Civil Remedy Notice of Insurer Violations
Login

Filing Number:     802739
Filing Accepted:  1/21/2025
         Print Filing
Complainant
Last/Business Name *  
CHARLES COMER AND MAGALY COMER   First Name  
Street Address * 239 DAHLIA CT.
City, State Zip * BRADENTON, FL 34212
Email Address * CKMCOMER@GMAIL.COM; MDHACKENSACK@HOTMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   CHARLES COMER AND MAGALY COMER   First Name  
Policy # * 79-C1-T464-0 Claim #* 59-75M5-67C
Attorney
Attorney is Applicable
Last Name* LEONARDIS First Name * RICHARD Initial
Street Address* 925 S. FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * RLEONARDIS@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* ETHAN AMADOR
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Unsatisfactory Settlement Offer
* 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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Loss settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The carrier was put on notice of the insureds’ windstorm damage claim. The carrier initially attempted to low-ball the claim. Subsequently, the insured prepared a loss package in the amount of $102,388.97needed to restore the property back to its pre-loss condition. Whereas, the carrier wrongfully represented the damages to the insureds’ property to be below the policy deductible. The insured has complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About one hundred days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $102,388.97, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned at (561)-892-9760 if you have any questions or concerns. Sincerely, Richard Leonardis Attorney at Law
Comments
User Id Date Added Comment
ebrooksherproperty@kpattorney.com 04-07-2025 This filed Civil Remedy Notice is hereby withdrawn pursuant to a settlement agreement between the claimant and the insurance carrier.
HAS-KD@kubickidraper.com 03-11-2025 March 11, 2025 VIA ELECTRONIC FILING THROUGH: WWW.FLDFS.COM (CIVIL REMEDY SYSTEM) AND BY EMAIL TO: 9589071052702236780074 Charles and Magaly Comer c/o Richard Leonardis, Esq. Kanner & Pintaluga 925 South Federal Highway Boca Raton, Florida 33432 Eservice: RLEONARDIS@KPATTORNEY.COM CIVIL REMEDY NOTICE RESPONSE DFS File No.: 802739 Complainant: Charles Comer and Magaly Comer Insured: Charles Comer and Magaly Comer Policy No.: 79-C1-T464-0 Claim No.: 59-75M5-67C Date CRN filed: January 21, 2025 Dear Policyholders: Undersigned counsel and the law firm of Kubicki Draper represent State Farm Florida Insurance Company (“State Farm”) with regard to the above-referenced claim. This shall serve as State Farm’s response to the “Civil Remedy Notice of Insurer Violations” (“CRN”), filed by or on behalf of Charles Comer and Magaly Comer (hereinafter “Complainants” or “Insureds”), with the Florida Department of Financial Services (“DFS”) on January 21, 2025. The CRN arises from a claim reported on October 16, 2024 under Complainants’ homeowners’ policy with State Farm, arising out of reported damage to the insured property as a result of Hurricane Milton. State Farm promptly acknowledged, investigated, and issued its claim decision. The Insureds were provided with a copy of the Homeowners’ Claims Bill of Rights and notification reminding them of certain duties after loss under the policy. The property was inspected on October 25, 2024. Based on the inspection, photos, and information provided, State Farm found the scope of covered damages to be limited. State Farm also observed pre-existing damage which was unrepaired from a previous State Farm claim. State Farm wrote an estimate for the scope of damages found to be covered for the subject claimed loss; however, it was found that the cost to repair the covered damages was less than the policy’s hurricane deductible. Accordingly, State Farm was unable to issue any payment on this claim. State Farm’s timely claim decision letter explained the basis for its claim decision and cited relevant policy provisions. Complainants were also notified of their right to request mediation through the DFS if they disagreed with the claim decision. Thereafter, Complainants’ public adjuster submitted an estimate that was excessive in price and scope, failed to account for depreciation (RCV only), and which included improper items like overhead and profit. The estimate notably failed to substantiate a basis for further claim payment. Complainants subsequently filed a Notice of Intent to Initiate Litigation (NOIL), to which State Farm timely responded by requesting a re-inspection, the scheduling of which is in progress as of the time of this CRN response. In any event, the CRN is both invalid and without merit, as will be explained below. The section of the CRN that is required to identify “all statutory provisions alleged to have been violated[,]” claims State Farm allegedly violated the following provisions in handling this claim: §624.155(1)(b)(1), Fla. Stat., “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), Fla. Stat., “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), Fla. Stat., “Failing to adopt and implement standards for the proper investigation of claims[;]” §626.9541(1)(i)(3)(b), Fla. Stat., “Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue[;]” §626.9541(1)(i)(3)(c), Fla. Stat., “Failing to acknowledge and act promptly upon communications with respect to claims[;]” and §626.9541(1)(i)(3)(f), Fla. Stat., “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.” State Farm denies that it violated any of the referenced statutory provisions or any applicable provision of Florida law in handling this claim. State Farm also denies the allegations in the “Reasons for Notice” section of the