Civil Remedy Notice of Insurer Violations
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Filing Number:     802700
Filing Accepted:  1/21/2025
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Complainant
Last/Business Name *  
WINSOR   First Name   MAUREEN
Street Address * 3164 SILKWOOD LANE
City, State Zip * PORT CHARLOTTE, FL 33953
Email Address * MAUREENWINS2@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WINSOR   First Name   MAUREEN
Policy # * SFLH3024153 Claim #* 63372
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W
Street Address* 2790 SUNSET POINT RD
City, State Zip* CLEARWATER , FL 33759
Email Address * GRANT@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SAFEPOINT INSURANCE COMPANY
NAIC Company Code 15341
 
Name of individual responsible for violation (if any):* RYAN WELCH, JOSE HERNANDEZ, STEFANIE L. ROSEN, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, SAFEPOINT INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Misrepresenting the terms of the insurance policy
Other : Not treating the Insured with good faith claims conduct
Other : Looking for ways to deny full recovery to the Insured
Other : Looking for ways to delay full recovery to the Insured
Other : Failing to properly investigate the Insured's loss
Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
Other : Not adjusting claims and evaluating loss properly
Other : Shifting the burden of insuring the loss to the Insured
Other : Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
Other : Failing to implement proper standards for the adjustment and investigation of claims
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
626.9541(1)(i)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language. "It is an accepted principle of law that when parties contract upon a matter which is the subject of statutory regulation, the parties are presumed to have entered into their agreement with reference to such statute, which becomes a part of the contract, unless the contract discloses a contrary intention." Westside EKG Assocs. v. Found. Health, 932 So. 2d 214, 216 (Fla. 4th DCA 2005), aff'd, 944 So. 2d 188 (Fla. 2006).
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SafePoint Insurance Company (the "Insurer") has committed the following in handling the Insured's claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the policyholder and the Insured; 3) looking for ways to deny benefit payments and otherwise "low ball" or "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; and 8) denying a claim which it knew or should have known the policy and Florida law provided coverage for. On or about August 30, 2023, while the subject policy was in full force and effect, the Insured's property was severely damaged by Hurricane Idalia. The areas impacted include but are not limited to the roofing system. The Insured timely submitted a claim on May 17, 2024, to the Insurer for hurricane damage and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 63372 to the loss and sent a roofing contractor to inspect the property. Then in a letter dated July 2, 2024, the Insurer notified the Insured that it was denying coverage for the loss. This coverage decision is incorrect. Denying coverage for the damage was wrongful as the damages are covered under the policy. Given the denial, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from the <cause of loss>, the Insured retained a roofing contractor. After assessing the damage and the true scope of repairs, the roofing contractor produced an estimate identifying $74,490.67 in covered damage to the dwelling. The foregoing estimate, photographs, and a letter of representation from the roofing contractor were sent to the Insurer. Upon receiving notice of the loss, the Insurer had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return the home to its pre-loss condition. However, when the Insurer conducted its inspection of the insured property, the Insurer's representative failed to conduct a thorough and adequate investigation, or the representative intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after investigating. As a result, the Insurer breached the policy by failing to fully indemnify the Insured for the covered loss. The Insurer misrepresented the loss and wrongfully denied coverage for the damage sustained to the Insured's property. According to the claims determination letter, the Insurer's representative observed damage to the roof but attributed the cause of this damage to several causes excluded by the policy. However, the Insurer never retained a professional engineer to determine the cause of this damage. Instead, the Insurer relied upon the causation opinions of a lay witness who will likely testify during his deposition that the Insurer never retained him to provide causation opinions and he lacks the credentials to even do so. Rather, the Insurer defaulted to deny coverage by relying on a faulty investigation. Also, the Insurer knows or should know that when independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine. Sebo v. Am. Home Assurance Co., 208 So. 3d 694, 697 (Fla. 2016). The concurring cause doctrine states that coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause. Id. at 698. A covered peril that meets with an uncovered peril may still provide for coverage under a policy when the covered peril triggered the events that eventually led to the loss. Id. at 697. The Insurer intentionally ignored covered damage to deny the reported loss and wrongfully fail to pay the Insured. This is an underhanded attempt to place the financial interests of the Insurer over those of the Insured and to delay and frustrate the Insured's ability to have his claim adjusted promptly to begin restoring his property. Given the Insurer's frustration of the claims process the denial, and the disagreement between parties regarding the scope of covered damage, the Insured proceeded to file its Notice of Intent to Initiate Litigation on December 9, 2024. In response, the Insurer sent email correspondence, dated December 23, 2024, in which it notified the insured that it was maintaining its wrongful undervaluation of the amount required to restore the Insured property to its pre-loss condition. The Insurer has failed in its duty to provide the Insured with protection it guarantees under its own policy of insurance and continues to disregard the severity of the loss, placing its own financial interests over the health and safety of the Insured at every turn. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer's claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured's interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully denied coverage for a loss that should have been covered under the subject policy. Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer's actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer's actions amount to but are not limited to the following: 1. Claim denial 2. Claim delay 3. Not treating the Insured with good faith claims conduct 4. Looking for way to reduce recovery to the Insured 5. Looking for ways to deny recovery to the Insured 6. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 7. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the Insured's interests 8. Placing the financial interest of the Insurer over that of the health and safety of the Insured 9. Shifting the burden of investigating onto the Insured 10. Conducting inadequate investigations 11. Making material misrepresentations Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1). Admit full coverage for the Insured's loss. (2). Tender full benefits owed to the Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via E-mail: SafePoint Insurance Company P. O. Box 291579 Tampa, FL 33687 claims@safepointins.com
Comments
User Id Date Added Comment
grant@krapflegal.com 07-29-2025 The details herein have been amicably resolved between the parties; therefore, we withdraw this Civil Remedy Notice.
