Civil Remedy Notice of Insurer Violations
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Filing Number:     800875
Filing Accepted:  1/14/2025
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Complainant
Last/Business Name *  
APARTAMENTOS QUINCE LLC   First Name  
Street Address * 3446-3448 SW 15TH STREET
City, State Zip * MIAMI, FL 33145
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   APARTAMENTOS QUINCE LLC   First Name  
Policy # * FSF1671706A 002 Claim #* KY23K2720993
Attorney
Attorney is Applicable
Last Name* MITCHELL First Name * JAMES Initial E.
Street Address* 12955 BISCAYNE BLVD., SUITE 201
City, State Zip* 33181 , FLORIDA 33181
Email Address * JMITCHELL@CMSLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   WESTCHESTER SURPLUS LINES INSURANCE COMPANY
NAIC Company Code 10172
 
Name of individual responsible for violation (if any):* SPENCER CASPERS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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)(d) Denying claims without conducting reasonable investigations based upon available information.
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.

Apartamentos Quince LLC, 235 Realty Holdings LLC, Apartmentos La Siete LLC, and Compania 112 Miami paid for a policy of insurance with Westchester Surplus Lines Insurance Company, which provides coverage for damages to Apartamentos Quince LLC’s (the “Insured”) property, including significant damage sustained as the result of fire. The Insurance Company has failed and refused to fully, timely and properly compensate the Insured for the damages suffered as the result of this covered loss. The Insured believes the following Policy language is at issue: BUILDING AND PERSONAL PROPERTY COVERAGE FORM 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 . . . b. Your Business Personal Property . . . c. Personal Property Of Others . . . 2. Property Not Covered Covered Property does not include: . . . d. Bridges, roadways, walks, patios or other paved surfaces; . . . g. Foundations of buildings, structures, machinery or boilers if their foundations are below: (1) The lowest basement floor; or (2) The surface of the ground, if there is no basement; h. Land (including land on which the property is located), water, growing crops or lawns (other than lawns which are part of a vegetated roof); . . . 4. Additional Coverages a. Debris Removal (1) Subject to Paragraphs (2), (3) and (4), we will pay your expense to remove debris of Covered Property and other debris that is on the described premises, when such debris is caused by or results from a Covered Cause of Loss that occurs during the policy period. The expenses will be paid only if they are reported to us in writing within 180 days of the date of direct physical loss or damage. . . . c. Fire Department Service Charge When the fire department is called to save or protect Covered Property from a Covered Cause of Loss, we will pay up to $1,000 for service at each premises described in the Declarations, unless a higher limit is shown in the Declarations. Such limit is the most we will pay regardless of the number of responding fire departments or fire units, and regardless of the number or type of services performed. . . . 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: . . . (2) Give us prompt notice of the loss or damage. Include a description of the property involved. (3) As soon as possible, give us a description of how, when and where the loss or damage occurred. (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 book and records. . . . (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. . . . F. Additional Conditions The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions: 1. Coinsurance If a Coinsurance percentage is shown in the Declarations, the following condition applies: a. We will not pay the full amount of any loss if the value of Covered Property at the time of loss times the Coinsurance percentage shown for it in the Declarations is greater than the Limit of Insurance for the property. Instead, we will determine the most we will pay using the following steps: (1) Multiply the value of Covered Property at the time of loss by the Coinsurance percentage; (2) Divide the Limit of Insurance of the property by the figure determined in Step (1); (3) Multiply the total amount of loss, before the application of any deductible, by the figure determined in Step (2); and (4) Subtract the deductible from the figure determined in Step (3). We will pay the amount determined in Step (4) or the Limit of Insurance, whichever is less. For the remainder, you will either have to rely on other insurance or absorb the loss yourself. . . . CAUSES OF LOSS - SPECIAL FORM A. Covered Causes Of Loss When Special is shown in the Declarations, Covered Causes of Loss means direct physical loss unless the loss is excluded or limited in this policy. . . . B. Exclusions . . . 