Civil Remedy Notice of Insurer Violations
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Filing Number:     802717
Filing Accepted:  1/21/2025
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Complainant
Last/Business Name *  
POWELL   First Name   DAVID AND JOYCE
Street Address * 2881 SE SAINT LUCIE BLVD.
City, State Zip * STUART, FL 34997
Email Address * LITIGATION@THEFREEMANLAWFIRMPA.COM
Complainant Type: * Insured
Insured
Last/Business Name*   POWELL   First Name   DAVID AND JOYCE
Policy # * FPH3-000139162 Claim #* 10000114691
Attorney
Attorney is Applicable
Last Name* FREEMAN First Name * BRIAN Initial
Street Address* 4245 FOWLER STREET
City, State Zip* FORT MYERS , FLORIDA 33901
Email Address * LITIGATION@THEFREEMANLAWFIRMPA.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):* TEMIKA LESLIE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Claim Denial
Unfair Trade Practice
Other : Bad Faith
* 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)(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)(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.
* Specific policy language that is relevant to the violation.
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The Insureds are in possession of a copy of their insurance policy and believe their Insurance Policy language relevant to the violations includes all applicable insurance policy coverages, loss payment provisions, valuation provisions and other terms and conditions of Insurance Policy No.FPH3-000139162. In particular, the Insureds refer to the following insurance policy coverages included in their insurance policy: SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises". 2. We do not cover land, including land on which the dwelling is located. B. Coverage B – Other Structures 1. We cover other structures on the "residence premises" set apart from the dwelling by clear space. This includes structures connected to the dwelling by only a fence, utility line, or similar connection. 2. We do not cover: a. Land, including land on which the other structures are located; b. Other structures rented or held for rental to any person not a tenant of the dwelling, unless used solely as a private garage; c. Other structures from which any "business" is conducted; or d. Other structures used to store "business" property. However, we do cover a structure that contains "business" property solely owned by an "insured" or a tenant of the dwelling, provided that "business" property does not include gaseous or liquid fuel, other than fuel in a permanently installed fuel tank of a vehicle or craft parked or stored in the structure. 3. The limit of liability for this coverage will not be more than 10% of the limit of liability that applies to Coverage A. Use of this coverage does not reduce the Coverage A limit of liability. D. Loss Settlement In this Condition D., the terms "cost to repair or replace" and "replacement cost" do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.11. Ordinance Or Law under Section I – Property Coverages. Covered property losses are settled as follows: 1. Property of the following types: a. Personal property; b. Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; c. Structures that are not buildings; and d. Grave markers, including mausoleums; at actual cash value at the time of loss but not more than the amount required to repair or replace. 2. Buildings covered under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: a. If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, without deduction for depreciation, but not more than the least of the following amounts: (1) The limit of liability under this policy that applies to the building; (2) The replacement cost of that part of the building damaged with material of like kind and quality and for like use; or (3) The necessary amount actually spent to repair or replace the damaged building. If the building is rebuilt at a new premises, the cost described in (2) above is limited to the cost which would have been incurred if the building had been built at the original premises. b. If, at the time of loss, the amount of insurance in this policy on the damaged building is less than 80% of the full replacement cost of the building immediately before the loss, we will pay the greater of the following amounts, but not more than the limit of liability under this policy that applies to the building: (1) The actual cash value of that part of the building damaged; or (2) That proportion of the cost to repair or replace, without deduction for depreciation, that part of the building damaged, which the total amount of insurance in this policy on the damaged building bears to 80% of the replacement cost of the building. c. To determine the amount of insurance required to equal 80% of the full replacement cost of the building immediately before the loss, do not include the value of: (1) Excavations, footings, foundations, piers, or any other structures or devices that support all or part of the building, which are below the undersurface of the lowest basement floor; (2) Those supports described in (1) above which are below the surface of the ground inside the foundation walls, if there is no basement; and (3) Underground flues, pipes, wiring and drains. d. We will pay no more than the actual cash value of the damage until actual repair or replacement is complete. Once actual repair or replacement is complete, we will settle the loss as noted in 2.a. and b. above. However, if the cost to repair or replace the damage is both: (1) Less than 5% of the amount of insurance in this policy on the building; and (2) Less than $2,500; we will settle the loss as noted in 2.a. and b. above whether or not actual repair or replacement is complete. e. You may disregard the replacement cost loss settlement provisions and make claim under this policy for loss to buildings on an actual cash value basis. You may then make claim for any additional liability according to the provisions of this Condition D. Loss Settlement, provided you notify us, within 180 days after the date of loss, of your intent to repair or replace the damaged building. J. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable 60 days after we receive your proof of loss and: 1. Reach an agreement with you; 2. There is an entry of a final judgment; or 3. There is a filing of an appraisal award with us.
 
* Facts and circumstances giving rise to the violation.
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During the policy period, on May 19, 2024, the Insureds’ home located at 2881 SE Saint Lucie Blvd. Stuart, FL 34997, owned by David and Joyce Powell ("Insureds"), suffered windstorm related physical and structural damage, a covered loss under the subject insurance policy. Please see insurance policy language above that indicates insurance coverage for windstorm damage to the Insureds’ home and roof system as a direct result of a windstorm. Subsequent to the windstorm, the Insureds immediately reported the loss to their insurance carrier, First Protective Insurance Company, ("Insurer"). Since the beginning of the claims process, the Insureds fully cooperated in the Insurer's investigation of the Insureds’ windstorm damage claim. Despite overwhelming evidence the Insureds’ home and roof system had been significantly physically and structurally damaged by a windstorm, all covered losses under the subject insurance policy; the Insurer unreasonably and improperly investigated, inspected, evaluated, adjusted and failed to pay the correct amount of damage to the Insureds’ home and roof system. The Insurer performed a completely inadequate investigation of the damage to the Insureds’ home and roof system. The Insurer retained adjuster Johnny Richemond (“Mr. Richemond”), to inspect the windstorm damage to the Insureds’ home and roof system. Mr. Richemond documented windstorm damage to the Insureds’ screen enclosure, but failed to document the extensive damage to the Insureds’ home and roof system. Mr. Richemond prepared a damage estimate totaling a mere $278.57 for all of the windstorm damage to the Insureds’ home and roof system. On August 14, 2024, the Insurer sent correspondence to the Insureds informing the Insureds their windstorm damage claim was partially denied. The Insurer based its decision solely on an inspection from a field adjuster, but refused to provide any report prepared as a result of the Insurer’s inspection. The Insureds retained, at their own expense, Aaron Penn, (“Mr. Penn”), of Archer Claims to inspect their home and roof system for windstorm damage. During his inspection, Mr. Penn documented extensive physical and structural windstorm damage to the Insureds’ roof system, exterior damage and damage to the Insureds’ windows. As a result of Mr. Penn’s inspection, Mr. Penn provided the Insureds with a damage estimate in the sum of $225,227.53. The Insurer did not extend coverage for the clearly evident damage as a direct result of the windstorm as set forth in Mr. Penn’s damage estimate. The Insurer failed to extend full coverage for the Insureds’ clearly evident windstorm damage, indicating the Insurer does not have proper standards for investigating the proper scope and amount of damage caused by a covered loss. The Insureds provided all the evidence necessary supporting the actual costs associated with the complete replacement of their roof system and the amount necessary to repair the interior and exterior damage to their home in order to restore their home to its pre-loss condition. However, despite this evidence and information, the Insurer failed and refused to pay for the Insureds’ damage in order to restore their home to its pre-loss condition. Moreover, the Insurer did not perform a legally sufficient windstorm damage investigation by failing to perform a substantial structural damage investigation and determination as required by The Florida Building Code and failing to retain a licensed Florida Professional Engineer to investigate the full extent of physical and structural damage to the Insureds’ home and roof system as a direct result of the windstorm. The Insurers failure to perform this very important substantial structural damage determination and failed to retain a licensed Florida Professional Engineer to assist the Insurer in its investigation of this windstorm damage claim further indicates the Insurer did not comply with the basic requirements inherent in the proper investigation of windstorm damage claims, and instead performs inadequate and incomplete investigations in order to improperly partially deny valid claims. The Insureds provided the Insurer with an overwhelming amount of evidence to support the extensive physical and structural damage to their home and roof system and other windstorm related damage to their home and a comprehensive damage estimate from Mr. Penn. Notwithstanding, the Insurer failed and refused to pay the amount necessary to restore