Civil Remedy Notice of Insurer Violations
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Filing Number:     802713
Filing Accepted:  1/21/2025
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Complainant
Last/Business Name *  
WESTMORELAND   First Name   ANITA
Street Address * 11295 OAKRIDGE TRAIL
City, State Zip * SEMINOLE, FL 33772
Email Address * AWESTY1102@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WESTMORELAND   First Name   ANITA
Policy # * 5371392503 Claim #* 01000126359
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial
Street Address* 2501 S. TAMIAMI TRAIL
City, State Zip* SARASOTA , FLORIDA 34239
Email Address * ESERVICE@ROSSLEGALFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
Name of individual responsible for violation (if any):* JEANA WILLIAMS, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY FIRST PROTECTIVE INSURANCE COMPANY D/B/A FRONTLINE INSURANCE COMPANY INVOLVED IN THE CLAIM
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Dwelling Coverage provisions Perils Insured Against Loss Payment Loss Settlement
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. First Protective Insurance Company d/b/a Frontline Insurance Company (“INSURER”) has breached the public’s trust by its adjustment of Anita Westmoreland (“INSURED”) claim of loss. First Protective Insurance Company d/b/a Frontline Insurance Company’s mailing address is P.O. Box 958405, Lake Mary, FL 32795. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSURED’S property located at 11295 Oakridge Trail, Seminole, FL 33772 which sustained significant damage from Windstorm on or about October 9, 2024. The INSURED immediately reported the loss to INSURER and allowed for inspection. The INSURED suffered damage to the roof, exterior, and interior of the property. INSURER inspected the property and accepted coverage for the claim; however they estimated the loss to total just $11,033.4. There was also an HVAC repair invoice that was submitted for reimbursement in the amount of $640.00. The INSURED’S hurricane deductible is $9,831.00 and recoverable depreciation applied was $402.29. Payment was issued in the amount of $575.97. The INSURED retained Storm One Claims, LLC. to assist with determining the amount of damage sustained to the property. Storm One prepared an estimate in the amount of $127,296.36. The INSURED is owed additional insurance benefits in order to return the property to pre-loss condition. Therefore, demand is hereby made as follows: Estimate & HVAC Repair $127,936.36 Less Prior Payments $575.97 Less Deductible $9,831.00 TOTAL $117,529.39 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §624.02 defines “insurance” as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $117,529.39 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim. Attachments: PA Estimate, HVAC receipt and proposed complaint
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 04-16-2025 The Insured, Anita Westmoreland, hereby provide notice to the Florida Department of Financial Services and First Protective Insurance Company d/b/a Frontline Insurance Company, that the issues outlined in Civil Remedy Notice filing #802713 have been resolved between the parties and First Protective Insurance Company d/b/a Frontline Insurance Company has cured all allegations listed therein. Accordingly, Anita Westmoreland, hereby withdrawals Civil Remedy Notice filing #802713 filed on 01/21/25.
ailene.rogers@petersonbernard.com 03-20-2025 March 20, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, FL 3399-0322 Re: Insured: Anita Westmoreland Complainant(s): Anita Westmoreland Claim No: 01000126359 Policy No: 53713692503 Filing Accepted: 01/21/2025 Date of Loss: 10/09/2024 Our File Number: 1515.57385 ___________ Dear Sir or Madam: We represent First Protective Insurance Co. d/b/a Frontline Insurance (“Frontline”) in connection with the above-referenced claim. We are in receipt of a Civil Remedy Notice of Insurer Violations (herein referred to as the “Notice”) submitted by attorney Vanessa Ross on behalf of Anita Westmoreland (herein referred to interchangeably as “Complainant” or “Insured”) and accepted by the Florida Department of Financial Services on January 21, 2025, with filing number 802713. Please allow this correspondence to serve as Frontline’s response to the Notice. The CRN alleges that Frontline has violated Florida Statutes sections 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(c), and 626.9541(1)(i)(3)(d)). The Notice names most statutory provisions that could be claimed against an insurance company, regardless of whether relevant or applicable to the minimal alleged facts contained in the Notice. The Complainant submits little to no facts or circumstances whatsoever to support these allegations, and the statutes asserted above have no application whatsoever to the loss alleged, the facts associated with the investigation of the claim, or the claim determination made. As such, Frontline requests that the CRN to be stricken. The deluge of spurious allegations in the CRN that are wholly unrelated to this claim renders the entire CRN non-compliant with statutory mandates as the CRN fails to enable the insurer the ability to investigate any alleged violation. The Fourth District Court of Appeals confirmed dismissal of an action for bad faith based upon a lack of specificity in a civil remedy notice similar to the one that has been filed by Complainant. See Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Therein, the court highlighted that “the plain language of section 624.155(3)(b) instructs the policyholder