Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 801655

Filing Accepted: 1/16/2025

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Complainant

Last/Business Name *

TIBAVINSKY

First Name

WILLIAM AND GLORIA

Street Address *

6136 VOYAGERS PLACE

City, State Zip *

APOLLO BEACH, FL 33572

Email Address *

WILLTIB@HOTMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		TIBAVINSKY		First Name		WILLIAM AND GLORIA
Policy # *		SJ31145956		Claim #*		202410013682

Attorney

Attorney is Applicable

Last Name*	ROSS First Name * VANESSA Initial
Street Address*		2501 S. TAMIAMI TRAIL
City, State Zip*		SARASOTA , FLORIDA 34239
Email Address *		ESERVICE@ROSSLEGALFL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		SLIDE INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 17227

Name of individual responsible for violation (if any):* BENJAMIN TEMPLE, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SLIDE 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 We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises". Perils Insured Against We insure against risk of direct physical loss to property described in Coverages A and B. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable 60 days after we receive your proof of loss and: 1. Reach an agreement with you; 2. There is an entry of a final judgment; or 3. There is a filing of an appraisal award with us. Loss Settlement In this Condition C., the terms "cost to repair or replace" and "replacement cost" do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.11. Ordinance Or Law under Section I – Property Coverages. Covered property losses are settled as follows: 1. Property of the following types: a. Personal property; b. Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; c. Structures that are not buildings; and d. Grave markers, including mausoleums; at actual cash value at the time of loss but not more than the amount required to repair or replace.

* 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. Slide Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of William Tibavinsky and Gloria Tibavinsky (“INSURED”) claim of loss. Slide Insurance Company’s mailing address is 4221 W. Boy Scout Blvd Suite 200, Tampa, FL 33607. 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 6136 Voyagers Place, Apollo Beach, FL 33572 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 exterior and interior of the property. INSURER inspected the property, but denied coverage for the claim. They did not write an estimate because of the full denial. The INSUREDS’ hurricane deductible is $6,815.00. 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 $62,436.81. 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 $62,436.81 Less Prior Payments $0.00 Less Deductible $6,815.00 TOTAL $55,621.81 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 $55,621.81 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
mthornton@slideinsurance.com		03-15-2025		Vanessa Ross, Esq. Ross Legal 2501 S Tamiami Trl Sarasota, FL 34239 eservice@rosslegalfl.com RE: Complainant: William Tibavinsky and Gloria Tibavinsky Insured: William Tibavinsky and Gloria Tibavinsky Claim No: 202410013682 Policy No: SJ31145956 CRN Filing No.: 801655 Dear Vanessa Ross: Please allow this correspondence to serve as Slide Insurance Company’s (“Slide”)’s response to the Civil Remedy Notice (“CRN”) filed on behalf of William Tibavinsky and Gloria Tibavinsky (“Insured”). The CRN was accepted by the Department on January 16, 2025. Without waiving any objections to the sufficiency of the CRN, and subject to a reservation of all rights and defenses herein, Slide denies all allegations that it violated Florida Statutes or any other codes, regulations, and/or rules in the handling of this matter. Slide challenges the validity of the CRN as it does not identify the specific policy terms the Insured claims Slide failed to follow. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875, 879 (Fla. 4th DCA 2021); Demase v. State Farm Florida Insurance Company, 351 So.3d 136, 138-39 (Fla. 5th DCA 2022) (holding the trial court properly determined a civil remedy notice that failed to state with specificity the relevant policy language was legally insufficient). Thus, the CRN is deficient and should be returned by the Department. CLAIM FACTS Slide issued a homeowners’ insurance policy to the Insured for property located at 6136 Voyagers Place, Apollo Beach, Florida, in effect for the period from June 27, 2024 to June 27, 2025 (the “Policy”). On October 17, 2024, the Insured filed a claim for damage to their property from Hurricane Milton. Specifically, the Insured stated the floor in the storage area below the stairs was wet. The date of loss was reported as October 13, 2024. Slide acknowledged receipt of the claim and assigned a licensed field adjuster to inspect the property. At the inspection on October 27, 2024, the field adjuster did not find any evidence of wind or storm-related damage to the shingle roof, exterior elevations, or windows. On the interior, staining was documented around the base of the wall and carpeting in the storage closet located underneath the stairs. No other damage was reported or observed. In furtherance of the investigation, Slide retained a licensed engineer, Keystone Experts + Engineers (“Engineer”) to complete an evaluation of the property. Based on review of the inspection photographs and documentation of the claimed damages, the Engineer concluded the water intrusion in the stairwell closet was the result of wind-driven rain through deteriorated exterior stucco, which showed signs of prior repair attempts. In a letter dated December 27, 2024, Slide advised the Insured that because the reported damage was from water seeping through the exterior stucco, not a storm-created opening, the loss was precluded from coverage pursuant to the terms, conditions, and exclusions of the Policy. Slide provided the Insured a written explanation of the coverage decision and supporting documentation, in accordance with Florida law and the Policy. On or about January 15, 2025, Ross Legal Group, PA, submitted a letter of representation on the Insured’s behalf. The letter of representation did not attach supporting documents or provide any further information regarding the Insured’s claim. The desk adjuster assigned to the claim acknowledged the representation and provided the relevant claim documents to the Insured’s attorney per their request. This CRN was filed the next day on January 16, 2025. To date, neither the Insured nor their representatives have submitted any information that would alter Slide’s understanding of the loss and coverage. Slide maintains that it has acted in accordance with the terms of the subject insurance policy and the law in its adjustment of the claim. The facts and circumstances set forth in the CRN are misleading, vague, and incomplete. The Insured has presented no evidence to support the allegations of claim delay, claim denial, unfair trade practice, unsatisfactory settlement offer, or any other violations of Florida law or the Policy. Rather, the facts show Slide promptly investigated the loss, made communications as necessary to adjust the claim, and notified the Insured of the coverage decision within the statutory time frame. DENIAL OF ALL VIOLATIONS OF FLORIDA STATUTE The CRN alleges Slide violated §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(c), and 626.9541(1)(i)(3)(d), Fla. Stats. Notwithstanding the position that the CRN is legally insufficient, Slide denies all allegations that it violated Florida law in the handling of the subject claim. As provided in the above narrative, the underlying claim was investigated and adjusted in as thorough and expedient a manner as possible. Upon receipt of the claim, Slide retained licensed individuals to complete a prompt inspection of the Insured’s property to verify the reported loss. Based on the on-site inspection and representations by the Insured regarding the scope of the damages, Slide advised the Insured of the coverage determination within the statutory time frame. Thus, Complainant’s allegations that the company failed to diligently investigate, misrepresented material facts or policy provisions, or failed to properly or fully communicate with the Insured are unsupported by the documented circumstances of the claim. In fact, no specific instances of the purported conduct are provided in the CRN. The facts show Slide has consistently acted promptly upon all communications with respect to this claim, communicated with the Insured and/or their representatives regarding the claims asserted, conducted a reasonable investigation of the reported loss, and rendered a decision on coverage based on the available evidence. Thus, Slide asserts strict compliance with its statutory obligations. CONCLUSION In filing this response, Slide does not intend to waive any rights or defenses that it may have in law or under the policy. Rather, Slide expressly reserves all such rights and defenses without exception or limitation. Should there be any questions or further inquiry with respect to this matter, please contact the undersigned at mthornton@slideinsurance.com. Sincerely, /s/ Marianne Thornton Marianne Thornton, Esq. Staff Counsel

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