Civil Remedy Notice of Insurer Violations
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Filing Number:     801775
Filing Accepted:  1/17/2025
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Complainant
Last/Business Name *  
REBELO, ET. AL.   First Name   CAMILO
Street Address * 14920 LAGUNA DRIVE, FT. MYERS, FL 33908
City, State Zip * FT. MYERS, FL 33908
Email Address * CAMILOREBELO@HOTMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   REBELO, ET. AL.   First Name   CAMILO
Policy # * FPH5003662-02 Claim #* FPI233036
Attorney
Attorney is Applicable
Last Name* TORRES First Name * GISELLE Initial M
Street Address* 350 N. LAKE DESTINY ROAD
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * GTORRES@ITSABOUTJUSTICE.LAW
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FLORIDA PENINSULA INSURANCE COMPANY
NAIC Company Code 10132
 
Name of individual responsible for violation (if any):* FLORIDA PENINSULA INSURANCE COMPANY
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Other : Under valued the claim.
Claim Delay
Unsatisfactory Settlement Offer
* 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)(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 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.
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.

Section 1 Property Coverages – Coverage A – Dwelling Section 1 Property Coverages – Coverage B – Other Structures Section 1- Conditions – 3. Loss Settlement Section 1 – Conditions – 10. Loss Payment
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about September 28, 2022, the Insureds, Camilo Rebelo, Liliana Alverenga, and Camila Alverenga, suffered significant damage to their home located at 14920 Laguna Drive, Ft. Myers, FL 33908 as a result of Hurricane Ian. Prior to the loss, Florida Peninsula Insurance Company (“FPIC”), had issued a policy of insurance (Policy No.: FPH5003662-02) for the Insureds’ property. Said policy was in full force and effect on date of loss and afforded coverage for a hurricane loss. During Hurricane Ian, the National Weather Service issued several weather advisory and warnings, including a hurricane warning affecting Lee County specifically stating up to 140mph gusts; it further noted an extensive potential impact with considerable roof damage to sturdy buildings, with some window, door, and garage door failure leading to structural damages. Additionally, areas in Lee County were evacuated. FPIC was notified of the loss by the Insureds and assigned claim number FPI233036. During the course of FPIC’s investigation, the Insureds made the property available for inspection, provided facts and information surrounding the loss, and complied with FPIC’s adjustment of the claim. Despite fully cooperating with FPIC’s investigation, FPIC failed to conduct a thorough assessment of the Insureds’ claim which caused FPIC to woefully underestimate the scope and cost of repairs. Although FPIC acknowledged coverage for damage caused by the storm, FPIC refused to cover the roof replacement with little to no supporting evidence. FPIC underestimated the scope and cost of repairs for the roof and the exterior even though there was clear evidence of hurricane and wind damages, including severe wind uplift upon the tiles causing fasteners to loosen and bend. This allowed further damage to the tiles and roofing underlayment. Even though FPIC knew there was substantial hurricane damage to the roof that required replacement, FPIC and its adjusters misrepresented the cause and scope of the damages to the Insureds which allowed FPIC to underestimate and under value the claim. It is clear that FPIC has not acted honestly or fairly towards its Insureds. FPIC and its adjusters have misrepresented the scope and cause of damages to the residence and misapplied exclusions in the policy in order to deny coverage for much of the Insureds’ claim. As is the case here, it has become a general business practice of FPIC to not implement proper claims handling procedures, to hire consultants that routinely ignore or intentionally misidentify relevant evidence, and to not settle claims in good faith when under all circumstances it should have. FPIC regularly undervalues claims in order to avoid issuing payment on losses that it knows are covered under the policy. FPIC also routinely refuses to pay claims in full when it has the ability to do so, waits to see if its insureds contest their coverage determinations. FPIC has developed this deliberate strategy in order to deter its insureds from challenging its coverage determinations and hinder their ability to seek additional payment for monies owed under the policy. FPIC’s decision to not adjust losses in good faith in accordance with section 627.70131, Florida Statues, unnecessarily delays resolution of its claims and leaves claimants with no choice but to incur further time and expense just to be fully indemnified. FPIC has completely abdicated its duty to adjust and has put the onus on its Insureds before State Farm is willing to issue benefits or make repairs that it knows are owed. FPIC’S pattern and practice of underrepresenting the actual cost and cause of damages is evidence that it does not act fairly or honestly towards the Insureds during its adjustment process and that it has failed to implement proper standards for the investigation and handling of its claims. In order to cure this civil remedy notice, FPIC must immediately tender $208,021.29, less the applicable deductible and prior payment(s), to “Camilo Rebelo, Liliana Alverenga, and Camila Alverenga and Cohen Law Group”. The amount of $208,021.29 applies to indemnity only. The Insureds seek attorney fees and costs in addition to the indemnity amount. The written acknowledgement should be provided to the Insureds’ counsel, Giselle M. Torres, Esq., at 350 N. Lake Destiny Road, Maitland, Florida 32751.