to ‘state with specificity’ information in the notice; to specify ‘language of the statute, which the authorized insurer allegedly violated;’ and to ‘[r]eference specific policy language that is relevant to the violation, if any.’” Julien at 878. The Fourth District Court of Appeal further found that casual reference to a multitude of statutes or listing whole sections of the insurance policy did not satisfy the specificity requirements of a civil remedy notice. See id. at 878-879. Although the Notice is a nullity because it fails to comply with the specific notice and information requirements of the Civil Remedy Notice of Insurer Violation document provisions as set forth in section 624.155 and Florida case law, Frontline, in an abundance of caution, responds and specifically denies any and all allegations of misconduct in claims handling, investigation, communication, evaluation and/or any other act of bad faith and denies violating any Florida Statute applicable to acknowledging and promptly acting upon claims communications. Frontline further denies that it has declined coverage for the claim without conducting reasonable investigations based upon available information. To the contrary, Frontline made every effort to ensure coverage was provided pursuant to the policy terms. Frontline denies that it failed to adopt and implement standards for the proper investigation of claims. Frontline specifically denies violation of each subsection of sections 624.155 and 626.9541 listed in the Notice and denies any and all other alleged acts of not attempting in good faith to promptly settle this claim. As set forth below, at all times Frontline has acted fairly and honestly relevant to Insured’s claim. Frontline has, in all respects, acted in good faith to settle the claim and acted fairly and honestly toward the Insured and with due regard to her interests. The allegations in the instant Notice lack any cognizable merit and are factually inconsistent with all events relevant to the instant claim. Frontline has always worked in good faith to diligently investigate, evaluate, adjust and conclude Insured’s claim in accordance with the terms of the subject policy of insurance and with Florida law. As established by the history of the claim as set forth below, all the violations alleged in the Notice, statutory and otherwise, are wholly conclusory and lack any basis in fact: On October 16, 2024, Frontline first received notice of the claim from the Insured’s Public Adjuster, Storm One Claims LLC., (hereinafter, “the PA”) who reported alleged damages to the property as the result of Hurricane Milton, which allegedly occurred on October 09, 2024. By letter from Frontline to Insured dated October 16, 2024, Frontline confirmed receipt of the Insured’s claim. Also in the letter, and pursuant to Insured’s duties prescribed in the Section I – Conditions, Your Duties After Loss provisions of the policy, Frontline requested that Insured complete, sign, date, and notarize the Sworn Proof of Loss (“SPOL”) and Claim for Damaged Property forms and return them to Frontline within sixty (60) days from the date of the letter (October 16, 2024). Frontline included the forms with the letter. By separate letter from Frontline to the Insured, also dated October 16, 2024, Frontline informed the Insured of her right to mediate the claim through the Department of Financial Services mediation program and explained how to request mediation. Frontline also provided a detailed overview of the mediation process. By separate letter from Frontline to the Insured, also dated October 16, 2024, Frontline notified the Insured of the claim as the owner of record of the insured property. Frontline included with the letter a copy of the Homeowner Claims Bill of Rights. Also on October 16, 2024, Frontline made initial contact with the Insured and advised that an adjuster would be reaching out to schedule an inspection of the subject property. By telephone conference on October 17, 2024, Frontline mutually coordinated the inspection with the Insured and confirmed the same would take place on October 23, 2024. On October 17, 2024, the PA provided the Insured’s Public Adjuster Contract with Storm One Claims, executed by the Insured on October 14, 2024. The PA also provided their Letter of Representation and W-9 Form to Frontline on the same date. On October 23, 2024, Frontline’s Field Adjuster (“FA”) conducted an inspection of the property with the Insured, Anita Westmoreland. A PA representative was not present for the inspection. At the time of inspection, photographs were taken documenting the condition of the roof, exterior and interior of the property. The FA prepared an estimate for repairs based on the observed damages related to the date of loss. On October 27, 2024, Frontline’s Desk Adjuster sent an email correspondence to the Insured to advise that additional information regarding the claim was required and inquired about scheduling a call to discuss the claim. Also on October 27, 2024, the Insured responded to Frontline’s email correspondence and informed the Desk Adjuster that they had contacted their PA, and the PA would get in touch with Frontline. On November 5, 2024, Frontline received a copy of the PA’s estimate in the amount of $127,296.36, photos of the Insured property, and a copy of a Sworn Proof of Loss that the Insured had executed on November 4, 2024. The SPOL also listed the amount of damage claimed as $127,296.36. By letter dated November 7, 2024, Frontline acknowledged the PA’s Letter of Representation, received on October 17, 2024. A copy of the