Civil Remedy Notice of Insurer Violations
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Filing Number:     801969
Filing Accepted:  1/17/2025
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Complainant
Last/Business Name *  
GARRARD   First Name   LINDSAY AND MARK
Street Address * 10333 FLINTLOCK DR.
City, State Zip * SANDERSON, FL 32087
Email Address * MARKGARRARD01@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GARRARD   First Name   LINDSAY AND MARK
Policy # * 79-CM-R409-7 Claim #* 59-71L4-68W
Attorney
Attorney is Applicable
Last Name* NIPPS First Name * ROBERT Initial
Street Address* 203 FORT WADE, SUITE 260
City, State Zip* PONTE VEDRA , FLORIDA 32081
Email Address * RNIPPS@WOOLSEYMORCOM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* WENDY OWENS (FLA. ADJ. LIC. # P002482)
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Other : Wrongful claim denial
Other : Unfair claim settlement practices
Other : Unreasonable investigation
Other : Failure to act on claim
Other : Failure to conduct a reasonable investigation based on available information
Other : Failure to maintain proper complaint handling procedures
Other : Misrepresenting the insurance policy provisions to the insured
Other : Misrepresenting Florida statutory provisions to the insured
Other : Misrepresenting facts to the insured
Other : Failure to acknowledge and act promptly upon communications with respect to claims
Other : Denying claims without conducting reasonable investigations based upon available information
* 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)(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.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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 I – PERILS INSURED AGAINST COVERAGE A – DWELLING We will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. **** COVERAGE B – PERSONAL PROPERTY We will pay for accidental direct physical loss to the property described in Coverage B by the following perils . . . Windstorm or hail. **** [W]e will pay for any resulting loss from items a. through l. unless the resulting loss is itself a Loss Not Insured as described in this section. **** [W]e will pay for any resulting loss from items 3.a., 3.b., and 3.c. unless the resulting loss is itself a Loss Not Insured as described in this section. **** ADDITIONAL COVERAGES **** 2. Temporary Repairs. If damage is caused by a loss insured, we will pay the reasonable and necessary cost you incur for temporary repairs to covered property to protect the property from further immediate damage or loss. **** Also refer to: Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all 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.

624.155(1)(a)(1) – violating 626.9541(1)(i) 626.9541(1)(a)(1) -- misrepresenting the terms of an insurance policy. 626.9541(1)(i) -- unfair claim settlement practices. Facts of the case: State Farm Insurance Company (“State Farm”) has committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of State Farm; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) State Farm has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring. In Florida, the work of adjusting insurance claims engages the public trust. State Farm has breached this duty by its adjustment of the insured’s claim of loss. State Farm has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above. State Farm has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Despite the insured’s timely notification to State Farm of the insurance claim, State Farm has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. State Farm has failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, State Farm has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of the damages. In exchange for a premium paid by the insured, State Farm issued the subject insurance policy providing coverage for the insured policy for “accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy.” As such, the subject all-risk Policy contains coverage for all direct physical losses to the insured property unless the loss is specifically and unambiguously excluded from coverage by the Policy. On or about July 26, 2024, the insured property suffered a windstorm loss, and the insured immediately submitted a claim to State Farm for property damage, i.e., storm and wind damage to the roof system. Hence, the insured suffered a substantial loss regarding the real property and continue to suffer such loss. Having suffered such substantial damage, the insured promptly notified State Farm of the loss in an effort to mitigate the current damage and prevent the exacerbation of any additional losses. The desired result did not follow. State Farm since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, State Farm has failed and refused to properly settle the insured’s claim in good faith. The insured has requested that State Farm conduct an investigation, admit coverage, and pay damages; State Farm has failed and refused to do so. In short, State Farm has failed to handle its insured’s claim in good faith in violation of Fla. Stat. 624.155(1)(b)(1), 624.155(1)(b)(3), and 626.9541(1)(i). Based upon State Farm’s investigation and property inspection, which confirmed windstorm damages, State Farm nevertheless sent correspondence to the insured dated August 22, 2024, (signed by State Farm’s adjuster, Wendy Owens - Fla. Adj. lic. # P002482) communicating its decision to open coverage for the claim. However, in its decision, State Farm incorrectly determined the roof sustained minimal damage, and as a result, opened coverage in the amount of $2,277.66 which is less than the Insured’s deductible of $3,027.00. In regard to insurance contracts, a specific refusal to pay a claim is the breach which triggers the cause of action. Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 892 (Fla. 2003); Donovan v. AIIC Fire and Cas. Co., 574 So. 2d 285, 286 (Fla. 2nd DCA 1991) (finding that a breach of contract takes place at the moment the insurance company refuses to pay a claim). Therefore, State Farm breached the Policy. Moreover, State Farm’s argued exclusions and/or limitations to coverage are devoid of anti-concurrent causation language. Thus, “coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause.” Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694, 699 (Fla. 2016). In addition, under the Policy, any ensuing loss to property not excluded or excepted in this policy is covered. Hence, there are a myriad of coverages under the Policy that would provide coverage for the loss. Nevertheless, State Farm failed and refused to acknowledge the full extent of covered loss and pay all amounts due and owing for the loss. Therefore, State Farm breached the Policy. Questioning the propriety of State Farm’s continued coverage determination, and given the extensive nature of the physical damage, the insured retained a consulting licensed contractor, Tom Gannon with LSC Construction Consultants, LLC (“LSC”), to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on his investigation, Mr. Gannon likewise concluded that a windstorm on or about July 26, 2024 caused damage to the exterior of the insured property (particularly the roof warranting replacement). Moreover, Mr. Gannon determined that at least $61,569.68 worth of repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss. Nevertheless, State Farm failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, State Farm breached the Policy. As such, State Farm’s coverage determination is a blatant misrepresentation of the available coverages under the Policy in direct violation of Fla. Stats. 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), 626.9541(1)(a)(1), and 626.9541(1)(i)(2) and is nothing more than a mere pretext to wrongfully delay this claim. As a result, State Farm has materially misrepresented the coverages under the subject policy to the insured for the purpose and with the intent of effecting settlement of the insured’s claim on less favorable terms than those provided in, and contemplated by, the subject policy in direct violation of Fla. Stat. § 626.9541(1)(i)(2). Further, State Farm is in violation of Florida statutes §§ 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), and 626.9541(1)(a)(1) by misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue; and also in violation of Fla. Stat. 626.9541(1)(i)(3)(d) by refusing to cover the full loss of the insured’s claim without conducting a reasonable investigation based upon available information. In summary, the insured’s loss is clearly covered by the terms of the policy of insurance with State Farm. However, State Farm chose to open coverage for the insured’s loss, but only for a mere fraction of the actual damage sustained by the insured property. To date, State Farm continues to deny the insured full indemnity for the claim. While State Farm refuses to honor this claim, a jury in Baker County will likely do what State Farm has refused; exercise the benefit of doubt in favor of the insured in finding full coverage for this loss. Indeed, the insured will undoubtedly meet the burden of proof at trial, under the State Farm all-risk policy, to show that, while State Farm provided insurance coverage, damage occurred to the insured property. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 942 (Fla. 4th DCA 2018). With the data presented within State Farm’s investigation and LSC’s investigation, State Farm’s burden to demonstrate by the greater weight of the evidence that all the physical damage to the insured property was caused solely by excluded perils under the policy and not in combination with a covered peril has not and cannot be met. See Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694 (Fla. 2016). Despite clear indicators of covered damage, State Farm nevertheless refused to provide coverage for the total loss of the insured’s claim. As of today, State Farm has failed and refused to inform the insured of his/her rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has failed and refused to adequately indemnify the insured for the loss and defiantly continues to do so. Indeed, from the time of receiving the claim, State Farm has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss. Notably, under Florida law, “[t]he filing of a lawsuit does not extinguish the insurer’s obligations under the policy to adjust and pay the claim.” Tristar Lodging, Inc. V. Arch Specialty Ins. Co., 434 F. Supp. 2d 1286, 1289 (M.D. Fla. 2006). To date, the insured has made a good faith effort to comply with all of the requirements under the subject policy of insurance, and it is only fair that State Farm do the same. Yet, that is not the case. The insured feels that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, State Farm is putting the insured property at risk. As a responsible property owner, the insured purchased insurance to protect the property, paid all of the premiums, and has kept up to date with the responsibilities under the policy. Yet, when the insured needed to rely on the insurance because of this unforeseen loss, State Farm turned its back and delayed coverage that the insured is rightfully owed. Ultimately, State Farm has failed and refused to properly investigate the loss. The insured has requested that State Farm admit coverage, which it has, but refuses to fully indemnify the insured for the loss and pay the amounts necessary to properly repair the insured’s property, despite knowing it is required to do so. In short, State Farm has failed to handle its insured’s claim in good faith. In Florida, the work of adjusting insurance claims engages the public trust; State Farm has breached this duty by its insufficient adjustment of the insured’s claim. State Farm has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. State Farm has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. 