Civil Remedy Notice of Insurer Violations
Login

Filing Number:     803644
Filing Accepted:  1/27/2025
         Print Filing
Complainant
Last/Business Name *  
SALGADO   First Name   JUAN
Street Address * 1119 TENNESSEE AVENUE
City, State Zip * ST. CLOUD, FL 34769
Email Address * MYA@GREENLAWGRP.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SALGADO   First Name   JUAN
Policy # * D2LG04X0436636 Claim #* M34630
Attorney
Attorney is Applicable
Last Name* GREEN First Name * PAUL Initial
Street Address* 8833 PERIMETER PARK BLVD. STE. 104
City, State Zip* JACKSONVILLE , FLORIDA 32216
Email Address * PAUL@GREENLAWGRP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CENTAURI SPECIALTY INSURANCE COMPANY
NAIC Company Code 12573
 
Name of individual responsible for violation (if any):* CARLA DAVIS AND ALL SUPERVISORS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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.
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)(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.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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.

See below
 
* 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 9th, 2024, Juan Salgado (hereinafter “INSURED”), suffered property damage at his property located at 1119 Tennessee Avenue, St. Cloud, FL 34769. The property suffered extensive damage to the roof. Centauri Insurance. (hereinafter “Centauri”) issued an insurance policy for the Insured’s property, Policy Number D2LG04x0436636, which was in full force and effect on the date of the loss. The loss was the result of a significant windstorm. Shortly following the loss, the Insured retained the Green Law Group (hereinafter “FIRM”) to help expedite the claim to restore the property to its pre-loss condition. FIRM timely notified CENTAURI of the damage sustained to the property and contemporaneously provided an estimate of the damages in the amount of $37,703.18. Despite demand of payment, CENTAURI has failed or refused to pay full value to protect and return property to pre-loss CENTAURI’s refusal to adequately and otherwise make INSURED whole, constitutes a breach of contract. As a result of CENTAURI ‘’forementioned breach of contract, it has become necessary for INSURED to retain the services of FIRM. CENTAURI has engaged in a customary business practice and a deliberate course of conduct to hinder resolution of its claims until they enter litigation CENTAURI regularly and consistently “shuffles” desk adjusters when the undersigned attorney calls to discuss claims. One adjuster will imply he can help on the claim but after several minutes state that he does not have the authority to settle the claim, and another desk adjuster is needed for that claim. This practice is used solely to insulate CENTAURI in litigation by saying that their adjusters are available to adjust and settle claims and are not avoiding settling. However, all is doing is “passing off” a claim from one adjuster to another in an effort to delay and frustrate the process. CENTAURI regularly and consistently denies justified claims outright, omits or denies specific line items required to properly repair/replace a homeowner’s roof, and uses deceptive tactics, some, aforementioned, to prolong the process in a hope that the homeowner will cancel his retainer with the FIRM. It has become a pattern of practice for CENTAURI to not settle claims when it could do so, and these dilatory tactics serve no purpose other than to increase profits. CENTAURI has violated the following statutory provisions: §642.155(1)(b)(1) - Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly towards its insured and with due regards 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 reasonable clear, under one portion of the insurance policy coverage in order to influence settlement under other provisions of the insurance policy coverage; §626.9541(1)(i)(2) – A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy; §626.9541(1)(i)(3) – Committing or performing with such frequency as to indicate a general business practice any of the following: (a) Failing to adopt and implement standards for the proper investigation of claims; (b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; (c) Failing to acknowledge and act promptly upon communications with respect to claims; (d) Denying claims without conducting reasonable investigations based upon available information; (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 with 30 days after proof-of-loss statements have been completed; (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; (g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim; (h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. To remedy this Civil Remedy Notice and to cure the conduct giving rise to the violations described herein, CENTAURI must immediately: (i) tender the full remaining payment to FIRM, on behalf of INSURED; (ii) make payment of any pre-judgment interest owed under Florida law, including §627.70131(5)(a), which is accruing daily; (iii) make payment for the additional expense incurred by the insured in hiring an attorney; and (iv) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim. The aforementioned payments should be tendered to the insured’s attorneys at Green Law Group, 8833 Perimeter Park Blvd., Suite 104, Jacksonville, Florida 32216.