correspondence was sent to the Insured and the PA was copied. By separate letter from Frontline to the Insured and their PA, also dated November 7, 2024, Frontline acknowledged receipt of the Insured’s Sworn Statement in Proof of Loss (“Proof of Loss”) received on November 5, 2024, and sent their first Request for Information (“RFI”.) The RFI requested supporting documents, including but not limited to: all photographs, emails, estimates, job quotes, invoices, receipts, a detailed statement of damages, a list of all contractors, salespersons, or individuals working in the construction trade involved in the loss, a detailed estimate of anticipated repair expenses, the pre-sale inspection report, and other pertinent documents the Insured wished Frontline to consider. On November 10, 2024, Frontline spoke with the Insured and discussed the results of the inspection and advised that a reinspection would be completed. On November 10, 2024, Frontline issued its coverage determination letter. The correspondence advised that the letter was a follow up to Frontline’s conversation from earlier that day regarding the results of the inspection. The letter provided that Frontline’s inspection on October 23, 2024, revealed minor wind damage to all slopes, including the ridge cap, front elevation window screen, rear elevation siding, window screen and patio screen, water damage to the bedroom ceiling, water damage to the bathroom ceiling and front, left and rear wind damage to the vinyl fence. The letter further noted that based on Frontline’s current and ongoing evaluation and based on the information provided by the Insured to date, the loss of $9,561.50 was less than the policy deductible of $9,831.00 and therefore as a result, payment could not be made. An estimate of the covered damages with a Statement of Loss was included for the breakdown of the claim. The letter provided that if settlement could not be reached, either party could demand mediation pursuant to the rules of the Florida Department of Financial Services and as stated in the Policy. Moreover, pertinent policy provisions including SECTION I-CONDITIONS were outlined. Lastly, Frontline provided that their evaluation of the claim was ongoing and that additional payments may be issued. On November 15, 2024, Frontline attempted to contact the PA to schedule a reinspection of the property with the PA present, however the PA could not be reached and there was no option to leave a voicemail. On November 16, 2024, a second inspection was mutually coordinated to take place on November 25, 2024. In order to fully investigate the damages claimed in the PA’s estimate, a reinspection on behalf of Frontline was conducted by Frontline’s Field Adjuster on November 25, 2024. Present for the second inspection were the Insured and the Insured’s the Public Adjuster representative Shay Akinrefon. The Field Adjuster scoped, diagrammed, and took photos during the subsequent inspection. By letter correspondence dated December 4, 2024, Frontline acknowledged receipt of the Insured’s Sworn Statement in Proof of Loss (“Proof of Loss”) received on November 25, 2024. The correspondence stated that Frontline could neither accept nor reject the Proof of Loss as the investigation of the claim was ongoing and directed the PA and the Insured to submit any additional documents for consideration via Frontline’s web portal. Also on December 4, 2024, Frontline issued its second coverage determination letter which advised that Frontline had inspected the insured property on October 23, 2024, and again on November 25, 2024. Frontline provided that based on its evaluation, damages to the roof, bedroom ceiling, bathroom ceiling, front, left, and rear fence runs, rear elevation siding, window screen, and screen enclosure screen were observed. However, no damage was noted to the right fence run, soffit, bedroom walls, and bathroom walls. Additional damages due to wear, tear, and deterioration to the porch trim, exterior window trim, exterior outlet and dryer vent covers, garage trim, precipice wall siding, and gable vent were observed. The correspondence once again advised that based on the current evaluation and information provided by the Insured, the loss of $9,766.97 was less than the policy deductible of $9,831.00, and therefore coverage could not be extended. The letter further stated that the Insured’s Policy did not provide coverage for damages resulting directly or indirectly from wear and tear or deterioration. Accordingly, the claim for damages to the porch trim, exterior window trim, exterior outlet and dryer vent covers, garage trim, precipice wall siding, and gable vent were thereby denied. The letter referenced pertinent provisions of the policy including SECTION I-EXCLUSIONS and SECTION I-CONDITIONS, duties after loss, and informed the Insured/PA, the denial of certain areas of the property did not relieve the Insured from her duty to maintain and further protect the property. On the same date, Frontline provided copies of the estimate, coverage letter, statement of loss, and SPOL response letter to the PA via email and advised they would be reviewing the HVAC motor material, once provided. By way of email on December 9. 