2. We will not pay for loss or damage caused by or resulting from any of the following: a. Artificially generated electrical, magnetic or electromagnetic energy that damages, disturbs, disrupts or otherwise interferes with any: (1) Electrical or electronic wire, device, appliance, system or network; or (2) Device, appliance, system or network utilizing cellular or satellite technology. For the purpose of this exclusion, electrical, magnetic or electromagnetic energy includes but is not limited to: (a) Electrical current, including arcing; (b) Electrical charge produced or conducted by a magnetic or electromagnetic field; (c) Pulse of electromagnetic energy; or (d) Electromagnetic waves or microwaves. But if fire results, we will pay for the loss or damage caused by that fire. . . . 3. We will not pay for loss or damage caused by or resulting from any of the following, 3.a. through 3.c. But if an excluded cause of loss that is listed in 3.a. through 3.c. results in a Covered Cause of Loss, we will pay for the loss or damage caused by that Covered Cause of Loss. . . . b. Acts or decisions, including the failure to act or decide, of any person, group, organization or governmental body. c. Faulty, inadequate or defective: (1) Planning, zoning, development, surveying, siting; (2) Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; (3) Materials used in repair, construction, renovation or remodeling; or (4) Maintenance; of part or all of any property on or off the described premises. . . . PROTECTIVE SAFEGUARDS A. The following is added to the Commercial Property Conditions: Protective Safeguards 1. As a condition of this insurance, you are required to maintain the protective devices or services listed in the Schedule above. 2. The protective safeguards to which this endorsement applies are identified by the following symbols: "P-1" Automatic Sprinkler System, including related supervisory services. Automatic Sprinkler System means: a. Any automatic fire protective or extinguishing system, including connected: (1) Sprinklers and discharge nozzles; (2) Ducts, pipes, valves and fittings; (3) Tanks, their component parts and supports; and (4) Pumps and private fire protection mains. b. When supplied from an automatic fire protective system: (1) Non-automatic fire protective systems; and (2) Hydrants, standpipes and outlets. "P-2" Automatic Fire Alarm, protecting the entire building, that is: a. Connected to a central station; or b. Reporting to a public or private fire alarm station. "P-3" Security Service, with a recording system or watch clock, making hourly rounds covering the entire building, when the premises are not in actual operation. "P-4" Service Contract with a privately owned fire department providing fire protection service to the described premises. "P-5" Automatic Commercial Cooking Exhaust And Extinguishing System installed on cooking appliances and having the following components: a. Hood: b. Grease removal device; c. Duct system; and d. Wet chemical fire extinguishing equipment. "P-9", the protective system described in the Schedule B. The following is added to the Exclusions section of: Causes Of Loss – Basic Form Causes Of Loss – Broad Form Causes Of Loss – Special Form Mortgage holders Errors And Omissions Coverage Form Standard Property Policy We will not pay for loss or damage caused by or resulting from fire if, prior to the fire, you: 1. Knew of any suspension or impairment in any protective safeguard listed in the Schedule above and failed to notify us of that fact; or 2. Failed to maintain any protective safeguard listed in the Schedule above, and over which you had control, in complete working order. If part of an Automatic Sprinkler System or Automatic Commercial Cooking Exhaust And Extinguishing System is shut off due to breakage, leakage, freezing conditions or opening of sprinkler heads, notification to us will not be necessary if you can restore full protection within 48 hours.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Determined to deprive the Insured of compensation for a devastating fire loss, the Insurance Company came up with creative excuses to dodge its contractual obligations – first by charging the Insured with failing to comply with the Policy’s requirement for Protective Safeguards despite sworn evidence to the contrary, and then by overvaluing the insured property in order to apply an egregious coinsurance penalty to deprive the Insured of any payment. The Insured owns a duplex property located at 3446-3448 SW 15th Street, Miami, Florida 33145 (the “Property”). The policyholders obtained coverage under a policy of insurance issued by Westchester Surplus Lines Insurance Company (the “Insurance Company” or the “Carrier”) with a coverage term from July 25, 2023, through July 25, 2024. In applying for coverage, the Insured noted the Policy’s requirement for the use of Protective Safeguards, including installation of functioning and operating smoke detector in all units and/or occupancies. In accordance with