Civil Remedy Notice of Insurer Violations
Login

Filing Number:     803354
Filing Accepted:  1/24/2025
         Print Filing
Complainant
Last/Business Name *  
REDDOCH   First Name   KEVIN & CARA
Street Address * 15498 WHISPERING WILLOW DR
City, State Zip * WELLINGTON, FL 33414
Email Address * KEVINSREDDOCH@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   REDDOCH   First Name   KEVIN & CARA
Policy # * EDH4000242 Claim #* EDI965987
Attorney
Attorney is Applicable
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   EDISON INSURANCE COMPANY
NAIC Company Code 12482
 
Name of individual responsible for violation (if any):* BRYAN SWAIN, LAURIE AHOLA AND OTHER AGENTS, EMPLOYEES, REPRESNTATIVES AND CONTRACTORS OF EDISON INSURANCE COMPANY
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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
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.
Enter all words or phrases (one at a time) that should be used to filter.

HOMEOWNERS 3 - SPECIAL FORM AGREEMENT In reliance on the information you have given us, we agree to provide the insurance coverages indicated in the Policy Declarations. **Failure to provide specific policy language is not a fatal omission in complying with Fla. Stat. 624.155**
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about October 9, 2024, the Insured, Michael Reddoch and Cara Reddoch (the “Insureds”), suffered devastating damage their home located at 15498 Whispering Willow Dr, Wellington, FL 33414 (the “Subject Property”) as a result of a tornado that hit the Wellington, Florida area in the hours before Hurricane Milton battered down on the State of Florida. The October 9, 2024, tornado was not only devastating, but entirely unexpected and unprecedented. The October 9, 2024, tornado was rated an EF3 tornado on the Fujita Scale. The Fujita Scale ranges from F0 to F5 categories. Per the Fujita Scale, the winds produced by an EF3 tornado range from 158-206 miles per hour and the damage that can be expected is categorized as “severe damage,” meaning that the damage that should be expected to be caused by an EF3 tornado include damages to exterior walls, roofs blown off homes, collapsed or severely damaged metal buildings and flattened forests and farmland. Footage of the October 9, 2024, tornado and its aftermath made national headlines. There is no room to doubt that the Subject Property was directly impacted by the October 9, 2024. EF3 tornado. The photos of the Subject Property speak for themselves – the windows were blown out, doors blown out, fencing was destroyed, roof tiles were ripped clean off, trees and other landscaping were leveled, gutters ripped off, screen enclosure ripped to shreds, the pool was full of debris, the exterior patio drainage is cracked and broken, the exterior stucco of the home is cracked, the exterior flooring is cracked, light fixtures were ripped off, garage doors damaged by flying debris and wind, the interior of the home is destroyed – glass is embedded in the furniture and walls, kitchen cabinets are ruined, flooring throughout the home is destroyed, amongst other severe damages. In short, it is a miracle the Subject Property is still standing. The Insureds’ public adjuster could not have presented this claim for damages to Edison Insurance Company any more diligently, organized or detailed. Documents submitted by the Insured’s public adjuster submitted to Edison Insurance Company include but are not limited to: - Repair estimate - Contractor’s estimates - Over one thousand (1,000) photographs of the damages to the interior, exterior and contents - Comprehensive Microsoft Excel spreadsheet with 552-line items of damaged Contents - Itemized Xactimate estimate of all contents with photographs of each item and a website link to the item - Lease documents for the property the Insured had to move his family to in the aftermath of the tornado Edison Insurance Company’s behavior with respect to this claim is nothing short of outright bad faith. While Edison Insurance Company has acknowledged that coverage should be afforded for the damages to the Subject Property, it has severely undervalued the damages and repairs necessary to bring the Subject Property to pre-loss condition. It is especially important to draw the reader’s attention to the above-referenced Excel Spreadsheet with 552-line items of damaged Contents and the accompanying itemized Xactimate estimate of all contents with photographs of each item and a website link to each item. The Insureds and their public adjuster could not have been more diligent or organized in presenting the claim for damages Contents to Edison Insurance Company. Alarmingly, Edison