Civil Remedy Notice of Insurer Violations
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Filing Number:     800488
Filing Accepted:  1/10/2025
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Complainant
Last/Business Name *  
DICUS   First Name   FRANK AND PATTI
Street Address * 10442 HERITAGE BAY BLVD.
City, State Zip * NAPLES, FL 34120
Email Address * IAMFRANKD@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   DICUS   First Name   FRANK AND PATTI
Policy # * FH-0000162824-08 Claim #* HO0124425848
Attorney
Attorney is Applicable
Last Name* O'NEIL First Name * JONATHAN Initial
Street Address* 203 FORT WADE, SUITE 260
City, State Zip* PONTE VEDRA , FLORIDA 32081
Email Address * JONATHAN@WOOLSEYMORCOM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   MONARCH NATIONAL INSURANCE COMPANY
NAIC Company Code 15715
 
Name of individual responsible for violation (if any):* ROSMEY HONDARES (FLA. ADJ. LIC. #W626491)
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Wrongful claim denial
Other : Unfair claim settlement practices
Other : Unreasonable investigation
Other : Failure to act on claim
Other : Failure to conduct a reasonable investigation based on available information
Other : Failure to maintain proper complaint handling procedures
Other : Misrepresenting the insurance policy provisions to the insured
Other : Misrepresenting Florida statutory provisions to the insured
Other : Misrepresenting facts to the insured
Other : Failure to acknowledge and act promptly upon communications with respect to claims
Other : Denying claims without conducting reasonable investigations based upon available information
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Coverage A – Dwelling and Coverage B – Other Structures: We insure against risk of direct physical loss to property described in Coverages A and B only if that loss is a physical loss to property. **** [A]ny ensuing loss to property described in Coverages A and B not excluded or excepted in this policy is covered. **** Coverage C – Personal Property: We insure for direct physical loss to the property described in Coverage C caused by a peril listed below unless the loss is excluded in the SECTION – I Exclusions . . . 2. Windstorm or hail. **** ADDITIONAL COVERAGES **** 1. Debris Removal. We will pay your reasonable expense for the removal of: a. debris of covered property if a Peril Insured Against causes the loss; or b. ash, dust or particles from a volcanic eruption that has caused direct loss to a building or property contained in a building. Debris removal expense is included in the limit of liability applying to the damaged property. 2. Emergency Mitigation Serivces. We will pay the reasonable cost incurred by you for “emergency mitigation services”. The most we pay for such costs is limited to the greater of: (1) $3,000; or (2) 1% of the limit that applies to your Coverage A limit of liability. **** 3. Trees, Shrubs and Other Plants We cover trees, shrubs, plants or lawns, on the "residence premises," for loss caused by the following Perils Insured Against: Fire or lightning, Explosion, Riot or civil commotion, Aircraft, Vehicles not owned or operated by a resident of the "residence premises," Vandalism or malicious mischief or Theft. We will pay up to 5% of the limit of liability that applies to the dwelling for all trees, shrubs, plants or lawns. No more than $500 of this limit will be available for any one tree, shrub or plant. We do not cover property grown for “business” purposes. This coverage is additional insurance. **** 11. Ordinance Or Law a. You may use up to 25% of the limit of liability that applies to Coverage A for the increased costs you incur due to the enforcement of any ordinance or law which requires or regulates: (1) The construction, demolition, remodeling, renovation or repair of that part of a covered building or other structure damaged by a Peril Insured Against; (2) The demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must be totally demolished because of damage by a Peril Insured Against to another part of that covered building or other structure; or (3) The remodeling, removal or replacement of the portion of the undamaged part of a covered building or other structure necessary to complete the remodeling, repair or replacement of that part of the covered building or other structure damaged by a Peril Insured Against. b. You may use all or part of this ordinance or law coverage to pay for the increased costs you incur to remove debris resulting from the construction, demolition, remodeling, renovation, repair or replacement of property as stated in a. above. **** 12. “Fungi”, Wet Or Dry Rot, Or Bacteria a. The amount shown in the Declarations for this ADDITIONAL COVERAGE is the most we will pay for: (1) The total of all loss payable under SECTION I – PROPERTY COVERAGES caused by “fungi”, wet or dry