CRN, including denying any improper: (1) claim delay, (2) unfair trade practices and/or (3) unsatisfactory settlement offer. State Farm denies all of these allegations. State Farm also objects that Complainants cannot later attempt to rely on any provisions and/or grounds not specified in this CRN. Specifically to § 624.155(1)(b)(1), Fla. Stat., State Farm has at all times handled the claim in good faith and has acted honestly towards its policyholders, while attempting to reach a claim resolution promptly and efficiently. As is explained more fully above and below, State Farm reached a claim decision based on its thorough investigation into the claim; by contrast, Complainants have not provided any evidence of a violation of this statutory provision. Specifically to § 624.155(1)(b)(3), Fla. Stat., State Farm has at all times handled the claim in good faith and has acted promptly in investigating the claim, in fact opening coverage based on the initial investigation, though the amount of coverage fell below deductible. As is explained more fully above and below, State Farm reached a claim decision based on its thorough investigation into the claim; by contrast, Complainants have not provided any evidence of a violation of this statutory provision. Furthermore, State Farm is continuing to investigate this claim as promptly as possible. Specifically to § 624.155(1)(i)(3)(a), Fla. Stat., State Farm has at all times handled the claim in good faith and by contrast, Complainants have not provided any evidence of a violation of this statutory provision. Specifically to § 624.155(1)(i)(3)(b), Fla. Stat., State Farm has at all times handled the claim in good faith and all statements made to Complainants and/or their representatives have been truthful and accurate representations of policy terms, conditions, and/or applicable claim handling procedures. By contrast, Complainants have not provided any evidence of a violation of this statutory provision. Specifically to § 624.155(1)(i)(3)(c), Fla. Stat., State Farm has at all times handled the claim in good faith and has acted promptly in investigating the claim, in fact opening coverage based on the initial investigation, though the amount of coverage fell below deductible. As is explained more fully above and below, State Farm reached a claim decision based on its thorough investigation into the claim; by contrast, Complainants have not provided any evidence of a violation of this statutory provision. Furthermore, State Farm is continuing to investigate this claim as promptly as possible. Specifically to § 624.155(1)(i)(3)(f), Fla. Stat., State Farm has at all times handled the claim in good faith and has been clear in communications with Complainants and/or their representatives about the claim decision, the basis of the claim decision, and any policy terms, conditions, or provisions governing the claim decision or its basis. By contrast, Complainant has not provided any evidence of a violation of this statutory provision. Contrary to all such allegations in the CRN, State Farm has acted reasonably, fairly, honestly, promptly, and in good faith in its efforts to investigate, adjust, and resolve this claim based on its investigation. State Farm’s claim decision was made within a reasonable time and after investigation, based on the available information, and in accordance with the policy and Florida law. Complainants’ disagreement with the claim decision is not evidence of bad faith. In addition, State Farm objects that allegations such as the foregoing in the CRN are totally lacking in any meaningful specificity, factual basis, and/or explanation, as required by §624.155, which invalidates the CRN. Moreover, State Farm respectfully and categorically denies without limitation each and every allegation of Complainants within the CRN, including but not limited to denying the alleged violations of the cited provisions of Florida law and denying the allegations in the “Reasons for Notice” section. State Farm also denies any and all stated, implied, and/or unspecified allegations of the CRN, including but not limited to denying any alleged claim delay, unsatisfactory settlement offers, unfair trade practices, not attempting in good faith to settle claims, failing to adopt and implement standards for proper investigation, making misrepresentations, failing to acknowledge and act promptly on communications, denying claims without conducting reasonable investigation, failing to affirm or deny coverage, failure to promptly or properly provide reasonable explanations, failing to promptly give notice of additional information needed to process the claim, failing to timely adjust and issue a decision on the claim, and the like, whether or not specifically alleged by the CRN. State Farm has not violated any applicable provision of Florida law in handling this claim. As noted above, State Farm also objects to the CRN based on multiple defects, which render the CRN invalid. Foremost, the CRN fails to comply with §624.155(3)(b), Fla. Stat., which requires the CRN to specify the facts and circumstances giving rise to the alleged violations, the statutory provisions allegedly violated, as well as the relevant policy language at issue in the alleged violations. All such requirements must be strictly construed and complied with, as a claim for first-party bad faith does not exist apart from §624.155 creating it. This was confirmed by the appellate court’s decision in Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021) (on rehearing), where the Fourth District held that a CRN is invalid and precludes a bad faith claim where, as here, it fails to strictly comply with the specificity and other requirements