Insurance Company overlooked the Excel Spreadsheet and Xactimate estimate and still asked the Insureds to prepare Edison Insurance Company’s own “Memory Sheets,” which would have not only been a triplicate of the documents already provided, but the job requirement of the Edison Insurance Company representative to have prepared pursuant to the documentation provided by the Insureds and their public adjuster. In fact, Edison Insurance Company’s representative went so far as to ask the Insureds’ public adjuster to go back out to the property and look for anything that may have been overlooked and to report back to her! The Insureds and their public adjuster provided all the necessary documentation, and then some, to Edison Insurance Company over sixty (60) days ago and Edison Insurance Company continued to give the Insureds a run around by failing to acknowledge the provided documents and even still asking for additional time to make a coverage determination. It is also important to note that the Subject Property is entirely uninhabitable. Consequently, the Insureds have signed a lease for a rental property in order to have somewhere inhabitable and safe to live with their children while the Subject Property is repaired. The lease and monthly payment requirements were provided to Edison Insurance Company and so Edison Insurance Company was put on notice that the monthly rent is $4,500.00, for a total of $55,200.00 for the year. What did Edison Insurance Company do? It issued two (2) months of payment to the Insureds. The practice of insurance carriers to drag Insureds through the mud during the claims process is becoming more and more prevalent and Edison Insurance Company’s behavior here only emphasizes the mistreatment and abuse Insureds are forced to endure. The Insureds here have a completely destroyed property and Edison Insurance Company is still refusing to do the right thing by its Insureds. Not only has the Insureds’ public adjuster had to have essentially pulled teeth since the claim was reported in order to get any responses (let alone a name of an adjuster for Edison Insurance Company), but the Insureds have been alarmingly underpaid. To date, the Insureds’ public adjuster continues to struggle to get a response or attention The Insureds are hopeful that Edison Insurance Company turns things around and does right by them and actually properly investigates and adjusts this claim in order to bring the Subject Property to pre-loss condition. In order to remedy its violations of Florida Statutes, Edison Insurance Company, must engage in the bi-lateral adjustment of this claim, communicate with its Insureds’ public adjuster and issue proper payment once and for all in order for the Insureds to make the necessary repairs to their devastated home.
Comments
User Id Date Added Comment
peartjean@becklawpa.com 02-26-2025 Department of Financial Services Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: Civil Remedy Notice of Insurer Violation Complainants : Kevin Reddoch and Cara Reddoch Insureds : Kevin Reddoch and Cara Reddoch Policy Number : EDH4000242 Claim No. : EDI965987 DFS File Number : 803354 Acceptable Date : January 24, 2025 Insurer : Edison Insurance Company To Whom It May Concern: Please be advised that we represent Edison Insurance Company (“Edison”) in the above-referenced matter. Kindly consider this to be Edison’s report to the Department on the disposition of the alleged violations. Edison maintains that it has not been in any violation of the law and that the Civil Remedy Notice of Insurer Violation (“CRN”) filed by Kevin Reddoch and Cara Reddoch (“Insureds”) is defective on its face and fails to comply with the specificity requirements under Florida Statute 624.155. As such, Edison objects to the Department’s acceptance of the above-referenced CRN. By way of background, this matter involves alleged Hurricane Milton property damage, which according to the Insureds, purportedly occurred on or about October 9, 2024. Claim”). Edison wrote to the Insureds acknowledging notice of the claim on October 10, 2024. On October 21, 2024, Edison’s independent field adjuster inspected the Insureds’ property. As a result of Edison’s investigation and inspection, Edison afforded coverage and tendered payment to the Insureds in the amount of $121,806.51 Coverage A Dwelling, $5,016.75 Coverage B Other Structures, and $9,200.00 Coverage D Loss of Use, which was based on the estimated actual cash value of the loss less the policy’s applicable hurricane deductible of $13,762.00, and advised that no coverage was afforded for damage to the Insureds’ lanai frame and screen enclosure as it is expressly excluded