Comments
User Id Date Added Comment
kmixon@gspalaw.com 02-28-2025 February 28, 2025 Via email & posted to DFS Website Paul Green, Esquire Green Law Group DFS Filing No: 803644 Accepted: January 27, 2025 RE: Insured: Juan Salgado Claim No.: M34630 Policy No.: D2LG04X0436636 Date of Loss: October 09, 2024 Dear Mr. Green: This shall serve as amendment to the response from Centauri Specialty Insurance Company (“Centauri”) in relation to the Civil Remedy Notice of Insurer Violation (“Notice”) accepted by the Department of Financial Services (“Department”) on January 27, 2025, for insured, Juan Salgado. Centauri denies the allegations asserted in the Notice, and denies any improper or dilatory conduct in its response or handling in the claim. Centauri stands by its denial of each and every allegation made against it in the Notice. Centauri further stands by its denial of any violation of the Florida Statutes and violations of any other code or statutory provision or ethical guideline or contractual obligations. Centauri further stands by its position that it has acted fairly and with due diligence both in its claim review actions, and towards the Insured, throughout its investigation of the claim. Notwithstanding, the Insured and her representatives/assignees and Centauri have reached a mutual global settlement in exchange for a global release of all claims including but not limited to the release of the claims, attorney’s fees, interests, costs, potential bad faith, etc., etc., as well as, among other things. As such, when Centauri reached this settlement agreement, all purported violations set forth in the Notice were resolved. Accordingly, Centauri has effectively cured any alleged, and denied, deficiencies to the extent any deficiencies had ever existed. Centauri Insurance Company has fully and adequately respond to the insured’s allegations alleged in the Notice filed with the Department. Should the Department have any questions or further inquiry with respect to this matter, please contact the undersigned. Regards, GROELLE & SALMON, P.A. Carlos M. Marante For the Firm
kmixon@gspalaw.com 01-31-2025 January 31, 2025 Via email & posted to DFS Website Paul Green, Esquire Green Law Group 8833 Perimeter Park, Blvd. Suite 104 Jacksonville, Florida 32216 DFS Filing No: 803644 Accepted: January 27, 2025 RE: Insured: Juan Salgado Claim No.: M34630 Policy No.: D2LG04X0436636 Date of Loss: October 09, 2024 Dear Mr. Green: This shall serve as the response of Centauri Specialty Insurance Company (“Centauri”) to the Civil Remedy Notice of Insurer Violation (“Notice”) accepted by the Department of Financial Services (“Department”) on January 27, 2025, for insured, Jaun Salgado. Centauri denies the allegations asserted in the Notice, and denies any improper or dilatory conduct in its response or handling in the claim. Centauri has acted promptly, diligently, and fairly in its response, evaluation, and handling of the claim. Centauri offers this written response in support of its position, notwithstanding the Notice fails to comply with the statutory requirements of Florida Statute §624.155. The insured offers no factual support for those allegations that Centauri violated Florida Statutes, including Statutes, §624.155 and §626.9541, and Centauri disputes the conclusory narrative asserted by the insured in the Notice and denies any statutory violation. To allow a full understanding of the factual history of the claim, Centauri offers the following summary of documented facts, followed by specific response to the allegations asserted in the Notice. Documented Facts: This claim of loss was reported by the insured on December 19, 2024, as alleged damages the insured property located at 1119 Tennessee Avenue, Saint Cloud, Florida 34769 as a result of Hurricane Milton, which reportedly occurred on October 9, 2024, over two months earlier. Centauri promptly acknowledged receipt of the claim, and Centauri assigned claim number M34630 for purposes of its investigation. Centauri retained an independent field adjuster to inspect the risk. On or about January 14, 2025, the independent filed adjuster conducted his field inspection of the insured property on behalf of Centauri. During his inspection, the independent field adjuster was pointed to the damages of the property. Thereafter, on January 22, 2025, Centauri promptly informed Complainant of the estimate repairs that could relate to the reported claim and informed of the need to complete the investigation to finalize a determination of coverage. Despite this, this Notice was filed. F.S. §624.155(1)(b)(1): Centauri denies violation of Florida Statute §624.155(1)(b)(1), as it made a good faith effort to resolve the insured’s claim and has at all times acted in accordance with the terms, conditions, and coverages of the insurance policy. The inspection, claim’s investigation and information made available to Centauri supported a claim for potential damages covered and/or limited to the express terms of the policy. Accordingly, this allegation is not factually supported, and is denied. F.S. §624.155(1)(b)(3): Centauri denies violation of Florida Statute §624.155(1)(b)(3), as Centauri at all times provided prompt settlement of the claim when it became clear, upon receipt of all necessary information made available, that coverage and settlement for said coverage was warranted. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(2): Centauri denies violation of Florida Statute §626.9541(1)(i)(2), as this allegation has no merit whatsoever and is not factually supported. At no time during the investigation of the claim or in its coverage determination was a material misrepresentation made to an insured or any other individual with potential interest to benefits/proceeds to the policy. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(a): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(a), as it has adopted and implemented standards for the proper investigation of claims. The facts show Centauri promptly responded to the claim of loss and performed an extensive evaluation thereof. The inspection, claim’s investigation and information made available to Centauri supported a claim for potential damages covered and/or limited to the express terms of the policy. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(b): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(b), as this allegation has no merit and is not factually supported. Centauri investigated the claim, inspected the property, and informed of the potential damages covered and/or limited to the express terms of the policy. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(c): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(c), as it has never failed to respond to any communications made the insured. Centauri’s investigation determination was in accord with, and supported by, the evidence obtained during its investigation and at all times timely communicated with the insureds. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(d): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(d), as this allegation has no merit and is not factually supported. Centauri promptly inspected the property, investigated the claim, and then informed insured of the claim’s investigation and findings in a timely fashion thus performing a reasonable and diligent investigation. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(e): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(e), as this allegation has no merit and is not factually supported. Centauri promptly investigated the claim provided written notice regarding the claim in a timely fashion, including written notice regarding all options available to the insured regarding the coverage, and copy of the estimated cost for repairs. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(f): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(f), as it sent the insured correspondence advising the claim subject to the terms of the policy. Accordingly, this allegation has no merit, is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(g): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(g), as this allegation has no merit and is not factually supported. Centauri promptly inspected the property, investigated the claim, provided the insured with Centauri’s rights and the insureds obligations/duties pursuant to the policy of insurance, and only then following an evaluation of all information available provided status of the coverage investigation. Accordingly, this allegation is not factually supported, and is denied. F.S. §626.9541(1)(i)(3)(h): Centauri denies violation of Florida Statute §626.9541(1)(i)(3)(h), as this allegation has no merit and is not factually supported. Centauri performed its investigation in accordance to its rights under the policy, provided notice to the insureds of their obligations under the policy. Accordingly, this allegation is not factually supported, and is denied. Conclusion: The Notice submitted by the Insured and accepted by the Department fails to comply with the pleading requirements of Florida Statute §624.155. Centauri has fully responded to all substantial factual assertions as well as the conclusory allegations. Centauri has handled the insured’s claim with diligence and has at all times acted fairly in the administration of the claim and has treated the insured with honesty and due regard to their interests, and has done so in compliance with the policy of insurance and Florida law. Centauri Insurance Company has attempted to fully and adequately respond to the insured’s allegations alleged in the Notice filed with the Department. Should the Department have any questions or further inquiry with respect to this matter, please contact the undersigned. Regards, GROELLE & SALMON, P.A. Carlos M. Marante For the Firm
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