Civil Remedy Notice of Insurer Violations
Login

Filing Number:     803422
Filing Accepted:  1/24/2025
         Print Filing
Complainant
Last/Business Name *  
HUNT   First Name   JONATHAN
Street Address * 2718 BRUCE STREET
City, State Zip * MATLACHA, FL 33993
Email Address * N/A
Complainant Type: * Insured
Insured
Last/Business Name*   HUNT   First Name   JONATHAN
Policy # * EDH4061410-05 Claim #* EDI949420
Attorney
Attorney is Applicable
Last Name* ELIMELECH First Name * REBECCA Initial R
Street Address* 1500 N.E. 162ND ST.
City, State Zip* MIAMI , FLORIDA 33162
Email Address * RELIMELECH@ILGPA.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   EDISON INSURANCE COMPANY
NAIC Company Code 12482
 
Name of individual responsible for violation (if any):* N/A
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGES COVERAGE A – Dwelling We cover: 1. The dwelling on the “residence premises” shown in the Declarations, including structures attached to the dwelling; and 2. 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.” COVERAGE B – Other Structures 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. SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES 1. We insure for sudden and accidental direct loss to property described in Coverages A and B only if that loss is a physical loss to covered property.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Jonathan Hunt (hereinafter the “Insured”), paid for a policy of insurance with Edison Insurance Company (hereinafter, “Insurer”) bearing policy number EDH4061410-05 (the “Policy”). The Policy provides coverage for damage to the Insured’s property located at 2718 Bruce Street, Matlacha, FL 33993 (the “Property”), including the significant damage that occurred as a result of Hurricane Ian on or about September 28, 2022 (the “loss”). Specifically, the Insured’s Property sustained substantial damage to the tile roof, window, screens, and lanai. The gutters are missing, there are cracks in the stucco, and there are cracks in the ceilings. There is exterior damage, interior cracks and the garage screen is down. The Insured promptly reported their claim to the Insurer. On October 29, 2022, the Insurer sent a letter to the Insured advising that the damages to the Property totaled $1,145.21 for Coverage A (Dwelling), $28.90 for Coverage C (Content), $138.47 for Coverage C (Food Loss). In this letter, the Insurer partially denied the claim based on their investigation. The Insurer denied coverage for damage to the laminated floors due to wind-driven rain, alleging there was no peril-created opening in the roof, exterior walls, windows, or doors that allowed water to enter the interior. Also, the Insurer denied coverage for the screen replacement, claiming that the policy does not provide coverage for screen material costs associated with removing or replacing screens. The Insured subsequently contacted the InsuranceBusters.net, who conducted a thorough inspection of the property and compiled an estimate of damages. InsuranceBusters.net, on behalf of the Insured, forwarded said estimate which fully detailed the Insured’s damages and total $340,043.54. On June 29, 2023, the Insurer sent a letter informing the Insured that they will issue checks in the amount of $22,029.63 for Coverage A - Dwelling, $183.99 for Coverage B - Appurtenant Structures, $883.81 for Coverage C- Personal Property, and $261.53 for Coverage C - Food Loss. However, the Insurer refuses to resolve the Insured’s claim and pay for all damages to the Property. On September 25, 2023, the Insurer sent a letter, reaffirming their prior coverage decision, alleging that their supplemental review of the claim showed age-related deficiencies that are excluded per the policy. The Insurer’s conduct is in bad faith and violates Florida’s statutes concerning the adjustment of insurance claims. First, Florida Statute § 624.155(1)(B)(1) requires good faith in the settlement of claims. The Insurer is in violation of this Statute for failing to provide a reasonable repair estimate. What is more, the Insurer violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle the claim, when the obligation to settle the claim became reasonably clear. Again, the Insurer failed to make a good faith offer to settle this claim and failed to account for the full scope of the damages. They failed to respond to the estimate provided by InsuranceBusters.net, on the Insured’s behalf, in a timely manner. They are obligated to provide coverage for all damages to the Insured’s Property, and not attempt to resolve this claim with lowball offers. Additionally, the Insurer’s conduct violates Florida Statute § 626.9541, which prohibits unfair settlement practices. More specifically, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. Further, the Insurer has violated Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly with the Insured and its counsel. On February 20, 2023, InsuranceBusters.net sent their contract to the Insurer, but the Insurer failed to acknowledge the correspondence. On February 23, 2023, InsuranceBusters.net emailed the Proof of Loss to the Insurer and, as a reminder, advised the Insurer of the 14-day timeline for reciprocating communications. Despite InsuranceBusters.net’s constant efforts to correspond, the Insurer failed to respond to InsuranceBusters.net and the Insured for more than four months. On March 1, 2023, March 21, 2023, and March 30, 2023, InsuranceBusters.net emailed the Insurer in an attempt to arrange a