Comments
User Id Date Added Comment
tsalehi@salehiboyer.com 02-13-2025 VIA ELECTRONIC SUBMISSION: civilremedy@myfloridacfo.com Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Re: Complainant: Camilo Rebelo Et. al. Policyholder: Camilo Rebelo Et. Al. Filer: Giselle M. Torres, Esq. Claim #: FPI233036 Policy #: FPH5003662-02 Date of Loss: September 28, 2022 CRN Filing No.: 801775 CRN Filing Date: 1/17/2025 To Whom It May Concern at The Department of Financial Services: With this correspondence, Florida Peninsula Insurance Company (“FPIC”) responds to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Giselle M. Torres, Esq. on behalf of Camilo Rebelo et. al. (the “Complainants” or “Claimants”). After reviewing the CRN, FPIC conducted a thorough review of its handling of the Complainant’s claim. FPIC denies that it has violated any of the statutes referenced in the CRN. At all times, FPIC has acted in good faith, fairly and honestly toward the Complainant and with due regard for their interests. FPIC also argues that the CRN fails to actually describe the alleged violations and fails to provide any information such as facts and circumstances which would allow FPIC to correct the alleged violations. The Complainant alleges violations of the following statutory provisions: 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. FPIC denies the allegation that it violated the above referenced statute. 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. FPIC denies the allegation that it violated the above referenced statute. 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. FPIC denies this allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. FPIC denies this allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. FPIC denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. FPIC denies the allegation that it violated the above referenced statute. 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. FPIC denies the allegation that it violated the above referenced statute. 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 received 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). FPIC denies the allegation that it violated the above referenced statute. FPIC specifically denies each and every one of the Complainant’s allegations that it violated any of the above referenced statutes. In addition to the allegations specifically denied above, FPIC generally denies all allegations presented in this CRN as FPIC has not violated any statute or rule. CRN MUST BE DISMISSED The CRN must be dismissed first and foremost because the Complainant failed to allege specific, actual facts in support of any of their statutory allegations. Next, the CRN requires that the Complainant “pursuant to section 624.155, F.S., please indicate all statutory provisions alleged to have been violated.” The CRN filed in this matter includes numerous statutory provisions that could be claimed against an insurance company, regardless of whether they are relevant or applicable to the allegations contained in the Notice. Because the CRN fails to allege specific facts and/or circumstances in support of its allegations, FPIC is unable to properly respond; as such, the CRN should be rejected and returned. The CRN is completely devoid of any factual allegations relating to the monetary amount of any claims. See Rousso v. Liberty Surplus Ins. Corp., No. 10-cv-20554, 2010 WL 7367059, at *4 (S.D. Fla. Aug. 13, 2010) (“In this case, the Plaintiffs do not explain how or identify which claims or suits the Defendant responded to in a manner that was contrary to good faith, unfair, or dishonest.”). This glaring deficiency fails to apprise FPIC of the nature of any purported violation and cannot satisfy the statutory standard of “pleading the facts and circumstances” giving rise to the violation with specificity. The CRN first addresses Section 624.155(1)(b)(1), Florida Statutes, which addresses an insurer’s refusal to attempt to settle in good faith. The CRN, however, does not specify when any settlement opportunity or proposal existed, the details of the settlement proposal, the nature of the underlying claim(s), or the circumstances supporting the conclusion that the unspecified refusal to settle was not in good faith. To the extent the CRN suggests that FPIC should tender payment due on the claim, the CRN fails to provide any description of the facts and circumstances supporting this contention. The complainants alleged violation of Section 626.9541(1)(b)(3) the Complainant alleged that FPIC failed 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 policy coverage but provides no substantive examples or specific facts that would substantiate such an allegation. Next, the complainants allege violation of Section 626.9541(1)(i)(2) but do not describe in detail the misrepresentation but instead makes a general conclusory allegation. In Florida, the elements one must meet in order to have a prima facie case for misrepresentation would include: A false statement about a material fact; The person who made the statement knew it was false; Ther person who made the statement intended to influence the other party; and the other party relied on the statement and suffered harm. The CRN is devoid of any such facts that would support such an allegation. FPIC vehemently states that this allegation, itself, is a false statement that, frankly, shocks the conscience. Moreover, the alleged violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, the CRN’s failure to describe any of the facts or circumstances of the claim precludes FPIC from evaluating what error, if any, allegedly occurred during the investigation of the claim. Complainant cannot possibly support the position that FPIC failed to adopt and implements standards for the proper investigation of the claim because the CRN provides little to no description of the facts or circumstances of FPIC’s investigation, the disposition of the claim, or the facts and circumstances indicating FPIC’s investigation was in some way defective. As