this obligation, the Insured retained Edwin A. Perez, the owner of Cuklas Carpentry of FLA, Inc., to install a smoke detector in each unit. Mr. Perez visited the Property in July 2023 and confirmed the smoke detector installed in each unit was on and functional. On or about August 4, 2023, shortly after Mr. Perez visited the unit, the Property was severely damaged when a fire broke out in the upstairs unit numbered 3448. The Property suffered significant fire and smoke damage and was further damaged by water used by City of Miami Fire Rescue Units to extinguish the flames. To address the substantial damage to the Property, the Insured immediately submitted a claim to the Insurance Company. Instead of properly adjusting the Insured’s loss and timely paying the Insured for the damage to the Property so it could make the necessary repairs, the Insurance Company began its efforts to avoid its contractual obligations to fully compensate the Insured for the claim. The Insurance Company first assigned the loss to an outcome-oriented adjuster, George Graham from Crawford & Company, although Mr. Graham was neither competent nor qualified to opine as to the cause, scope or valuation of the damage. It was clear that Mr. Graham approached the loss with an eye towards denial. He inspected the Property on behalf of the Carrier on September 5, 2023, and noted significant fire and water damage to the second floor of the building, as well as ceiling intrusion to the ground floor. However, Mr. Graham incorrectly reported that a smoke detector was not present in either unit of the Property. The Carrier then retained Leon Dotson of JS Held LLC, a company routinely retained by the Insurance Company, to inspect the premises on December 13, 2023. Mr. Dotson determined the fire originated in Bedroom 2 of the upstairs unit but could not determine the ignition source. After having reviewed Mr. Graham’s findings, Mr. Dotson unsurprisingly confirmed Mr. Graham’s earlier observation and reported the absence of a smoke detector in each unit at the Property. Following the inspections, the Insurance Company accomplished its ultimate goal of denying coverage to its Insured. On April 12, 2024, the Insurance Company issued a Declination of Coverage letter advising that it had “completed its factual investigation.” The Carrier acknowledged the significant fire and water damage to the Property observed by both Mr. Graham and Mr. Dotson but relied on its self-interested adjusters’ allegation that the Property was not equipped with a functioning smoke detector in each unit. Based on this incorrect presumption, the Carrier alleged coverage was excluded for the loss because no Protective Safeguards were in place at the time of the loss. The Carrier further justified its refusal to issue payment by alleging that the Property “did not meet the coinsurance condition” of the Policy. Without providing the method or means by which the property was valued, the Carrier simply concluded the value of the Property to be $340,032.00. That seemingly arbitrary and self-interested figure was used to determine the property is not compliant with the policy’s co-insurance provision, thus the 21.51% co-insurance penalty was applied to reduce any payment that may be due to the Insured. The Insurance Company’s application of the co-insurance penalty was calculated in such a manner as to guarantee the Insured’s property would appear underinsured. Pursuant to the policy, “Property Not Covered” is defined to exclude from coverage, “… walks, patios or other paved surfaces . . . Foundations of buildings, structures . . . if their foundations are below: . . . The surface of the ground . . . Land (including land on which the property is located) . . . .” Yet, the Insurance Company, without explanation or further detail, unilaterally set the value of the Property. At a minimum, the Carrier’s valuation does not reflect any reductions for the value of the building’s foundation or other property not covered by the policy, making the valuation immediately suspect. To deprive the Insured of coverage, the Insurance Company inflated the property’s value to ensure the penalty would apply. Dismayed by the Carrier’s position, especially the wrongful determination that the Property lacked a smoke detector in each unit, the Insured sought to resolve the misinformation by providing a sworn affidavit from Edwin A. Perez, the carpenter who installed and maintained the smoke detector in each unit, confirming that he installed the smoke detector in the hallway ceiling in front of the bathroom entrance in the subject unit, and that he entered the subject unit in July 2023 and confirmed the smoke detector was on and functional. The Insured provided a second sworn affidavit from its HVAC technician, Arian De La Vega, attesting to the presence of a smoke detector in the subject unit, and confirming that Ms. De La Vega had inadvertently set off the smoke detector on August 3, 2023, the