2024, the PA provided the “AC blower receipt” and advised that the Insured had the prior unit available, if additional documents or photos were needed. Also on December 9, 2024, Frontline responded to the PA’s email correspondence and acknowledged the AC invoice. Frontline further provided that they were reviewing the document and would reach out if more information was required. On December 18, 2024, Frontline issued a letter to the PA and the Insured which stated that Frontline’s inspections on October 23, 2024, and November 25, 2024, revealed damages to the roof, bedroom ceiling, bathroom ceiling, front, left, and rear fence runs, rear elevation siding, window screen, and screen enclosure screen. Moreover, Frontline stated that based on its current and ongoing evaluation, in addition to the information provided by the PA/Insured, a check in the amount of $575.97 for replacement of the HVAC motor, as well as the estimate of covered loss, and Statement of Loss providing a breakdown of the payment were enclosed with the letter. The correspondence stated that once a contractor had been selected and repairs completed, if the estimate for repairs exceeded the enclosed estimate and/or if additional damages were discovered, Frontline must be informed immediately and documentation in support must be provided. Frontline outlined the Insured’s additional duties under the policy and reserved their right to inspect the property or require additional information prior to the release of additional funds. The letter concluded by advising that if an agreement could not be reached, either party could demand mediation in accordance with the rules of the Florida Department of Financial Services and as stated in the Policy. Also on December 18, 2024, Frontline sent the PA and Insured an email which contained the supplemental estimate, payment letter and statement of loss. On December 20, 2024, Frontline issued another letter to the Insured and the PA which noted that in its December 18, 2024, correspondence, Frontline extended coverage for the roof, bedroom ceiling, bathroom ceiling, front, left, and rear fence runs, rear elevation siding, window screen, HVAC motor and screen enclosure in the amount of $575.97. The correspondence further advised that Frontline denied coverage for the porch trim, exterior window trim, exterior outlet and dryer vent covers, garage trim, precipice wall siding, and gable vent. Accordingly, Frontline provided that the undisputed payment was based on the coverage determination letter, which was also provided for review. In addition, an estimate was included which contained a description of each item of covered, damaged property, the extent of covered damage, and the estimated amount to repair or replace each item. The letter also addressed the PA’s estimate for $127,296.36 and the dispute regarding the covered loss which led to the reinspection of the property on November 25, 2024. Frontline provided that based on the competing estimates, Frontline was continuing to evaluate the claim and expressed their desire to reach an agreement as to the amount of the covered loss. Lastly, the letter requested that the Insured/PA reach out to Frontline in order to come to an agreement, and if a settlement could not be reached, either party may demand mediation in accordance with the rules of the Florida Department of Financial services and the subject policy. The letter referenced excerpts from the policy pertaining to mediation and appraisal, as well as the Insured’s duties after loss. On January 21, 2025, Frontline received a letter of representation from the Insured’s attorney. Also on January 21, 2025, the Civil Remedy Notice of Insurer Violations and Notice of Intent to Initiate Litigation were submitted to the Department of Financial Services by counsel on behalf of the Insured, Anita Westmoreland. As demonstrated above, at all times, Frontline conducted a timely and thorough and good faith evaluation of this claim and provided coverage pursuant to the Policy. Frontline has at all times fully complied with all obligations imposed by the Policy of Insurance and Florida Law. In closing, the Civil Remedy does not comply with other provisions of Florida Statute section 624.155, and, regardless of the lack of the compliance, Frontline denies all allegations contained in the Notice and denies violating any provision or duties set forth in the Policy and further asserts compliance with the Policy and all of its provisions and endorsements. While Frontline’s response set forth herein is meant to be comprehensive, this response is based upon the limited information provided in the Civil Remedy Notice and the information Frontline has to date. If Complainant believes Frontline is not in possession of all the facts, Complainant should immediately inform Frontline. Frontline’s response is not necessarily exhaustive and does not preclude Frontline from asserting any other valid reason for the lack of compliance with Florida Statute section 624.155. Also, this response, or any act or failure to act on the part of Frontline or any agent or representative of Frontline, should not be construed as a waiver of any rights or defenses, including but not limited to, proper notice and service by Insureds, 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 alleged in the Civil Remedy Notice of Insurer Violation. Contrary to the allegations made in the Notice, Frontline has fully complied with the provisions of the policy and has always acted fairly and honestly toward the Insured, with due regard for the Insured’s interests. Accordingly, Frontline respectfully requests that the Notice be rejected for all the reasons set forth above. Please do not hesitate to contact me with any questions, concerns or requests for additional information pertaining to this matter. Sincerely, /s/ Ailene S. Rogers Ailene S. Rogers For the Firm ASR:ggr cc: Vanessa Ross, Esquire
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