Civil Remedy Notice of Insurer Violations
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Filing Number:     799950
Filing Accepted:  1/8/2025
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Complainant
Last/Business Name *  
DANIEL A. WARNER   First Name  
Street Address * 8 SUGAR MILL LANE S
City, State Zip * FLAGLER BEACH, FL 32136
Email Address * DAW459@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   DANIEL A. WARNER   First Name  
Policy # * GL038FL0300028 Claim #* EV2024037222
Attorney
Attorney is Applicable
Last Name* GOTTLIEB First Name * MATTHEW Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MGOTTLIEB@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   GREAT LAKES INSURANCE SE
NAIC Company Code
 
Name of individual responsible for violation (if any):* LAURA SHAMHART
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
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)(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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the insured’s storm event claim. The carrier initially attempted to low-ball the claim. Subsequently, the insured prepared a loss package in the amount of $125,426.14 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $541.07 only, leaving a remainder in the amount of $124,885.07 to be paid in order to cure the breach, less any applicable policy deductible. The insured has complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About two hundred days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insured’s property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insured’s interests; refusing to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $125,426.14, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Idaly Ellis at (561)-892-9674 if you have any questions or concerns. Sincerely, Matthew Gottlieb Attorney at Law
Comments
User Id Date Added Comment
ebrooksherproperty@kpattorney.com 12-09-2025 This filed Civil Remedy Notice is hereby withdrawn pursuant to a settlement agreement between the claimant and the insurance carrier.
ebrooksherproperty@kpattorney.com 12-08-2025 This filed Civil Remedy Notice is hereby withdrawn pursuant to a settlement agreement between the claimant and the parties.
agirard@bakerdonelson.com 02-17-2025 Dear Sir or Madam: Baker, Donelson, Bearman, Caldwell & Berkowitz PC has been retained by Great Lakes Insurance SE (“GLISE”) to respond to that certain Civil Remedy Notice (“CRN”) assigned File Number 799950 by the Florida Department of Financial Services and filed by Daniel A. Warner (the “Insured”), concerning Policy Number GL038FL0300028 with effective period from September 15, 2023 to September 15, 2024 (the “Policy”). In response to the CRN, GLISE states as follows: As a preliminary matter, GLISE denies all allegations set forth in the Complainant’s CRN, submits that no such violations have occurred, and maintains the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida law. The CRN is form-pled, generic, intentionally vague, and replete with self-serving and unsupported conclusions of fact and determinations of law. In fact, the scant facts stated are belied by the information and documentation comprising the claim file materials, and which fail to show a bona fide claim for bad faith conduct. The Complainant appears to be wholly mistaken concerning material aspects of the claim adjustment, and it is apparent there is misinformation surrounding the actions GLISE took in adjusting this claim. The allegations and oversights in the CRN simply do not reflect the most basic facts surrounding this claim and the Policy, and the CRN should accordingly be rejected. The CRN form requires that the Complainant, “Pursuant to Section 624.155, F.S. please indicate all statutory provisions alleged to have been violated.” The Complainant’s CRN cites six statutes as allegedly violated, accusing GLISE of not attempting to settle in good faith, failing to promptly settle claims when the obligation to settle a claim has become reasonably clear, failing to adopt and implement standards for the proper investigation of claims, misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue, failing to acknowledge and act promptly upon communications with respect to claims, and failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy for denial of a claim or for the offer of a compromise settlement. The facts identified in the CRN, or lack thereof, do not support the alleged violation of any of the statutory provisions cited, and the Insured’s generic claim of bad faith conduct does not sufficiently apprise GLISE of the actual circumstances upon which this CRN is based. Rather it is merely a “form” notice not specific to this claim. The vague and generic nature of the violations alleged highlights the deficient nature of the CRN and severely hinders GLISE’s ability to meaningfully respond. The CRN should be rejected and