day prior to the subject loss, when he was performing work on the coil of the central air conditioning system and activated the smoke detector’s alarm with fumes from the heated coil. The two affidavits provided uncontroverted proof that smoke detectors were, in fact, present at the Property, in accordance with the terms of the Policy. The Insured remained hopeful the sworn affidavits would prove compliance with the policy’s terms and the Carrier would accordingly reconsider its wrongful denial of coverage. Despite being afforded sworn evidence that its justification for the claim denial fails because the Insured had complied with all Protective Safeguards provided for within the Policy, the Insurance Company refused to reevaluate its position and withdraw its baseless denial. On August 13, 2024, the Insurance Company issued correspondence advising that Mr. Graham and Mr. Dotson “reviewed” the executed affidavits and – without the benefit of a reinspection of the Property, or making any effort to speak with the affiants about the contents of their affidavits – “confirmed that there were no smoke detectors present or observed in the debris or at the loss location.” The Insurance Company should have retained unbiased, qualified and competent experts to re-inspect the Property to identify the presence of the smoke detector in each unit sworn to exist in two separate affidavits, especially given that considerable rubble and debris caused by the fire loss could have obscured the smoke detector from immediate view. While the Fire Department was attempting to put out the large fire, they also pulled down ceilings, among other actions, to expose hot spots and put out the fire, as well as overhauling the fire area once the fire was knocked down, thereby possibly contributing to the smoke detector being obscured. Not to mention, the Fire Incident Report stated the subject unit “had hoarding conditions throughout, creating some difficulty in reaching fire and conducting searches.” The Fire Incident Report also stated that “the drywall had fallen off the walls and ceiling onto the floor,” which could further contribute to the visibility of the smoke detector after the fire because the detector was installed on drywall. Yet, the Carrier deprived the Insured of a fair investigation and adjustment, wholly disregarded the sworn evidence provided by the Insured confirming the existence of Protective Safeguards and relied only on the word of its outcome-oriented adjusters who each visited the Property only once and yet could somehow verify (from memory) the absence of a smoke detector. The loss devastated the Insured’s Property. Not only did the building and contents suffer substantial damage, but the occupants were also forced to relocate from the Property, and a dog sadly passed away. As a result of the devastating loss, the City of Miami required the subject building be repaired or demolished. Absent insurance benefits from the Insurance Company, the Insured was left with no choice but to demolish the property and sell the land. The Carrier’s unreasonable delay and refusal to properly compensate the Insured prevented the Insured from recovering from the loss and resulted in the forced demolition and eventual sale. The Insured has been abandoned by its Insurance Company. The Carrier’s refusal to resolve the claim forced the Insured to retain an attorney to protect its contractual rights under the Policy. The Insured has and will continue to incur and unnecessarily suffer damages, including costs to prosecute this claim, attorney’s fees, lost rental income, and delay damages if the Insurance Company does not retain competent, qualified, and unbiased representatives, participate in good faith adjustment practices, and communicate with the Insured’s representative(s) to negotiate a fair compromise of the claim within 60 days of the filing of this Civil Remedy Notice. The failure of the Insurance Company to fully and completely compensate the Insured demonstrates either inexcusable negligence or an intentional decision to elevate its own interests over those of its Insured. The Insurance Company’s refusal to properly investigate, adjust, and fully compensate the Insured for the claim evidences the Insurance Company’s violation of section 626.9541(1)(i)(3)(a) and (d), Florida Statutes, which require the Insurance Company to “adopt and implement standards for the proper investigation of claims” and to conduct “reasonable investigations based upon available information.” The Carrier’s misrepresentation of pertinent facts and insurance policy provisions relating to coverages at issue constitutes a violation of 626.9541(1)(i)(3)(b). The failure to acknowledge and act promptly upon communications with respect to claims constitutes a violation of 626.9541(1)(i)(3)(c). The Insurance Company failed its Insured in refusing to properly investigate and adjust the loss. It refused to acknowledge and appreciate the sworn affidavits