mutual inspection for the Insurer to engage in fair claims handling. However, the Insurer was still unresponsive. On July 10, 2023, the Insurer sent a letter to the Insured admitting that they delayed issuing payment. In this letter, the Insurer advised that they will issue four checks in the amount of $6.29, $752.57, $30.19 and $8.93 for the interest owed as the Insurer did not issue payment within the timeframe required pursuant to Florida Statutes. Moreover, as mentioned above, the Insurer failed to account for the full scope of the damages and has additionally failed to respond to the estimate provided by InsuranceBusters.net, on behalf of the Insured, in a timely manner, delaying the resolution of this claim. Had the Insurer done so, it would have immediately settled this claim on a fair and reasonable basis and provided full coverage to its Insured. Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: (1) create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations and avoid this from occurring in the future; (2) immediately tender all insurance proceeds due and owing its Insured under the Policy in the amount of $340,043.54 (less the deductible and any prior payments), plus all statutory interest; (3) act fairly and honestly towards its Insured and with due regard for his interests in attempting to settle their Insured’s claim; (4) hold the claim open in the event that its errors and delay does or may cause the Insured to suffer either further loss and/or damage; and, (5) stipulate to the Insured’s entitlement to attorney’s fees and court costs pursuant to Florida Statutes §§ 627.428 and 626.9373. Acknowledgment This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statutes section 624.155, should Edison Insurance Company fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
Comments
User Id Date Added Comment
vveliz@qpwblaw.com 02-18-2025 VIA DFS WEBSITE Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Jonathan Hunt Claim No: EDI949420(“subject claim”) Policy No: EDH4061410-05(“policy”) Loss Location: 2718 Bruce Street, Matlacha, FL 33993 (“property”) CRN Filing No: 803422 CRN Acceptance Date: 01/24/2025 RE: CIVIL REMEDY NOTICE - DFS FILING NUMBER 803422 Dear Sir or Madam: The undersigned counsel represents Edison Insurance Company (“Edison”) in regard to the alleged dispute as to the subject claim number listed above involving an alleged windstorm with a date of loss of on or about September 28, 2022, made under the Policy of insurance Edison issued to the Insured/Complainant, Jonathan Hunt. This correspondence constitutes Edison Insurance Company’s response to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) filed on behalf of Jonathan Hunt (referenced herein “Complainant”) regarding the claim listed above. Based on the below response, the Civil Remedy Notice should be rejected and returned by the Department of Financial Services as it is substantively defective and objectionable for the reasons stated herein, and, without waiving objections, as it completely misstates the facts surrounding this claim. ALLEGED STATUTORY VIOLATIONS 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. Edison specifically denies the allegation that it has violated the above referenced statute. Edison did not violate these provisions. The CRN does not include any facts to support this allegation. Edison conducted a thorough investigation in good faith. Simply because the outcome of Edison’s investigation revealed covered damages less than Complainant’s unjust demand for compensation, does not mean that Edison has violated the above statute. This allegation is without merit. 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. Edison specifically denies the Complainant’s allegation that it has violated the above referenced statute. Edison did not violate these provisions. The CRN does not include facts to support this allegation. Edison conducted a thorough investigation in good faith and issued its coverage determination based on the Policy’s provisions, conditions, exclusions and endorsements. This allegation is without merit. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Edison specifically denies the Complainant’s allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Edison did not fail to adopt and implement standards for the proper investigation of the claim. Edison further denies that it does not have proper standards in place for the investigation of claims. This allegation is without merit. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Edison specifically denies the Complainant’s allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Edison conducted a thorough investigation in good faith and promptly and continually communicated with the insured regarding the Claim. This allegation is without merit. 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof of loss statements have been completed. This allegation is patently false. Edison specifically denies the Complainant’s allegation that it has violated the above referenced statute. Edison did not violate these provisions. The CRN does not include any facts to support this allegation. Edison conducted a thorough, complete and comprehensive investigation in good faith. Edison promptly and continually communicated with the insured regarding the Claim. Edison issued its coverage determination based on the Policy’s provisions, conditions, exclusions and endorsements. This allegation is without merit. 