Civil Remedy Notice of Insurer Violations
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Filing Number:     801633
Filing Accepted:  1/16/2025
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Complainant
Last/Business Name *  
JOHNSON   First Name   KATRINA
Street Address * 1887 WINDMILL DRIVE
City, State Zip * ORLANDO, FL 32818
Email Address * CLAY@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JOHNSON   First Name   KATRINA
Policy # * MLR21149689678 Claim #* 00201728104
Attorney
Attorney is Applicable
Last Name* KUHN First Name * CLAYTON Initial
Street Address* 2110 WEST PLATT STREET
City, State Zip* TAMPA , FLORIDA 33606
Email Address * CLAY@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN SECURITY INSURANCE COMPANY
NAIC Company Code 42978
 
Name of individual responsible for violation (if any):* ANY AND ALL PERSONS ASSOCIATED WITH THE CLAIMS HANDLING FROM AMERICAN SECURITY INSURANCE COMPANY
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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.
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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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.

THE POLICY LANGUAGE RELEVANT TO THE VIOLATIONS INCLUDES ALL APPLICABLE LOSS PAYMENT AND COVERAGE PROVISIONS OF POLICY NUMBER MLR21149689678, INCLUDING THE DECLARATIONS PAGE AND ALL ENDORSEMENTS TO THE POLICY, WITH RESPECT TO COVERAGES A, B, C, AND D. ADDITIONALLY, ANY SECTIONS RELIED UPON BY THE INSURER IN ITS DENIAL TO FULLY PAY THE CLAIM, INCLUDING THE DUTIES IN THE EVENT OF LOSS PROVISIONS AND THE POLICY'S EXCLUSION OF COVERAGE PROVISIONS.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Katrina Johnson (hereinafter “Insured”) is a homeowner insured with an all-risks policy issued by American Security Insurance Company (hereinafter “Carrier”). On or about September 28, 2022, Insured’s home located at 1887 Windmill Drive, Orlando, Florida 32818 sustained significant damage as a result of a windstorm event. Specifically, Hurricane Ian created multiple openings to the roof of Insured’s property. This resulted in interior water damage to various areas of the interior of Insured’s property including but not limited to, den, storage room, multiple bedrooms, kitchen, living room, and dining room. The Loss is covered under Insured’s policy issued by Carrier. The Insured mitigated damages by contacting Loss Restorations LLC who performed mitigation services on the subject property. All of the relevant documents were provided to Carrier. Insured promptly reported the claim and fully cooperated with all requests for inspections. Carrier assigned Claim No. 00201728104 to the loss. The Insured has fully cooperated with Carrier’s investigation of the claim, including providing all requested documentation and complying with all post-loss policy conditions. Specifically, the Insured, with assistance from their public adjuster, submitted an estimate for $37,496.37, which was a fair and reasonable assessment for the repair/replacement of damages. Loss Restorations LLC has an outstanding balance in the amount of $13,682.86 for their mitigation services. Carrier failed to retain qualified experts necessary to identify the repairs necessary to restore the property to its pre-loss condition. Despite Insured providing Carrier with a detailed estimate, Carrier failed to pay Insured the amount necessary to repair/replace the damaged property, less the applicable deductible. Instead, Carrier wrongfully denied full coverage for the loss by not making a coverage decision within the timeframe given by the State of Florida. This has become a common business practice for Carrier. Despite the Insured submitting all of the necessary paperwork and following the guidelines set out by Carrier for these types of claims, Carrier has allowed the claim to pass the 90-day coverage decision period in violation of Section 626.9541(1)(i)(4), Florida Statutes. It has been well over 90 days since reporting the loss and Carrier continues to delay the claim. They have yet to provide any facts or explanations for its failure to properly communicate with the Insured and refuses to act in accordance with its statutory and contractual obligations. Under the circumstances surrounding this claim, had Carrier acted fairly and honestly toward the Insured and with due regard for the Insured’s interests, Carrier could and should have attempted in good faith to settle this claim. Carrier did not and, instead, dishonestly, and unfairly placed its own interests well ahead of those of the Insured. In doing so, Carrier violated Section 624.155(1)(b)(1), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to adopt and implement standards for the proper investigation of claims in violation of Section 626.9541(1)(i)(3)(a), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to conduct a reasonable investigation based upon available information. In denying full coverage for this claim without conducting reasonable investigations based upon available information, Carrier has violated Section 626.9541(1)(i)(3)(d), Florida Statutes. By representing to Insured that the Policy does not afford full coverage for this loss, Carrier is misrepresenting pertinent facts and/or insurance policy provisions relating to coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes. When applying the facts present here to Florida law, it is clear that Carrier is acting in bad faith. 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 based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Carrier has breached this duty by refusing to properly and timely adjust the loss. Moreover, Section 69B-220.201 of the Florida Administrative Code defines Carrier’s adjusters conduct here as an unfair claims settlement practice. Specifically, Section 69B-220.201(3) provides that “[a]n adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured” and that “[a]n adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.” As detailed above, Carrier’s investigation and adjustment of this claim was done in a manner prejudicial to Insured, was incomplete, and lacked truthful and unbiased reports of the facts. As of the date of this Notice, it has been 840 since the loss, and Carrier has yet to pay the claim in full. Carrier has more than enough information and is still refusing to accept coverage for the Insured’s claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Carrier can cure the defects outlined in this Civil Remedy Notice and avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Insured’s estimate of damages $37,496.37, and Loss Restorations LLC in the amount of $13,682.86, less applicable deductible, which is the reasonable amount of the covered loss pursuant to the policy. A copy of this form has been submitted to the Florida Department of Financial Services who has transmitted the same to the following parties providing them notice of the filing of this Civil Remedy Notice: Carrier.