from Mr. Perez and Mr. De La Vega attesting to the presence of a smoke detector in the unit, it failed to make any efforts to speak with Mr. Perez and Mr. De La Vega to verify their sworn statements in any way, relied only on the unqualified and unsubstantiated word of its own self-interested adjusters in concluding there was no smoke detector present (despite sworn evidence to the contrary), and refused to retain qualified experts to reinspect the Property to confirm its unsupported position on the presence of a smoke detector. The Carrier refused to reconsider its incorrect opinion once it was provided proof that the Insured did, in fact, have Protective Safeguards in place at the time of the loss. The Carrier also misrepresented the value of the Insured’s Property in order to improperly apply a co-insurance penalty. All available information leads to one conclusion – the Insured’s property was damaged by a covered loss for which it is entitled to full and complete compensation. Yet, the Insurance Company shirked its responsibilities in efforts to deprive the Insured of its contractual right to a fair adjustment and payment. The actions taken by the Insurance Company in the handling and adjustment of the Insured’s claim occur with such frequency as to indicate a general business practice and these acts are willful, wanton, and in gross disregard for the rights of its Insured. The Insurance Company’s actions amount to, but are not limited to: A. “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;” (Fla. Stat. 624.155(1)(b)(1). B. “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;” (Fla. Stat. sec. 624.155(1)(b)(3)) C. Claim Delay; D. Claim Denial; and E. Unfair Trade Practices The Insurance Company’s actions further amount to unfair claim settlement practices: 1.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; (Fla. Stat. 626.9541(1)(i)(2)). 2.Committing or performing with such frequency as to indicate a general business practice any of the following: a.Failing to adopt and implement standards for the proper investigation of claims; (Fla. Stat. 626.9541(1)(i)(3)(a)) b.Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (Fla. Stat. 626.9541(1)(i)(3)(b)) c.Failing to acknowledge and act promptly upon communications with respect to claims; (Fla. Stat. 626.9541(1)(i)(3)(c)) d.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; (Fla. Stat. 626.9541(1)(i)(3)(f)) e. Failing to promptly notify the insured of any additional information necessary for the processing of a claim; (Fla. Stat. 626.9541(1)(i)(3)(g)) f.Failing to clearly explain the nature of the requested information and the reasons why such information is necessary; (Fla. Stat. 626.9541(1)(i)(3)(h)). In addition to the above statutory violations, the Insurance Company’s adjuster violated the following ethical requirements of Florida Administrative Code 69B-220.201: (3) Code of Ethics . . . An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: (b) An adjuster shall treat all claimants equally. 2. An adjuster shall adjust all claims strictly in accordance with the insurance contract. (c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. (d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. (f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. (o) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. In Florida, the work of adjusting insurance claims engages the public trust. During the adjustment of the Insured’s claim, the Insurance Company breached this duty by failing to adhere to and comply with the above referenced obligations. To cure the defects outlined above, the Insurance Company must: A.Withdraw its declination of coverage for the Insured’s covered loss; B.Tender all insurance proceeds due and owing to the Insured that would reasonably place the Insured back into a pre-loss condition; C.Timely communicate with the Insured’s representative(s) to complete the proper adjustment of the Insured’s loss by participating in good faith negotiations to reach an agreement relating to the parties’ dispute over coverage, scope and amount; D.Immediately issue payment for statutory interest for any late payments and owed profit/overhead; E.Act fairly and honestly towards the Insured and with due regard for its interests; F.Hire a fair, unbiased, and qualified adjuster(s) and expert(s) to properly assess the Insured’s damages; G.Timely and substantively respond to the Insured’s communications; H.Timely adjust the claim with the Insured and avoid/limit any additional delay, costs, and prejudice that the Insurance Company’s conduct above has caused and continues to cause the Insured; I.Participate in good faith claims adjustment to avoid the Insured incurring unnecessary costs of litigation. J.Provide the Insured with an explanation on the Insurance Company’s valuation of the Insured property to support the Insurance Company’s application of the Policy’s co-insurance penalty and claim that the property was under-insured.
