Civil Remedy Notice of Insurer Violations
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Filing Number:     804260
Filing Accepted:  1/30/2025
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Complainant
Last/Business Name *  
MARIA MANOR ASSOCIATION, INC   First Name  
Street Address * 4158 TAMIAMI TRAIL
City, State Zip * CAPE CORAL, PO 33952
Email Address * ALEX@TARNOVSKYLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   MARIA MANOR ASSOCATION, INC.   First Name  
Policy # * HCP006891-3 Claim #* H103854
Attorney
Attorney is Applicable
Last Name* LOPEZ First Name * ALEJANDRO Initial E
Street Address* 7000 W. PALMETTO PARK ROAD,, SUITE: 210
City, State Zip* BOCA RATON , FL 33433
Email Address * ALEX@TARNOVSKYLAW.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):* ROBERT WAGNER AND ALL ADJUSTERS, SUPERVISORS, ATTORNEYS, MANAGEMENT AND INDIVIDUALS ASSOCIATED WITH OR RETAINED HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY CONCERNING THE CLAIM AT ISSUE
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Non-renewal
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

FLORIDA - CLAIM PAYMENT PROVISION- CONDOMINIUM The following (4.g.(3)) is added to the Loss Payment section of CP 00 17 10 00 – Condominium Association Coverage Form. (3) Within 90 days of receiving notice of claim, unless we deny the claim during that time or factors beyond our control reasonably prevent such payment. If a portion of the claim is denied, then the 90- day time period for payment of claim relates to the portion of the claim that is not denied. Paragraph (3) applies only to the following: (a) A claim under a policy covering residential property; (b) A claim for building or contents coverage if the insured structure is 10,000 square feet or less and the policy covers only locations in Florida; or (c) A claim for contents coverage under a tenant's policy if the rented premises are 10,000 square feet or less and the policy covers only locations in Florida. CP 00 17 0607 Coverage We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss. 1. Covered Property Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2., Property Not Covered, if a Limit of Insurance is shown in the Declarations for that type of property. a. Building, meaning the building or structure described in the Declarations, including: (1) Completed additions; (2) Fixtures, outside of individual units, including outdoor fixtures; (3) Permanently installed: (a) Machinery; and (b) Equipment; (4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including: (a) Fire-extinguishing equipment; (b) Outdoor furniture; (c) Floor coverings; and (d) Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering that are not contained within individual units; ********A Hurricane is a covered loss under the Policy*********** The insured has complied with all pre loss conditions and Heritage agrees that there is damage from a covered peril. If any exclusions exist, the insured does not know of them as Heritage has failed to identify any applicable exclusions in the Policy. This policy is a perils insured against policy and the insured has done their part. Absent any exclusions, payment must be made or at least coverage value must be provided.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Maria Manor Association (the “Insured”) purchased homeowners insurance policy number HCP002236 (the “Policy”) from Heritage Insurance Company (the “Insurer” or “Heritage” ). The Policy provided coverage for the Insured’s residential property located at 4158 Tamiami Trail, Port Charlotte, FL 33952 (the “Property”). The Policy was in full force and effect, with all premiums paid, when the Insured suffered a physical loss as result of Hurricane Ian on September 28, 2022. Hurricane Ian was a powerful category 4 storm devastating South West Florida where the property is located. The insured timely notified Heritage of the Loss and in response, Heritage assigned claim number H103854 to the Loss. Heritage sent its field adjuster, Robert Wagner, to inspect the loss on 10/26/2022. Generally, the property contains the following structures: There are twenty two-story residential buildings with four condominium units on each floor, totaling one hundred and sixty units, three carports, and an office. The exterior walls are wood studs covered with exterior sheathing, finished with brick veneer, and supported by a grade slab. From first glance, it was obvious that Heritage was not going to do the right thing. In addition to the twenty residential buildings there is an office building, and a car port. On at least one of the residential buildings, Building “U”, the roof was torn almost completely off. Yet, Mr. Wagner states in his estimate “the buildings appeared in good condition except for the immediate damaged areas.” Is this referring to the building without a roof as the immediate damaged areas? From the beginning, Heritage was out to underpay this claim and leave its insured struggling to rebuild. Ultimately for all of the damaged structures, On July 21, 2023, almost three hundred days after the passage of Hurricane Ian, Heritage finally sent its coverage determination letter with the following language: “The prepared estimate for the covered