Civil Remedy Notice of Insurer Violations
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Filing Number:     799710
Filing Accepted:  1/7/2025
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Complainant
Last/Business Name *  
BERRY   First Name   MONA AND CHRIS
Street Address * 700 42ND AVENUE SOUTH
City, State Zip * ST. PETERSBURG, FL 33705
Email Address * MONAT2000@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BERRY   First Name   MONA AND CHRIS
Policy # * FPH5546963-00 Claim #* FPI250820
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial
Street Address* 2501 S. TAMIAMI TRAIL
City, State Zip* SARASOTA , FLORIDA 34239
Email Address * ESERVICE@ROSSLEGALFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FLORIDA PENINSULA INSURANCE COMPANY
NAIC Company Code 10132
 
Name of individual responsible for violation (if any):* RORY THREATT AND CANDISE JONES, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY FLORIDA PENINSULA INSURANCE COMPANY INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Dwelling Coverage provisions Perils Insured Against Loss Payment Loss Settlement
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Florida Peninsula Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Mona Berry and Chris Berry (“INSURED”) claim of loss. Florida Peninsula Insurance Company’s mailing address is 903 NW 65th St, Suite 200, Boca Raton, FL 33487. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSUREDS’ property located at 700 42nd Avenue South, St. Petersburg, FL 33705 which sustained significant damage from windstorm on or about October 9, 2024. The INSUREDS immediately reported the loss to the carrier allowed for inspection. The INSURER inspected the property and determined that the property suffered damage totaling $5,796.76, which fell below the deductible amount. The INSUREDS retained Claim Rescue LLC to assist with determining the amount of damage sustained. Claim Rescue prepared an estimate in the amount of $288,408.94, consisting of $280,112.33 under Dwelling and $8,296.61 under Other Structures. See estimate attached hereto. Florida Peninsula accepted coverage for damage to the roof, but only for one shingle square and one square of modified bitumen roof, which is not possible to install. The carrier also accepted coverage for the wood fence, but the Insureds have a vinyl fence. Broken windows were not accepted in the carrier estimate, however the windows were broken due to wind during the storm when a tree branch broke through. Therefore, demand is hereby made as follows: Estimate $295,571.94 Less Deductible $14,658.00 TOTAL $280,913.94 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §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 in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $280,913.94 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: PA Estimate, contents list
Comments
User Id Date Added Comment
pcole@conroysimberg.com 02-26-2025 We are in receipt of a Civil Remedy Notice of Insurer Violation (“CRN”) filed on behalf of Florida Peninsula Insurance Company’s Named Insureds, Mona Berry and Chris Berry, which was accepted by the Department of Financial Services on January 7, 2025, and assigned Filing No. 799710. The CRN revolves around a claim (FPI250820) filed for alleged damage from a windstorm, named Hurricane Milton, that occurred on October 9, 2024 at the Insureds’ single-family residence located at 700 42nd Avenue South, St. Petersburg, Florida 33705. The home was built in 1949 and is comprised of a shingle roof that was installed in 2022. At the time of loss, the Insured’s home was covered under an HO3 Policy, Policy number FPH5546963-00, issued by Florida Peninsula Insurance Company (“The Company”). At the outset, it should be stated that the CRN is defective and does not conform with the requirements of filing a CRN as it contains inaccurate factual allegations, lacks the required specificity and does not provide an opportunity for the Company to reasonably respond to the alleged violations contained in the CRN. The CRN merely contains conclusory reasons for the Notice, such as failing to settle claims in good faith, failing to implement standards for the proper investigation, and failing to acknowledge and act promptly upon communications, to name a few. For example, the Notice alleges that the Company violated the following statutory provisions of Florida Statutes §624.155: • §624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all other 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)(d) Denying claims without conducting reasonable investigations based upon available information. The CRN fails to identify specific facts as related to the broad and conclusory allegations. Blanket references to policy provisions and statutes without specification deems the Civil Remedy Notice deficient. Julien v. United Property and Casualty Insurance Co., 311 So.3d 875 (Fla. 4th DCA 2021). Notwithstanding, the Company explicitly denies violations of any applicable Florida Statute in the adjustment of the referenced claims. The Company specifically denies that it has not attempted in good faith to settle the Insured’s claim when under all the circumstances it could and should have done so and it denies that it has failed to act fairly and honestly toward its Insured’s interests. Moreover, the Company specifically denies that it refused to