jheck@colodnyfass.com 02-25-2025 This firm represents SafePoint Insurance Company (“SafePoint”) in connection with Claim No. 63372 (the “Claim”) made under homeowner’s insurance Policy No. SFLH3024153-02 (the “Policy”), and for the purposes of responding to Civil Remedy Notice of Insurer Violation (“CRN”) No. 802700 (the “Notice”) filed by attorney Grant W. Krapf on behalf of the insured, Maureen Winsor (“Winsor”). In the Notice, Winsor alleges “Unfair Trade Practice,” “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlement Offer,” “Misrepresenting the terms of the insurance policy” “Not treating the insured with good faith claims conduct,” “Looking for ways to deny full recovery to the insured,” Looking for ways to delay full recovery to the insured,” “Failing to properly investigate the insured’s loss,” “Failing to provide the insured with the full benefits awarded under the contract of insurance in a t [sic],” “Not training, supervising, or managing adjusters properly so that prompt and full payments are made,” “Not adjusting claims and evaluating loss properly,” “Shifting the burden of insuring the loss to the insured,” “Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured,” and “Failing to implement proper standards for the adjustment and investigation of claims,” supposedly in violation of sections 624.155(1)(b)(1), 624.155(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(1)(i)(3)(c), Florida Statutes (collectively, the “alleged violations”). SafePoint denies the alleged violations and objects to the Notice for failure to comply with the statutory requirements of section 624.155, Florida Statutes. The Florida Supreme Court has held that section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 Sp/ 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied with all statutory requirements. Section 624.155(3)(b)(3), Florida Statutes, requires that a CRN state with specificity the name of any individual involved in the violation. The Notice fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of section 624.155, the Complainant must name the individual(s) involved with specificity as it relates to the purported violation to allow SafePoint to properly investigate the allegations. Here, Winsor does not identify the person or persons at SafePoint with the most knowledge of the facts regarding any alleged violation(s), rather it states: “RYAN WELCH, JOSE HERNANDEZ, STEFANIE L. ROSEN, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, SAFEPOINT INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.” The Purported Notice does not have the requisite specificity as to whom the Winsor is asserting has knowledge as to each specific allegation contained in the Purported Notice. Accordingly, the Notice is insufficient as a matter of law. Thus, the CRN is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. The Notice also fails to comply with the requirement of section 624.155(3)(b)(4), Florida Statute, which requires “reference to specific policy language that is relevant to the violation.” The Notice fails to reference any policy language whatsoever. Instead, the Notice states, “…The violations alleged are statutorily based and do not rely on any specific policy language.” However, Winsor alleges numerous Policy violations throughout the Notice, including “Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.” Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes, as the actual specific Policy provisions are not properly identified. This deficiency applies to all allegations in the Purported Notice, including without limitation: “Unfair Trade Practice,” “Claim Denial,” “Claim Delay,” “Unsatisfactory Settlment Offer,” “Misrepresenting the terms of the insurance policy” “Not treating the insured with good faith claims conduct,” “Looking for ways to deny full recovery to the insured,” Looking for ways to delay full recovery to the insured,” “Failing to properly investigate the insured’s loss,” “Failing to provide the insured with the full benefits awarded under the contract of insurance in a t[sic],” “Not training, supervising, or managing adjusters properly so that prompt and full payments are made,” “Not adjusting claims and evaluating loss properly,” “Shifting the burden of insuring the loss to the insured,” “Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured,” and “Failing to implement proper standards for the adjustment and investigation of claims” supposedly in violation of Sections 624.155(1)(b)(1), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b) and 626.9541(1)(i)(3)(d) Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Notice fails to “state with specificity” the “statutory provision, including specific language of the statute, which the authorized insurer allegedly violated” and the “specific policy language that is relevant to the violation.” With regard to the alleged violations of section 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); section 626.9541(1)(i)(3)(d) (Denying claims without conducting reasonable investigations based upon available information); and