626.9541(1)(i)(4): Failing to pay undisputed amounts of partial or full benefits owed under first party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). This allegation is patently false. Edison specifically denies the Complainant’s allegation that it has violated the above referenced statute. Edison did not violate these provisions. The CRN does not include any facts to support this allegation. Edison conducted a thorough, complete and comprehensive investigation in good faith. Edison promptly and continually communicated with the insured regarding the Claim. Edison issued its coverage determination based on the Policy’s provisions, conditions, exclusions and endorsements. This allegation is without merit. In addition to the allegations specifically denied above, Edison generally denies all allegations presented in this CRN, as Edison has not violated any statute, Code or Rule. SPECIFICITY REQUIREMENTS Florida Statute requires that a CRN state the facts and circumstances giving rise to the alleged violations with specificity sufficient to allow an insurer to “cure” the alleged violations within the sixty-day statutory period. See Fla. Stat. § 624. 155(3)(b)(2). See also Lane v. Westfield Ins. Co., 862 So. 2d 774, 777 (Fla. 5th DCA 2003), Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). However, here, the CRN is deficient and defective in that it fails to state with sufficient specificity the necessary facts in support of the Insured’s contentions, including but not limited to, those that would be necessary for Edison to “cure” the alleged violations. Further, the subject CRN provides what appears to be several boilerplate and conclusory statements, which fail to describe any accurate facts constituting violations of the statutes cited therein. Thus, because the allegations in the CRN are incomplete and incorrect, they fail to provide actual notice of the specific allegations and the actions that Edison could undertake to cure any alleged violations. 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193 (N. D. Fla. 2008). Blanket references to policy provisions and statutes without specification deems the Civil Remedy Notice deficient. Julien v. United Property and Casualty Insurance Co., 311 So. 3d 875 (Fla. 4th DCA 2021). For the reasons set forth herein, Edison hereby objects to the subject CRN and states it does not intend to waive, ratify or otherwise accept the deficiencies in the CRN, and reserves the right to contest the legal adequacy of the CRN hereinafter as appropriate. As to the content of the CRN here, it is important to note that said CRN is a nullity and should be rejected because the CRN fails to comply with the specific requirements mandated by Florida Statutes §624.155. Specifically, Fla. Stat. § 624.155(3)(b)(2) requires the Complainant to set forth with specificity, sufficient factual allegations to state a prima facie case of an insurer violation, so as to put the insurer on notice and be afforded the opportunity to cure the deficiency. However, the Insured failed to do so in the subject CRN and instead only included conclusory statements, which lack even minimal specificity and/or lack the underlying factual basis to support them. The Insured’s failure to describe any actual facts or circumstances to support the alleged statutory violations in the CRN precludes Edison from evaluating what error, if any, allegedly occurred during the claim process. 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 and incorrect allegations with no basis in fact or circumstances. Consequently, the CRN lacks the requisite minimal specificity and Edison is unable to determine what specifically the Complainant is claiming was done by or on behalf of Edison that constitutes the bad faith alleged. Further, the CRN fails to provide the names of any individuals alleged to have violated these provisions. Consequently, the CRN lacks the requisite minimal specificity and Edison is unable to determine who is claimed to have acted in bad faith. Due to the absence of specific and accurate information regarding the alleged acts or omissions by Edison which allegedly give rise to any violation of the Civil Remedy Statute, Edison is limited in its ability to set forth specific facts to address and/or refute these unsubstantiated assertions. Notwithstanding, Edison explicitly denies violations of any applicable Florida Statute in the adjustment of the subject claim and realleges and re-asserts its specific denials to the alleged violations in the subject CRN as set forth above. Edison maintains that it has acted and continues at all times to act in good faith during the investigation and adjustment of the Insured’s claim. Further, Edison wishes to dispel even the inference of any statutory violation and reiterates below the various reasons which clearly show the proper handling of the subject claim by Edison. Additionally, the CRN fails to state with specificity the facts relevant to any alleged policy violation. Julien v. United Property and Casualty Insurance Co., 311 So.3d 875 (Fla. 4th DCA 2021). The CRN refers to general language without any details as to how any provisions were actually violated. Thus, the CRN does not satisfy the requirements. Moreover, as stated in Demase v. State Farm Florida Insurance Company, 351 So. 3d 136 (Fla. Dist. Ct. App. 2022), and as a condition precedent to bringing a first-party bad faith case, an insured must provide timely notice of the alleged violation to the authorized insurer and to the DFS. The Insured has