Civil Remedy Notice of Insurer Violations
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Filing Number:     802979
Filing Accepted:  1/22/2025
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Complainant
Last/Business Name *  
AUCHEY   First Name   CHAD
Street Address * 6804 S ELEMENTA ST.,
City, State Zip * TAMPA, FL 33616
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   AUCHEY   First Name   CHAD
Policy # * 1501-2101-4082 Claim #* FL24-0137024-K524
Attorney
Attorney is Applicable
Last Name* WALLACE First Name * BLAKE Initial
Street Address* 8635 W. HILLSBOROUGH AVE., STE. 401
City, State Zip* TAMPA , FLORIDA 33616
Email Address * BLAKE@KLINGLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* DONALD SAENZ AND LEONARDO RENDON
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
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.

The specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. Specifically, the loss payment provision states “we will adjust all losses with you.” Yet, the carrier did not consult the homeowner in deciding who would investigate the cause or amount of damages, and what the ultimate payment should be. On January 2, 2025, a certified copy of the policy as well as other claim documentation was requested by counsel of the insured. To date of the filing of this civil remedy notice the policy has not been provided by the carrier. This is in violation of F.S. §626.9541(1)(i)(3)(c) as the carrier has failed to acknowledge and act promptly upon communications with respect to claims. F.S. §627.70131(1)(a) provides that upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

January 22, 2025 Sent Via E-Portal UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY RE: Insured : CHAD AUCHEY (hereinafter, “Insured/Claimant”) Policy # : 1501-2101-4082 Claim # : FL24-0137024-K524 Property Address : 6804 S Elementa St., Tampa, FL 33616 Persons most knowledgeable of facts giving rise to the Violations: Donald Saenz, Leonardo Rendon Dear UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY: Please find enclosed the civil remedy notice filed for the above referenced claim. This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statute §624.155 As discussed in greater detail in the notice, the carrier has not attempted in good faith to settle the claimant’s claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its claimant and with due regard for its interests. The carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim. 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 insured…”). The carrier was put on notice of the insured’s Hurricane Milton claim on October 21, 2024. Since the commencement of the claim the carrier has failed to timely communicate with the insured. It is obvious that the carrier is not attempting to pay for the clearly covered damages owed under the policy. The carrier assigned Leonardo Rendon, who is not an engineer, to inspect the loss. On November 6, 2024, the carrier made the unilateral determinations that A) the damages to the property, including the interior would be excluded under the policy and therefore be denied and that B) the damages that were covered failed to exceed the deductible on the policy and that the insured would be entitled to $0 after the application of the deductible. It was clear that the damages exceeded the deductible. Moreover, in reaching those conclusions, Universal failed to adopt and implement standards for the proper investigation of claims. There was no explanation whatsoever as to how Universal determined which items of damage were caused by covered or excluded perils. Furthermore, the carrier’s failure to assign a qualified and experienced engineer further violates F.S. §626.9541(1)(i)(3)(a). Moreover, as the carrier denied coverage without conducting a reasonable investigation based upon available information, the carrier violated F.S. §626.9541(1)(i)(3)(d). Additionally, the carrier failed to describe how it arrived at the amount it withheld for depreciation. The policy does not explain how depreciation or actual cash value is calculated, and the carrier did not explain the facts or applicable law in relation to the payment made. This is a violation of F.S. §626.9541(1)(i)(3)(f). The insured has been compelled to obtain an independently adjusted estimate totaling in the amount of $96,684.42 that would be needed to repair the property back to its pre-loss condition. The insured has complied with all the carrier’s requests to date. The carrier has still refused to pay the fully covered amount owed under the policy, instead electing to stand by its unilaterally determined deficient valuation of the loss while denying the rest of the loss. This is in violation of F.S. 624.155(1)(b)(1) and 624.155(1)(b)(3) as the carrier is clearly placing the company’s interests before the claimant’s interests and not attempting in good faith to settle claims. It is clear that the carrier is not treating the claimant 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 claimant; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the claimant’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the claimant’s loss in a timely manner. 