED 1. If you are designated in the Declarations as: c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. Based upon investigation and the Policy’s provisions, this claim is not made against an insured on the CBIC Policy and CBIC’s denial was proper on that basis. Further, the 2024-2025 Policy contains a Classification Limitation Endorsement which limits coverage only to those operations described in the Classification(s) of operations shown on the Policy’s Declarations or the Policy Coverage Schedule. Work performed outside of those operations is not covered. The Classification codes on Kevtan’s Policy are: 91342 CARPENTRY - CONSTRUCTION - RESIDENTIAL - Includes construction, service, and repair of residential property three stories or less in height with primary work of rough carpentry, framing, wood siding installation and finishing work. Excludes any exterior work exceeding three (3) stories in height. TERRITORY: 006 91341 CARPENTRY – INTERIOR – Includes the installation, service, repair, or removal of doors, shelving, floors, cabinets, windows and wood, hardwood, or parquet flooring. Includes installation of backing material related to wood flooring work. Not applicable to contractors engaged in any other carpentry operation at the same job or location. Excludes abatement work. Includes tear-out and removal of existing cabinetry & woodworking prior to installation. TERRITORY: 006 Even if the entities with whom Claimant entered into the roofing contract qualified as an insured, coverage would not be afforded in the matter based upon the roofing work falling outside of the Classification codes listed on Kevtan’s Policy. CBIC’s further basis for denial was proper. Finally, the 2024-2025 Policy contains an Excluded Operations endorsement, stating that the Policy will not provide any coverage or supplementary payments for defense or expense costs under any part of the policy for any claim arising wholly or in part out of any of certain enumerated activities, and includes: d) Roofing, roof work, or any activity of any kind on any roof, including any construction, repair, maintenance, cleaning or inspection of any roof; except chimney cleaning as provided by classification 91481 if covered. CBIC’s reference to this policy endorsement as further basis for its denial was proper. CBIC maintains that its claim denial was proper and that there is no coverage for this claim. As the claim was handled properly, there can be no violation of 624.155(1)(b)(1), as there is no duty to cover and settle the claim. Please note that CBIC’s response is not necessarily exhaustive and does not preclude CBIC from asserting any other valid reason for the purported lack of compliance with Florida Statute 624.155. This letter and any failure to act on the part of CBIC or any agent or representative of CBIC should not be construed as a waiver of any rights or defenses. All such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations alleged in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Sincerely, /s/ Karen R. Dunbar, Esq.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008