section 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); SafePoint responds as follows: The Claim was reported by Winsor on May 17, 2024, for a loss which is alleged to have occurred on or about August 30, 2023. SafePoint acknowledged receipt of the claim the very same day and promptly adjusted the Claim pursuant to the terms and conditions of the Policy. SafePoint’s field adjuster inspected the property on May 22, 2024. Following the field adjuster’s inspection, SafePoint determined that it was necessary for a roofing contractor to inspect the property. The roofing contractor conducted an inspection of the property on June 11, 2024, and following that inspection, SafePoint received and reviewed the roofing contractor’s report to evaluate coverage. SafePoint relied upon the expert’s findings in its handling of this claim and conveyed those findings, as well as the basis for its denial, including citing to the relevant policy language, to Winsor. The alleged violations are based solely on the fact that the Claim was denied. However, an insurer that denies payment on a claim is not guilty of bad faith as a matter of law. Vest v. Travelers Ins. Co., 753 So.2d 1270, 1275 (Fla. 2000). Rather, “[t]he insurer has a right to deny claims that it in good faith believes are not owed on a policy.” Id. A good faith denial precludes liability “[e]ven when it is later determined by a court or arbitration that the insurer . . . was mistaken.” Id. The contentions that SafePoint did not address this claim fairly and promptly are without merit. Winsor’s Notice is devoid of any factual support for alleged violations of section 624.155(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); section 626.9541(1)(i)(3)(a) (Failing to adopt and implement standards for the proper investigation of claims); section 626.9541(1)(i)(3)(b) (Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue); and section 626.9541(1)(i)(3)(d) (Failing to acknowledge and act promptly upon communications with respect to claims). It appears Winsor took a shotgun-style approach to the Notice, listing “bad faith” statutes without attempting to demonstrate the applicability of each. Chall’s notice falls woefully short of the specificity required to properly place Frontline on notice of the specific statute and policy provision relevant to SafePoint’s alleged violation. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Pursuant to section 624.155(3)(b)(2), Florida Statutes, the Notice must state the facts and circumstances giving rise to the alleged violations. Instead, Winsor’s notice contains only conclusory allegations that SafePoint has “intentionally ignored covered damage to deny the reported loss and wrongfully fail to pay the Insured” and “failed in its duty to provide the Insured with protection it guarantees under its own policy of insurance and continues to disregard the severity of the loss, placing its own financial interests over the health and safety of the Insured at every turn.” For example, the Notice alleges that SafePoint “misrepresented the loss and wrongfully denied coverage for the damage sustained to the Insured's property. According to the claims determination letter, the Insurer's representative observed damage to the roof but attributed the cause of this damage to several causes excluded by the policy. However, the Insurer never retained a professional engineer to determine the cause of this damage. Instead, the Insurer relied upon the causation opinions of a lay witness who will likely testify during his deposition that the Insurer never retained him to provide causation opinions and he lacks the credentials to even do so. However, it offers no facts to support these allegations other than what “is believed” by the insured. We trust that the foregoing is sufficient to advise you of SafePoint’s position with regard to this matter, and to respond to the vague and conclusory allegations contained in the Notice, which are unsupported by facts, devoid of logic and intended solely to tarnish SafePoint’s name and reputation. SafePoint has at all times, acted fairly, honestly and in good faith in its dealings with Winsor. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. SafePoint unequivocally denies each and every allegation asserted in the Notice. At no time has SafePoint breached any duty to Winsor. An insurer is not required to pay whatever amount the Insured demands. Finally, SafePoint retained a field adjuster and a roofing expert and conducted an inspection of the subject property to investigate the Insured’s claim. Thereafter, Safepoint made a coverage decision pursuant to all applicable policy language and statutes. Please be advised, by this response, SafePoint neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. SafePoint hereby expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions, please contact the undersigned. Respectfully submitted, Fernando J. Valle, Esq., Colodny Fass, 1401 NW 136th Ave., Suite 200, Sunrise, FL 33323, Telephone: (954) 492-4010.
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