Civil Remedy Notice of Insurer Violations
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Filing Number:     802935
Filing Accepted:  1/22/2025
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Complainant
Last/Business Name *  
MUNTOIU   First Name   DANIEL & MARIELA
Street Address * 17330 46TH CT N
City, State Zip * LOXAHATCHEE, FL 33470
Email Address * MUNTOIUDANIEL@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MUNTOIU   First Name   DANIEL & MARIELA
Policy # * W013366979 Claim #* 3300507855
Attorney
Attorney is Applicable
Last Name* ALTMAN First Name * ALEXIS Initial
Street Address* 925 SOUTH FEDERAL HIGHWAY, 7TH FLOOR
City, State Zip* BOCA RATON , FL - FLORIDA 33432
Email Address * AALTMAN@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   TOWER HILL INSURANCE EXCHANGE
NAIC Company Code 17179
 
Name of individual responsible for violation (if any):* KYLE RAMUS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Unsatisfactory Settlement Offer
Claim Delay
* 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.
* 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.

This notice is given in order to perfect the right to pursue the civil remedy authorized by section 624.155, Florida Statutes. Daniel & Mariela Muntoiu (“insured”) purchased an all-risk policy of insurance with Tower Hill Insurance Exchange (“carrier”) to cover their home. The Insured made a claim after suffering damages from Hurricane Ian. The loss was a direct result of a covered peril under the all-risk policy. Although it is clear that the damages are covered, the carrier has not attempted in good faith to settle the insured’s claim 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 their interests. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). The insured put the carrier on notice of the damages to their home after Hurricane Ian caused damages. An engineer was sent out. This is a practice of Tower Hill to send out engineers, specifically SDII Global, who have been paid millions of dollars to write up reports misrepresenting the cause of loss as falling under exclusions under the policy. Thereafter the claim for the roof damage was denied. It is clear that Tower Hill advised the engineer that they needed to write that the damages found to the roof were all a result of causes excluded under the policy. Pursuant to Florida Statute §624.155(1)(b)(1), Tower Hill has failed to settle the claim in good faith when it could and should have done so. The damage to the Insured’s property was clearly caused by a covered peril under the Policy, but Tower Hill has intentionally and wrongfully denied the roof and interior damage, and callously delayed the claim process. Tower Hill has not shown a good faith intention to pay what was owed but rather has underpaid the claim for financial gain and profit. Pursuant to Florida Statute §626.9541(1)(i)(3)(a), Tower Hill has a duty to adopt and implement standards for the proper investigation of claims. The field adjuster sent out on behalf of Tower Hill displayed a lack of knowledge, improper training, and/or intent to misrepresent damages. Pursuant to Florida Statute §626.9541(1)(i)(3)(c), Tower Hill failed to acknowledge and act promptly upon communications with respect to claims as they ignored the request by Public Adjuster to provide a certified copy of Insured’s policy of insurance. Florida law mandates that insurers and adjusters do not mislead the Insured. Florida Insurance companies that fail to follow these Florida laws and regulations, designed to protect consumers, do not only breach their duties under the policy of insurance but do so in bad faith. In violation of Florida Statute §626.9541(1)(i)(3)(b), Tower Hill intentionally misrepresented the available coverage under the policy. Tower Hill intentionally misrepresented that the roof was damaged by the storm stating that the interior damages were. Furthermore, the Insured believes Tower Hill repeatedly and as a standard business practice engages in this behavior to deprive its Insured of their rightful insurance proceeds when they experience a covered loss. Insured contends Tower Hill has implemented a claims program and business practices that are tailored to increase its profits at the expense of benefits that are owed to its customers and that other Insured have been refused insurance proceeds due and owing under the policy in the same or similar circumstances, and some have been provided inadequate insurance monies under the same or similar facts or circumstances. This is wrongful conduct and directly violates the purpose of insurance coverage. Tower Hill ’s wrongful conduct and omissions include, but are not limited to: claim delay, not conducting a full and prompt investigation, not treating the policyholder with good faith claims conduct, Tower Hill g for ways to reduce recovery to Insured; Tower Hill g for ways to delay full recovery to Insured; holding back and failing to pay portions of claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the policyholder’s interests; establishing severity control initiatives and otherwise establishing a culture of not fully and promptly paying claims following losses; and failing to pay the full amount of the Insured’s damage despite knowing it must do so. Consequently, these actions have caused undo frustration and financial harm to the Insured. As a direct and proximate result of the poor handling of this Claim by Tower Hill the Insured sustained extracontractual damages. Due to the bad faith actions of Tower Hill, Insured was forced to engage the services of the Public Adjuster to attempt to recover the settlement to which they are rightfully entitled. 