Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 801568

Filing Accepted: 1/16/2025

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Complainant

Last/Business Name *

DUANY

First Name

EFRAIN

Street Address *

915 BEAR LAKE BLVD

City, State Zip *

APOPKA, FL 32703

Email Address *

NOTICES@SHARANLAWSERVICES.COM

Complainant Type: *

Insured

Last/Business Name*		DUANY		First Name		EFRAIN
Policy # *		2MR1500261760		Claim #*		00201594325

Attorney

Attorney is Applicable

Last Name*	SHARAN First Name * NITI Initial
Street Address*		1221 S. 21ST AVE
City, State Zip*		HOLLYWOOD , FLORIDA 33020
Email Address *		NOTICES@SHARANLAWSERVICES.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		AMERICAN SECURITY INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 42978

Name of individual responsible for violation (if any):* AMERICAN SECURITY INSURANCE COMPANY(INSURER) MELAKU ABEBE (CLAIMS EXAMINER) MARK SOLAZZO JR (FIELD ADJUSTER) DARRIUS MARZETTE (CLAIMS ADJSUTER) ALONG WITH ALL ADJUSTERS, SUPERVISORS, MANAGEMENT, AND ALL ASSOCIATED INDIVIDUALS INCLUDING PILOT CLAIM SE
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Unsatisfactory Settlement Offer
	Unfair Trade Practice
	Claim Delay
	Other : Failure to Properly Investigate Claim and with Due Regard to Insureds' Interest
	Other : Failure to Acknowledge and Act Promptly to Communications Regarding Claim
	Other : Failure to Pay Claim in Full
	Other : Failure to Adopt standards for proper investigation of claim
	Other : Failure to settle the claim in good faith

* Statutory provision(s) which the insurer allegedly violated.

	624.155(1)(b)(1)		Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
	624.155(1)(b)(3)		Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(b)		Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Loss Payment or Settlement Provision Duties After Loss

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

This complaint is made on behalf of Efrain Duany (“Duany”). In consideration of the premium paid to it by Duany, American Security Insurance Company (“American”) issued a Homeowner’s Insurance Policy, Policy No.: 2MR1500261760 (the “Policy”). On September 28, 2022, while the Policy was in full force and effect the Duanys’ property, located at 915 Bear Lake Blvd, Apopka, FL 32703 (“the Property”) suffered damage caused by a Hurricane. TheHurricane caused damage to the Property to areas including, but not limited to, the roof, exterior, interior and contents. Hurricane damage is a covered peril under the policy. After notifying American of the loss, American’s Claims Department opened a claim and assigned Claim No.: 00201594325. The following timeline of events details the nature of Americans’ improper adjustment and delay of Duany claim. On September 28, 2022, a Hurricane caused damages to the Property. The public adjuster reported the claim to American within a reasonable timeframe under the circumstances. On January 9, 2023, American acknowledged the claim and advised in part it would consider any estimates from the public adjuster submitted for damages to the property along with other estimates which American may obtain. Pursuant to Florida Statute 627.71031(1)(a) (2022 version) Upon an insurer’s receiving communication with respect to a claim, the insurer shall, within 14 calendar days, review and acknowledge receipt of such communication. American failed to acknowledge the claim within 14 calendar days. On January 17, 2023, American sent its coverage letter advising their investigation revealed the damage found to the property did not exceed Duany policy deductible of $4,535.00…… no evidence wind damage to the roof. The ridge cap that was ripped/ torn from an overhanging tree branch brushing against the ridge cap and no due to wind damage. The field adjuster Mark Solazzo estimated wind damages to the roof soffit, gutter and fascia, including coverage for debris removal and included labor minimums for the roofs siding and enclosed the “low ball” “undervalued” below deductible estimate in the amount of $270.73 less than the policy deductible of $4,535.00. American issued its purported conclusion of their investigation based on the inspection through the field adjuster. American excluded coverage for the roof without sending an Engineer, General Contractor or Licensed Roofer to determine the cause and origin of the damage and yet willfully and intentionally chose to underpay the claim significantly. Even though requested by the public adjuster American failed to provide clarification on the experience, training and background on the adjuster who inspected the property and made the claim decision. On April 1, 2023, American was provided with a detailed estimate from a licensed independent adjuster and HAAG Certified Inspector regarding the damages and the scope necessary for repairs in the amount of $36,570.14. Pursuant to Florida Statute 627.71031(1)(a) (2023 version) Upon an insurer’s receiving communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication. As of date American failed to acknowledge the estimate submitted on April 1, 2023, nor request an additional inspection. American has failed to continue to investigate the covered claim for approximately two years. American failed to evaluate and issue a subsequent determination based on the estimate provided on April 1, 2023. On January 12, 2025, American was provided with an updated detailed estimate from a licensed independent adjuster and HAAG Certified Inspector regarding the damages and the scope necessary for repairs in the amount of $99,974.48. At the inspection, the field adjusters failed to conduct a thorough investigation. American must investigate claims in an unbiased manner. It is apparent American breached its obligation and because of that American significantly underestimated the scope of the damage to the above-referenced property, which is its duty under the contract of insurance issued by it. American "low balled" the Insured’s to place its financial interests above the Insured’s interest in restoring the property to its pre-loss condition. American and its adjustor have conspired to misrepresent the true scope of damages to the Insured’s property and the actual replacement cost of the damages. American continues to act without due regard for Insureds’ interest. It is anticipated that American will continue with this type of tactic by using aggressive claims and litigation tactics to delay the Duanys’ claim. American has committed ethical violations in that American has failed to adjust the Duanys’ claim in an unbiased way. To date, American has failed and/or refused to provide Duanys’ with all the insurance benefits due and owing, despite knowing that the Duany has sustained covered damages to his Property. Despite the Duanys’ pleas, American has not tendered the full amount needed to repair its Property under the Policy. Instead, American is attempting to deny coverage with an end goal of “low- balling” the claim. As of date, despite multiple requests American has failed to provide a Certified Copy of the Insurance Policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by this section. American must cure its violations by tendering payment in the amount of $99,974.48.