their home to its pre-loss condition. The work of adjusting insurance claims in Florida engages the public trust. In the instant case, the Insurer breached this duty through its complete failure to properly investigate, inspect, evaluate, adjust and pay the windstorm damage claim of the Insureds. The Insurer's failure to properly inspect, investigate, evaluate, adjust and pay for the damage to the Insureds’ home and roof system, failure to communicate with the Insureds, and improper handling of the Insureds’ windstorm damage claim clearly indicates the Insurer failed to adopt and implement proper standards for the investigation, evaluation and adjustment of claims; failed to properly train, manage, supervise and promote claims adjusters so Insureds, such as the Insureds in this case, receive good faith, fair and prompt adjustment of claims; and failed to conduct a full and fair investigation of this windstorm damage claim. The Insurer furthermore failed to provide full reasons and facts to the Insureds for the partial denial of their windstorm damage claim resulting in the statutory violations as set forth in this notice. The Insurer also breached its duty to the Insureds by failing to timely and promptly pay the correct indemnity owed to its Insureds. This duty is owed by the Insurer to its Insureds and is inherent in the insurance claims process. The Insureds promptly provided all the necessary documentation, evidence and information for a timely resolution of their windstorm damage claim, including an itemized damage estimate from Mr. Penn and extensive documentation of the damage to their home as a direct result of the windstorm to the Insurer which clearly shows the damage to the Insureds’ home exceeds the grossly inadequate undisputed amount of damage the Insurer documented to the Insureds’ home and failed to provide a detailed damage estimate of such damages documented by the Insurer to the Insureds. To date, the Insurer failed to provide timely and prompt payment for the correct amount of the Insureds’ damage. To date, the Insureds performed all conditions precedent required of them under their insurance policy with the Insurer and under Florida law. However, the Insurer and its agents failed and refused to properly investigate, inspect, evaluate, adjust and pay the Insureds’ windstorm damage claim and failed to tender all insurance proceeds due and owing to the Insureds under the subject insurance policy. Due to the Insurer's intentional delay and insufficient investigation of the Insureds’ windstorm damage claim, the Insureds were forced to obtain legal counsel at a significant cost and expense to attempt to recover what they are legally owed under their insurance policy with the Insurer. The concept of insurance is that it is the insurer's granting of timely and prompt indemnity or security against a contingent loss. Fla. Stat. § 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 an Insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Simply put, the Insurer failed to comply with its duty to indemnify the Insureds and breached the insurance policy. The Insurer failed and refused to properly investigate, inspect, evaluate, adjust and pay the Insureds’ windstorm damage claim. The Insurer failed and refused to pay the correct amount of insurance proceeds to date owed to the Insureds as required by the insurance policy and Florida law. Refusal and failure to pay the Insureds’ windstorm damage claim, when under all the circumstances it could have and should have done so had it acted fairly and honestly towards the Insureds is a breach of the insurance policy and a violation of Florida Law. The actions taken by the Insurer in the handling and adjustment of the Insureds’ windstorm damage claim were willful, wanton, and in disregard of the rights of its Insureds and occur with such a frequency as to indicate a general unfair and deceptive business practice in violation of Florida Statutes § 624.155 and § 626.9541. Based on the foregoing actions and omissions, the Insurer engaged in wrongful claims handling conduct, including but not limited to, the following: 1) Improper claim denial; 2) Improper claim delays; 3) Not conducting a full and fair investigation of the Insureds’ windstorm damage claim; 4) Looking for ways to deny recovery to the Insureds; 5) Overlooking covered damages to the Insureds’ home and roof system and failing to retain a professional engineer if causation was in question; 6) Failing to pay the necessary amounts due and owing to restore the Insureds’ home to its pre-loss condition; 7) Not adjusting the claim and not evaluating the loss properly, promptly and fairly so as to provide full and prompt indemnity to its Insureds; 8) Failing to implement proper standards for the adjustment and investigation of insurance claims; 9) Failing to pay the requisite monies owed for the Insureds’ loss, despite receipt of a detailed damage estimate from Mr. Penn and supporting documentation; 10) Not training, supervising or managing adjusters and independent contractors properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholders’ interests by attempting to deny or minimize payments owed; 11) Establishing severity control initiatives and otherwise establishing a culture of not fully and promptly paying claims following losses. The Insurer violated the statutes set forth above based on the conduct described herein. The Insurer failed and refused to tender insurance proceeds required by its insurance policy with its Insureds. In addition, the Insurer failed to reasonably and properly pay and resolve the Insureds’ windstorm damage claim for money damages when under all the facts and circumstances, it could have and should have done so if it had acted fairly and honestly towards its Insureds. The Insurer’s improper actions are well documented and have occurred with such frequency as to constitute a general unfair and deceptive business practice and were made in a reckless disregard for its Insureds’ rights. The Insurer placed its interest above and before the Insureds’ interest in this matter. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must do the following: A. Immediately pay the Insureds’ windstorm damage claim in the amount of the Mr. Penn’s damage estimate of $225,227.53, plus interest, less the applicable deductible. B. Agree to tender any recoverable depreciation once it has been incurred per the terms of the insurance policy.
Comments
User Id Date Added Comment
bkelley@wallenkelley.com 03-19-2025 March 19, 2025 Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Bldg., 200 E. Gaines Street Tallahassee, Florida 32399-0322 Re: Complainants: David and Joyce Powell Address: 2881 SE Saint Lucie Blvd, Stuart, FL 34997 Email: litigation@thefreemanlawfirmpa.com Insureds: David and Joyce Powell Policy #: FPH3-000139162 Claim: 10000114691 Attorney: Brian Freeman Email: litigation@thefreemanlawfirmpa.com Address: 4245 Fowler Street, Fort Myers, FL 33901 DOI File #: 802717 Date of Acceptance: January 21, 2025 To Whom It May Concern: Please accept this as the response of First Protective Insurance Company ("Frontline") to the Civil Remedy Notice filed by the Complainants, David and Joyce Powell. It should be noted from the onset that the address listed by the Complainants is incorrect. Accordingly, the instant Civil Remedy Notice is defective. Notwithstanding this error, Frontline’s response is specifically in regard to Claim 10000114691, which is related to a claim for Insureds’ property located at 2831 SE Saint Lucie Boulevard, Stuart, FL 34997, which was Insureds by Frontline under Policy # FPH3-000139162 with effective dates of that Policy being July 1, 2023 through July 1, 2024, and was in effect on the alleged date of loss, May 19, 2024. Statement of Facts This matter arises from an alleged windstorm claim at the Insureds’ Stuart, Florida residence. For the convenience of the reader, I have broken down the Statement of Facts that will detail Frontline’s handling of the file. 1. Claim: 10000114691 The instant claim was reported to Frontline on July 22, 2024, two months following the alleged date of loss of May 19, 2024. After receipt of the claim, Frontline assigned a claim number, 10000114691, and, on July 22, 2024, sent an acknowledgment letter to the Insureds. In addition, Frontline provided a Homeowners’ Bill of Rights to inform them of their rights under the Policy. Frontline also sent correspondence requesting an executed sworn proof of loss in an effort to ascertain the amount of damages being claimed and a third letter informing the Insureds of their right to mediate the claim. Specifically, the claim notification letter stated: “This communication is intended to confirm receipt of the above-captioned claim, filed under your Frontline insurance policy. Your claim will be handled by Frontline’s claim team, who will contact you to discuss the claims process, initiate an investigation and arrange for an inspection of the loss, as needed. As required by your policy conditions, please take the necessary steps to protect covered property from further damage. Additionally, please photograph, document, and save all receipts for any emergency or temporary repairs. Please also retain for our inspection all damaged property. Please be advised that in order to adequately investigate your claim, Frontline is requesting you complete, sign, date, notarize and return to Frontline the enclosed Proof of Loss and Claim for Damaged Property forms within sixty (60) days from the date of this letter. Frontline may also require you and/or any others to submit to an Examination Under Oath to discuss the circumstances of the claim(s). These requests are made pursuant to the policy conditions outlined in Section I – Conditions … Your Duties After Loss, which we encourage you to carefully review in your Frontline policy of insurance. Thank you for insuring with Frontline. We appreciate your business and look forward to working together to solve this matter.” Thereafter, Frontline retained the services of a licensed Field Adjuster, Johnny Richemond of Tracker Claims Services, to inspect the property and document the alleged damages. On July 24, 2024, Mr. Richemond called the Insureds to plan the inspection. However, when the Insureds failed to answer, he left a message requesting the Insureds call him back. On July 25, 2024, the Insureds called Frontline, and Frontline gave the Insureds the contact information of the Frontline Desk Adjuster that would be handling the claim. On July 26, 2024, Mr. Richemond again called the Insureds, and an inspection was scheduled for July 31, 2024. Also on July 26, 2024, Frontline’s Desk Adjuster, Temika Leslie, called the Insureds to take their statement about the claim. There, Mr. Powell stated that he noticed the damage the day after the May 19, 2024, storm, however, he did not report the claim immediately because his insurance agent did not visit