returned accordingly. As for the requirements under Fla. Stat. § 624.155(3)(b)(4), the CRN vaguely and broadly cites to “Loss settlement provisions,” without identifying any specific policy language that is relevant to the alleged violations. This vague and overbroad citation to fails to sufficiently inform GLISE as to what specific provisions of the Policy were violated and, as a result, what actions would be needed to correct the violations, much less failing to provide any information as to how these obligations were violated, hindering GLISE’s ability to meaningfully respond. As a result, the CRN should be rejected and returned. The CRN’s lack of specificity extends to the “factual” allegations that purportedly gave rise to the issues complained of by the Insured. Florida’s form for Civil Remedy Notice of Insurer Violations instructs complainants, in relevant part, as follows: “To enable the insurer to investigate and resolve your claim, describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time.” The CRN falls short of these instructions and sets forth vague, generic, unsupported, form-driven, and inaccurate allegations and self-serving conclusions – all of which GLISE denies. The CRN’s failure to specify the facts that purportedly triggered its filing demonstrates yet another reason why the CRN should be rejected and returned. Accordingly, GLISE respectfully requests the CRN be rejected for the reasons cited above. Notwithstanding the foregoing, GLISE now responds to the few facts alleged in the CRN. The Policy concerned real property located at 8 Sugar Mill Ln S, Flagler Beach, Florida 32136 (the “Property”). The Policy provides $750,000 in dwelling coverage, $38,000 in other structure coverage, $75,000 for personal property coverage, and $75,000 for loss of use, with a water damage sublimit of $10,000. However, the Policy covers only direct physical loss to the Property, while specifically excluding coverage for, among other things, wear/tear/deterioration, mechanical breakdown or latent defect, and faulty or inadequate design, repair, maintenance, etc. On August 7, 2024, the Insured provided notice to GLISE of a water loss occurring on May 18, 2024, nearly three months earlier. The Insured specified that the loss was a roof leak from a storm. On that same day, Kanner & Pintaluga, P.A. sent a letter of representation of the Insured signed by Matthew Gottlieb (“Insured’s Counsel”). GLISE’s independent adjuster (“IA”) promptly inspected the Property on August 16, 2024. In addition to the inspection, the IA contacted Jacob Mausg of Ford Roofing (the “Roofer”) to inquire about the roof repairs and the cause of the damage to the roof. The Roofer was hired by the Complainant to make repairs to the roof, which had already been completed prior to the inspection, so no damage could be observed by the IA. The Roofer confirmed that the interior water damage was caused by a defective pipe jack or deteriorated flashing sealant. Such damage would not be covered by the Policy, which excludes coverage for damages caused by defects or deterioration, as were observed here. The Roofer further confirmed that there was no wind damage to the roof, and that the damages to the interior were the result of leakage and not a wind created opening that allowed water to access the interior. As for the damages to the living room, the Roofer confirmed that the damage occurred on a separate occasion from a different proximate cause, which would be a separate claim subject to a separate deductible. There is no evidence to support that Complainant is owed any additional coverage for the damages to the roof or living room. The Complainant’s own agent, the Roofer, contradicts that a covered loss occurred to either the roof or the living room. Accordingly, the IA did not include the damages to the roof and the living room in his estimate of the subject claim. A reservation of rights letter (the “Letter”) was sent to the Insured by Trident Claims Management, LLC, the third-party claims administrator responsible for adjusting the claim (the “TPA”), on or about August 22, 2024. The Letter reserved all GLISE’s rights under the Policy and provided a summary of coverages under the Policy. On September 23, 2024, Insured’s Counsel provided an estimate prepared by Arman Thompson of PK Estimates (the “PA”), which included a replacement of the roof and repairs to the living room, both of which the IA determined were not covered by the Policy. Shortly thereafter, on September 25, 2024, the IA communicated over e-mail with Insured’s Counsel to discuss the Insured’s claim. Insured’s Counsel suggested possible appraisal before even inquiring about the IA’s estimate. The IA took care to inform Insured’s Counsel in detail the reasons why the damage to the roof and living room ceiling was not covered, as discussed above. On September 27, 2024, Insured’s Counsel submitted to the TPA an estimate and