Civil Remedy Notice of Insurer Violations
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Filing Number:     803741
Filing Accepted:  1/27/2025
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Complainant
Last/Business Name *  
PARKER   First Name   TINA
Street Address * 1461 LE BARON AVENUE
City, State Zip * JACKSONVILLE, FL 32207
Email Address * [WITHELD'
Complainant Type: * Insured
Insured
Last/Business Name*   PARKER   First Name   TINA
Policy # * HOH604725 Claim #* H010024864
Attorney
Attorney is Applicable
Last Name* ROLLE First Name * CRAIG Initial D.
Street Address* 708 E. COLONIAL DR., SUITE 103
City, State Zip* 32803 , FLORIDA 32803
Email Address * CR@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* SEE BELOW
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
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)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Specific policy language contained in the Insured's insurance contract that is relevant to the violations by Carrier Insurance Company includes, but is not limited to, the following: Coverage A, B, C, D and E Provisions, all additional Coverage Provisions, all coverage provided by endorsement or rider, the declarations page, loss payment or settlement provisions, provisions pertaining to the duties in the event of a loss, all terms and conditions pertaining to Section I of the insurance policy, the insurance policy’s definitions section, the insurance policy’s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the Insured’s property; and all other relevant policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In consideration of payment of an annual premium, an all-risk residential property insurance policy was in full force and effect with Heritage Property & Casualty Insurance Company (“Carrier”) bearing policy number HOH604725 and claim number H010024864, for a property located at 1461 Le Baron Avenue, Jacksonville, FL 32207 (Property). The owners of the Property are the named Insureds, Tina Parker and Sean Sedacca. On or about August 10., 2024, the Insureds’ Property suffered a loss due to inclement weather. In response, the Carrier assigned the above claim number to this loss and conducted an inspection of the Property. Shortly thereafter, the Carriers improperly denied coverage for this covered loss. Unhappy with the Carrier’s treatment and handling of this claim, the Insured retained the undersigned counsel which could have been avoided had the Carrier properly investigated and correctly paid the entire estimate for this claim. The Carrier failed to promptly settle the Insured’s insurance claim when the obligation to settle the insurance claim had become reasonably clear. The Carrier has therefore NOT acted in good faith during the adjustment of this claim. Specifically, the Carrier has violated the following statutory provisions under Florida law: • Carrier has violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented with evidence that it has underpaid this claim, the Carrier still refuse to made additional payments. • The Carrier has violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insured for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. • The Carrier has also violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Quite simply, Carrier and its representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insured. In addition, after being placed on notice as to the blatant failure to properly adjust this claim, Carrier has yet to rectify their actions and do right thing by the Insured by paying the money she is contractually owed. We believe Carrier will profit from its wrongful conduct and its behavior is tantamount to unfair claim settlement practices under Florida Stat. 626.9541(1)(i)(3). As noted above, the Carrier violated § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon the communications with respect to the claim. The Insured has more than complied with every request and duty under the Policy and there has still been no action by Carrier to rectify its underpayment of this claim. In the event the Carrier needs additional information, it has failed to promptly notify the Insured in a timely manner. Moreover, this pattern of behavior is perpetuated by Carrier and its representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insured throughout the insurance claim process. Several duties and responsibilities owed to the Insured were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from Carrier approaching the investigation and settlement in a manner prejudicial to the Insured, failing to allow a fair settlement with her and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insured was not afforded the professional duties entrusted on Carrier by the public. As of the filing of this civil remedy notice, Carrier has failed to adequately compensate the Insured for the damage that occurred on or about February 4, 2024. As a direct result of Carrier ’s delay and failure to respond to the Insured, she was forced to seek the help of legal counsel. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that Carrier knowingly and intentionally delayed the claims process to further disadvantage the Insured. The financial detriment caused to the Insured is a direct result Security First’s reckless delay of the claim and litigation process. The Insured was (and still is) dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. In other words, the Insured has held up her end of the contractual bargain whereas the Carrier has not. The Insured timely filed her claim once they had discovered the source of the covered loss and the ensuring damage caused by it. All requested information and documentation were turned over to Carrier and its representatives promptly by the Insured. Carrier failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insured how she may remedy any deficiencies in her claim, and failed to provide her with qualified representatives to ensure the claim was initially adjusted, evaluated, estimated properly, and paid fully. To deny the Insured the benefit of the bargain after she has satisfied all of the obligations is morally and ethically reprehensible, and reeks of Unfair Trade Practice. Upon information and belief, the actions complained of, among others, made by Carrier so often as to constitute a general business practice, evidencing a motive to enhance its profits, and designed to cause a detrimental effect to its policy holder. Carrier was aware that the Insured’s damages were in covered under the policy yet took advantage of them in an attempt to force them into an irreparable disadvantaged position by underpaying the claim. The Carrier hopes that its conduct will force the Insured to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Carrier fail to cure the violations set forth in this Civil Remedy Notice within the given time period. To cure the defects outlined in this Civil Remedy Notice, Carrier must: (1) Immediately tender all insurance proceeds due and owing to the Insured that are fairly owed to them under the insurance policy that would reasonably place them back to a pre-loss condition pursuant to the estimate of damages in the amount of $24,444.00.