Comments

User Id		Date Added		Comment
alaine.greenberg@hklaw.com		03-18-2025		VIA UPLOAD onto DFS website Florida Department of Financial Services Division of Insurance Regulation Consumer Assistance / Civil Remedy Section Larson Building, 200 East Gaines Street Tallahassee, Florida 32399-0322 Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION DOI File No.: 801568 Complainant: Efrain Duany Claim No.: 00201594325 Filed by: Niti Sharan, Esq. Reported DOL: September 28, 2022 Dear Sir or Madam: American Security Insurance Company (“American Security”) received the Civil Remedy Notice of Insurer Violation (“CRN”) submitted on behalf of Efrain Duany (“Complainant”), accepted by the Department of Financial Services (the “Department”) on January 16, 2025 regarding claim number 00201594325 (the “Claim”) reported under a lender-placed certificate, number 2MR1500261760 (the “Certificate”). As a general matter, American Security objects to the validity of the CRN, as it is deficient on its face. Complainant fails to name the correct insurer in which it alleges violations against. Indeed, the body of the CRN names State Farm Florida Insurance Company instead of American Security. In addition, the CRN lacks the specificity required by s. 624.155(3)(a), Florida Statutes. The CRN provides nothing more than vague, ambiguous and conclusory allegations regarding what Complainant believes to be American Security's motivations, positions and business practices – none of which are true or supported by any facts. Florida law is clear that a claimant is required to state with specificity the “facts and circumstances giving rise to the violation,” to allow the insurer to understand and cure any purported violation. Longpoint Condo. Assn. v. Allstate Ins. Co., 2005 WL 1315810 (N.D. Fla. 2005). A written CRN which is vague and “shotgun” in nature or is written in general terms fails the specificity requirement of the statute. See Heritage Corp. of South Fla. v. National Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. 2010); Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The very purpose of the civil remedy notice, pursuant to Chapter 624, is to inform the insurer of alleged violations with specific information to encourage settlement of the subject claim. “The sixty-day window [as provided for in F.S. §624.155] is designed to be a cure period that will encourage payment of the underlying claim, and avoid unnecessary bad faith litigation.” Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1278 (Fla. 2000). Notice sent to the Department of Insurance concerning settlement violation(s) is intended to serve as a basis for the Department to assist in the settling of claims and to monitor the insurance industry. Id. However, whenever a complainant provides little in the way of adequate notice, the statutory intent of the CRN is frustrated. Without any specificity alleged whatsoever, the CRN is facially deficient as a matter of law. In further response to the CRN, American Security categorically denies all of the allegations contained therein and specifically denies that it has violated the Florida Statutes cited in the CRN with respect to the handling of the Claim. Notwithstanding the foregoing, the parties have amicably resolved all matters set forth in the CRN, without admission of liability by either party. If you are in need of or seek any further information, please feel free to contact the undersigned. Very truly yours, /s/ Alaine S. Greenberg cc: Niti Sharan, Esq. Andrea N. Aguilar, 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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

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