properly investigate the claim or refused to tender all insurance proceeds without waiver of its objections, rights and defenses, the Company maintains that it has acted and continues at all times to act in good faith during the investigation and adjustment of the Insured’s claim, and wishes to dispel even the inference of any violation, and reiterates below the reasons which clearly show the proper handling of the Insured’s claim. Additionally, the Civil Remedy Notice demands “cures” for the alleged defects that are improper under Florida case law. In Talat Enter., Inc., v. Aetna Cas. And Sur. Co., 753 So.2d 1278, 1281 (Fla. 2000), the Supreme Court of Florida held that the scope of what can be “cured” is limited to the alleged non-payment of the contractual amount due to an insured. As a result, Florida Peninsula Insurance Company objects to the CRN as it is defective and should be rejected. In order to understand the deficiencies of this Notice, however, and reserving all objections to the subject CRN, the background of this case is necessary. On October 23, 2024, the insureds reported this Hurricane Milton claim as having occurred on October 9, 2024. The insureds reported interior and exterior damage. It is important to note that from the start, Florida Peninsula Insurance Company (the “Company”) communicated with its Insureds and/or their representatives on a regular basis. In fact, when the claim was reported on October 23, 2024, a first notice of loss letter acknowledging the claim was immediately sent out to the insureds advising the homeowners of their Bill of Rights as Insureds, and their pre-suit mediation opportunities. Further, later in the claim adjustment process, the Insureds were advised of those same rights again, so it was very clear that the Insureds were informed of what they could do to protect themselves under the circumstances should they disagree with the Carrier’s handling and decision. The insureds retained a public adjuster (“PA”) from Claim Rescue, LLC who provided a letter of representation on October 24, 2024. The Company provided the PA with a certified copy of the insurance policy on November 20, 2024 as requested. By letter dated November 19, 2024, a coverage determination was issued wherein the Insureds were advised that based on the estimate, the damage to the property was less than the insureds’ contractual deductible which was $14,658.00. Therefore, the Company advised it was unable to make a payment for the claim. The November 19th letter also notified the insureds based on the investigation of the claim, and the terms of the policy, it had determined that there was no coverage for part of the claim. Specifically, the Company explained that the damages to the home, including the stucco, appeared to be consistent with wear and tear, which was considered a result of normal aging and maintenance issues rather than damage caused by a covered storm event. The Company also advised that the damage to the soffit appeared to be a result of rot, which was also not covered by the policy. The Company further advised that the interior damages of the home were determined to be the result of wind-driven rain, which unfortunately such type of damage was not covered under the policy as it fell outside the scope of covered perils. Lastly, the Company advised that, similarly, the damages to the garage were also determined to be the result of wind-driven rain which was not covered under the policy. The insureds then retained counsel who filed a Notice of Intent to Initiate Litigation on January 7, 2025 which contained a demand in the amount of $309,205.00. The Company responded to the NOIL by letter dated January 20, 2025. Counsel also filed the Civil Remedy Notice with the Department on behalf of the Insureds on January 7, 2025. The Insured’s counsel complains that there is a disagreement as to scope and pricing in this case, among other items. While that might be true, that does not rise to the level of a statutory violation, it is merely a disagreement with the value of the loss. Certainly, as is noted above through the chronology of this loss, an appropriate claims handling procedure was in place to give due consideration to the claim. Florida Peninsula Insurance Company has communicated with its Insured and his representatives as required. Florida Peninsula Insurance Company has inspected the loss and damages thoroughly and given a thorough assessment of its findings and conclusions made. The fact that Florida Peninsula Insurance Company was not in agreement with the position of the Insured or her representatives and the estimates prepared on her behalf, does not rise to the level of statutory violations. Certainly, as is noted above through the chronology of this loss, an appropriate claims handling procedure was in place to give due consideration to the claim. As demonstrated above, the Company has, thus far, undertaken a thorough adjustment process and investigation, and the decision that it has made as to what is compensable and what is not has been amply explained to the Insured. The Company has, at all times, acted fairly and promptly toward its Insured and with full regard to her interests, and has complied with its obligations in this claim process. Any further information which may be required is available upon request.
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