Comments
User Id Date Added Comment
chad.pasternack@kennedyslaw.com 07-11-2025 Westchester Surplus Lines Insurance Company (“Westchester”) hereby responds to the May 14, 2025 supplement to Civil Remedy Notice No. 800875 filed by Apartamentos Quince, LLC. Westchester objects to the supplement for failure to comply with the requirements of Fla. Stat. Section 624.155(3)(a)-(b). Notwithstanding this objection, the circumstances and evidence described in the supplement are inaccurate and incomplete. The supplement refers to a deposition of Miriam Arteaga, who, according to the transcript provided by Apartamentos Quince, LLC, testified that she observed a smoke detector at the property, but that it was not functioning. The supplement also refers to a deposition of Manuel Veldes, owner of Apartamentos Quince, LLC, who attests to there having been smoke detectors at the property ten months prior to the fire. The supplement omits the fact that Amparo Ruiz, a tenant of the property, testified that there were no smoke detectors at the property. These deposition transcripts were all provided to Westchester after Apartamentos Quince, LLC filed the supplement, and none of these documents establish that there were functioning smoke detectors at the property at the time of the fire. Nonetheless, on July 11, 2025, Westchester requested Apartamentos Quince, LLC provide copies of any photographs in its possession taken after the fire that depict smoke detectors at the property. Apartamentos Quince, LLC has not yet provided copies of any such photographs. Additionally, the supplement does not explain its contentions that “the Carrier appears to be aligning itself with the liability insurer’s defense counsel in the pending lawsuit filed by the tenants.” Westchester specifically denies each and every accusation of wrongful conduct made against it in the Notice. Should the Department require further evidence, elaboration, or clarification in the context of the Notice and this response, please do not hesitate to contact the undersigned.
vchavin@cmslawgroup.com 05-14-2025 Apartamentos Quince LLC (the “Insured”) files this Supplement to provide additional evidence of Westchester Surplus Lines Insurance Company’s (the “Insurance Company” or the “Carrier”) continuing failure to fairly investigate and resolve the above-referenced claim, in violation of its obligations under Florida law and the terms of the Policy. The original Civil Remedy Notice filed on January 14, 2025, charges the Carrier with either inexcusable negligence or an intentional decision to elevate its own interests over those of its Insured when it refused to properly investigate, adjust, and fully compensate the Insured for claim number KY23K2720993 for significant damage to the insured Property caused by a fire. The Civil Remedy Notice challenges the Carrier’s improper denial of the claim on the incorrect assumption that the Insured failed to comply with the Policy’s requirement for the use of Protective Safeguards, including installation of functioning and operating smoke detectors in all units and/or occupancies. Since the filing of the original Civil Remedy Notice, it has become increasingly clear that the Carrier is committed not to investigating the loss objectively, but instead to affirming its denial of coverage by disregarding evidence it deems inconvenient. During the claim adjustment, the Carrier was presented with conflicting evidence regarding the existence of functioning smoke detectors in the insured Property at the time of the fire. This included two sworn affidavits — one from Edwin A. Perez, who installed and inspected the smoke detectors in July 2023, and another from Arian De La Vega, who inadvertently triggered the smoke detector alarm on August 3, 2023, while completing work at the Property, the day before the fire. Rather than considering these affidavits in good faith or attempting to reconcile this testimony with its own adjusters' observations, the Carrier summarily dismissed the affidavits. Notably, the Carrier made no effort to interview either affiant, re-inspect the Property for verification, or otherwise test the credibility of the sworn statements. The Carrier instead relied entirely on the original inspections by its own outcome-oriented representatives, George Graham and Leon Dotson, both of whom visited the Property only once and immediately after a destructive fire that left the Property in a severely compromised state, complete with debris, ceiling collapses, and documented hoarding conditions that would obscure any small ceiling-mounted devices. The Carrier’s expert also inspected the loss after the property was left open to the public – where evidence could have been tampered with. Since the Civil Remedy Notice was filed, the Carrier has been presented with — and has ignored — additional conflicting evidence that further underscores the uncertainty and factual dispute over the presence of smoke