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 is the fact that payment must be made timely and promptly so that the insured may mitigate their damages to put them back into the position they were prior to loss as quickly as possible. State Farm breached this duty. The actions taken by State Farm in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such a frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541. State Farm’s actions amount to but are not limited to the following: 1. Claim delay 2. Wrongful claim denial 3. Unfair trade practice 4. Unfair claim settlement practices 5. Unreasonable investigation 6. Failure to act on claim 7. Failure to conduct a reasonable investigation based on available information 8. Failure to maintain proper complaint handling procedures 9. Misrepresenting the insurance policy provisions to the insured 10. Misrepresenting Florida statutory provisions to the insured 11. Misrepresenting facts to the insured 12. Failure to acknowledge and act promptly upon communications with respect to claims 13. Denying claims without conducting reasonable investigations based upon available information 14. Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. 15. 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. 16. Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 17. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 18. Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 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 an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed. Therefore, to cure the defects outlined in this civil remedy notice, State Farm must: (1): Admit full coverage for the insured’s loss; (2): Tender all insurance monies due and owing to the insured for the loss under the subject Policy; A copy of this form submitted to the FDFS has been emailed and/or uploaded and also printed out and mailed to the following parties providing them notice of the filing of this civil remedy notice: State Farm Florida Insurance Company PO Box 106169 Atlanta, GA 30348-6169 statefarmfireclaims@statefarm.com
Comments
User Id Date Added Comment
lalfano@alfanokingsford.com 03-10-2025 Dear Mr. and Mrs. Garrard: This letter has been directed to you through your attorney as State Farm Florida Insurance Company’s (“State Farm”) formal response to the allegations set forth in the purported Civil Remedy Notice (“Notice”) of insurer violation dated January 17, 2025. This Notice was filed on your behalf by Attorney Robert Nipps, Esq. of Woolsey Morcom PLLC and purports to comply with §624.155, Florida Statutes. (A copy of this Notice is attached as Exhibit A). In your purported Notice, there is an indication that State Farm did not handle your claim in good faith because State Farm delayed your claim, it denied your claim, it committed some unidentified form of unfair trade practice, it somehow misrepresented the insurance policy to you, and did not issue payment of benefits you believe are owed to you, along with many other unfounded claims. State Farm denies each of these allegations, and as the facts below will demonstrate, your claim was properly investigated, and State Farm did not treat you unfairly in its adjustment of the claim. On July 26, 2024, you submitted the subject water damage claim to State Farm with the reported date of loss being that same day, July 26, 2024. On July 27, 2024, State Farm Representative Shemaiah Garvin spoke with you, at which time you advised that roof shingles are missing as a result of a heavy storm, which caused rainwater to enter your home. The same day, State Farm sent correspondence to you advising you of your Duties After Loss and the Homeowner Claims Bill of Rights. (Please see attached Exhibit B and Exhibit C). On July 29, 2024, State Farm Representative Wendy Owens spoke with you and scheduled an inspection of your property to occur the next day, July 30, 2024. On July 30, 2024, Ms. Owens inspected the interior of your property with you present. On August 9, 2024, State Farm inspected the roof and exterior of your property with you present, however, a tarp on the roof prohibited a full inspection. On August 13, 2024, State Farm Representative Brittney Belt received your call inquiring about the status of the claim, at which time she advised that the tarp on your roof had not been removed for State Farm’s inspection, and that it would accept photographs of the area beneath the tarp for further consideration. The same day, State Farm received two separate emails from you attaching photographs of the roof prior to the installation of the tarp. (Please see attached Exhibit D). On August 20, 2024, Ms. Owens sent you email correspondence acknowledging receipt of the photographs and requesting information for any damaged personal property being claimed. (Please see attached