the home until a week after the storm. He also waited until after the completion of inspections by contractors the following week to report the claim. Due to the uncertainties that arose from such a lapse in time between the date of loss and the date of reporting, out of an abundance of caution, of July 30, 2024, Frontline sent a Reservation of Rights letter stating: “We received your claim on July 22, 2024, for hail damage to the roof and the screen enclosure with a reported date of loss of May 19, 2024. We are issuing this reservation of rights letter to you because there is a question as to whether Frontline is obligated to indemnify you under the policy for the reported loss. Frontline will evaluate every claim which is reported to us and make payment for those losses which are covered under your policy number FPH3-000139162, with effective dates of July 1, 2023 to July 1, 2024; however, we must inform you that based on our preliminary evaluation, we have identified issues that may restrict, limit or exclude coverage, and we will be continuing our evaluation under a Reservation of Rights. Failure to comply with the following “Duties After Loss” may have jeopardized, or may result in prejudice to, Frontline’s evaluation of this claim: • It is questionable whether you gave immediate notice of the loss to us or our agent as the claim was reported 64 days after the reported date of loss. • It is questionable whether you protected the insured property from further damage. In addition, the following policy exclusions may apply to the loss based on the facts provided to Frontline thus far: Your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An "assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any "insured" seeking coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. For the reasons set forth above, and for any other good and valid reasons which may become known during our evaluation of this claim, you are notified that any action taken by Frontline or its authorized representatives to evaluate the cause of loss, determine the amount of loss or damage, or attempt to adjust any claim arising out of the alleged loss shall not waive any of the terms or conditions of the policy of insurance described above. Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert such additional policy defenses at any time. We request that you provide the following documents and information that are material to Frontline’s evaluation of your claim: • Proof of Loss: Submit a Sworn Statement in Proof of Loss executed by all named insureds. Please provide the requested information through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents). Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (321) 275-7724. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” On July 31, 2024, Mr. Richemond inspected the property in the presence of Mr. Powell. During that inspection, Mr. Richemond took photographs of the exterior, interior, and roof of the home. He subsequently prepared a report summarizing his findings and sent the report and photographs to Frontline to review. After a review of these materials, on August 14, 2024, Frontline made a coverage determination and sent a letter to the Insureds that advised them as follows: “This letter follows our conversation on August 14, 2024, when we discussed the results of our evaluation and the policy provisions which apply to your claim. Frontline evaluated the claim you reported on July 22, 2024, for wind and hail damage to your roof. As part of that evaluation, Frontline inspected the insured location on May 19, 2024. The inspection did not reveal any wind or hail damage to the roof; however, the screen enclosure did display hail damage to the screen. The roof demonstrated evidence of age-related wear & tear, cracks, and deterioration which is consistent with the age of 26 years. Based upon Frontline’s current evaluation, as well as the information you have provided to date, enclosed is the estimate of the covered damage and a Statement of Loss providing a breakdown of your claim. As you will note, the loss of $278.57 is less than the policy deductible of $1,000.00. As a result, we are not able to extend payment at this time. Once you have selected a contractor to complete the covered repairs to your home, if the estimate for repairs exceeds the enclosed estimate and/or if additional damages are discovered, you must immediately inform us by producing any updates to documents including revised descriptions of loss, scope of loss, estimates or other supporting documentation and allow an inspection by a Frontline representative before repairs are made. Failure to do so may jeopardize your ability to recover the full amount of the additional damages. Frontline reserves the right to inspect the property or require additional information prior to the release of any additional funds. Respectfully, we are unable to pay for replacement of your roof as your Homeowners Policy excludes coverage for wear and tear and age-related deterioration. Your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - PERILS INSURED AGAINST Paragraph A.1 . in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we will not pay for, any "diminution in value.” 2. We do not insure, however, for loss: c. Caused by: (6) Any of the following: (a) Wear and tear, marring, deterioration; (b) Mechanical breakdown, latent defect, inherent vice or any quality in property that causes it to damage or destroy itself; (c) Smog, rust or other corrosion, or dry rot; The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Our denial of your claim for replacement of the dwelling roof does not relieve you of any duty to maintain your property, and you should move forward with any repairs necessary to protect the property from further damage. Your Homeowners Policy assigns you specific duties following a loss, including the duty to protect the property from further damage, keep an accurate record of repairs, and produce updates including revised descriptions of loss, scope of loss, estimates or other supporting information. Please note the following Duties After Loss in your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, which state in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An ·assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: 1. "Your" Duties After Loss b. To the degree reasonably possible, retain the damaged property and any photographs of the damaged property; and Allow us to inspect, subject to the paragraph above, all damaged property prior to its removal from the "residence premises" and make copies of the photographs. e. Protect the property from further damage. The following must be performed: (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing documents Which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any "insured" seeking coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. h. As often as we reasonably require: (1) Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; (2) Provide us with records and documents we request and permit us to make copies; (8) For losses covered under Coverage A and B, allow us to reinspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any "assignees(s)" or third parties were completed, or following a supplemental or re-opened claim. j. Produce any updates to the documents and information described above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) As this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. The duties above apply regardless of Whether you, an "insured" seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. If we fail to agree on the settlement of your loss, either you or we may demand a mediation in accordance with the rules established by the Florida Department of Financial Services and as stated in your policy. Your policy states in relevant part: SECTION 1- CONDITIONS In Forms HO 00 03, HO 00 04 and HO 00 06: F. Appraisal is deleted and replaced by the following: F. Mediation or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either may: 1. Demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. The loss must be $500 or more, prior to the application of the deductible; or there must be a difference of $500 or more between the loss settlement amount we offer and the loss settlement amount that you request. The settlement in the course of the mediation is binding only if both parties agree, in writing, on a settlement and you have not rescinded the settlement within 3 business days after reaching settlement. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided to you. We will pay the cost of conducting any mediation conference except When you fail to appear at a conference. That conference will then be rescheduled upon your payment of the mediator's fee for that rescheduled conference. However, if we fail to appear at a mediation conference, we will pay the actual cash expenses you incur in attending the conference and also pay the mediator's fee for that rescheduled conference. If, however, we demanded the mediation and either party rejects the mediation results, you are not required to submit to, or participate in, any appraisal of the loss as a precondition to action against us for failure to pay the loss. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert additional policy defenses at any time. Should you have any questions or concerns or have any additional information you would like to be considered, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at 321-249-1365. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” This letter was also followed by a phone call to the Insureds that explained the coverage decision and applicable Policy provisions and exclusions. On August 14, 2024, the Insureds submitted a Sworn Proof of Loss. Accordingly, on August 20, 2024, Frontline sent an acknowledgment letter stating: “We acknowledge receipt of your Sworn Statement in Proof of Loss (“Proof of Loss”) on August 14, 2024. Based upon the terms and conditions of your insurance policy, Frontline denied your claim storm damages to the roof. Please refer to the enclosed letter dated August 14, 2024. While coverage has been denied, Frontline will evaluate and consider any new information that you submit in support of your claim. Please feel free to submit new information for our consideration through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents). Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (321) 275-7724. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” On August 26, 2024, Frontline received a Letter of Representation stating that Archer Claims would be representing the Insureds in this Claim. Thus, on August 26, 2024, Frontline’s Desk Adjuster, Temika Leslie, called Archer Claims and, when there was no answer, left a message with her contact information. In further response to the Letter of Representation, on August 29, 2024, Frontline sent an acknowledgment letter stating: “This serves to acknowledge our receipt of your Letter of Representation between our policyholder David Powell and Joyce Powell and Archer Claims. These documents were submitted and addressed to Frontline Insurance and received on August 29, 2024. Pursuant to your request, attached please find the estimate and Frontline’s coverage determination letter. Your request for a certified copy of the policy has been submitted and will be forwarded under separate cover. As we continue to evaluate this claim, we look forward to working with you to discuss the facts and circumstances to determine if the policy covers the loss. Should you have any questions or concerns please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at (321) 275-7724. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” Frontline then sent a Certified Copy of the Policy and a copy of the coverage decision letter to the Insureds’ Public Adjuster on August 30, 2024. On September 6, 2024, Frontline emailed the Insureds’ representative requesting a legible Sworn Proof of Loss and other documents. Thus, on September 9, 2024, the Insureds submitted another Sworn Proof of Loss, and on September 10, 2024, Frontline sent another acknowledgment letter stating: “We acknowledge receipt of your Sworn Statement in Proof of Loss (“Proof of Loss”) on September 6, 2024. However, the Proof of Loss fails to comply with the requirements set forth in your policy as follows: 1. The Proof of Loss was not legible. Your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION 1- CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An "assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: i. Submit to us, within 60 days after the loss, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of the loss; (3) The interest of all "insureds,” "assignees” if any, and all others in the property involved and all liens on the property; (4) Other insurance which may cover the loss; (5) Changes in title or occupancy of the property during the term of the policy; (6) Specifications of damage to the dwelling and other structures, including; (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and other supporting documentation that exists shou Id be included to the extent it is reasonable and practical to obtain; (7) The inventory of damaged personal property described in C.7. above; (8) Receipts for additional living expenses incurred and records that support the fair rental value; and (9) Evidence or affidavit that support a claim under the Credit Card, Fund Transfer Card, Forgery and Counterfeit Money coverage, stating the amount and cause of loss. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Due to your failure to fully comply with the Policy Conditions, Frontline has been prejudiced in its ability to properly and timely adjust and/or evaluate your claim. Please note, however, our evaluation of your claim is ongoing. Frontline will continue to consider any new documents provided. 1. Please provide a legible copy of the sworn proof of loss. Please submit the requested information through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents). Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (321) 275-7724. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” On September 11, 2024, Frontline sent an additional Reservation of Rights and Request for Information letter to the Insureds and their Public Adjuster that advised that: “We received your claim on July 22, 2024, for hail damage to the roof and the screen enclosure with a reported date of loss of May 19, 2024. We are issuing this reservation of rights letter to you because there is a question as to whether Frontline is obligated to indemnify you under the policy for the reported loss. Frontline will evaluate every claim which is reported to us and make payment for those losses which are covered under your policy number FPH3-000139162, with effective dates of July 1, 2023 to July 1, 2024; however, we must inform you that based on our preliminary evaluation, we have identified issues that may restrict, limit or exclude coverage, and we will be continuing our evaluation under a Reservation of Rights. Failure to comply with the following “Duties After Loss” may have jeopardized, or may result in prejudice to, Frontline’s evaluation of this claim: • It is questionable whether you gave immediate notice of the loss to us or our agent as the claim was reported 64 days after the reported date of loss. • It is questionable whether you protected the insured property from further damage. • It is questionable whether you have cooperated with us in our investigation of your claim. • It is questionable whether you have shown us the damaged property and the cause of loss and the condition it was in at the time of loss. In addition, the following policy exclusions may apply to the loss based on the facts provided to Frontline thus far: • It is questionable whether the loss was caused by repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, that occurs or develops over a period of 14 or more days, whether hidden or not. • It is questionable whether the loss was caused by wear and tear, marring, deterioration. • It is questionable whether the loss was caused by settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs or ceilings. Your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - PERILS INSURED AGAINST Paragraph A.1. in Form HO 00 03 is dele1ed and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we won’t not pay for, any "diminution in value.” 2. We do not insure, however, for loss: c. Caused by: (6) Any of the following: (a) Wear and tear, marring, deterioration; (b) Mechanical breakdown, latent defect, inherent vice or any quality in property that causes it to damage or destroy itself; (c) Smog, rust or other corrosion, or dry rot; (f) Settling, shrinking, bulging or expansion, including resultant cracking, of bulkheads, pavements, patios, footings, foundations, walls, floors, roofs ,or ceilings; For the reasons set forth above, and for any other good and valid reasons which may become known during our evaluation of this claim, you are notified that any action taken by Frontline or its authorized representatives to evaluate the cause of loss, determine the amount of loss or damage, or attempt to adjust any claim arising out of the alleged loss shall not waive any of the terms or conditions of the policy of insurance described above. Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert such additional policy defenses at any time. We request that you provide the following documents and information that are material to Frontline’s evaluation of your claim: • Cause of Loss Documentation: Retain and provide evidence of the cause of loss and provide documentation as to the repair of the source of loss. • Engineer inspection: Frontline has engaged the services of an engineering firm to assist in our evaluation of the claimed damages. Insured should be available to attend the engineer inspection. • Recorded Statement: We are requesting an additional recorded statement by phone and will contact you to schedule same. • Proof of repairs: Submit all documents from the any documentation for any prior repairs on the roof. • Sworn Proof of Loss: Please provide a legible sworn proof of loss, the prior Sworn Proof of Loss received was not legible. • Examination Under Oath: Frontline reserve’s the right to request and conduct an Examination Under Oath with David Powell and Joyce Powell. Please provide the requested information through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents). Please note the following Duties After Loss in your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An "assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any "insured" seeking coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Should you have any questions or concerns, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (321) 275-7724. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” Frontline, in order to obtain additional information, then made the determination that a cause and origin analysis done by a Professional Engineer would be necessary to verify the alleged damages associated with the claim. Accordingly, on September 20, 2024, Frontline retained the services of Milton Engineering Consultants, P.A. (“Milton”) to conduct such an analysis. Milton assigned a licensed Professional Engineer, Oscar Tazoe, P.E., to do the inspection, who called the Insureds and their representatives on September 23, 2024 to schedule the inspection for October 4, 2024. On October 4, 2024, Mr. Tazoe, P.E. inspected the property in the presence of Mr. Powell and a representative from Archer Claims. Mr. Tazoe took photographs of the inspected areas and documented damages and their causes, if any. Following the inspection, he prepared a peer reviewed report containing his analysis and relevant photographs. Thereafter, he submitted his report to Frontline. The report contained the scope of the inspection and the following conclusions: • “The moisture that affected the ceiling finishes in the living room and laundry room can be attributed to moisture originating at roof leaks. • The roof leaks affecting the living room and laundry room can be attributed to rainwater penetrating unsealed gaps, cracks and openings in the roofing assembly. The probable cause of the gaps, cracks and openings are due to long-term deterioration of the roofing materials, intrinsic openings associated with the metal roof vents, and/or lack of proper maintenance and cannot reasonably be attributed to wind-related or hail-related damage. • MEC’s inspection revealed evidence to suggest that the roof leakage that affected the living room is not of recent origin and likely predates the reported date-of-loss. • MEC’s inspection revealed no evidence to corroborate the allegation that the concrete tile roof of the residence sustained wind-related or hail-related damage associated with a storm event on the reported date-of-loss. • The extent of conditions to the exterior of the residence that MEC can attribute to potential hail exposure on the reported date-of-loss is limited to one (1) exterior window frame on the north elevation with a cosmetic paint chip, one (1) downspout gutter with indentations at the northwest corner of the residence, two (2) window screen panels with circular abrasions along the west elevation of the residence, and one (1) indentation on the metal roof vent above the laundry room.” On October 25, 2024, the Insureds’ Public Adjuster called Frontline’s Desk Adjuster after the Public Adjuster emailed an updated Sworn Proof of Loss. On this call the Public Adjuster queried whether a Recorded Statement was still necessary, and the Desk Adjuster responded that it was. However, when Frontline’s Desk Adjust called back at the scheduled time for the Recorded Statement on October 25, 2024, the Public Adjuster was no longer