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)(d), 627.4137(1), and Fla. Stat. §627.70131. The actions taken by Universal in the handling/adjustment of the insured’s claim were willful, wanton, malicious, and in reckless disregard for the rights of any insureds and occur with such frequency as to indicate a general business practice, and further are in violation of Florida Statutes §624.155 and F.S. §626.954. Indeed, when performing a search on the Florida Department of Financial Services website’s Civil Remedy Notice of Insurer Violation page the results of searches of violations of the statutes referenced herein by the carrier returned the following results thereby indicating that the number of times they occur rise to the level of a general business practice, and warrant punitive damages: §624.155(1)(b)(1) = 18,813 §624.155(1)(b)(3) = 13,672 §626.9541(1)(i)(3)(a) = 17,351 §626.9541(1)(i)(3)(c) = 13,564 §626.9541(1)(i)(3)(d) = 10,529 §626.9541(1)(i)(3)(f) = 10,937 Based upon the above-referenced acts and omissions, the carrier has breached the insurance contract by failing to pay the amount due to the insured, by denying coverage which existed under the insurance contract with the insured in the instant dispute, by failing to adjust the loss with the insureds, and by failing to perform an adequate investigation. These are violations and breaches of the policy language cited above. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay the complete covered loss in the amount of $96,684.42 less any applicable policy deductible; 2) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made; and 3) provide the insured and insured’s counsel with a certified copy of the policy. A copy of this letter and filed form submitted to the FDFS has been emailed to the carrier. The specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. Specifically, the loss payment provision states “we will adjust all losses with you.” Yet, the carrier did not consult the homeowner in deciding who would investigate the cause or amount of damages, and what the ultimate payment should be. On January 2, 2025, a certified copy of the policy as well as other claim documentation was requested by counsel of the insured. To date of the filing of this civil remedy notice the policy has not been provided by the carrier. This is in violation of F.S. §626.9541(1)(i)(3)(c) as the carrier has failed to acknowledge and act promptly upon communications with respect to claims. F.S. §627.70131(1)(a) provides that upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer. If you have any questions or concerns, please send all correspondence via email to Blake@klinglaw.com and Jorlyn@KlingLaw.com to ensure a prompt response. We ask that all correspondence be done via email rather than regular mail. Should you need to send something regular mail, please advise us prior to sending same via the emails above. Sincerely, Blake M. Wallace, Esq. Blake M. Wallace Attorney at Law Enclosed: Civil Remedy Filing
Comments
User Id Date Added Comment
sm1130@universalproperty.com 03-12-2025 March 12, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 802979 Filing Date: 1/22/2025 Complainant(s): Chad Auchey Insured(s): Chad Auchey Policy No.: 1501-2101-4082 Claim No.: FL24-0137024-K524 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice filed by attorney Blake Wallace, on behalf of Complainant, Chad Auchey (also referenced as “Insured.”) The Notice alleges violations of Sections 624.155, 626.9541, 627.4137, and 627.70131, Fla. Stats. Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notice is deficient as a matter of law as it fails to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Section 624.155(3)(b), Florida Statutes the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language, which the authorized insurer allegedly violated; 2. the facts and circumstances giving rise to the violation; 3. the name of any individual involved in the violation; 4. reference to specific policy language that is relevant to the violation, if any...; 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Department of Financial Services (“DFS”), created form DFS-10-363, which lays out 15 requirements that the Complainant(s) must respond to with specificity. The Florida Supreme Court holds that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant(s) specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). The Notice fails to meet the requirement of Section 624.155, Florida Statutes, on several grounds. First, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notice fails to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Complainant provides four (4) reasons for submitting the Notice. However, the Complainant’s allegations regarding these “Reasons for Notice” have no factual support anywhere in the Notice. The Notice asserts general allegations containing inaccurate and conclusory statements rather than specifying facts to support any alleged statutory violation. For example, the Notice states “[t]he carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured.” The Complainant fails to assert any facts to support these conclusory statements. Further, at no time has Universal placed the burden to investigate the claim on the Insured. As an additional example, the Notice states in part: “It is clear that the carrier is not treating the claimant 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 claimant; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the claimant’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the claimant’s loss in a timely manner. 