Civil Remedy Notice of Insurer Violations
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Filing Number:     800946
Filing Accepted:  1/14/2025
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Complainant
Last/Business Name *  
JOHNSON   First Name   KATHY
Street Address * 2101 OPILANA STREET
City, State Zip * ORLANDO, FL 32837
Email Address * KATHY_J2001@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JOHNSON   First Name   KATHY
Policy # * 80C113469 Claim #* 59-75W6-20L
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial
Street Address* 2501 S. TAMIAMI TRAIL
City, State Zip* SARASOTA , FL 34239
Email Address * ESERVICE@ROSSLEGALFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* DANIEL CHAMBERS, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY STATE FARM FLORIDA INSURANCE COMPANY INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

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

In Florida, the work of adjusting insurance claims engages the public trust. State Farm Florida Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Kathy Johnson (“INSURED”) claim of loss. State Farm Florida Insurance Company’s mailing address is PO Box 106169, Atlanta, GA 30348. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSUREDS’ property located at 2101 Opilana Street, Orlando, FL 32837 which sustained significant damage from Wind on or about October 9, 2024. The INSUREDS immediately reported the loss to INSURER and allowed for inspection. The INSUREDS suffered damage to the roof, exterior, and interior of the property. INSURER inspected the property and accepted coverage for the claim, however they estimated the loss to total just $662.68, which was under the INSUREDS’ hurricane deductible of $4,748.00 so no payment was tendered. The INSUREDS retained Storm One Claims LLC. to assist with determining the amount of damage sustained to the property. Storm One prepared an estimate in the amount of $55,426.43. The INSUREDS are owed additional insurance benefits in order to return the property to pre-loss condition. Therefore, demand is hereby made as follows: Estimate $55,426.43 Less Prior Payments $0.00 Less Deductible $4,748.00 TOTAL $50,678.43 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $50,678.43 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: PA Estimate and Proposed Complaint
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 06-23-2025 The Insured, Kathy Johnson, hereby provide notice to the Florida Department of Financial Services and State Farm Florida Insurance Company, that the issues outlined in Civil Remedy Notice filing #800946 have been resolved between the parties and State Farm Florida Insurance Company has cured all allegations listed therein. Accordingly, Kathy Johnson, hereby withdrawals Civil Remedy Notice filing #800946 filed on 1/14/2025.
rphelps@duttonlawgroup.com 03-03-2025 RE: RE: Civil Remedy Notice 800946; Filing Accepted 1/14/2025 Insured: Kathy Johnson Policy No.: 80-C1-1346-9 Claim No.: 59-75W6-20L Date of loss: October 9, 2024 Ntc. of loss: October 25, 2024 Property Location: 2101 Opilana St, Orlando, FL 32837 Dear Sir/Madam: This correspondence shall serve as the response of State Farm Florida Insurance Company (“State Farm”) to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) that the Department of Financial Services (“Department”) accepted on January 14, 2025, and that the Insured’s attorney, submitted to the Department. State Farm denies all of the allegations asserted in the Notice and denies any improper conduct or claims response in the handling of these claims. State Farm has acted fairly and with due diligence both in its claim review actions, and towards the Insureds, throughout the claim. A first-party bad faith claim is in derogation of the common law and must be strictly construed. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136, 140 (Fla. 5th DCA 2022) (J. Sasso, concurring specially). State Farm denies all the allegations asserted in the Notice and denies any improper conduct or claims response in the handling of these claims. As the facts below show, State Farm has acted fairly and with due diligence both in its claim review actions, and towards the Insureds, throughout the claim. FACTS On October 25, 2024, State Farm received notice of a claim for windstorm damage at the Insured Property located at 2101 Opilana St, Orlando, FL 32837. A public adjuster with Storm One Claims, LLC reported that the Insured Property sustained damage following the passage of Hurricane Milton. On that same day, the public adjuster submitted a copy of their letter of representation, contract, and W9. On October 26, 2024, State Farm submitted their temporary repairs letter and homeowner’s bill of rights letter to the Insured and her public adjuster. The letters were resent on November 18, 2024, to include the correct State Farm company adjuster. On November 18, 2024, State Farm made contact with the Insured. She reported that Hurricane Milton had come through and caused damages to her roof. The Insured was advised of her obligations to make temporary repairs until State Farm had come out and had the opportunity to inspect the property. On November 21, 2024, the public adjuster submitted a copy of their estimate, along with a notification that the Insured had