Comments
User Id Date Added Comment
ncarlisle@heritagepci.com 02-12-2025 February 12, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Tina Parker and Sean Sedacca Insured: Tina Parker and Sean Sedacca Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 803741 Filing Accepted: January 27, 2025 Claim No: H010024864 Policy No.: HOH604725 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 803741, filed on behalf of Insureds, Tina Parker and Sean Sedacca (“Complainants”), and accepted by the Department on January 27, 2025. Heritage’s asserts the subject Civil Remedy Notice is legally insufficient and non-compliant with Florida law. It contains subjective and conclusory allegations without supporting facts. Florida Statute 624.155, requires specificity in civil remedy notices. It is without a doubt a condition that must be satisfied in order for one to perfect the right to sue under the statute. To perfect the right to sue under the statute, the Insured(s) must specifically notify the Insurer of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F. Supp. 773, 776 (M.D. Fla. 1996). The Notice makes all kinds of allegations to include: Failing to adopt and implement standards for proper investigation; Failing to acknowledge and act promptly upon the communications with respect to the claim; Investigation and settlement in a manner prejudicial to the Insured; Failing to allow a fair settlement with Insured; Intentionally delaying claims process; Gross mismanagement of the claim; and Unfair Trade Practice. Yet, the Notice failed to provide a single instance to support the preceding allegation(s), which Heritage unambiguously denies. Complainants included excepts from Florida Administrative Code to assert allegations of misconduct by the Adjusters. First, this statutory section is not one of the statutes enumerated under Section 624.155, Florida Statutes and its inclusion in this Notice is unwarranted and without merit. Further, Complainants have failed to specify the nature of the alleged violation and have asserted no facts to support the supposed violations. Regardless, Heritage denies any violation(s) of the Administrative Code. If the Complainants honestly believe that there was any type of violation, Heritage requests that the Complainants provide specific information with respect to each alleged violation(s) denoted in the Notice including the name of each individual involved, the date of each violation, a description of each violation, and copies of documentation referencing each violation. As it stands now, the Notice is insufficient for the purpose of allowing Heritage to fully respond and/or remedy the alleged violations, if any. On September 5, 2024, Trinity Restoration and Roofing with Complainant, Tina Parker filed a claim for damage to the ceiling in the master bedroom and roof to have occurred on August 10, 2024, as a result of wind storm. Heritage acted promptly to complete its inspections. After its inspections and investigation, the claim was denied in accord with the findings from the inspections and the terms within the Policy. Moreover, this claim was properly adjusted in compliance with Florida Statute. Remarkably, the findings from the Field Adjuster and Engineer remains unrefuted. Heritage does not believe there was any form of violation(s), and questions the validity of the Notice filed by Complainants, which is merely a Machiavellian use of Florida Statute §624.155, in a poor attempt to impose on Heritage the obligation to honor what Complainants promised to provide as a selling point in their for sale advertisement of this property: “new 50 year transferable warranty roof will be installed prior to closing.” Heritage has at all times performed its obligations under the insurance Policy in a prompt and diligent manner with due regard for the interest of its Insureds. In fact, none of the listed violations or allegations have occurred and Heritage categorically denies any violations of §624.155 and §626.9541, Fla. Stat., together with any and all other statutes, regulations, codes and rules. Due to the lack of any factual and circumstantial basis to support any bad faith allegations, Heritage request, through this response that the Department of Financial Services reject the Notice for lack of subject matter specificity pursuant to Florida Statutes. Heritage continues to reserve all of its rights under the policy, at law and in equity. In the event this matter is not pursued further, the Department may consider this letter to be Heritage’s report on the final disposition of any alleged violation(s). If anyone at the Department has any question concerning this matter, please contact Heritage or the undersigned for further information. Respectfully, /s/ Sunita Trelles Sunita Trelles Esquire Staff Counsel Heritage Property & Casualty Insurance Co. CRN Response
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