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)(d), 627.4137(1), and Fla. Stat. §627.70131.” The Complainant’s conclusory statements and alleged statutory violations outlined above are unsupported by facts in the Notice and do not provide the requisite specificity as to how Universal allegedly violated any policy provision or statute. The Notice further alleges, “when performing a search on the Florida Department of Financial Services website’s Civil Remedy Notice of Insurer Violation page the results of searches of violations of the statutes referenced herein by the carrier returned the following results thereby indicating that the number of times they occur rise to the level of a general business practice…” The Notice once again does not specify any facts to support any of these speculative allegations. Significantly, a Civil Remedy Notice filing is in no way indicative that there is any wrongdoing on the part of an insurer. Simply generally referencing other civil remedy notices filed against Universal does not in fact show a “general business practice” as the Complainant suggests. Moreover, the Complainant is required to provide with specificity the facts and circumstances giving rise to the alleged violation strictly related to Complainant’s allegations, not conjecture or speculation of what may be the carrier’s business practices. The failure to specify facts to support the conclusory allegations of misconduct hinders Universal’s ability to appropriately investigate the allegations in the Notice. As a result, the Complainant fails to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. Second, the Notice fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. To comply with the requirements of Sec. 624.155, Fla. Stat., the Complainant(s) must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to properly investigate the allegations. The Notice lacks the necessary specificity as required by Sec. 624.155, Fla. Stat., because the Notice states “DONALD SAENZ AND LEONARDO RENDON.” The Complainant fails to specify what, if anything, the named individuals are knowledgeable about and/or what if anything they did or failed to do regarding the claim at issue. Therefore, the Notice does not have the requisite specificity as to whom the Complainant is asserting has knowledge as to each specific allegation contained in the Notice and this failure precludes Universal from investigating the alleged violations and potentially cure them. Accordingly, the Notice is insufficient as a matter of law. Third, the Notice fails to satisfy Section 624.155(3)(b)(4), Florida Statutes, because it fails to reference any specific policy language relevant to any alleged violation(s). Instead, the Notice improperly cites to Sections 626.9541 and 627.70131, Florida Statutes; however, these sections are not contained within the Policy and moreover, there are no facts specified to place Universal on notice of how it or whom allegedly violated these statutes. Additionally, the Notice states in pertinent part, “[t]he specific policy provisions the carrier violated are the loss payment provision, the loss settlement provision, and the coverage provisions. The Notice fails to identify how the referenced provisions relate to any alleged violation. The broad references to provisions in the Policy provide no guidance or explanation, such that Universal is left to wonder what policy provisions Complainant believes were allegedly violated or breached and why. General, vague, and overbroad references to policy provisions do not satisfy the specificity required by Section 624.155(3)(b)(4), Florida Statutes. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). In summary, as outlined above, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity including, but not limited to, the failure to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations, the failure to reference specific policy language relevant to the alleged violation, and the failure to sufficiently allege facts and circumstances giving rise to any violation. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notice. On October 21, 2024, Universal was notified by the Insured, Chad Auchey, that the insured location was damaged on October 10, 2024. On October 30, 2024, Universal inspected the property and documented any visible damage. On November 6, 2024, pursuant to the terms of the Policy, Universal advised the Insured that the estimated cost of repairs for the direct physical loss to property, at that time, fell below the applicable deductible. The subject Policy initially pays at least the actual cash value of the insured loss, less any applicable deductible. Then, it will pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. To date, Universal has not received any documentation showing the amount necessary to perform such repairs or that expenses have been incurred in excess of the estimate prepared by Universal. Universal did not breach any duty to its Insured. An insurer has no obligation to pay whatever amount its insureds demand. Accordingly, the alleged statutory violations and factual allegations of wrongdoing set forth in the Notice lack factual support and are without merit. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Universal complied with all policy provisions and applicable Florida Statutes and law regarding the adjustment of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the Notice filed by the Complainant. Sincerely, /s/ Stephen Methe Stephen Methe
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