to Section 626.9541(1)(i)(3)(b), Florida Statutes, the CRN provides only conclusory and unsupported allegations of FPIC’s “misrepresentation” or false statements relating to the facts of the claim or coverage at issue. Because the CRN fails to describe any of facts or circumstances of the claim with any particularity, FPIC is precluded from evaluating what error, if any, allegedly occurred during the claim process. Moreover, as to Section 626.9541(1)(i)(3)(d), Florida Statutes, the CRN does not describe any standards applicable to the purported “claim” advanced by the Complainant, much less any facts and circumstances giving rise to the contention that FPIC denies claims without conducting reasonable investigations based upon available information. FPIC vehemently denies this allegation. As to Section 626.9541(1)(i)(3)(f), FPIC promptly provided the complainants with a coverage determination and the basis for said coverage determination. The CRN implies that FPIC denied the claim based on its conclusory allegation under this statute. FPIC did not deny the complainants claim and found coverage. The parties simply do not agree on the amounts. FPIC denies that there was any violation under this statute. Finally, Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported, conclusory, and incorrect allegations with no basis in fact or circumstance. Aside from the fact that the allegations are devoid of any specific facts, the tenor and inferences of the allegations are wholly without merit and FPIC denies each and every one. The allegations set forth in the CRN are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and clearly intended solely to tarnish FPIC’s name and reputation. FPIC, at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. FPIC at no time misrepresented any pertinent facts or insurance policy provisions. FPIC conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. Finally, FPIC promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. As it relates to the facts of the claim, FPIC received notice of the subject loss from the Insureds on or about October 7, 2022, with an alleged date of loss reported as September 28, 2022. On or about October 26, 2022, an independent field adjuster inspected the Insureds’ property on FPIC’s behalf. On or about December 12, 2022, FPIC provided the Insureds with a detailed coverage determination finding coverage for the dwelling in the amount of $806.66 after depreciation and the screen enclosure in the amount of $6,098.49 after depreciation and the application of the Insureds’$12,826.00 deductible. The coverage determination was provided to the Insureds within sixty (60) days of the claim being reported to FPIC pursuant to Fla. Stat. 627.70131 (7)(a) which states in part: Within 60 days after an insurer received notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer. The insured provided no proof of repairs to the property that exceeded the amount provided in the above coverage determination. There was not supplemental claim filed and/or requested. However, the Insureds filed their Notice of Intent to Initiate Litigation (NOIL) on March 1, 2023. FPIC filed its response to the Insureds NOIL on March 14, 2023 which expressed its disagreement with the amount of the Insured’s alleged damage and extended the courtesy to the Insured to contact FPIC regarding any questions. FPIC ‘s coverage determination was based on the totality of the information that was provided to FPIC during the initial claim investigation. Furthermore, FPIC’s letter attached an excerpt of the relevant policy language which, in part, formed the basis of FPIC coverage determination. FPIC communicated reasonably with the Complainant about the claim and provided the Complainant with a reasonable explanation for each of its actions. FPIC’s NOIL response discussed its coverage determination provided Insureds along with detailed explanation regarding its position to stand by its coverage determination. FPIC did everything possible to keep its Insureds informed throughout the claims process. Additionally, the CRN contains “cures” for the alleged defects; however, the listed “cures” are improper pursuant to Florida case law, specifically the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000). The Talat case provides that the scope of what can be "cured" is limited to the alleged non-payment of the contractual amount due to the insureds. Talat also commented that, “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the insured. In the context of a first-party insurance claim, the contractual amount due the insured is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As a result, only a demanded “cure” relating to the specific amount needed to repair covered damages is proper and legal – any remaining “cures” are improper remedies and contrary to Florida law. In closing, FPIC first believes that the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute § 624.155, Florida Statute § 626.9541, and Florida case law, and regardless of the rejection, FPIC denies all allegations contained in the CRN and submits that there are no violations. While this response is meant to be comprehensive, FPIC based the above-mentioned statements upon the limited information provided in the CRN and the information FPIC has been provided to date. If the Complainant feels that FPIC is not in possession of all the facts, please provide such additional information as soon as possible. Please note that FPIC’s response is not necessarily exhaustive and does not preclude the assertion of other valid reasons for seeking rejection and return of the CRN. Also, nothing in this letter, or any act or failure to act on the part of FPIC or any agent or representative of FPIC should be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation alleged in the CRN. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Regards, s/ Lanzce A. Francis Lanzce A. Francis, Esquire On behalf of Florida Peninsula Insurance Company
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