detectors. The issue has been addressed via deposition testimony in a pending lawsuit filed by the Property’s tenants (Arteaga, et al. v. Apartamentos Quince, LLC in the Eleventh Judicial Circuit in and for Miami-Dade County, Florida Case No. 2024-007141-CA-01). Manuel Valdes, the Insured’s principal, testified under oath that the Property had two functioning smoke detectors located in the kitchen and directly outside the bathroom, and that he personally entered the apartment to conduct an annual inspection of the smoke detectors in October or November 2022. Mr. Valdes’ testimony mirrors that of Edwin A. Perez, who installed the smoke detectors for the Insured. The Property’s tenant, Miriam Artega Rodriguez, also testified that a smoke detector (although she dubbed it an “extinguisher” but confirmed it was a smoke detector after viewing a photograph) was installed in the kitchen above the refrigerator, though she assumed it did not work because it did not beep or make noise. The Carrier is aware of this sworn testimony that calls into question the presence of smoke detectors at the Property and, at a minimum, should have conducted a more thorough, unbiased investigation. Yet, the Carrier chose to ignore exculpatory evidence in favor of justifying a convenient denial. Moreover, it is deeply concerning that the Carrier appears to be aligning itself with the liability insurer's defense counsel in the pending lawsuit filed by the tenants. Instead of protecting the interests of its Insured, the Carrier is using that litigation — and tenant statements made in pursuit of damages — as a backdoor means to justify denying coverage. This apparent cooperation with adversarial interests constitutes a breach of the Carrier's duty of loyalty and good faith owed to its Insured. The Carrier’s decision to stand by its denial in the face of sworn contradictory evidence — without follow-up investigation — exemplifies an outcome-driven investigation designed to support denial, not truth. This pattern of conduct confirms that the Carrier has violated: • § 624.155(1)(b)(1), Fla. Stat. – Not attempting in good faith to settle claims when it could and should have done so; • § 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 proper investigation standards; • § 626.9541(1)(i)(3)(d) – Denying claims without a reasonable investigation; • § 626.9541(1)(i)(3)(b) – Misrepresenting pertinent facts relating to coverage. • To cure these violations, the Carrier must immediately: 1. Withdraw its declination of coverage; 2. Acknowledge the existence of sufficient evidence of compliance with the Protective Safeguards requirement; 3. Tender policy limits due and owing to the Insured; 4. Tender interest owed on any late payments issued. Absent full and compliance, the Carrier continues to subject itself to statutory liability under Florida law. This Civil Remedy Notice is given to perfect the right to pursue the civil remedy authorized by this section.
chad.pasternack@kennedyslaw.com 03-11-2025 Westchester Surplus Lines Insurance Company (“Westchester”) hereby responds to Civil Remedy Notice No. 800875 (“Notice”) filed by Apartamentos Quince LLC (“Apartamentos”) in connection with claim number KY23K2720993 under policy number FSF1671706A 002. Westchester objects to the Notice as facially defective because it does not state with specificity the information required by Fla. Stat. Section 624.155(3)(b): (1) The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; (1) The facts and circumstances giving rise to the violation; (3) The name of any individual involved in the violation; and (4) Reference to specific policy language that is relevant to the violation, if any. The Notice alleges Westchester violated Section 624.155(1)(b)(3), alleging that Westchester failed to promptly settle claims, when the obligation to settle became reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portion of the insurance policy coverage. However, the Notice does not identify what different insurance coverages are at issue or how Westchester tried to influence settlements under the respective coverages. The Notice alleges that Westchester violated Section 626.9541(1)(i)(3)(b), alleging Westchester misrepresented pertinent facts or insurance policy provisions relating to coverages at issue. In vague terms, the Notice alleges Westchester “misrepresented the value of the Insured’s Property in order to improperly apply a co-insurance penalty,” but does not explain how anything communicated by Westchester related to the value of the property was a misrepresentation. The Notice further alleges that Westchester violated Section 626.9541(1)(i)(3)(f), alleging that Westchester failed to promptly provide a reasonable explanation in writing of the basis in the insurance policy, in relation to the facts or applicable law, for denial of the claim. However, the Notice alleges that “the Insurance Company issued a Declination of Coverage letter,” in