Exhibit E). You responded that a mattress and ceiling fan were the only two items damaged. (Please see attached Exhibit F). On August 23, 2024, State Farm sent you its coverage determination, dated August 22, 2024, explaining that no wind or hail damage to the roof or exterior elevations of the home were observed. State Farm advised that the conditions to the roof are consistent with wear, tear, deterioration, and workmanship issues. These conditions are not covered under the subject policy. State Farm further advised that it had completed its evaluation of the claimed interior water damage and determined that the covered loss did not exceed the policy deductible. As such, State Farm was unable to issue payment. (Please see attached Exhibit G). State Farm also attached a copy of its estimate totaling $2,277.66 for the cost of repairs to the interior. The same day, State Farm sent correspondence advising you of your right to participate in the Florida Department of Financial Services mediation program. (Please see attached Exhibit H). On August 28, 2024, State Farm received a Letter of Representation from Robert Nipps, Esq. of Woolsey Morcom, PLLC on your behalf. (Please see attached Exhibit I). On October 21, 2024, State Farm received email correspondence from Woolsey Morcom requesting a certified copy of the policy, State Farm’s estimate, and a copy of its coverage determination. (Please see attached Exhibit J). On October 25, 2024, State Farm sent two email correspondences to Woolsey Morcom attaching a certified policy, its estimate and coverage determination. (Please see attached Exhibit K and Exhibit L). On December 30, 2024, State Farm received email correspondence from Woolsey Morcom attaching a Sworn Proof of Loss (“SPOL”) in the amount of $61,569.68, executed by you on December 16, 2024. (Please see attached Exhibit M). Additionally, the email attaches an estimate prepared by LSC Construction Consultants, LLC totaling $61,569.68. On January 6, 2025, State Farm sent correspondence to Woolsey Morcom acknowledging receipt of the SPOL and advising that it cannot accept the proof of loss as it was not submitted within the timeframe required by the policy, and that it cannot agree to the amount claimed therein. (Please see attached Exhibit N). On January 17, 2025, Mr. Nipps filed the subject Notice on your behalf. Additionally, on January 17, 2025, Mr. Nipps filed a Notice of Intent to Initiate Litigation (“NOIL”) in the amount of $61,570.00 on your behalf. (Please see attached Exhibit O). The NOIL attaches the estimate prepared by LSC Construction Consultants, LLC totaling $61,569.68. On January 27, 2025, State Farm sent email correspondence to Woolsey Morcom responding to the NOIL and making a settlement offer of $5,000.00 to resolve the claim. (Please see attached Exhibit P). As the above-referenced facts demonstrate, there is no support for your allegations against State Farm, and State Farm has properly handled this claim and treated you fairly in its adjustment. Florida Statute §624.155 requires specificity in Civil Remedy Notices. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000); Julien v. United Prop. & Cas. Inc. Co., 2021 Fla. App. LEXIS 3131 (Fla. 4th DCA 2021). Your Notice lacks any information in support of its allegations. For example, your Notice alleges that State Farm has “committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of State Farm; 4) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) State Farm has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured.” After providing this lengthy list of wrongful conduct, you provide no information whatsoever to show how State Farm possibly performed these behaviors. State Farm appropriately investigated your claim in good faith. As you provide no information to the contrary, your Notice fails to meet its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003); Julien v. United Prop. & Cas. Inc. Co., 2021 Fla. App. LEXIS 3131 (Fla. 4th DCA 2021). Accordingly, State Farm denies these unfounded allegations. In another long list of allegations, you allege that State Farm’s actions “amount to but are not limited to the following: Claim delay, Wrongful claim denial, Unfair trade practice, Unfair claim settlement practices, Unreasonable investigation; Failure to act on claim; Failure to conduct a reasonable investigation based on available information, Failure to maintain proper complaint handling procedures, Misrepresenting the insurance policy provisions to the insured, Misrepresenting Florida statutory provisions to the insured, Misrepresenting facts to the insured, Failure to acknowledge and act promptly upon communications with respect to claims, Denying claims without conducting reasonable investigations based upon available information, Failing to affirm or deny full or partial coverage of claims . . . or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed, Failing to promptly provide a reasonable explanation in writing to the insured . . . for denial of a claim or for the offer of a compromise settlement, Failing to promptly notify the insured of any additional information necessary for processing of a claim, Failing to clearly explain the nature of the requested information and the reasons why such information is necessary, and Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after insurer receives notice of a residential property insurance claim . . .” After listing these bald allegations, you again fail to provide any information to demonstrate that State Farm has engaged in such wrongful behaviors. These