Civil Remedy Notice of Insurer Violations
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Filing Number:     803755
Filing Accepted:  1/27/2025
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Complainant
Last/Business Name *  
DIAZ   First Name   OSMARIS
Street Address * 4401 WITHROWWOOD COURT
City, State Zip * ORLANDO, FL 32837
Email Address * [WITHHELD]
Complainant Type: * Insured
Insured
Last/Business Name*   DIAZ   First Name   OSMARIS
Policy # * 2570233771 Claim #* 01000114372
Attorney
Attorney is Applicable
Last Name* ROLLE First Name * CRAIG Initial D.
Street Address* 708 E. COLONIAL DR., SUITE 103
City, State Zip* ORLANDO , FLORIDA 32803
Email Address * CR@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FIRST PROTECTIVE INSURANCE COMPANY
NAIC Company Code 10897
 
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
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)(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 Insureds' insurance contract that is relevant to the violations by First Protective Insurance Company d/b/a Frontline Insurance 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 Insureds’ 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 First Protective Insurance Company d/b/a Frontline Insurance (“Carrier”) bearing policy number 2570233771 and claim number 01000114372, for a property located at 4401 Withrowwood Court Orlando, FL 32837 (Property). The owners of the Property is the named Insured, Osmaris Diaz. On or about September 28, 2022, the Insured’s Property suffered a loss from hurricane ian. In response, the Carrier assigned the above claim number to this loss and conducted an inspection of the Property. Shortly thereafter, the Carrier improperly denied coverage for this claim. Unhappy with the Carrier’s treatment and handling of this claim, the Insureds 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 Insureds’ 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 Insureds. 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 Insureds by paying the money they are 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 Insureds have 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 Insureds 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 Insureds throughout the insurance claim process. Several duties and responsibilities owed to the Insureds 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 Insureds were 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 Insureds 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 Insureds, they were 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 Insureds. The financial detriment caused to the Insureds is a direct result of CARRIER’s reckless delay of the claim and litigation process. The Insureds were (and still are) 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 Insureds have held up her end of the contractual bargain whereas the Carrier has not. The Insureds 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 bCarriers of its gross mismanagement of the claim, failed to inform the Insureds how they 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 Insureds the benefit of their bargain after they have 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 Insureds’ damages were 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 Insureds 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 $76,594.00.
Comments
User Id Date Added Comment
sandra@hoffmanpa.com 03-26-2025 This correspondence constitutes Frontline Insurance’s (“Frontline”) response to the Civil Remedy Notice of Insurer Violation you filed on behalf of Osmaris Diaz (“Insured”) regarding the Department of Financial Services (DFS) Filing Number and our Claim Number listed above. Frontline welcomes the opportunity to respond to this Civil Remedy Notice of Insurer Violation (“CRN”) and specifically denies each and every allegation contained in the Civil Remedy Notice filed in relation to this claim. Frontline believes that the Civil Remedy Notice you filed fails to comply with the specific notice and information requirements as set forth in the Civil Remedy Notice of Insurer Violation document provisions, Florida Statute §624.155, and Florida law. Notwithstanding, Frontline denies each and every alleged violation and statutory provision alleged to have been violated within the CRN, including §624.155 and §626.9541, including all subsections, subparts, and references thereto within the CRN. The Notice fails to set forth any specific policy language alleged to have been violated in accordance with Florida Statute §624.155(3)(b)(4). This failure to identify any specific policy provision allegedly relevant to the purported violations prevents Frontline from addressing any issues regarding the policy and is another reason why it does not comply with F.S. §624.155. See Julien v. United Prop. & Cas. Ins. Co., 46 Fla. L. Weekly D486 (Fla. 4th DCA Mar. 3, 2021) (finding that a civil remedy notice’s lack of specificity when referencing the policy language allegedly breached by the insurer violates F.S. §624.155(3)(b)(4) and is sufficient grounds for dismissal of the insured’s complaint). Instead, the CRN simply cites general policy headings such as “Coverage A, B, C, D, and E Provisions,” “all terms and conditions pertaining to Section I of the insurance policy” and “all insurance policy provisions that provide coverage to the Insureds’ property” and “all other relevant policy provisions” without providing the necessary specificity or elaboration as to any alleged statutory or policy violation. The CRN vaguely alleges that Frontline did not attempt to settle the claim when it could and should have done so; failed to adopt and implement standards to properly investigate claims; and failed to acknowledge and act promptly with respect to claims when adjusting the Insured’s claim but fails to state how Frontline either violated the statutes cited in the CRN or how Frontline failed to adhere to any policy language cited therein based on the vague allegations set forth in the CRN. Instead, the Insured vaguely alleges that Frontline has acted poorly based on its failure and refusal to properly investigate the Insured’s claim and tender all insurance proceeds they claim are due and owing under the Policy, failing to state how Frontline specifically failed to investigate and adjust the Insured’s claim under the policy provisions. Frontline finds this CRN to be invalid, insufficient, and containing self-serving general comments that lack merit and details regarding the alleged statutory violations alleged therein. Each alleged statutory violation is expressly denied. Frontline asserts that a state-licensed adjuster inspected the property in connection with the alleged damages claimed by the Plaintiff. The adjuster took over 80 photographs documenting in detail the conditions of the roof, exterior, interior, and attic portions of the home. Frontline kept in constant communication with the Insured or their representatives throughout the claims process, including sending multiple correspondence on the claim. Frontline dispatched a professional engineer from an independent engineering firm to further inspect and investigate the claimed damage. Frontline reviewed the documents provided by the Insured and/or their representatives. During the investigation neither the Insured nor their representatives provided supporting documentation or information to Frontline that would support or substantiate that the alleged loss was caused as a result of Hurricane Ian. Frontline informed the Insured of its claim determination in a detailed package outlining its investigation, findings and policy provisions being relied upon. An apparent disagreement by the claimant as to the coverage determination does not give rise to bad faith or misconduct on the part of Frontline. In closing, Frontline first believes that the Civil Remedy Notice does not comply with F.S. §624.155, and regardless of the lack of compliance, Frontline denies all allegations contained in the Civil Remedy Notice and submits there are no violations. While this response is meant to be comprehensive, Frontline’s response above is based upon the limited information provided in the Civil Remedy Notice and the information we have to date. If Osmaris Diaz believes that we are not in possession of all the facts, please inform us immediately. Please note that Frontline’s response is not necessarily exhaustive and does not preclude us from asserting any other valid reason for the alleged lack of compliance with F.S. §624.155. Also, this letter or any act or failure to act on the part of Frontline or any agent or representative of Frontline should not be construed as a waiver of any rights or defenses, including but not limited to proper notice and service by the claimant, available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation alleged 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.
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