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 regard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. This notice is provided in order to perfect a right to pursue the civil remedy authorized by Florida Statute §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay all amounts due and owing to the insured in the amount of $159,833.38 for indemnity benefits, minus any applicable deductible or prior payments; and 2) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. Should you have any questions upon receipt please contact the undersigned at 561-892-9988. Sincerely, Alexis Altman
Comments
User Id Date Added Comment
vgomez@kelleykronenberg.com 03-06-2025 This is Tower Hill Insurance Exchange Company’s (“Tower Hill ”) formal response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of Daniel & Mariela Muntoiu by yourself, as it relates to Claim number 3300507855. The Department of Financial Services (“DFS”) accepted the CRN on January 22, 2025, and assigned it filing number 802935. The following reply has been uploaded to the Department of Financial Services. Following the promulgation of Fla. Stat. § 624.155, the Department of Financial Services created a CRN form: Form DFS-10-363 which lays out 15 requirements as follows: 1) Complainants Name; 2) Complainants Address; 3) Complainants E-mail address; 4) Complainant type (Insured or otherwise); 5) Insured’s Name; 6) Insurance Policy Number; 7) Insurance Claim Number; 8) Attorney’s Name; 9) Attorney’s Address; 10) Attorney’s E-mail Address; 11) Type of Insurer (authorized or otherwise); 12) Name of Insurer; 13) Address of Insurer; 14) Type of Insurance (Commercial Property & Casualty or otherwise); and 15) Reason for Notice. See Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (4th DCA 2021). Notably, the CRN filed fails to include the Address of the Insurer making the subject CRN deficient. On June 5, 2020, the United States District Court for the Southern District of Florida addressed this issue in Pin-Pon Corporation v. Landmark American Insurance Company 2:20-cv-14013-DMM, wherein The Court granted Defendant’s Motion to Dismiss Plaintiff’s Statutory Bad Faith Action as the Plaintiff’s CRNs failed to specifically comply with all statutory requirements. Further, after reviewing the CRN, Tower Hill denies all allegation contained in the Insureds’ CRN. Tower Hill conducted a thorough review of its handling of the Insureds’ claim, Subject Claim No.: 3300507855. Tower Hill denies that it has violated any of the statutes as alleged in the CRN. At all times, Tower Hill acted in good faith, fairly and honestly toward its Insured and with due regard for the Insureds’ interests. Tower Hill also argues that the CRN fails to adequately describe the alleged violations and fails to provide sufficient information to allow Tower Hill to correct the alleged violations. The CRN requires the Insureds to “indicate all statutory provisions alleged to have been violated," pursuant to section 624.155, F.S. The notice filed by Alexis Altman, Esq., in the above-referenced matter includes statutory provisions that could be claimed against an insurance company regardless of whether they are relevant or applicable to the alleged facts contained in the Notice. Because the CRN fails to identify the specific facts applicable to the listed statutes that were allegedly violated with respect to the subject claim, Tower Hill is unable to properly respond and said CRN should be rejected and returned. Specifically, Insureds allege the following violations of Florida Statutes: • § 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 and his interests. TOWER HILL strictly denies any violation of any section of Florida Statute § 624.155(1) (b) (1). • § 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.. TOWER HILL strictly denies any violation of any section of Florida Statute § 624.155(1) (b) (3). • § 626.9541(1) (i) (3) (a): Failing to adopt and implement standards for the proper investigation of claims. TOWER HILL strictly denies any violation of Florida Statute §626.9541(1) (i) (3) (a). • § 626.9541(1) (i) (3) (b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. TOWER HILL strictly denies any violation of Florida Statute §626.9541(1) (i) (3) (b). • § 626.9541(1) (i) (3) (c): Failing to acknowledge and act promptly upon communications with respect to claims. TOWER HILL strictly denies any violation of Florida Statute §626.9541(1) (i) (3) (c). • § 626.9541(1) (i) (3) (d): Denying claims without conducting reasonable investigations based upon available information. TOWER HILL strictly denies any violation of Florida Statute § 626.9541(1) (i) (3) (d). Tower Hill specifically denies the Insureds’ allegations that Tower Hill