executed an agreement with His and Hers Roofing to complete the roof replacement at the Insured Property. On December 5, 2024, Daniel Chambers inspected the property on behalf of State Farm. Present for the inspection was the Insured, Kathy and a Public Adjuster by the name of Andy. Mr. Chambers did not identify any storm related damages to the exterior elevations or the roof. He did point out that a tarp was over a turbine on the roof that appeared to have been present since the September 11, 2023 date of loss. No repairs had been made following that claim. Mr. Chambers noted light water staining due to wind driven rain in the master bedroom and a bedroom. On December 6, 2024, State Farm issued their coverage decision letter. The correspondence advised the Insured that coverage would be extended for the water staining in the 2 bedrooms, but the amount ($662.68) would not exceed the $4,748.00 Hurricane deductible. The letter advised that no payment was issued. The correspondence goes on to explain that damages observed to the roof and exterior elevations were due to wear, tear and deterioration. The tarp from a prior claim was still on the roof over a year later. The letter cited losses not insured related to wear, tear and deterioration, along with the faulty and inadequate language. Along with the coverage determination, State Farm sent the Insured a copy of the policy, acknowledging communications dated October 25, 2024 and November 21, 2024 received from the Public Adjuster. On December 7, 2024, State Farm sent the Insured her notice of the right to go to mediation with the Florida Department of Financial Services. On December 23, 2024, State Farm received a SSPOL from the Insured’s Public Adjuster. The SSPOL claimed damages in the amount of $55,426.43. On December 28, 2024, State Farm responded to the SSPOL and advised the Insured’s Public Adjuster that they were not in agreement due to the pricing and scope of the estimate. State Farm also advised that the SSPOL was not sent in timely pursuant to the terms of the policy. Moreover, State Farm cited additional language supporting their coverage decision. The correspondence cited the Neglect exclusion, and the continued, repeated, seepage and leakage of water. On January 14, 2025, by and through counsel, the Insured submitted Property Insurance Notice of Intent to Initiate Litigation (“NOIL”) number 225281. The NOIL noted State Farm underestimated the loss. Included with the NOIL was the public adjuster estimate and a copy of a proposed complaint. The NOIL outlined a pre-suit settlement demand for $58,480.00. On January 27, 2025, State Farm responded to the NOIL that the claims decision would stand and that cost of the covered damages did not exceed the $4,748.00 Hurricane deductible. On January 14, 2025, State Farm received the subject Civil Remedy Notice. THE CIVIL REMEDY NOTICE (“the Notice” or “CRN”) Notice Against When asked to identify the person or persons most responsible for or most knowledgeable of the allegations, the Notice states “Daniel Chambers, and all other adjusters, supervisors, management and individuals associated with or retained by State Farm Florida Insurance Company involved in the claim.” However, the CRN fails to state any specific facts that Daniel Chambers, and all other adjusters, supervisors, management and individuals associated with or retained by State Farm Florida Insurance Company involved in the claim was responsible for or otherwise knowledgeable of. Civil remedy notices require specificity. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021) (strictly construing section 624.155, requiring specific individuals, and dismissing overly broad allegations). The CRN’s lack of specificity is improper and fails to comply with section 624.155. Without providing any specific allegations that Daniel Chambers, and all other adjusters, supervisors, management and individuals associated with or retained by State Farm Florida Insurance Company involved in the claim were responsible for or otherwise knowledgeable of, the CRN is impermissibly vague, overly broad, and statutorily deficient. Nevertheless, State Farm denies that any of its adjusters, supervisors, management, and/or other individuals violated any policy or statutory provision. At all times, State Farm acted fairly and with due diligence both in its claim review actions, and towards the Insureds and their representatives, throughout the claim. Reasons for Notice The following reasons are listed for the Notice: claim denial, claim delay, unsatisfactory settlement offer, and unfair trade practice. Each of these reasons are without factual support and are denied. State Farm addresses each reason below. Claim Denial: There are no facts to support this allegation that State Farm wrongfully denied the Insureds’ claim. The Notice merely alleges that State Farm did not pay the estimate that was ultimately submitted by the Public Adjuster. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. The evidence shows that there were damages observed at the property were long term in nature. No evidence to show that State Farm wrongfully denied this claim has been submitted. Therefore, this reason is unsupported, is conclusory, and is denied. Claim Delay: The Notice merely alleges that State Farm did not pay the estimate that was ultimately submitted by the Public Adjuster. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. The evidence shows that there were damages observed at the property were long term in nature. Unsatisfactory Settlement Offer: The Notice fails to provide any facts to support this reason. The Notice merely alleges that State Farm did not pay the Public Adjuster’s estimate as submitted. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. The evidence shows that the damages observed at the property were long term in nature, occurred over a number of events, and was not related to the alleged date of loss. No evidence to show that State Farm wrongfully denied this claim has been submitted. Therefore, this reason is unsupported, is conclusory, and is denied. Unfair Trade Practice: This reason is unsupported by the facts or the CRN. As the facts above show, State Farm performed a prompt and thorough investigation before issuing its coverage decision in accordance with the results of the inspection and the policy terms, conditions, and limitations. State Farm’s coverage decision was promptly issued to the Insureds. Further, there are no specific facts of any documents requested by State Farm that were not properly explained. The facts above show that no such requests were even made, and the allegation is inapplicable to this claim. Nevertheless, State Farm denies that it has engaged in any unfair trade practices or business practices to delay or deny claims. Therefore, this reason is unsupported, is conclusory, and is denied. No Violation of Statute(s) The documented facts clearly reflect that State Farm promptly responded to the Insured’s claim, performed a professional inspection of claimed damages, and advised the Insured of State Farm’s position on coverage. State Farm acted fairly and reasonably toward the Insured. Its handling of the claim was responsive to the Insured, and State Farm remained professional while seeking full and complete information in accordance with the specific terms of the insurance policy in considering whether coverage exists or payment was due. Section 624.155(1)(b)(1), Florida Statutes: State Farm denies violation of section 624.155(1)(b)(1), because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insureds’ allegations have been set forth in the Notice. There has been no evidence of a covered loss. Thus, this allegation of a statutory violation is denied. Section 624.155(1)(b)(3), Florida Statutes: State Farm denies violation of section 624.155(1)(b)(3), that it failed to promptly settle, when the obligation to settle had become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance coverage. This allegation is simply false and without basis. Absolutely no facts or circumstances supporting the Insureds’ allegations have been set forth in the Notice. Thus, this allegation of a statutory violation is denied. Section 626.9541(1)(i)(3)(a), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(a), as it has adopted and implemented standards for the proper investigation of claims. The facts show that State Farm promptly responded to the Insureds’ claim and assigned representatives to inspect the subject property. State Farm then made a coverage determination in compliance with the policy. The CRN fails to allege any facts regarding any standards that State Farm failed to comply with or that State Farm should adopt to avoid any alleged improper claims handling. Accordingly, this allegation is not factually supported and is denied. Section 626.9541(1)(i)(3)(c), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(c), as it promptly and timely provided a coverage decision along with its explanation behind its decision. The facts show that State Farm promptly responded to the Insureds’ claim and assigned representatives to inspect the subject property. State Farm then made a coverage determination in compliance with the policy. Although the CRN references a delay before denying the claim, the facts above show that State Farm issued a prompt coverage decision after completing its investigation. Accordingly, this allegation is not factually supported and is denied. Section 626.9541(1)(i)(3)(d), Florida Statutes: State Farm denies violation of section 626.9541(1)(i)(3)(d), as it promptly and timely provided a coverage decision along with its explanation behind its decision. The facts show that State Farm promptly responded to the Insureds’ claim and assigned representatives to inspect the subject property. It also shows that State Farm performed a professional and timely evaluation and addressed the alleged damages observed at the subject property in conjunction with the terms, conditions, and exclusions contained in the insurance policy issued to the Insured. State Farm then made a coverage determination in compliance with the policy. State Farm denied coverage because there was no evidence of an accidental direct physical loss associated with the reported date of loss. There are no facts alleged to show that State Farm failed to conduct a reasonable investigation. Accordingly, this allegation is not factually supported and is denied. Alleged Policy Violations The Insureds have failed to state with specificity which provisions, sections, conditions, or exclusions that State Farm has allegedly