an executed Sworn Proof of Loss in the amount of $125,426.14. Despite repeated attempts over several months to follow-up claim discussions with Insured’s Counsel to reach an agreed scope, including a call to the offices of Kanner & Pintaluga to confirm whether Mr. Gottlieb was still employed by the firm, neither the IA nor the TPA received any further communications from Insured’s Counsel. In fact, the CRN and accompanying correspondence signed by Mr. Gottlieb was the first contact had with Insured’s Counsel in more than three months. Unable to reach Insured’s Counsel for negotiation, on November 19, 2024, the TPA issued a coverage determination letter explaining the settlement of the Insured’s Claim and enclosing the IA’s estimate. A payment of $541.07 was sent that same day to Insured’s Counsel under separate cover. Insured’s Counsel neglected to respond to either correspondence. The CRN followed nearly two months later. The CRN’s allegations are largely just a list of statutory duties which essentially mirror the previously cited statutes, including allegations that GLISE: has not treated the insured with good faith claims conduct; failed to pay a claim clearly owed; has not adjusted the claim and evaluated the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failed to implement proper standards for the adjustment and investigation of claims by its adjusters and placed the company’s interests before the insured’s interests; refused to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. These allegations could not be further from the truth. The Complainant did not promptly put GLISE on notice of the loss, instead waiting nearly three months to do so, which action is in breach of the Complainant’s duties after loss and hindered GLISE’s investigation. As the summary above shows, GLISE promptly acknowledged and investigated the Insured’s claim of loss. GLISE inspected the Property and made numerous attempts to contact Insured’s Counsel, which went unanswered for nearly three months. Unable to make contact despite its best efforts, GLISE issued a coverage determination letter on November 19, 2024. The Complainant has offered no allegations, details, or evidence to support the finding that he is owed any payment whatsoever under the express terms, conditions, and exclusions of the Policy, much less provided a basis by which he could support a claim for bad faith. Notwithstanding the Complainant’s late reporting, GLISE provided written comprehensive reasons for why the claim had been partially denied. Absent any evidence contradicting its well-reasoned and extensively supported conclusions, GLISE has no reason to alter the stance set forth in its coverage determination letter. To cure the purported bad faith, the CRN demands GLISE: (1) pay the complete covered loss in the amount of $125,426.14, less any prior payments and less any applicable policy deductible; and (2) pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. GLISE has not been provided with any evidence that the Insured is due any further coverage for this claim under the Policy. Absent any proof indicating otherwise, no further coverage can or should be afforded at this time. Moreover, GLISE has made every effort to correspond with the Insured and his representatives as promptly and as thoroughly as possible throughout the entire adjustment process and has completed its adjustment in accordance with Florida law and the express terms and conditions of the Policy. Therefore, no basis exists to afford the Complainant the relief requested. Accordingly, for the reasons set forth above, GLISE respectfully requests that the Civil Remedy Notice of Insurer Violations be rejected and returned. While this response is meant to be comprehensive, it is based upon the limited, vague allegations set forth in the Complainant’s CRN and information made available to GLISE to date. Accordingly, this response to the Complainant’s CRN is not necessarily exhaustive and shall not preclude GLISE from asserting any other valid reason(s) for the rejection and return of the Complainant’s CRN. Further, GLISE expressly reserves all available rights and defenses available to it under the subject insurance policy, as well as Florida law. GLISE has always complied with the provisions of the applicable policy of insurance, while consistently acting fairly, honestly, and in good faith towards the Insured, with the utmost regard for the Insured’s interests. Neither this response, nor any actions taken by GLISE, should be construed as a waiver of any rights or defenses available under the subject policy, or Florida law. We trust this correspondence adequately addresses the matters raised in the Complainant’s CRN, but please do not hesitate to contact us with any questions, concerns or requests for additional information concerning this matter. Sincerely, David B. Levin
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