violated the above referenced statutes, any portion of the administrative code, or any Florida Statute reference in the instant CRN. Also, the CRN fails to set forth any specific policy language alleged to have been violated in accordance with Florida Statute §624.155(3) (b) (4), other than including counsel’s recitation and interpretation of what they believe is the applicable policy language to the alleged violation. The copy of the CRN simply provides counsel discussion of various sections of the insurance policy that were allegedly violated, some of which are wholly irrelevant to the Subject Claim in question. It is this failure to identify the specific policy provision(s) that is(are) allegedly relevant to the alleged violation(s) that prevent(s) Tower Hill from addressing any issues regarding the Subject Claim and Policy. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported, vague, ambiguous, and incorrect allegations with no basis in fact or circumstances. Aside from the fact that the allegations are devoid of any specific facts, the tenor and inferences of the allegations are wholly without merit and Tower Hill denies each and every one. Finally, the Notice fails with respect to its requirement to specify how Tower Hill may “cure” the alleged violations. The purpose of a Civil Remedy Notice is to provide a carrier with one last opportunity to “cure” the alleged violations. In this instance, there is no indication at all what action Tower Hill needs to take to cure the alleged violations other than the real “cure,” sought by the Insured, is payment of all insurance proceeds demanded by the Insured under the guise of “exhausting meaningful settlement negotiations,” notwithstanding Tower Hill ’s right to investigate and adjust the loss. The method for curing the violations alleged in a civil remedy notice are not determined by the Insured. Section 624.155 does not impose on an insurer the obligation to pay whatever the insured demands. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: Section 624.155 does not impose on an insurer the obligation to pay whatever the insured demands. . . . Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624.155(2)(d). . . . [t]o cure an alleged violation and to avoid a civil action, an insurer must pay the claim . . . before the sixty days expire. Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F.Supp. 773, 777-778 (M.D. Fla. 1996). The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624.155(2)(d). Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F.Supp. 773, 777-778 (M.D. Fla. 1996). For the aforementioned reasons, the Civil Remedy Notice is insufficient as a matter of law. Tower Hill acted in good faith, fairly and honestly toward the Insured in the adjustment of the instant claim. Tower Hill was contacted by the Insureds’ public adjuster nearly two years after the reported loss, and was informed of a loss from Hurricane Ian at the subject property. Tower Hill investigate the loss to determine the cause of loss, and if appropriate, cost to bring the property back to pre-loss condition. The property was inspected on September 6, 2024 and September 17, 2024 and a coverage decision rendered on October 3, 2024 was supported by the claim investigation. It is important to note, that while an insurance company is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. Florida law continually affirms the principle that an insurer has the right to investigate claims presented for payment. An insurance company is expressly afforded an opportunity to evaluate its rights and liabilities. Neither the subject policy nor does Florida law provide that a carrier must accept whatever demand for repairs it is provided by its Insureds as the amount necessary to repair a loss. In the instant case, the Insured proceeded to file a Notice of Intent to Initiate Litigation following the coverage decision. After several settlement communications, the Insureds and their representative and Tower Hill amicably entered into a settlement of this claim. Despite this settlement, the Insureds proceeded to file a frivolous lawsuit. In closing, Tower Hill takes the position that the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law, and regardless of the rejection, Tower Hill denies all allegations contained in the CRN and submits there are no violations to the insured. While this response is meant to be comprehensive, Tower Hill ’s response above is based upon the limited information provided in the CRN and the information TOWER HILL has to date. If the Insureds, or Alexis Altman, Esq., is in possession of information or facts that Tower Hill is not in possession of, Tower Hill requests all such information or facts be provided to it immediately. Please note that Tower Hill ’s response is not necessarily exhaustive and does not preclude it from asserting any other valid reason for seeking rejection and return of the CRN. Also, this letter or any act or failure to act on the part of Tower Hill or any agent or representative of Tower Hill should not be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation alleged in the CRN of Insurer Violation.
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