violated. Rather, the Notice states: DWELLING COVERAGE PROVISIONS PERILS INSURED AGAINST LOSS PAYMENT LOSS SETTLEMENT The CRN does not include any specific policy language. The failure to identify specific policy language is improper. See Julien, 311 So. 3d at 879; Boone v. State Farm Fla. Ins. Co., 48 Fla. L. Weekly D718a (Fla. 6th DCA April 6, 2023); Massey Constr. Grp., Inc. v. Heritage Prop. & Cas. Ins. Co., 30 Fla. L. Weekly Supp. 768a (Fla. 20th Cir. Ct. Nov. 29, 2022) (including virtually the entire policy language is not specific). The CRN is statutorily deficient because no specific policy language is cited. The Insureds are first-party claimants and must cite specific policy language regarding any alleged violation. Nevertheless, State Farm denies any alleged violations of the provisions of the subject policy of insurance. At all times during the handling and investigation of the Insureds’ claim, State Farm has followed each and every applicable policy provision and endorsement under the subject policy of insurance. The Proposed Cure is Invalid The Notice also does not properly allege what State Farm must do to cure these purported defects. State Farm did not commit any violations to cure. In addition, the Insureds did not allege valid methods for curing the violations as alleged in a Civil Remedy Notice of Insurer Violations. A civil remedy notice is “designed to be a cure period that will encourage payment of the underlying claim, and avoid unnecessary bad faith litigation.” Demase v. State Farm Fla. Ins. Co., 239 So. 3d 218, 221 (Fla. 5th DCA 2018) (quoting Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1282 (Fla. 2000). The Florida Supreme Court has explained the requirement to provide a valid cure: Section 624.155 does not impose on an insurer the obligation to pay whatever the Insured demands. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. § 624.155(2)(d). Talat Enters., 753 So. 2d at 1282 (citing Talat Enters. Inc. v. Aetna Cas. & Sur. Co., 952 F. Supp. 773, 777-78 (M.D. Fla. 1996)). The Notice states the following: Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1): Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2): INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for training and supervision of employees with regard to this types of claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other insurers from being treated unfairly and wrongfully; (3): INSURER must tender to the INSURED $50,678.43 as set forth above; and (4) INSURER must act fairly and honestly toward its INSURED and with due regard to her interests in attempting to settle its INSURED’S claim. This purported cure is precisely the type of expansive and illogical demand that the Florida Supreme Court rejected in Talat. The purported demand is vague and overly broad. The CRN fails to provide any specific guidelines that State Farm should engage in or avoid to correct any alleged improper claims handling. The CRN demands payment for a purported estimate that was never provided to State Farm before the filing of the CRN. The failure to provide the estimate referenced in the CRN improperly shortens any opportunity to evaluate and consider any opportunity to reconcile estimates. This “cure” improperly shortens the timeframe provided in section 624.155 by failing to give all information to State Farm prior to filing the CRN. Further, the CRN seeks payment of extracontractual damages via attorney’s fees and costs. The Florida Supreme Court has expressly rejected these types of “cures” as improper. The Notice fails to contain any specific facts showing that State Farm or its agents acted in bad faith in the investigation, inspection, evaluation, or handling of this claim. Therefore, the “cure” is invalid, and the CRN is statutorily deficient. CONCLUSION State Farm has handled the Insureds’ claim with diligence and has, at all times, acted fairly in the adjustment of the claim and has treated the Insureds with honesty and due regard to their interests, and State Farm has done so in compliance with the policy of insurance and Florida law. Once posed, State Farm promptly responded to the claim by promptly sending out an inspector to inspect the Insureds’ property, to include speaking to the Insured. Thereafter, State Farm advised the Insureds of State Farm’s coverage determination. If the Insureds honestly believe that there was any type of violation, State Farm has requested and continues its requests that the Insureds cooperate and provide specific information with respect to each alleged violation, including the name of each individual involved, the date of each violation, a description of each violation, and copies of documentation referencing each violation. As it stands now, the Notice is insufficient for the purpose of allowing State Farm to fully respond and/or remedy the alleged violations, if any. State Farm has tried to fully and adequately respond to the Insureds’ allegations alleged in the Notice filed with the Department. Should the Department have any questions or further inquiry with respect to this matter, please contact the undersigned. Very truly yours, DUTTON LAW GROUP, PA /s/ Richard R. Phelps Richard R. Phelps, Esq.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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