which Westchester advised that “coverage was excluded for the loss because no Protective Safeguards were in place at the time of the loss.” Accordingly, it is unclear what facts Apartamentos contends give rise to a violation of Section 626.9541(1)(i)(3)(f). For these reasons, the Notice is legally insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021). Notwithstanding that the Notice is legally insufficient, the facts and circumstances described in the Notice are inaccurate. Apartamentos reported a claim to Westchester for fire damage to the build located at 3446-3448 SW 15th Street, Miami, FL 33145 that occurred on August 3, 2023. Westchester engaged independent adjusting firm, Crawford Global Technical Services, which assigned George Graham. Mr. Graham contacted the representative of Apartamentos, Manny Valdes, on August 17, 2023. Mr. Graham inspected the property on September 5, 2023 and thoroughly photographed the property during his inspection. Mr. Graham confirmed the fire damage. He also inspected the property for smoke detectors, but was unable to find any smoke detectors or evidence of smoke detectors. Mr. Graham’s photographs do not reflect the presence of any smoke detectors. Westchester also engaged Leon Dotson, Senior Fire Investigator with J.S. Held, to assist with determining the cause and origin of the fire. Mr. Dotson inspected the property on September 5, 2023. He determined that the fire originated in the second bedroom and that there were no smoke detectors present within the apartment. Westchester denied coverage by letter dated April 12, 2024. The declination letter explains in detail the facts that support Westchester’s denial and cites the relevant policy language. Specifically, the Protective Safeguards Endorsement states: 1. As a condition of this insurance, you are required to maintain the protective devices or services listed in the Schedule above. *** We will not pay for loss or damage caused by or resulting from fire if, prior to the fire, you: 1. Knew of any suspension or impairment in any protective safeguard listed in the Schedule above and failed to notify us of that fact; or 2. Failed to maintain any protective safeguard listed in the Schedule above, and over which you had control, in complete working order. If part of an Automatic Sprinkler System or Automatic Commercial Cooking Exhaust And Extinguishing System is shut off due to breakage, leakage, freezing conditions or opening of sprinkler heads, notification to us will not be necessary if you can restore full protection within 48 hours. The required protective safeguard is: “Functioning and operating smoke detectors in all units and/or occupancies.” On July 17, 2024, Apartamentos submitted two affidavits, one of Edwin Perez, a handyman, and one of Arian De La Vega, an HVAC technician. Mr. Perez stated in his affidavit that he installed smoke detectors in the building in 2021 or 2022. He also stated that he was in the building in July 2023 to perform work in the bathroom, and while there, checked the smoke detector. Mr. De La Vega stated that he was at the property on August 3, 2023 to perform work on the HVAC system and that he accidentally set off the smoke detectors while there. On August 13, 2024, Westchester advised that it maintains its denial of coverage based on Mr. Graham and Mr. Dotson confirming that there were no smoke detectors present or observed in the debris. The tenants living in the property at the time of the fire filed a lawsuit captioned Arteaga, et al. v. Apartamentos Quince, LLC, Case No. 2024-007141-CA-01, in the Circuit Court of the Eleventh Judicial Circuit, in and for Miami-Dade County, Florida. The Complaint alleges, amongst other things, that Apartamentos failed to install smoke detectors. Apartamentos served answers to interrogatories in the lawsuit, signed by Mr. Valdes on October 2, 2024. Apartamentos did not identify either Mr. Perez or Mr. De La Vega as people with relevant knowledge. Additionally, the tenants served sworn answers to interrogatories signed on September 11, 2024. Their sworn answers state: “The owner of the house and property manager of the house failed to install smoke detectors ….” Westchester’s coverage determination is supported by the inspection of two independent professionals, photographs taken during their inspection, and sworn statements by people living in the property at the time of the loss. The statements in the affidavits offered by Apartamentos are inconsistent with the objective evidence and sworn statements by the tenants. Accordingly, Westchester’s denial of coverage was proper. Westchester specifically denies each and every accusation of wrongful conduct made against it in the Notice. Should the Department require further evidence, elaboration, or clarification in the context of the Notice and this response, please do not hesitate to contact the undersigned.
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