available. On October 28, 2024, via email, the Public Adjuster and Desk Adjuster scheduled the Recorded Statement for October 30, 2024. On October 30, 2024, Frontline’s Desk Adjuster took the Recorded Statement of Mr. Powell with his Archer Claims representative also present. During this Recorded Statement, the Mr. Powell stated that he was unaware of any damages until the contactor come out to the property. Mr. Powell continued to state that he noticed no other damages besides those already claimed and that he planned on using All American Roofing, whose prices were cheaper than the Public Adjuster’s estimate. Thereafter, on December 3, 2024, Frontline’s Desk Adjuster attempted to call the Public Adjuster, but there was no answer, so, the Desk Adjuster left a message to call back. The Desk Adjuster attempted to call the Public Adjuster again on December 13, 2024, this time, when there was no response, the Desk Adjuster also sent an email stating that the Public Adjuster should call her back. Additionally, on December 13, 2024, Frontline sent a check and a supplemental coverage determination letter which stated as follows:: “Frontline evaluated the claim you reported on July 22, 2024, for wind and hail damage to your roof. As part of that evaluation, Frontline inspected the insured location on May 19, 2024. The inspection did not reveal any wind or hail damage to the roof; however, the screen enclosure did display hail damage to the screen. The roof demonstrated evidence of age-related wear & tear, cracks, and deterioration which is consistent with the age of 26 years. Frontline engaged an engineer to identify the cause of loss and the extent of the damage. The engineer’s inspection did not reveal any hail damage to the dwelling roof; however, the engineer did observe evidence of blistering, wear and tear, and deterioration. The inspection also revealed no current evidence of leaking contributing to the reported date of loss. Engineer inspection revealed the following findings: • The moisture that affected the ceiling finishes in the living room and laundry room can be attributed to moisture originating at roof leaks. • The roof leaks affecting the living room and laundry room can be attributed to rainwater penetrating unsealed gaps, cracks and openings in the roofing assembly. The probable cause of the gaps, cracks and openings are due to long-term deterioration of the roofing materials, intrinsic openings associated with the metal roof vents, and/or lack of proper maintenance and cannot reasonably be attributed to wind-related or hail-related damage. • MEC’s inspection revealed evidence to suggest that the roof leakage that affected the living room is not of recent origin and likely predates the reported date-of-loss. • MEC’s inspection revealed no evidence to corroborate the allegation that the concrete tile roof of the residence sustained wind-related or hail-related damage associated with a storm event on the reported date-of-loss. • The extent of conditions to the exterior of the residence that MEC can attribute to potential hail exposure on the reported date-of-loss is limited to one (1) exterior window frame on the north elevation with a cosmetic paint chip, one (1) downspout gutter with indentations at the northwest corner of the residence, two (2) window screen panels with circular abrasions along the west elevation of the residence, and one (1) indentation on the metal roof vent above the laundry room. Based upon Frontline’s current evaluation, as well as the information you have provided to date, enclosed is our check in the amount of $1,421.53 for dwelling; the estimate of covered loss; and Statement of Loss providing a breakdown of the payment. Once you have selected a contractor to complete the covered repairs to your home, if the estimate for repairs exceeds the enclosed estimate and/or if additional damages are discovered, you must immediately inform us by producing any updates to documents including revised descriptions of loss, scope of loss, estimates or other supporting documentation and allow an inspection by a Frontline representative before repairs are made. Failure to do so may jeopardize your ability to recover the full amount of the additional damages. Frontline reserves the right to inspect the property or require additional information prior to the release of any additional funds. Respectfully, we are unable to pay for replacement of your roof as your Homeowners Policy excludes coverage for wear and tear and age-related deterioration. Additionally, it was noted that your living room damage wasn’t from the current date of loss as your Homeowners Policy insured for sudden and accidental damages. Your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by, states in relevant part: SECTION I - PERILS INSURED AGAINST Paragraph A.1 . in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded or limited in this policy. However, loss does not include, and we will not pay for, any "diminution in value.” 2. We do not insure, however, for loss: c. Caused by: (6) Any of the following: (a) Wear and tear, marring, deterioration; (b) Mechanical breakdown, latent defect, inherent vice or any quality in property that causes it to damage or destroy itself; (c) Smog, rust or other corrosion, or dry rot; Additionally, your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, states in relevant part: SECTION I - PERILS INSURED AGAINST Paragraph 2.c.(5) is deleted and replaced by the following: (5) Repeated seepage or leakage of water or the presence or condensation of humidity, moisture, or vapor, that occurs or develops over a period of time, whether hidden or not. In the event this exclusion applies, we will not pay for any damages sustained starting from the first day and instant the repeated seepage or leakage of water or steam, or the presence or condensation of humidity, moisture, or vapor began. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Our denial of your claim for replacement of the dwelling roof does not relieve you of any duty to maintain your property, and you should move forward with any repairs necessary to protect the property from further damage. Your Homeowners Policy assigns you specific duties following a loss, including the duty to protect the property from further damage, keep an accurate record of repairs, and produce updates including revised descriptions of loss, scope of loss, estimates or other supporting information. Please note the following Duties After Loss in your policy, HOMEOWNERS 3 – SPECIAL FORM HO 00 03 05 11 as modified by SPECIAL PROVISIONS – FLORIDA FIM 00 23 11 21, which state in relevant part: SECTION I - CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Duties After Loss. An ·assignment agreement" does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: 1. "Your" Duties After Loss b. To the degree reasonably possible, retain the damaged property and any photographs of the damaged property; and Allow us to inspect, subject to the paragraph above, all damaged property prior to its removal from the "residence premises" and make copies of the photographs. e. Protect the property from further damage. The following must be performed: (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing documents Which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any "insured" seeking coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. h. As often as we reasonably require: (1) Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; (2) Provide us with records and documents we request and permit us to make copies; (8) For losses covered under Coverage A and B, allow us to reinspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any "assignees(s)" or third parties were completed, or following a supplemental or re-opened claim. j. Produce any updates to the documents and information described above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) As this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. The duties above apply regardless of Whether you, an "insured" seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. If we fail to agree on the settlement of your loss, either you or we may demand a mediation in accordance with the rules established by the Florida Department of Financial Services and as stated in your policy. Your policy states in relevant part: SECTION 1- CONDITIONS In Forms HO 00 03, HO 00 04 and HO 00 06: F. Appraisal is deleted and replaced by the following: F. Mediation or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either may: 1. Demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. The loss must be $500 or more, prior to the application of the deductible; or there must be a difference of $500 or more between the loss settlement amount we offer and the loss settlement amount that you request. The settlement in the course of the mediation is binding only if both parties agree, in writing, on a settlement and you have not rescinded the settlement within 3 business days after reaching settlement. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided to you. We will pay the cost of conducting any mediation conference except When you fail to appear at a conference. That conference will then be rescheduled upon your payment of the mediator's fee for that rescheduled conference. However, if we fail to appear at a mediation conference, we will pay the actual cash expenses you incur in attending the conference and also pay the mediator's fee for that rescheduled conference. If, however, we demanded the mediation and either party rejects the mediation results, you are not required to submit to, or participate in, any appraisal of the loss as a precondition to action against us for failure to pay the loss. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Frontline does not intend by this letter to waive any policy defenses in addition to those stated above, but specifically reserves its right to assert additional policy defenses at any time. Should you have any questions or concerns or have any additional information you would like to be considered, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at 321-249-1365. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” On January 6, 2025, Frontline’s Desk Adjuster, Sabra Trumbull, was assigned the Claim, thus, when she was alerted that the Insureds retained an attorney, she requested the attorney’s information so that she could obtain a Letter of Representation. After being provided with information, on January 10, 2025, Ms. Trumbull called the Insureds’ counsel to introduce herself and request additional documents like the Letter of Representation. Frontline’s Desk Adjuster again called the Insureds’ counsel on January 14, 2025 when counsel had yet to send over the documents. Nevertheless, on January 21, 2025, this Civil Remedy Notice was filed. On January 22, 2025, Frontline received a Letter of Representation stating that the Freeman Law Firm, P.A. would be representing the Insureds in the claim. On January 23, 2025, Frontline sent a letter acknowledging the Letter of Representation stating: “This serves to acknowledge our receipt of your Letter of Representation between our policyholder David Powell and Joyce Powell and The Freeman Law Firm. These documents were submitted and addressed to Frontline Insurance and received on January 23, 2025. Pursuant to your request, attached please find Reservation of Rights, Final Report, Partial Denial letter and engineer report. Your request for a certified copy of the policy has been submitted and will be forwarded under separate cover. As we continue to evaluate this claim, we look forward to working with you to discuss the facts and circumstances to determine if the policy covers the loss. Should you have any questions or concerns please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. EST. I can be reached at 972-522-2103. If I am not available when you call, please leave me a detailed message, and I will return your call as soon as possible.” This letter was accompanied by an email to the Insureds’ counsel that provided prior correspondence and claim documents. On January 24, 2025, Frontline received a letter from the Insureds’ counsel demanding appraisal. Thus, on February 7, 2025, Frontline sent a response letter stating: “This confirms receipt of your letter dated January 24, 2025, in which you demanded appraisal pursuant to the conditions of your Homeowners 3 – Special Form HO 00 03 05 11 policy, as amended by Florida Special Provisions FIM 00 23 11 21. We have reviewed your demand for appraisal. After careful review of all claim documentation, we find your demand to be ineligible for the appraisal process because the policy conditions were not met. Please refer to your Frontline Policy, Homeowners 3 – Special Form HO 00 03 05 11, as amended by Florida Special Provisions FIM 00 23 11 21 which states in part: SECTION I – CONDINTION C. Duties After Loss is deleted and replaced with the following: C. Duties After Loss. An “assignment agreement” does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. The duties must be performed either by you, an “insured” seeking coverage, or a representative of either: … In Forms HO 00 03, HO 00 04 and HO 00 06: F. Appraisal is deleted and replaced by the following: F. Mediation or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either may: 2. Request an appraisal of the loss if we fail to agree on the amount of the loss. a. A request for appraisal must be in writing and be signed by all Named "Insureds" shown in the Declarations. You must comply with SECTION I - CONDITIONS, C. Duties After Loss before making a request for appraisal. At least 10 days before requesting appraisal, the party seeking appraisal must provide the other party with a written estimate of the amount of any dispute that results from the covered cause of loss. The estimate shall include a description of each item of damaged property in dispute as a result of the covered loss, along with the extent of damage and the estimated amount to repair or replace the item. The aforementioned policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. At this time, please note that Frontline has not received an executed demand for appraisal signed by all Named “Insureds” included within the Declaration Page (i.e. Joyce Powell and David Powell). Please be advised that Frontline makes no waiver of its right to deny and defend against this claim for any other valid and lawful reason, which may later be discovered or made known. Frontline expressly reserves all such rights. Should you have any questions, please feel free to contact me at (877) 744-5224, ext. 9073.” Additionally, on February 7, 2025, in its continued adjustment of the claim, Frontline, via the undersigned counsel’s office, sent a letter requesting, pursuant to the Policy, a re-inspection of the property and additional information stating: “I hope this letter finds you well. Please note at this time that Wallen Kelley represents First Protective Insurance Company in relation to the aforementioned matter. Please note at this time that Frontline is in receipt of the Civil Remedy Notice filed by your office. In response to same, First Protective Insurance Company is hereby requesting that your client allow a re-inspection of their property by a licensed general contractor from All Claims Repairs and Consulting. Accordingly, please notify Gwen Kelly (GKelly@wallenkelley.com), within the next three (3) days, what dates and times within the next ten (10) days the Insureds are available for said inspection. Moreover, First Protective Insurance Company would request any of the following documentation from your client in relation to the aforementioned claim: • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the installation, repair, or replacement of the roofing system currently in the property. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of the interior since May 19, 2024. • Permits, estimates, invoices, receipts, contracts, and any other documents pertaining to the repair or replacement of any part of the interior or exterior of the property, (including any patio, pool cage, pool or yard structures), since May 19, 2024. • Photographs or video showing the areas reported as damaged in this claim at any time since May 19, 2024. • Photographs or video showing any repair or replacement of the roof, interior (including all rooms and interior areas), exterior (including any outside fence, pool/patio area, shed or yard structures) or any other damaged area of the property as reported in this claim, since May 19, 2024. • All receipts, canceled checks, copies of checks, cash withdrawal statements, or any other documentation showing payments made to any persons or companies in relation to the damage claimed, the repair thereof, or any purchase or replacement related thereto. • All financial records, including checking account statements, savings account statements, credit card statements, and any other statements of other lines of credit, which reflect financial accounts you used or had access to from May 19, 2024 to present, and which were involved in any deposit or transfer of insurance proceeds or which pertain to any withdrawal or payment related to a repair or replacement of damaged items or areas related to the subject loss. • All estimates, invoices, reports, or other documents pertaining to inspections of the property made since May 19, 2024. • All documents reflecting your hiring or non-hiring of a public adjuster to represent you as to this claim. • All documents relating to any lawsuit brought by you against an insurer, or by an insurer against you, within the past fifteen (15) years. • An executed Sworn Proof of Loss for Claim 10000114691. • A copy of any estimate(s) prepared by your roofer/loss consultant for Claim 10000114691. • Any Assignment of Benefits You signed for 10000114691. • Any water remediation or mold remediation documents for Claim 10000114691. • Any documents related to Archer Claims’ work, assistance, repair, or involvement with Claim 10000114691. • Any documents related to All American Roofing, Inc’s work, assistance, repair, or involvement with Claim 10000114691. • Any documents related to Affordable Screening’s work, assistance, repair, or involvement with Claim 10000114691. These requests are being made pursuant to the following policy conditions: SECTION I – CONDITIONS C. Duties After Loss is deleted and replaced by the following: C. Your Duties After Loss. An “assignment agreement” does not change the obligations to perform the duties required under this Policy. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either: 1. “Your” Duties After Loss a. Give immediate notice to us or our agent. Except for Reasonable Emergency Measures taken under Additional Coverage 2., there is no coverage for repairs that begin before the earlier of: (1) 72 hours after we are notified of the loss; (2) The time of loss inspection by us; or (3) The time of other approval by us. If you unreasonably deny us access to inspect the loss during the period in a. above, coverage for repairs beyond Reasonable Emergency Measures begins the earlier of when we are given access to inspect the loss or when we fail to appear at a scheduled loss inspection. b. To the degree reasonably possible, retain the damaged property and any photographs of the damaged property; and Allow us to inspect, subject to the paragraph above, all damaged property prior to its removal from the “residence premises” and make copies of the photographs. c. Notify the police in case of loss by theft. d. Notify the credit card or fund transfer card company in case of loss under Credit Card or Fund Transfer Card coverages. e. Protect the property from further damage. The following must be performed: (1) Take reasonable emergency measures that are necessary to protect the covered property from further damage, as provided under Additional Coverage 2. A reasonable emergency measure under 5.a. above may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To reasonably the possible, degree the damaged property must be retained for us to inspect. (2) Keep an accurate record of repair expenses. To the degree reasonably possible, take pictures prior to repairs commencing. f. Cooperate with us in the investigation of a claim. This includes speaking to and sharing information with us or any person authorized to act on our behalf, and providing documents which can be reasonably obtained by you, to facilitate our investigation of the claim. You, any “insured” seeking coverage, or a representative of either of these: (1) Must cooperate with our investigation; (2) Must not act in any manner that prevents us or any person authorized to act on our behalf, from investigating the claim; and (3) May not act in any manner to obstruct our investigation. g. Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts, and related documents that justify the figures in the inventory. h. As often as we reasonably require: (1) Show us the damaged property and the cause of loss and the condition it was in at the time of loss, if possible, except as to any repairs performed under SECTION I – PROPERTY COVERAGES, Additional Coverages, 2. Reasonable Emergency Measures; (2) Provide us with records and documents we request and permit us to make copies; (3) You, and any and all “insureds;” and Any member, officer, director, partner, or similar representative of the association, corporation, or other entity, if you are the association, corporation, or other entity, who is an “insured;” must: (a) Submit to examination under oath and recorded statements at the location insured or other reasonable location designated by us, while not in the presence of each other or any other “insured;” (b) Provide government issued photo identification. If you do not possess government issued photo identification, a signed sworn statement identifying who you are may be provided; and (c) Sign any transcript of the examinations under oath and recorded statements; At our request, the examinations will be conducted separately and not in the presence of any other persons except legal representation; Such examinations and recorded statements must either be in person or utilize video and audio technology, or determined by us; both, as (4) Permit us to take samples of damaged and undamaged property for inspection, testing, and analysis; and (5) Any and all “insureds” must execute all authorizations for the release of information when requested by us, which we deem relevant to the investigation of your loss. (6) Allow us or any person authorized on our behalf: (a) Access to the “residence premises;” (b) To inspect the “residence premises” and to inspect, subject to 2. above, all damaged property prior to its removal from the “residence premises;” and (c) To require an “insured” or their representative, or both if reasonably possible, to be present at our inspection and to assist in identifying the damaged property during the inspection; (7) At our request, identify the person or persons with knowledge of how the loss occurred and the extent of damage; (8) For losses covered under Coverage A and B, allow us to reinspect, including but not limited to taking photographs and/or video of the property to confirm repairs invoiced by any “assignees(s)” or third parties were completed, or following a supplemental or re-opened claim. i. Submit to us, within 60 days after the loss, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The description of the loss, including the date and time of the loss, the cause of loss, a description of how the loss occurred, when the loss was discovered, and who discovered the loss; (2) The names of all persons who resided at the insured location at the time of the loss; (3) The interest of all “insureds,” “assignees” if any, and all others in the property involved and all liens on the property; (4) Other insurance which may cover the loss; (5) Changes in title or occupancy of the property during the term of the policy; (6) Specifications of damage to the dwelling and other structures, including; (a) Detailed descriptions of the damage to the property; (b) Repair estimates which show the extent of damage to each item or property; (c) Estimated amount(s) to repair or replace each item of property; and (d) Amount(s) of payment made for any temporary or permanent repairs. Photographs and other supporting documentation that exists should be included to the extent it is reasonable and practical to obtain; (7) The inventory of damaged personal property described in C.7. above; (8) Receipts for additional living expenses incurred and records that support the fair rental value; and (9) Evidence or affidavit that support a claim under the Credit Card, Fund Transfer Card, Forgery and Counterfeit Money coverage, stating the amount and cause of loss. j. Produce any updates to the documents and information described above, including revised descriptions of loss, scope of loss, estimates, or other supporting information: (1) As this information becomes available, and if additional loss or damage is discovered or incurred; and (2) If you are provided with new estimates or invoices regarding the losses submitted or not submitted in the proof of loss. The duties above apply regardless of whether you, an “insured” seeking coverage, or a representative of either retains or is assisted by a party who provides legal advice, insurance advice or expert claim advice, regarding an insurance claim under this Policy. Your clients are required to allow a reasonable re-inspection pursuant to the terms of the insurance policy under which you are seeking recovery and Florida Statute. Their duties after loss also obligate them to provide the requested documents as well. Pursuant to the terms of the insurance policy and Florida law, if they fail or refuse to comply, they may be denied recovery under the policy. If you have any questions at all or wish to further discuss these matters or schedule mediation for this matter, please call or email me at your earliest convenience.” On February 11, 2025, the Insureds, via their counsel, again demanded appraisal. On February 26, 2025, Frontline sent a response letter stating: “On February 11, 2025, Joyce and David Powell, through their attorney, Brian Freeman demanded appraisal. To qualify as a “competent” appraiser, neither the appraiser nor the company that employs the appraiser is entitled to receive a fee that is dependent on the amount of the appraisal award. However, the payment of an hourly or flat fee shall not render an appraiser incompetent. While Frontline agrees to participate in Appraisal in order to set the amount of loss, this agreement applies only to those items of the claim which have been presented to and investigated by Frontline, and over which the parties have arrived at a disagreement about the amount of loss. Frontline herein selects the following appraiser: Name: John Bruns, All Claims Repairs & Consulting Email: jbruns@allclaimsrepairs.com Telephone: (954) 456-6060 The appraisers must choose a “competent, disinterested umpire” within 15 days. If they cannot agree upon an umpire within 15 days, we may request that the choice be made by a judge. Each party will pay its own appraiser, including their costs associated with producing the appraisal estimate, above; and bear the other expenses of the appraisal and umpire equally. The appraisers and the umpire shall be given reasonable and timely access to inspect the property, in accordance with the terms of the policy. The written report of the agreement will be in writing and shall include the following: • A detailed list, including the amount to repair or replace, of each specific item included in the award from the appraisal findings; • The agreed amount of each item, its replacement cost value and corresponding actual cash value; and • The statement of “This award is made subject to the terms and conditions of the policy.” Accordingly, we direct you to HO 00 05 11 HOMEOWNERS 3 SPECIAL FORM as amended by the FIM 00 23 11 21 SPECIAL PROVISIONS – FLORIDA, which states in part: SECTION 1-CONDITIONS In Forms HO 00 03, HO 00 04 and HO 00 06: F. Appraisal is deleted and replaced by the following: F. Mediation or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either may: 2. Request an appraisal of the loss if we fail to agree on the amount of the loss. a. A request for appraisal must be in writing and be signed by all Named "Insureds" shown in the Declarations. You must comply with SECTION I - CONDITIONS, C. Duties After Loss before making a request for appraisal. At least 10 days before requesting appraisal, the party seeking appraisal must provide the other party with a written estimate of the amount of any dispute that results from the covered cause of loss. The estimate shall include a description of each item of damaged property in dispute as a result of the covered loss, along with the extent of damage and the estimated amount to repair or replace the item. b. In this event, each party will choose a competent appraiser within 20 days after receiving a written request from the other. To qualify as a competent appraiser, neither the appraiser nor the company that employs the appraiser is entitled to receive a fee that is dependent on the amount of the appraisal award. However, the payment of an hourly or flat fee shall not render an appraiser incompetent under this provision. c. The two appraisers will choose a competent, disinterested umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the "residence premises" is located. d. The appraisers will separately set the amount of the loss. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of the loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of the loss. In all instances, the written report of agreement will be in writing and shall include the following: (1) A detailed list, including the amount to repair or replace, of each specific item included in the award from the appraisal findings; (2) The agreed amount of each item, its replacement cost value and corresponding actual cash value; and (3) The statement of "This award is made subject to the terms and conditions of the policy. Each party will: (a) Pay its own appraiser, including their costs associated with producing the estimate in 2.a. of this provision, above; and (b) Bear the other expenses of the appraisal and umpire equally. e. You, we, the appraisers, and the umpire shall be given reasonable and timely access to inspect the property, in accordance with the terms of the policy. f. You" and "We" do not waive any rights by demanding or submitting to an appraisal and retain all contractual rights to determine if coverage applies to each item in dispute. g. Appraisal is only available to determine the amount of the loss of each item in dispute. The appraisers and the umpire have no authority to decide: (1) Any other questions of fact; (2) Questions of law; (3) Questions of coverage; (4) Other contractual issues; or to conduct appraisal on a class-wide basis. The policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Pursuant to the above referenced policy provisions, the appraisal panel has no authority to decide questions of fact, law, coverage, or other contractual issues. Further, “You” and “We” do not waive any rights by demanding or submitting to an appraisal and retain all contractual rights to determine if coverage applies to each item in dispute. Frontline expressly reserves all its rights, conditions, terms, provisions, endorsements, exclusions, or requirements contained in your Policy as well as Florida Law. Any obligation or legal rights, which may now or hereafter be available to you or to Frontline, are hereby reserved. If you have any additional information, or other items submit the same through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents) or email to appraisaldocs@flhi.com. Should you have any questions or concerns or have any additional information you would like to submit for consideration, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (877) 744-5224 ext. 9073. Should I not be available when you call, please leave me a detailed message and I will return your call as soon as possible.” After no response from the Insureds or their representatives, Frontline sent a second letter to the Insureds’ counsel on March 13, 2025 that advised them that: “This correspondence will serve as Frontline’s second request for you to comply with our written appraisal demand response dated February 26, 2025. Pursuant to the policy, you must name your “competent” appraiser within 20 days after receiving the written request. On February 26, 2025, Frontline sent a letter via email agreeing to participate in appraisal which included Frontline’s appraiser. To date, you