from coverage under the insurance policy. Edison further advised that the claim remains open for Additional Living Expenses and informed the Insureds that, “We are continuing to evaluate your claim involving your insured property and may issue additional payments. If you have questions, concerns, or additional information regarding your claim, we encourage you to contact us.” Edison informed the Insureds of the same in correspondence dated December 2, 2024. On December 23, 2024, Edison afforded coverage and issued payment to the Insureds’ Contractor, J&R Restoration Services Inc., in the amount of $26,475.00 based on a comparative estimate including emergency mitigation of roof tarping and board up services. On January 14, 2025, Edison afforded coverage and tendered payment to the Insureds in the amount of $15,251.42 Coverage A Dwelling and $9,200.00 Coverage D Loss of Use. Edison further advised that the claim remains open for a Re-Inspection of the Insureds’ Property and a Contents Valuation and again advised the Insureds that, “We are continuing to evaluate your claim involving your insured property and may issue additional payments. If you have questions, concerns, or additional information regarding your claim, we encourage you to contact us.” Edison informed the Insureds of the same in correspondence dated January 14, 2024. On January 24, 2025, the Insureds filed a CRN against Edison, which is a pre-requisite to a bad faith lawsuit under Florida Statute 624.155. The CRN alleges that Edison engaged in “Claim Delay, Unfair Trade Practice, [and] Unsatisfactory Settlement Offer.” Additionally, the CRN alleges that Edison has violated numerous Florida Administrative Codes and Statutes. On its face, this CRN merely contains accusations without any factual specificity to support them. As already mentioned, Edison maintains the CRN filed by the Insureds is defective on its face. Florida Statute 624.155 expressly requires factual specificity. The CRN filed by the Insureds merely contains boilerplate language and the same conclusory, generic, and legally insufficient allegations used routinely in a litany of other filings. Moreover, a complainant should not be able to simply file the same generic CRN without containing the requisite specificity. The purpose of a CRN is to place the carrier on notice of specific violations so that they can be corrected during the statutory “cure” period. This CRN fails to meet this requirement and as such, should not be able to proceed on such a defective and improper CRN that contains nothing more than accusations and conclusions without any specificity. The Civil Remedy Notice requires the Complainant "pursuant to section 624.155, F.S. please indicate all statutory provisions alleged to have been violated." The Notice filed in this matter includes almost every statutory provision that could be claimed against an insurance company, regardless of whether they are relevant or applicable to the conclusory facts alleged within the Notice. Because the Civil Remedy Notice fails to identify any specific statutes Edison is unable to properly respond as it does not comply with F.S. § 624.155. The Notice fails to set forth any specific policy language alleged to have been violated in accordance with F.S. § 624.155(3)(b)4. Instead, the Notice merely makes a broad reference to the “Homeowners 3 – Special Form” and “In reliance on the information you have given us, we agree to provide insurance coverages indicated in the Policy Declarations” of the insurance policy and fails to provide any specific policy language. This failure to identify the specific policy language allegedly relevant to the purported violations prevents Edison from addressing any issues regarding the insurance policy and is another reason why it does not comply with F.S. § 624.155. The Notice further fails to set forth with specificity the names of the individuals involved in the alleged violation as required by Florida Statute § 624.155(3)(b)3. The Notice generically mentions “Bryan Swain, Laurie Ahola and other agent, employees, representatives and contractors of Edison Insurance Company.” This broad and blanket reference to unnamed individuals prevents Edison from ascertaining the specific individuals purportedly involved with an alleged violation and fails to comply with F.S. § 624.155. The CRN alleges that Edison’s “behavior with respect to this claim is nothing short of outright bad faith,” “[Edison] has severely undervalued the damages and repairs necessary to bring the Subject Property to pre-loss condition,” “Edison overlooked the Excel Spreadsheet and Xactimate estimate and still asked the Insureds to prepared Edison