rot, or bacteria; (2) The cost to remove “fungi”, wet or dry rot, or bacteria from property covered under SECTION I – PROPERTY COVERAGES; (3) The cost to tear out and replace any part of the building or other covered property as needed to gain access to the “fungi”, wet or dry rot, or bacteria and; (4) The cost of testing of air or property to confirm the absence, presence or level of “fungi”, wet or dry rot, or bacteria whether performed prior to, during or after removal, repair, restoration or replacement. The cost of such testing will be provided only to the extent that there is a reason to believe that there is the presence of “fungi”, wet or dry rot, or bacteria; and (5) Any loss of use or delay in rebuilding, repairing or replacing covered property, including any associated cost or expense, due to interference at the “residence premises” or location of the rebuilding, repair or replacement, by “fungi”, wet or dry rot, or bacteria. Also refer to: Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

624.155(1)(a)(1) – violating 626.9541(1)(i) 626.9541(1)(a)(1) -- misrepresenting the terms of an insurance policy. 626.9541(1)(i) -- unfair claim settlement practices. Facts of the case: Monarch National Insurance Company (“MONARCH”) has committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of MONARCH; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) MONARCH has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring. In Florida, the work of adjusting insurance claims engages the public trust. MONARCH has breached this duty by its adjustment of the insured’s claim of loss. MONARCH has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above. MONARCH has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Despite the insured’s timely notification to MONARCH of their insurance claim, MONARCH has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. MONARCH has failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, MONARCH has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of the damages. In exchange for a premium paid by the insured, MONARCH issued the subject insurance policy which provided coverage for the insured property for “risk of direct physical loss to property described in Coverages A and B only if that loss is a physical loss to property.” As such, the subject all-risk Policy contains coverage for all direct physical losses to the insured property unless the loss is specifically and unambiguously excluded from coverage by the Policy. On or about September 28, 2022, (Hurricane Ian) the insured property suffered a windstorm loss and the insured immediately submitted a claim to MONARCH for property damage, i.e., storm and wind damage throughout the insured property. Hence, the insured suffered a substantial loss regarding the real property and continue to suffer such loss. Having suffered such substantial damage, the insured promptly notified MONARCH of the loss in an effort to mitigate the current damage and prevent the exacerbation of any additional losses. The desired result did not follow. MONARCH since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, MONARCH has failed and refused to properly settle the insured’s claim in good faith. The insured have requested that MONARCH conduct an investigation, admit coverage, and pay damages; MONARCH has failed and refused to do so. In short, MONARCH has failed to handle its insured’s claim in good faith in violation of Fla. Stat. 624.155(1)(b)(1), 624.155(1)(b)(3), and 626.9541(1)(i). Based upon MONARCH’s investigation and property inspection, which confirmed windstorm damages, MONARCH nevertheless sent correspondence to the insured dated July 31, 2024, (signed by MONARCH’s adjuster, Rosmey Hondares (Fla. Adj. Lic. #W6266491)) and communicated its unequivocal denial of the claim. In regard to insurance contracts, a specific refusal to pay a claim is the breach which triggers the cause of action. Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 892 (Fla. 2003); Donovan v. MONARCH Fire and Cas. Co., 574 So. 2d 285, 286 (Fla. 2nd DCA 1991) (finding that a breach of contract takes place at the moment the insurance company refuses to pay a claim). Therefore, MONARCH breached the Policy. Moreover, MONARCH’s argued exclusions and/or limitations to coverage are devoid of anti-concurrent causation language. Thus, “coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause.” Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694, 699 (Fla. 2016). In addition, under the Policy, any ensuing loss to property not excluded or excepted in this policy is covered. Hence, there are a myriad of coverages under the Policy that would provide coverage for the loss. Nevertheless, MONARCH failed and refused to acknowledge the covered loss and pay all amounts due and owing for the loss. Therefore, MONARCH breached the Policy. Questioning the propriety of MONARCH’s coverage denial, and given the extensive nature of the physical damage, the insured a loss consultant, Coastal Claims Services (“CCS”) to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on its investigation, CCS determined that a windstorm on or September 28, 2022, (Hurricane Ian) caused damage throughout the exterior of the insured property (particularly the roof warranting replacement). Moreover, CCS determined that at least $91,079.96 worth of repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss. Nevertheless, MONARCH failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, MONARCH breached the Policy. Thereafter, the insured sent correspondence to MONARCH enclosing their Sworn Statement in Proof of Loss and the supporting CCS report outlining the cause, scope, and cost of the loss along with other supporting documents and requested MONARCH to reconsider its coverage denial. Nevertheless, MONARCH failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, MONARCH breached the Policy. On January 10, 2025, the insured sent correspondence to MONARCH enclosing their Sworn Statement in Proof of Loss, the supporting CCS report outlining the cause, scope, and cost of the loss along with other supporting documents, the Notice of Intent to Initiate Litigation, and requested MONARCH to reconsider its coverage denial. To date, MONARCH has failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, MONARCH breached the Policy. As such, MONARCH’S coverage denial is a blatant misrepresentation of the available coverages under the Policy in direct violation of Fla. Stats. 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), 626.9541(1)(a)(1), and 626.9541(1)(i)(2) and is nothing more than a mere pretext to wrongfully deny and delay this claim. As a result, MONARCH has materially misrepresented the coverages under the subject policy to the insured for the purpose and with the intent of effecting settlement of the insured’s claim on less favorable terms than those provided in, and contemplated by, the subject policy in direct violation of Fla. Stat. § 626.9541(1)(i)(2). Further, MONARCH is in violation of Florida statutes §§ 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), and 626.9541(1)(a)(1) by misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue; and also in violation of Fla. Stat. 626.9541(1)(i)(3)(d) by denying the insured’s claim without conducting a reasonable investigation based upon available information. In summary, the insured’s loss is clearly covered by the terms of the policy of insurance with MONARCH. However, MONARCH chose to deny coverage for the insured’s loss. Despite clear evidence that the damages were covered and caused by a covered peril, the claim was denied. To date, MONARCH continues to deny the insured and its insured full indemnity for the claim. While MONARCH refuses to honor this claim, a jury in Collier County will likely do what MONARCH has refused; exercise the benefit of doubt in favor of the insured in finding full coverage for this loss. Indeed, the insured will undoubtedly meet the burden of proof at trial, under the MONARCH all-risk policy, to show that, while MONARCH provided insurance coverage, damage occurred to the insured property. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 942 (Fla. 4th DCA 2018). With the data presented within MONARCH’s investigation and CCS’s investigation, MONARCH’s burden to demonstrate by the greater weight of the evidence that all the physical damage to the insured property was caused solely by excluded perils under the policy and not in combination with a covered peril has not and cannot be met. See Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694 (Fla. 2016). Despite clear indicators of covered damage, MONARCH nevertheless inexplicably denied the insured’s claim. As of today, MONARCH has failed and refused to inform the insured of his rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has failed and refused to adequately indemnify the insured for the loss and defiantly continues to do so. Indeed, from the time of receiving the claim, MONARCH has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss. Notably, under Florida law, “[t]he filing of a lawsuit does not extinguish the insurer’s obligations under the policy to adjust and pay the claim.” Tristar Lodging, Inc. V. Arch Specialty Ins. Co., 434 F. Supp. 2d 1286, 1289 (M.D. Fla. 2006). To date, the insured has made a good faith effort to comply with all of the requirements under the subject policy of insurance, and it is only fair that MONARCH do the same. Yet, that is not the case. The insured feels that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, MONARCH is putting the insured property at risk. As a responsible property owner, the insured purchased insurance to protect the property, paid all of the premiums, and has kept