failed to provide such timely notice to Edison. BACKGROUND FACTS Aside from the fact that the allegations contained in the subject CRN lack specific facts, the tenor and inferences of statutory violations are wholly without merit, and Edison denies each and every one. Below are some of the relevant facts regarding the subject claim that the Insured failed to include in the CRN. On September 29, 2022, the Insured/Complainant Jonathan Hunt, contacted Edison to report a claim for damages as a result of Hurricane Ian with a date of loss on September 28, 2022. No further information was provided at the time of the initial reporting of the claim. Immediately, that same day, Edison sent correspondence to the Insured acknowledging receipt of the claim. Edison immediately issued a reservation of rights letter informing the Insured of their responsibilities under the Policy. Edison also included with its letter, the applicable Policy excerpt labeled “You Duties After Loss.” Because the insured property, located on a barrier island, was inaccessible for several weeks, inspection was conducted on October 15, 2022, once access to the island was restored. Ahead of this inspection, the Insured received an email from Edison with the name and contact information for the field adjuster assigned to the claim. In the interim, however, an advance payment was issued by Edison in good faith and sent to the Insured in the amount of $5,000.00 to the address requested by the Insured. This correspondence stated as follows: “We understand your home has been rendered unlivable due to Wind - Hurricane - Ian. Additional Living Expenses (ALE) coverage based on Coverage D – Loss of Use is available under your policy; however, it is paid on an incurred basis. Florida Peninsula Insurance is providing you an advance; however, this payment is issued against the Coverage C – Personal Property (Contents) portion of the claim to assist you with anticipated out-of-pocket expenses directly related to this claim.” As indicated above, inspection was completed on October 15, 2022. The field adjuster confirmed that there were no leaks to the interior of the property. Inspection of the roof was conducted by drone due to height. In addition, the Insured would not allow anyone to physically step onto the roof. The drone inspection revealed minor wind damage to the roof. Based on the inspection and investigation performed, Edison issued a damages estimate outlining the necessary repairs needed to restore the property to its pre-loss condition. Specifically, after application of the hurricane deductible and prior contents payment, a coverage determination correspondence was issued on October 29, 2022 along with claims payments totaling $1,145.21 for Coverage A, $28.90 for Coverage C, and $138.47 for food loss. Edison also included with its Coverage Determination Letter, an Estimate, Statement of Loss, applicable Policy language, and Mediation Statement. At that time, the claim was closed. On January 27, 2023, Edison received a “Proof of Loss Package” from Insureds’ public adjuster, along with an estimate totaling $340,043.54, RCV in support of same. A supplement was opened to address this estimate. After completion of a re-inspection of the insured property, a supplemental coverage determination correspondence was issued on June 29, 2023 along with a claims payment totaling $22,029.63 for Coverage A, $183.99 for Coverage B, $883.81 for Coverage C and $261.53 for Food loss. Edison also included with its Coverage Determination Letter, an Estimate, Statement of Loss, applicable Policy language, and Mediation Statement. In both coverage determination correspondences, the Insured was advised that pursuant to the subject policy, Edison will initially pay the actual cash value of the loss, less any applicable deductible. Edison will then pay any remaining amounts necessary to perform such repairs or replacement as work is performed and expenses are incurred. The Insured thereafter filed an initial lawsuit against Edison, alleging that Edison breached the subject insurance policy by failing to make full payment of insurance proceeds. At no time between Edison’s payment for the Insured’s claim and the Insured’s filing of his initial lawsuit did the Insured submit invoices to Edison showing that actual repairs had begun in accordance with the repair estimate scope of damages. In fact, out of a total of $30,740.80 paid to the Insured after application of the Policy’s $9,090.00 hurricane deductible, the Insured testified under oath that he had spent a total of $2,955.40 in repairs to the insured property and the rest was “sitting in the bank.” The facts remain the same. Edison conducted a good faith comprehensive and prompt investigation of this claim. Edison consistently and promptly communicated with the Insured and their representatives and conducted an inspection of the property. When Edison received requested information about the claim, it conducted further investigation and addressed same. Edison respectfully denies any wrongdoing in the adjustment and handling of the Subject Claim and further denies any and all allegations that it violated any statutes. Instead, Edison acted quickly and responsibly and in accordance with the terms and provisions of the applicable Policy of insurance as well as with F.S. §624.155 and §626.9541 and its sub-parts. INACCURACY OF ALLEGATIONS IN THE SUBJECT CRN The case specific facts related to Edison’s handling of the subject claim provided above