of the statute. The CRN here is likewise invalid. For example, the subject CRN refuses or fails to reference any particular policy language at all, aside from the overbroad and vague reference to the “Loss settlement provision,” with no explanation. However, the loss settlement provision contains several provisions, clauses, and terms, none of which are specified in the CRN. The body of the CRN then adds an equally vague reference to the “Section I – Perils Insured Against,” which was not listed where required earlier in the CRN. Equally problematic, this policy does not contain a provision entitled “Perils Insured Against” at all. The part of the policy meant may be “Section I – Losses Insured.” Contrary to what the CRN claims, neither the provisions set forth under that nor any other part of the policy would purportedly cover all “direct losses” to the property. Rather, this policy’s insuring agreement only covers “accidental direct physical loss” as a threshold prerequisite to coverage. The body of the CRN also makes mention of an alleged policy condition which in reality does not exist. In particular, the CRN claims that “Section I – Conditions” allegedly requires “payment of a claim within 90 days”. However, the provision most likely meant by this vague reference instead provides that State Farm will pay or deny the claim or a portion of the claim within a specified timeframe running from the first notice of loss, unless prevented by factors beyond State Farm’s control, as further set forth in the policy and as per §627.70131(5)&(7), Fla. Stat. Thus, the CRN misrepresents the actual policy provisions. The defects are clearly prejudicial. The CRN offers no basis or policy provisions that might alter or warrant reconsideration of State Farm’s claim decision. The CRN also wholly fails to explain how State Farm allegedly breached any provisions of the subject policy or how any provisions of the policy relate to the subject claim or alleged bad faith statutory violations. This CRN literally forces State Farm to “guess” what policy provisions Complainants believe were allegedly violated or breached and why. An insurer cannot be forced to “guess” about these or any other matters. The CRN is therefore invalid and without merit. At a bare minimum, Complainants cannot predicate any future bad faith case on any alleged policy breaches, precisely because the CRN totally fails to reference any specific policy provisions that may be at issue. Compounding all of this, effective December 16, 2022, Complainants must obtain an adverse adjudication that State Farm breached the insurance contract as a prerequisite to bringing an action for extra-contractual damages under §624.155(1)(b). See §624.1551, Fla. Stat. (amended effective 12/16/22). Further confirming the prejudice, the subject policy was issued after the tort reform bill that was enacted effective March 24, 2023 (HB837), and well after the prior amendments that were enacted effective December 16, 2022 (SB-2A). As a result, all of those statutory changes clearly apply to the subject policy and claim, as will any other relevant amendments that preceded the issuance of this policy. This solidifies the conclusion the CRN is invalid and without merit. State Farm further objects to the CRN, and the CRN is defective additionally because it lacks sufficient specificity with regard to the alleged statutory violations, which, again, is expressly required by §624.155(3)(b), Fla. Stat. For example, the CRN fails to adequately identify or explain how State Farm violated the provisions of Florida law cited in the CRN, how the alleged violations relate to the facts of the specific claim, and/or what actions and amount(s) are being demanded or the basis for demanding any such actions/amounts. As further discussed above, the CRN identifies a number of statutory provisions that were allegedly violated. The body of the CRN also lists several alleged bad faith “actions,” but without identifying which if any statutory provision(s) they might relate to. Despite vaguely citing multiple statutory provisions, the CRN offers no meaningful explanation as to how any were allegedly violated or how they relate to the subject claim or allegations in the CRN. On the contrary, the CRN is replete with conclusory assertions unsupported by any meaningful factual basis. The CRN describes the loss generically as a “windstorm damage claim,” with no explanation. The CRN does not even identify the date of loss, first notice of loss, nor does it explain what areas of the home were allegedly impacted or included in the damages they are demanding—which are over and above the already excessive estimate initially provided by the PA, discussed herein above. The few facts provided by the CRN are so boilerplate they could apply to nearly any property damage claim. Some of the allegations are also internally inconsistent and/or contrary to the actual facts of this claim. For example, the CRN claims Complainants have fully complied with the policy’s post-loss obligations, when that is just not true. The most notable example is their failure to promptly submit a sworn proof of loss. The CRN then accuses State Farm of purported delays, when that could not be further from the truth. Complainants’ bare disagreement with the claim decision, referenced as a “low-ball”, is not a valid basis for asserting bad faith. In sum, the CRN totally fails to explain how State Farm’s handling or investigation of the claim was in any way deficient. It fails to allege any specific facts as to why the referenced statutory provisions were allegedly violated, let alone explain what policy provisions were allegedly breached and why. Overall, the CRN