Civil Remedy Notice of Insurer Violations
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Filing Number:     801827
Filing Accepted:  1/17/2025
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Complainant
Last/Business Name *  
RIVERA   First Name   CARLOS AND MARY
Street Address * 2682 NUMILLA DR
City, State Zip * ORLANDO, FL 32839
Email Address * [WITHHELD]
Complainant Type: * Insured
Insured
Last/Business Name*   RIVERA   First Name   CARLOS
Policy # * P008824814 Claim #* 255945
Attorney
Attorney is Applicable
Last Name* ROLLE First Name * CRAIG Initial D.
Street Address* 708 E. COLONIAL DR., SUITE 103
City, State Zip* ORLANDO , FLORIDA 32803
Email Address * CR@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SECURITY FIRST INSURANCE COMPANY
NAIC Company Code 10117
 
Name of individual responsible for violation (if any):* SEE BELOW
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
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)(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.

Specific policy language contained in the Insureds' insurance contract that is relevant to the violations by Security First Insurance Company includes, but is not limited to, the following: Coverage A, B, C, D and E Provisions, all additional Coverage Provisions, all coverage provided by endorsement or rider, the declarations page, loss payment or settlement provisions, provisions pertaining to the duties in the event of a loss, all terms and conditions pertaining to Section I of the insurance policy, the insurance policy’s definitions section, the insurance policy’s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the Insureds’ property; and all other relevant policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In consideration of payment of an annual premium, an all-risk residential property insurance policy was in full force and effect with Security First Insurance Company (“Carrier” or “Security First”) bearing policy number P008824814 and claim number 255945, for a property located at 2682 Numilla Dr Orlando, FL 32839 (Property). The owners of the Property are the named Insureds, Carlos Rivera and Mary Rivera. On or about September 28, 2022, the Insureds’ Property suffered a loss from Hurricane Ian. In response, the Carrier assigned the above claim number to this loss and conducted an inspection of the Property. Shortly thereafter, the Carrier improperly denied coverage for the loss. Unhappy with the Carrier’s treatment and handling of this claim, the Insureds retained the undersigned counsel which could have been avoided had the Carrier properly investigated and correctly paid the entire estimate for this claim. The Carrier failed to promptly settle the Insureds’ insurance claim when the obligation to settle the insurance claim had become reasonably clear. The Carrier has therefore NOT acted in good faith during the adjustment of this claim. Specifically, the Carrier has violated the following statutory provisions under Florida law: • Carrier has violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented with evidence that it has underpaid this claim, the Carrier still refuse to made additional payments. • The Carrier has violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insured for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. • The Carrier has also violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Quite simply, Security First and its representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insureds. In addition, after being placed on notice as to the blatant failure to properly adjust this claim, Security First has yet to rectify their actions and do right thing by the Insureds by paying the money they are contractually owed. We believe Security First will profit from its wrongful conduct and its behavior is tantamount to unfair claim settlement practices under Florida Stat. 626.9541(1)(i)(3). As noted above, the Carrier violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. The Insureds have more than complied with every request and duty under the Policy and there has still been no action by Security First to rectify its underpayment of this claim. In the event the Carrier needs additional information, it has failed to promptly notify the Insureds in a timely manner. Moreover, this pattern of behavior is perpetuated by Security First and its representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insureds throughout the insurance claim process. Several duties and responsibilities owed to the Insureds were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from Security First approaching the investigation and settlement in a manner prejudicial to the Insured, failing to allow a fair settlement with her and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insureds were not afforded the professional duties entrusted on Security First by the public. As of the filing of this civil remedy notice, Security First has failed to adequately compensate the Insureds for the damage that occurred on or about February 4, 2024. As a direct result of Security First ’s delay and failure to respond to the Insureds, they were forced to seek the help of legal counsel. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that Security First knowingly and intentionally delayed the claims process to further disadvantage the Insureds. The financial detriment caused to the Insured is a direct result Security First’s reckless delay of the claim and litigation process. The Insureds were (and still are) dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. In other words, the Insureds have held up her end of the contractual bargain whereas the Carrier has not. The Insureds timely filed her claim once they had discovered the source of the covered loss and the ensuring damage caused by it. All requested information and documentation were turned over to Security First and its representatives promptly by the Insured. Security First failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insureds how they may remedy any deficiencies in her claim, and failed to provide her with qualified representatives to ensure the claim was initially adjusted, evaluated, estimated properly, and paid fully. To deny the Insureds the benefit of their bargain after they have satisfied all of the obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the actions complained of, among others, made by Security First so often as to constitute a general business practice, evidencing a motive to enhance its profits, and designed to cause a detrimental effect to its policy holder. Security First was aware that the Insureds’ damages were in covered under the policy yet took advantage of them in an attempt to force them into an irreparable disadvantaged position by underpaying the claim. The Carrier hopes that its conduct will force the Insured to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Security First fail to cure the violations set forth in this Civil Remedy Notice within the given time period. To cure the defects outlined in this Civil Remedy Notice, Security First must: (1) Immediately tender all insurance proceeds due and owing to the Insureds that are fairly owed to them under the insurance policy that would reasonably place them back to a pre-loss condition pursuant to the estimate of damages in the amount of $73,970.00.