up to date with the responsibilities under the policy. Yet, when the insured needed to rely on the insurance because of this unforeseen loss, MONARCH turned its back and delayed and wrongfully denied coverage that the insured is rightfully owed. Ultimately, MONARCH has failed and refused to properly investigate the loss. The insured has requested that MONARCH admit coverage and pay damages, MONARCH has failed and refused to do so, and continues to refuse to fully indemnify the insured for the loss and pay the amounts necessary to properly repair the insured’s property, despite knowing it is required to do so. In short, MONARCH has failed to handle its insured’s claim in good faith. In Florida, the work of adjusting insurance claims engages the public trust; MONARCH has breached this duty by its insufficient adjustment of the insured’s claim. MONARCH has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. MONARCH has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. 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 is the fact that payment must be made timely and promptly so that the insured may mitigate their damages to put them back into the position they were prior to loss as quickly as possible. MONARCH breached this duty. The actions taken by MONARCH in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such a frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541. MONARCH’S actions amount to but are not limited to the following: 1. Claim delay 2. Wrongful claim denial 3. Unfair trade practice 4. Unfair claim settlement practices 5. Unreasonable investigation 6. Failure to act on claim 7. Failure to conduct a reasonable investigation based on available information 8. Failure to maintain proper complaint handling procedures 9. Misrepresenting the insurance policy provisions to the insured 10. Misrepresenting Florida statutory provisions to the insured 11. Misrepresenting facts to the insured 12. Failure to acknowledge and act promptly upon communications with respect to claims 13. Denying claims without conducting reasonable investigations based upon available information 14. 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. 15. 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. 16. Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 17. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 18. Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 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 an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed. Therefore, to cure the defects outlined in this civil remedy notice, MONARCH must: (1): Admit full coverage for the insured’s loss; and (2): Tender all insurance monies due and owing to the insured for the loss under the subject Policy. A copy of this form submitted to the FDFS has been emailed and/or uploaded and also printed out and mailed to the following parties providing them notice of the filing of this civil remedy notice: Monarch National Insurance Company c/o HP Managing PO Box 13239 Tallahassee, FL 32317 claims@monarchnational.com
Comments
User Id Date Added Comment
jonathan@woolseymorcom.com 11-13-2025 Withdrawn
tacham@hpmanaging.com 03-11-2025 March 11, 2025 Via E-mail & Posting on DFS Website Jonathan O’Neil, Esq. 203 Fort Wade, Suite 260 Ponte Verda, Florida 32081 Jonathan@woolseymorcom.com RE: Complainant(s): Frank and Patti Dicus Insured(s): Frank and Patti Dicus Claim No: HO0124425848 Policy No: FH-0000162824-08 DFS Filing Number: 800488 Acceptance Date: January 10, 2025 Insurer: Monarch National Insurance Company To Whom it May Concern: Please allow this correspondence to serve as Monarch National Insurance Company’s (“Monarch”) official response to the Civil Remedy Notice of Insurer Violations (“Notice”). Monarch maintains that it has not been in any violation of the law and that the Notice is defective on its face and fails to comply with the specificity requirements under Florida Statute 624.155. As such, Monarch objects to the Department’s acceptance of the above-referenced Notice. Monarch has acted in good faith and with due regard for the insureds’ interests, and denies each and every allegation contained in the Notice. Monarch denies any wrongdoing in the adjustment and handling of the above-referenced claim, and denies any and all allegations that it committed any acts or violated any Florida statutes or law. Monarch has acted in good faith and in accordance with the terms and provisions of the applicable policy of insurance as well as with the law. Please note that nothing herein should be deemed as a waiver by Monarch. Monarch hereby expressly reserves all rights without exception or limitation. If you require additional information, please contact me. Sincerely, /s/ Tyler Acham, Esq. Tyler Acham In-House Counsel Monarch National Insurance Company
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