Insurance Company’s own ‘Memory Sheets,’ which would have not only been a triplicate of the documents already provided, but the job requirement of the Edison Insurance Company representative to have prepared pursuant to the documentation by the Insureds and their public adjuster,” “Edison Insurance Company’s representative went so far as to ask the Insures’ public adjuster to go back to the property and look for anything that may have been overlooked and to report back to her”. The CRN goes on to allege that, “The Insureds and their public adjuster provided all the necessary documentation, and then some, to Edison Insurance Company over sixty (60) days ago and Edison Insurance Company continued to give the Insureds a run around by failing to acknowledge the provided documents and even still asking for additional time to make a coverage determination” and “the Insureds have signed a lease for a rental property in order to have somewhere inhabitable and safe to live with their children while the Subject Property is repaired. The lease and monthly payment requirements were provided to Edison Insurance Company and so Edison Insurance Company was put on notice that the monthly rent is $4,500.00, for a total of $55,200.00 for the year. What did Edison Insurance Company do? It issued two (2) months of payment to the Insureds.” Lastly, the CRN alleges that “[t]he practice of insurance carriers to drag Insureds through the mud during the claims process is becoming more and more prevalent and Edison Insurance Company’s behavior here only emphasizes the mistreatment and abuse Insureds are forced to endure. The Insureds here have a completely destroyed property and Edison Insurance Company is still refusing to do the right thing by its Insureds. Not only has the Insureds’ public adjuster had to have essentially pulled teeth since the claim was reported in order to get any responses (let alone a name of an adjuster for Edison Insurance Company), but the Insureds have been alarmingly underpaid,” and “[t]o date, the Insureds’ public adjuster continues to struggle to get a response or attention,” and “[t]he Insureds are hopeful that Edison Insurance Company turns things around and does right by them and actually properly investigates and adjusts this claim in order to bring the Subject Property to pre-loss condition”. Edison maintains that the CRN’s allegations, including, but not limited to, those referenced in the preceding three (3) paragraphs are improper, factually incorrect, unfairly vague to put the carrier on notice of any alleged violations, and do not comply with the specificity requirements under F.S. § 624.155. Notwithstanding, Edison maintains that it has not been in violation of any statutory provision and has adjusted the subject claim pursuant to the terms, conditions, exclusions, and exemptions of the Policy. Finally, the Civil Remedy Notice contains “cures” that are not available under the insurance policy or the Civil Remedy Statute. The CRN alleges that in order to “cure”, Edison must: “engage in the bilateral adjustment of this claim, communicate with its Insureds’ public adjuster and issue proper payment once and for all in order for the Insureds to make the necessary repairs to their devasted home.” On its face, this is nothing more than a recitation of alleged statutory violations without providing any specificity as to the facts of the alleged claim and/or violation, and thus, is statutorily deficient. The CRN merely lists numerous statutes without any specific factual connection and broadly refers to the insurance policy without reference to any specific language in the insurance policy. Accordingly, the CRN is defective and unenforceable as a matter of law because it fails to comply with the requirements under F.S. § 624.155. Based on the information outlined above, Edison requests that the DFS reconsider its acceptance of the above-referenced CRN and further requests that the DFS provide Edison with a list of the guidelines and requirements utilized by the DFS in determining to accept this defective CRN. As outlined above, Edison has not acted in bad faith in handling the subject claim, has not been in violation of any law, and has adjusted the subject claim pursuant to the terms, conditions, exclusions, and exemptions of the Policy. Edison further maintains that the CRN, as filed, is defective on its face as it fails to meet the specificity requirements of F.S. § 624.155. Should the Department require additional information, please do not hesitate to contact us. Sincerely, JOSHUA S. BECK, ESQUIRE
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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