Comments
User Id Date Added Comment
stewart.pedigo@securityfirstflorida.com 02-19-2025 Via Electronic Filing: Florida Department of Financial Services Bureau of Consumer Assistance c/o: Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0322 Via Email: CRAIG D. ROLLE 708 E. COLONIAL DR., SUITE 103, ORLANDO, FL 32803 BUY@ITSABOUTJUSTICE.LAW Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION Filing No.: 801827 Insured: CARLOS AND MARY RIVERA Insurer: Security First Insurance Company Claim No.: 255945 Policy No.: P008824814 Date of Loss: 09/28/2022 Dear Sir or Madam: This correspondence is in response to the Civil Remedy Notice of Insurer Violations (hereinafter referred to as the “CRN”) was filed by Craig D. Rolle on behalf of his clients, Carlos and Mary Rivera (hereinafter referred to as “Insured”). Please be advised that the undersigned represents the interests of Security First Insurance Company (hereinafter referred to as “Security First”) with respect to the above-referenced matter. The Florida Department of Financial Services (hereinafter referred to as “Department”) assigned this CRN an acceptance date of 1/17/2025 and DFS File No.: 801827. This matter concerns a property damage claim made by the Insured pursuant to a homeowners’ insurance policy provided by Security First Policy No. P008824814 and assigned Claim No. 255945. As the basis for filing the CRN against Security First, Carlos and Mary Rivera asserts in the “Reasons for Notice” section violations such as _ Claim Denial _ Claim Delay _ Unsatisfactory Settlement Offer _ Unfair Trade Practice, along with the following statutory violations: 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, and 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. Security First welcomes this opportunity to respond to the CRN and denies each allegation contained therein. The allegations made in the CRN are premature, as the insured has failed to perfect the claim for bad faith and the CRN does not meet the specificity requirement of Section 624.155, Florida Statutes. This CRN does not sufficiently support the allegations stated above. As is standard procedure, upon the first notice of the claim, the subject property was dutifully inspected by an SFIC representative, which was documented through photographs. The insureds representative opened the claim with a reported date of loss as September 28, 2022. The CRN incorrectly references the reported date of loss as “the damage that occurred on or about February 4, 2024”. The CRN also asserts that the Insureds timely filed the claim. Security First Insurance Company timely inspected by a field adjuster and a roofing contractor. The file was reviewed and 23 days after the claim was opened, a coverage determination was discussed with the Public Adjuster and a determination letter was mailed to the Insured. I. Perfecting a Claim for Bad Faith SFIC specifically denies all allegations set forth in the Notice. SFIC contends that the Notice should be rejected and returned by the Department of Financial Services as it is premature. Pursuant to statute, there is no potential violation until a breach of contract is established. § 624.1551, Florida Statutes. Accordingly, any Notice filed prior to a finding that SFIC has breached the terms of the policy, is not ripe and is premature and thus fails to perfect Robert and Patricia Mazzaro rights to pursue civil remedies under Florida Statutes. II. Specificity Requirement The Insured’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for Civil Remedy Notices. In addition, it fails to meet even the most basic requirements of the Statute. Pursuant to the terms of the statute, (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. a. The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require (emphasis added): b. (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. i. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. ii. The facts and circumstances giving rise to the violation. iii. The name of any individual involved in the violation. iv. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third-party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. v. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad- faith actions, the Legislature provided this sixty-day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1284 (Fla. 2000). Thus, the Notice cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So. 2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”) See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017) (sufficiency means specificity). In Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875, 879 (Fla. 4th DCA 2021), the Honorable Court stated: The Middle District of Florida was confronted with a civil remedy notice that was similarly broad in scope and concluded that listing nearly all policy provisions on the notice did not satisfy the statute. Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). The court explained that “[i]f the statute contained no specificity requirement, [then] the [insureds’] casual ‘reference’ to the entire insurance policy undoubtedly would suffice.” Id. But, the court continued, “the Legislature included ‘specific’ or a variant not once but twice in the statute.” Id. As a result, the insureds’ listing of whole sections of the insurance policy “appear[ed] to lack specificity.” Id. In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiffs’ counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiffs’ counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be more clear. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. III. Conclusion At all times, Security First has acted in good faith in its handling of the claim and it has acted fairly, honestly, and with due regard for the Insured’s interest and in determining obligations to Insured. Specifically, Security First has complied with its obligations under the applicable Florida Statutes and the applicable Security First Insurance policy. Security First specifically denies any claim for bad faith and argues that the insured’s claim for bad faith is premature. Security First continues to reserve all its rights under the policy, at law and in equity. Regardless, Insured’s conclusory allegations fail to place Security First on notice of any purported violations. Furthermore, the Civil Remedy Notice fails to identify how to cure the allegations set forth. The allegations are without basis. It is clear Security First properly handled and adequately investigated the claim. We hope that this response has answered any concerns regarding this matter. If the Department has any question concerning this matter, please do not hesitate to contact me. Sincerely, _______________________ Stewart Pedigo Security First Insurance Company 1001 Broadway Avenue Ormond Beach, Florida 32714 stewart.pedigo@securityfirstflorida.com Telephone Number: 386/242-2475
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