Comments
User Id Date Added Comment
dbatista@shutts.com 03-17-2025 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 OF INSURER VIOLATION DOI File No.: 801633 Complainant: Katrina Johnson Claim No.: 00201728104 Filed by: Clayton Kuhn, Esq. Reported DOL: November 17, 2023 Dear Sir or Madam: This law firm represents American Security Insurance Company (“American Security”) with regard to the Civil Remedy Notice of Insurer Violation (“CRN”) filed on behalf of Katrina Johnson (the “Complainant”), on January 16, 2025. The CRN involves a claim reported under Certificate Number MLR21149689678 (the “Certificate”) issued by American Security under the provisions of Katrina Johnson’s lender’s Master Policy. The Certificate has an effective period of May 1, 2023 through May 1, 2024, pursuant to which PHH Mortgage Services (the “Lender”), is the “Named Insured” and Katrina Johnson is the Borrower (the “Borrower”). The Certificate insures, without limitation and as more fully set forth therein in accordance with the terms, conditions and exclusions, the dwelling located at 1887 Windmill Drive, Orlando, Florida 32818 (the “Property”), which secures a note and recorded mortgage owned by the Lender. The CRN pertains to an alleged ceiling collapse claim (the “Claim”) that reportedly occurred on November 17, 2023. The Claim, assigned claim number 00201728104, was reported to American Security on November 17, 2023. On November 20, 2023, American Security sent a letter to the Lender acknowledging the Claim and assigned an adjuster to conduct an inspection of the Claim. On or about November 21, 2023, an adjuster inspected the Property on behalf of American Security. On January 9, 2024, American Security sent a letter to the Borrower advising the investigation indicated damages to the Property were a result of wear and tear. Thus, no payment would be issued on the Claim. American Security included the applicable policy language from the Certificate in the letter. Over three months later, on April 12, 2024, American Security received an email from Trust Public Adjusters (“Trust PA”) attaching its letter of representation on behalf of the Complainant. On April 22, 2024, American Security sent a letter to Trust PA, which among other things, acknowledged receipt of its letter of representation. On April 30, 2024, Trust PA sent an email to American Security attaching mitigation and tarp invoices for alleged services performed at the Property by Loss Restorations. On May 1, 2024, Trust PA sent an email to American Security regarding scheduling an inspection of the Property. On June 4, 2024, Trust PA sent an email to American Security attaching its estimate for the alleged damages to the Property. On January 9, 2024, Trust PA sent an email to American Security requesting a copy of the Certificate. On January 16, 2025, the Complainant, through her counsel Kuhn Raslavich, P.A. (“KR Firm”), filed a Notice of Intent to Initiate Litigation (the “Notice of Intent”). That same day, on January 16, 2025, Complainant filed this Civil Remedy Notice. On January 17, 2025, American Security sent a letter to the KR Firm in receipt of the Notice of Intent and re-asserted its denial of coverage. On February 3, 2025, Complainant filed a lawsuit against American Security in the Circuit Court of the 9th Judicial Circuit Court in and for Orange County. The CRN is deficient and fails to comply with the requirements of Section 624.155, Fla. Stat. Specifically, the CRN does not provide an explanation as to how American Security failed to comply with the terms of the Certificate with specific factual support of specific language in the Certificate pertaining to the Claim, such that it failed to provide American Security with an opportunity to cure. Next, the CRN makes false, boilerplate accusations, and does not contain any specific facts supporting the violations alleged. The failure to provide any factual support for the alleged violations renders the CRN fatally defective. Contrary to the allegations of the CRN, at no time has American Security ever acted in bad faith. At all times material to this Claim, American Security: (a) Acted in good faith to adjust the Claim, acting fairly and honestly in its dealings with Complainant and her representatives regarding the Claim; (b) Promptly investigated the Claim; (c) Acknowledged and acted promptly in response to the reported Claim and in all communications with the Complainant and her representatives; and (d) Promptly provided a reasonable explanation in writing to the Complainant regarding the basis for denial of the Claim under the Certificate. American Security has acted reasonably and in good faith at all times in adjusting this Claim and believes that the allegations in this CRN lack specificity, are baseless and without merit. If you are in need of or seek any further information, please feel free to contact the undersigned. Very truly yours, /s/ David Batista David O. Batista
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