boilerplate allegations are merely hollow recitations of the language of various Florida Statutes without a single piece of information relating to the facts of your claim. The facts, as outlined above, contradict your allegations of bad faith. As such, your Notice again fails to meet its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. In continuing with your pattern of making unsupported allegations, your Notice asserts that “the work of adjusting insurance claims engages the public trust,” and that State Farm “has breached this duty by its adjustment of the insured’s claim of loss . . . has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above . . . has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages.” Your Notice then fails to specify how State Farm’s guidelines for investigation are inadequate, or how they led to an improper investigation of your claim. You also fail to describe how State Farm has failed to train and supervise its adjusters. State Farm conducted a full investigation of your claim and accepted the appropriate amount of coverage for the loss. You also allege that State Farm “since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy.” Your Notice does not identify which policy provisions were allegedly misrepresented to you, nor does it describe any communication from State Farm where such a misrepresentation was made. Your Notice then alleges that has “failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance,” and has “failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, State Farm has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of damages.” Yet, your Notice provides no explanation as to how State Farm is in any way obligated to extend additional coverage for the subject claim. State Farm is not required by the policy to tender insurance proceeds for conditions specifically excluded from coverage. Despite this, State Farm has extended a settlement offer for an amount that exceeds its estimate of covered damages in a god-faith effort to amicably resolve this claim without the need for litigation. It is clear that State Farm has not “refused to acknowledge the covered loss” as you have alleged. Your Notice then attacks State Farm’s coverage determination directly, alleging that state Farm “incorrectly determined the roof sustained minimal damage, and as a result, opened coverage in the amount of $2,277.66 which is less than the Insured’s deductible.” This is a misrepresentation of State Farm’s coverage decision. While it is true that State Farm’s estimate of the loss falls below the deductible amount, State Farm did not open coverage for damage to the roof, which it found to be excluded from coverage altogether. Your Notice further alleges that State Farm’s “argued exclusions and/or limitations to coverage are devoid of anti-concurrent causation language,” and that “there are a myriad of coverages under the Policy that would provide coverage for the loss. Nevertheless, State Farm failed or refused to acknowledge the covered loss and pay all amounts due and owing for the loss.” However, State Farm has acknowledged the covered loss and provided you with an estimate for the cost of repairs. Your Notice fails to identify any provisions of the subject policy that would provide coverage for the claimed damages beyond State Farm’s evaluation of the loss. You allege that your hired contractor, Tom Gannon, “concluded that a windstorm on or about July 26, 2024 caused damage to the exterior of the insured property . . . moreover, Mr. Gannon determined that at least $61,569.68 worth of repairs would be required to return the property to its pre-loss condition as a result of the windstorm loss.” In this regard, you later allege that State Farm “chose to open coverage for the insured’s loss, but only for a mere fraction of the actual damage sustained by the insured property.” The truth is that your contractor’s estimate calls for extensive repairs to your property but does nothing to demonstrate causation of the listed damaged areas and how they apply to the policy in favor of coverage. You have provided no other information to State Farm in support of your claim as evidence that a covered loss occurred outside the scope of State Farm’s estimate. Your Notice also alleges that State Farm “has refused to inform the insured of their rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has refused to adequately indemnify the insured for the loss and defiantly continues to do so.” As is an ongoing issue with your Notice, these allegations are false and made with absolutely no factual support. State Farm sent you multiple items of correspondence advising you of your rights and duties pursuant to the subject policy and Florida statutes. Moreover, State Farm is in no way obligated to indemnify you for damages that are specifically excluded from coverage. Your Notice continues by asserting that “from the time of receiving the claim, State Farm has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss.” Yet, your Notice provides no support for this speculative allegation. As the facts of your claim demonstrate, State Farm has not caused any delay in the adjustment of your claim. State Farm completed two timely inspections of your property and sent its coverage determination to you shortly thereafter. Lastly, your Notice alleges that State Farm has violated several Florida Statutes without providing any factual support to demonstrate how State Farm engaged in such behaviors. For instance, your Notice alleges that State Farm violated Fla. Stat. § 624.155(1)(b)(1) by “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” and violated Fla. Stat. § 624.155(1)(b)(3) by “failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear.” As previously discussed, you have not identified any facts about this claim to show that State Farm should have or was obligated to settle the claim at any time. Despite this, State Farm has attempted to settle the claim in good faith, which you have seemingly ignored. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(2) through “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.” Yet, your Notice does not identify any specific instance or communication in which State Farm has made any misrepresentation during the adjustment of your claim. State Farm has offered to settle your claim pursuant to Florida Statutes §627.70152 (4)(b). Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(a) by “failing to adopt and implement standards for the proper investigation of claims.” As previously discussed, you have failed to identify any conduct or standards exercised by State Farm during the investigation of your claim that would be considered improper. The facts above show that State Farm completed a prompt and proper investigation of your claim. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(b) by “misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.” As previously discussed, you have failed to identify any specific facts or provisions of the policy that were supposedly misrepresented to you, nor do you identify any specific communications containing said misrepresentations. State Farm’s coverage determination letter clearly outlines the relevant policy provisions that State Farm based its decision upon. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(c) by “failing to acknowledge and act promptly upon communications with respect to claims.” Yet, your Notice does not identify any specific communications from you or your representatives that State Farm has failed to respond to. State Farm made timely responses to all communications and materials received on your behalf during the adjustment of your claim. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(d) by “denying claims without conducting reasonable investigations based upon available information.” This is clearly untrue, and you fail to identify how State Farm’s investigation was unreasonable in any way. The above facts demonstrate that State Farm considered all available information when making its coverage determination. You have not provided any additional information in support of your claim for State Farm to review. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(e) by “failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.” Yet, you fail to identify the specific action prescribed by the statute that State Farm failed to comply with. State Farm provided you and your attorney with multiple copies of its coverage determination letter and estimate of the loss. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(f) by “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.” This is demonstrable false, as State Farm’s coverage determination letter clearly outlines the factual basis for its decision and identifies the specific policy provisions that apply to the loss. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(g) by “failing to promptly notify the insured of any additional information necessary for the processing of a claim,” and violated Fla. Stat. § 626.9541 (1)(i)(3)(h) by “failing to clearly explain the nature of the requested information and the reasons why such information is necessary.” The language of the statute clearly indicates that there can be either a violation of § 626.9541 (1)(i)(3)(g) or § 626.9541 (1)(i)(3)(h), but not both, as these behaviors conflict with each other. Either way, your Notice fails to identify any information to demonstrate that State Farm has violated either statute. As the facts show, State Farm completed its investigation will all of the necessary information available and made no such further requests from you. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(4) by “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).” However, the amount of undisputed benefits in this matter does not exceed the policy deductible. Thus, State Farm has no obligation to issue payment pursuant to this statute. Your Notice fails to provide any evidence demonstrating that State Farm violated any of the referenced statutes aside from a mere recitation of the statutory language that is repeated throughout. State Farm denies that it violated any statutory provisions in its handling of the claim. Moreover, your Notice alleges that “the actions taken by State Farm in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541.” Your Notice has failed to demonstrate that State Farm has engaged in any of the alleged wrongful conduct when adjusting your claim, let alone any other claim with such frequency as to constitute a general business practice. As has already been a problem with the Notice, it continues to fail to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. State Farm denies that this claim has been handled in bad faith, unfairly, or with delay. State Farm hereby denies each and every allegation against it as put forth in your Notice. State Farm has in the past, and continues at the present time, to make all efforts to promptly resolve this claim in a fair and reasonable fashion and in full accord with the insurance policy and Florida law.
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