implicitly address many of the vague allegations contained within the Insured’s CRN and further establish that Edison undertook a thorough investigation in accordance with applicable statutory requirements and professional standards of care. It is important to note that the Insured has not provided any factual support for any of the above allegations. Instead, the facts support that Edison promptly contacted the Insured, inspected the claim shortly after it was reported, and issued a coverage determination. When additional information was provided, Edison conducted additional evaluations and addressed the information appropriately and within the required time frame. The circumstances support that Edison conducted a good faith, thorough, prompt investigation with the information provided. The Insured is alleging bad faith in a scenario where Edison conducted a comprehensive and prompt investigation in good faith. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurers’ violation as you understand them at this time”, the purpose of which is “to enable the insurer to investigate and resolve [the] claim”, the Civil Remedy Notice itself only provides completely false allegations with no basis in fact or circumstances. As clearly set forth above and contrary to the allegations set forth in the Notice, Edison’s investigations and adjusting of its Insured’s claim was prompt, thorough, and complete. When additional information was provided, the claim was reopened and investigated. Furthermore, the Insured has included absolutely no facts or evidence to support any claims in the Notice. All of these baseless claims support Edison’s position that the claim was properly adjusted, and the Insured does not actually have any concrete facts to support a bad faith allegation. The Civil Remedy Notice states that Edison can rectify these violations in the following ways: (1) create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations and avoid this from occurring in the future; (2) immediately tender all insurance proceeds due and owing its Insured under the Policy in the amount of $340,043.54 (less the deductible and any prior payments), plus all statutory interest; (3) act fairly and honestly towards its Insured and with due regard for his interests in attempting to settle their Insured’s claim; (4) hold the claim open in the event that its errors and delay does or may cause the Insured to suffer either further loss and/or damage; and, (5) stipulate to the Insured’s entitlement to attorney’s fees and court costs pursuant to Florida Statutes §§ 627.428 and 626.9373. However, the Civil Remedy Notice does not show how Edison has failed to comply with the statutory provisions alleged to have been violated. Evidently, this Civil Remedy Notice was filed in bad faith as it is being used as an improper mechanism designed solely for the purpose of intimidating Edison into potentially overpaying the Insured. For the aforementioned reasons, Edison categorically denies that it has acted with bad faith in connection with this claim. CONCLUSION The purpose of a CRN is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000). However, the CRN here does not serve this purpose because it does not provide any means as to how Edison can “cure” the alleged defects. This failure to provide a proper opportunity to cure renders the CRN improper. Longpoint Condominium Associations v. Allstate Insurance Co. , 2005 WL 131580 (N. D. Fla. June 2, 2005). Moreover, the method for curing the violations alleged in a civil remedy notice are not determined by the insured. 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). . . . To 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). Here, Edison properly adjusted the subject claim as it investigated the loss within the statutory time frame. Edison denies all of the allegations contained in the subject CRN, which is defective and improper, as Edison has not violated any of the subject statutes. Edison further states that the accusations made against it in the subject CRN are patently false. In closing, Edison first believes that the Civil Remedy Notice 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. Due to the lack of any factual and circumstantial basis to support the allegations therein, Edison respectfully requests, through this response, that the DFS return and reject the CRN for lack of specificity pursuant to Florida Statutes. Regardless of the rejection, Edison denies all allegations contained in the Civil Remedy Notice and submits there are no violations. While Edison’s response herein is meant to address the allegations in the Insured’s Notice, it is based upon the limited information provided in the Civil Remedy Notice and the information presented to date. If the Insureds feel that Edison is not in possession of all the facts, please inform the undersigned immediately. Please note that Edison’s response is not necessarily exhaustive and does not preclude Edison or anyone on Edison’s behalf from asserting any other valid reason for seeking rejection and return of the Civil Remedy Notice. Also, this letter or any act or failure to act on the part of Edison or any agent or representative of Edison 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. On behalf of Edison, we trust that this response addresses the allegations in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very Truly Yours, QUINTAIROS, PRIETO, WOOD & BOYER, P.A.
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