have not named your appraiser, which is a failure to comply with the appraisal provision of the policy. Please provide the name and contact information within five (5) days of this letter. To qualify as a “competent” appraiser, neither the appraiser nor the company that employs the appraiser is entitled to receive a fee that is dependent on the amount of the appraisal award. However, the payment of an hourly or flat fee shall not render an appraiser incompetent. Accordingly, we direct you to HO 00 05 11 HOMEOWNERS 3 SPECIAL FORM as amended by the FIM 00 23 11 21 SPECIAL PROVISIONS – FLORIDA, which states in part: SECTION 1-CONDITIONS In Forms HO 00 03, HO 00 04 and HO 00 06: F. Appraisal is deleted and replaced by the following: F. Mediation or Appraisal. If you and we fail to agree on the settlement regarding the loss, prior to filing suit, you must notify us of your disagreement in writing so that either may: 2. Request an appraisal of the loss if we fail to agree on the amount of the loss. a. A request for appraisal must be in writing and be signed by all Named "Insureds" shown in the Declarations. You must comply with SECTION I - CONDITIONS, C. Duties After Loss before making a request for appraisal. At least 10 days before requesting appraisal, the party seeking appraisal must provide the other party with a written estimate of the amount of any dispute that results from the covered cause of loss. The estimate shall include a description of each item of damaged property in dispute as a result of the covered loss, along with the extent of damage and the estimated amount to repair or replace the item. b. In this event, each party will choose a competent appraiser within 20 days after receiving a written request from the other. To qualify as a competent appraiser, neither the appraiser nor the company that employs the appraiser is entitled to receive a fee that is dependent on the amount of the appraisal award. However, the payment of an hourly or flat fee shall not render an appraiser incompetent under this provision. c. The two appraisers will choose a competent, disinterested umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a court of record in the state where the "residence premises" is located. d. The appraisers will separately set the amount of the loss. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of the loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of the loss. In all instances, the written report of agreement will be in writing and shall include the following: (1) A detailed list, including the amount to repair or replace, of each specific item included in the award from the appraisal findings; (2) The agreed amount of each item, its replacement cost value and corresponding actual cash value; and (3) The statement of "This award is made subject to the terms and conditions of the policy. Each party will: (a) Pay its own appraiser, including their costs associated with producing the estimate in 2.a. of this provision, above; and (b) Bear the other expenses of the appraisal and umpire equally. e. You, we, the appraisers, and the umpire shall be given reasonable and timely access to inspect the property, in accordance with the terms of the policy. f. You" and "We" do not waive any rights by demanding or submitting to an appraisal and retain all contractual rights to determine if coverage applies to each item in dispute. g. Appraisal is only available to determine the amount of the loss of each item in dispute. The appraisers and the umpire have no authority to decide: (1) Any other questions of fact; (2) Questions of law; (3) Questions of coverage; (4) Other contractual issues; or to conduct appraisal on a class-wide basis. The policy provisions are only excerpts from your policy. All policy terms and conditions continue to apply to your claim. Pursuant to the above referenced policy provisions, the appraisal panel has no authority to decide questions of fact, law, coverage, or other contractual issues. Further, “You” and “We” do not waive any rights by demanding or submitting to an appraisal and retain all contractual rights to determine if coverage applies to each item in dispute. Frontline expressly reserves all its rights, conditions, terms, provisions, endorsements, exclusions, or requirements contained in your Policy as well as Florida Law. Any obligation or legal rights, which may now or hereafter be available to you or to Frontline, are hereby reserved. If you have any additional information, or other items submit the same through the web portal at www.frontlineinsurance.com (Main Menu > Upload Claim Documents) or email to appraisaldocs@flhi.com. Should you have any questions or concerns or have any additional information you would like to submit for consideration, please feel free to contact me Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. I can be reached at (877) 744-5224 ext. 9073. Should I not be available when you call, please leave me a detailed message and I will return your call as soon as possible.” To date, no new information has been provided to Frontline of the undersigned counsel. However, on March 14, 2024, counsel for the Insureds advised that they had selected Dave Griffey as their appraiser for this matter. Accordingly, the appraisal process for this claim is still on ongoing at this time. 2. Nature of the Complainants’ Civil Remedy Complaint In the Civil Remedy Notice, the Complainants allege Frontline violated: 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 Insureds and with due regard for her or his interests. Section 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. 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. Section 626.9541(1)(i)(3)(c)— Failing to acknowledge and act promptly upon communications with respect to claims. Section 626.9541(1)(i)(3)(d)— Denying claims without conducting reasonable investigations based upon available information. Section 626.9541(1)(i)(3)(f)— Failing to promptly provide a reasonable explanation in writing to the Insureds 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. Section 626.9541(1)(i)(3)(g)— Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Section 626.9541(1)(i)(3)(h)— Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. These accusations are unfair given the nature of the facts and damage surrounding this claim. Here, the claim was processed, the Insureds’ property was inspected on numerous occasions, requests for information were sent, multiple statements of the Insured were taken, and Frontline to reasoned coverage decisions. Specifically, first, Frontline asserts that it did act in good faith, fairly, and honestly towards the Insureds by taking all necessary steps to determine coverage all while keeping in constant communication with the Insureds and their representatives. Second, Frontline asserts it agreed to appraise this claim after receipt of a compliant request for same from the Insureds’ counsel. Third, Frontline asserts that it does have standards for the proper investigation of claims, standards that it used during the evaluation of this claim, including sending a Field Adjuster to inspect the property in person in addition to requesting paper documents for Desk Adjusters to evaluate, sending a Professional Engineer to inspect the property, taking multiple statements of the Insureds, and continuing to adjust the claim even after a decision had been made. Fourth, Frontline asserts that it made no misrepresentations to the Insureds, and in all communications with the Insureds, Frontline used exact Policy language. Fifth, Frontline asserts that it always acted promptly and often followed up with the Insureds when they did not respond promptly to Frontline’s communications. Sixth, Frontline asserts that it reached its coverage decisions after a reasonable adjustment of the claim, including multiple inspections, taking multiple recorded statements, through communicating with the Insureds throughout the process, while requesting information when needed. Seventh, Frontline sent numerous written communications to the Insureds explaining its bases, while using direct policy language, and thus, did not violate section 626.9541(1)(i)(3)(f). Eighth, Frontline asserts that it did promptly notify the Insureds when additional information was needed, numerous times. Finally, Frontline asserts that it did explain why the requested information was necessary, using language directly from the Policy to supplement its reasonings. Further, the Complainants have failed to ask for a proper cure of their Civil Remedy Notice. Instead, they have asked for the following cure(s): A) Immediately pay the Insureds’ windstorm damage claim in the amount of the Mr. Penn’s damage estimate of $225,227.53, plus interest, less the applicable deductible; and B) Agree to tender any recoverable depreciation once it has been incurred per the terms of the insurance policy. Frontline responds: A) This is an improper cure remedy because, after a complete, fair, and reasonable adjustment of the claim, it was revealed that there was only partial covered of the Insureds’ claim as they reported it, and thus, the damages alleged in Mr. Penn’s estimate are largely uncovered. This is further an improper cure remedy because, even if they were all covered damages, it is based on an estimate and is not a reflection of actual costs owed by Frontline, if any. Finally, Frontline would note that this request is improper as the matter is currently in appraisal and Frontline would only owe for any amounts determined by the appraisal panel that were not already paid by the carrier. B) This is an improper cure remedy because Frontline has paid all amounts due under the Policy including recoverable depreciation, if any. Conclusion Frontline asserts that there was no misconduct in the adjustment of the Insureds’ claim. As can be seen from the above, Frontline has credible evidence to support its belief that the claim was properly adjusted. The claim was processed, the Insureds’ property was inspected multiple times, letters requesting documentation and information were sent, Recorded Statements of the Insureds took place, and Frontline reasonably came to its coverage decisions after proper and thorough adjustment. Additionally, Frontline has spent considerable time and resources in the investigation of this matter (and continues to do so via the appraisal process) and believes that its efforts were made in good faith and based on the information available at the time of the claim. In turn, this Civil Remedy Notice unfairly characterizes the facts of the Insureds’ claim and unfairly paints Frontline in a negative light. Moreover, the lack of specificity within the Civil Remedy Notice, has not given Frontline the ability to “cure” the allegations contained herein above. Sincerely, Lee Alhanti Lee Alhanti, Esq. On Behalf of First Protective Insurance Company
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008