fails to give any meaningful claim specific facts or explanation which might shed some light on the CRN’s boilerplate, baseless accusations. This is prejudicial and renders the CRN invalid. It also underscores that this CRN is meritless. The CRN also makes improper demands which likewise invalidate the CRN for lack of specificity and/or as otherwise contrary to Florida law. For instance, the CRN expressly and impermissibly demands that State Farm must pay (unspecified) extra-contractual damages like pre-judgment interest as a purported condition of “curing” the CRN. Confirming that extra-contractual damages are being claimed is the CRN’s demand that the property be returned to it’s “pre-loss” condition, when that is not what the policy requires; to the contrary, again, the policy requires accidental direct physical loss to trigger coverage, and then any coverage or payment is subject to the policy’s terms, conditions, limitations, and exclusions, together with any endorsements. So demanding that the property be returned to “pre-loss” condition is tantamount to claiming extra-contractual damages. Any and all such demands are patently impermissible and render the CRN invalid. Florida law does not impose on an insurer the obligation to pay whatever the insured or claimant demands. Rather, in a first-party matter such as this, an insurer is only required to pay the contractual amount still owed under the policy—if any. Thus, any demand that the insurer must purportedly pay attorney’s fees, costs, interest or any other type of extra-contractual damages renders the CRN invalid on its face and a legal nullity. Alternatively, the CRN is ambiguous as to whether extra-contractual damages are being claimed. The result is the same: The CRN is invalid and without merit. Compounding these defects, even assuming arguendo statutory interest might be owed, it would not be owed from the “date of loss” as demanded by this CRN. Rather, statutory interest would only be owed from the first notice of loss, if at all. The demand is invalid in any event for the reasons just explained. Without question, the CRN falls far short of the specificity and other requirements of §624.155 and is therefore invalid. The CRN fails to give State Farm meaningful notice of the alleged policy breaches and statutory violations, and it thereby thwarts the ability to fully respond or cure in response to the CRN. This contravenes the purpose and requirements of Florida law, including the notice and safe harbor or “cure” provisions of §624.155, Fla. Stat., which are a necessary prerequisite to any future bad faith action. See, e.g., Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000). Thus, due to the lack of specificity of the CRN and other defects, the CRN is invalid, without merit, and cannot serve as a condition precedent to any action for alleged bad faith under §624.155, Fla. Stat., or otherwise under Florida law. Subject to and without waiving these denials and objections and any other available defenses, State Farm states that it has not violated any applicable provision of Florida law in handling this claim or in any way related to this claim. Rather, State Farm has at all times acted in good faith, fairly, honestly, and with reasonable diligence in its handling and investigation of the claim, including with regard to any claim decisions made with respect to the alleged losses or in any way related to this matter. The foregoing provides examples but is not exhaustive. State Farm has at all times been, and continues to be, open to communication with the Complainants and/or their representatives regarding this matter. State Farm remains willing to review and consider any additional information which Complainants believe to be relevant to this matter and requests that any such additional information or documentation be provided immediately. State Farm will evaluate any additional information or documentation it receives in good faith. State Farm has at all times handled this claim in good faith and is continuing to handle it in good faith. The foregoing provides examples but is not exhaustive. In any event, the allegations in the CRN amount, at most, to a mere disagreement regarding the cause of loss and/or the scope of coverage for the alleged losses. Disagreement regarding such matters is not bad faith and cannot serve as a basis for any future bad faith claim against State Farm. Accordingly, State Farm denies the allegations of the CRN and objects to the CRN as invalid and without merit. The denials and objections herein are not necessarily exhaustive and this response shall not prevent State Farm from asserting any other appropriate objections, denials, and/or defenses related to this claim and/or CRN. As a final matter, it should be emphasized that the subject policy issued by State Farm is governed by the policy’s terms, conditions, limitations and exclusions together with any endorsements. This CRN response does not waive any provisions of the policy. Furthermore, any action taken by or on behalf of State Farm or its authorized representative(s), whether in the past or future, to investigate the alleged loss, to adjust any claim or request for payment, or in any way related to or arising out of the subject claim or loss, shall not waive any provisions of the policy. Thank you for your time and attention in this matter. Please contact us if you have any questions or require additional information. Sincerely, /s/ Eli M. Marger, Esq. Eli M. Marger, Esq. Kubicki Draper, PA EMM@kubickidraper.com
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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




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