wind damage to the roof, exterior elevations, interior drywall and mitigation completed, that which is the responsibility of the Association, results in an amount owed to you. Under separate cover, we will be issuing a settlement check in the amount of 478,431.66” Without representation at the time, the insured hired a roofer they wanted to do the work and found out immediately that the small payment issued by Heritage would do nothing to make them whole. The damage to each of the roofs from the Hurricane and the tarps used to mitigate damage made the roofs unrepairable, except Heritage was short in both scope and cost of repairs. The insured submitted the estimates from their contractor hoping that Heritage would help, still hoping that Heritage would do the right thing. Instead Heritage issued an additional coverage letter on August 31, 2023 with the following language: Heritage is in receipt of your contractor’s, Storm Force Roofing, estimate for supplemental roof replacement items and scope. As an agreement has been reached regarding the pricing and scope of accepted roof repairs, a supplemental payment is owed to you. Per the attached (2) estimates as outlined by Storm Force Roofing, a supplemental check in the amount of $590,574.51 will be sent under separate cover. This was their explanation: Replacement Cost Value $1,156,637.93 Less Recoverable Depreciation $0.00 Less Non Recoverable Depreciation $87,631.76 Actual Cash Value $1,069,006.17 Less Deductible $0.00 Less Prior Payment $478,431.66 Net ACV payment $590,574.51 Recoverable Depreciation $0.00 Total with Recoverable Depreciation $590,574.51 Heritage took the estimates from the roofer and issued a payment. EXCEPT they subtracted out the prior payment and the deductible to issue additional payment for the roof. This is incorrect. Only a small portion of the original payment was attributed to the roofs. Repairs were afforded to areas of the roof, and the estimate contains areas damage amounts for the INTERIOR. How does Heritage think it is paying for the roofs when they are including money that should be allocated for the interior as the cost of the roofs. Right there it should have realized it was short because the estimate provided by the Insured’s Contractor would pay for only the roofs. TO DATE THEY HAVE NOT SENT A CORRECT UNDISPUTED FOR THE INTERIOR. The hurricane occurred on September 28, 2022. As we sit here today, Heritage has failed to issue an undisputed for the interior of the property. If it had paid the estimate from the roofer, it should have deducted the areas ONLY allocated for the roof as a prior payment, rather than deducting the entire prior payment which included areas having nothing to do with the roof. This is in violation of their own policy. The Policy states as follows: Loss Payment a. In the event of loss or damage covered by this Coverage Form, at our option, we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property, subject to b. below; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality, subject to b. below. We will determine the value of lost or damaged property, or the cost of its repair or replacement, in accordance with the applicable terms of the Valuation Condition in this Coverage Form or any applicable provision which amends or supersedes the Valuation Condition. b. The cost to repair, rebuild or replace does not include the increased cost attributable to enforcement of any ordinance or law regulating the construction, use or repair of any property. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. d. We will not pay you more than your financial interest in the Covered Property. It is indisputable that damage to the COVERED property has not been paid. Only coverage for the roofs has been afforded despite the indisputable evidence that even Heritage themselves found to the interior. Heritage is in violation of the Loss Settlement provisions of the policy. In fact, not just their adjuster found interior damage, damage to the windows, and damage to the exterior, which have all not been paid for but they also have hired an engineer that has found damage to all of those areas. ALL UNDISPUTED damage that has not been paid for. John Runkle P.E. inspected the property, the following is a sample of some of the findings in his report. “Damaged siding, Damaged lanai acrylic screen, water stained drywall ceiling, water stained below windowsill, damaged metal siding, drywall separation at window jab.” These are just a few of the descriptions of the damage, where is the payment for that? Two representatives on behalf of Heritage have found damage to the interior, exterior and windows, yet payment has only been made for the roofs. In addition to this being in violation of the Policy, it is also in violation of Florida Law Section 627.70131 (7)1(a) which states: Within 90 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer’s claim payment is less than specified in any insurer’s detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. Any payment of an initial or supplemental claim or portion of such claim made 90 days after the insurer receives notice of the claim, or made more than 15 days after there are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured must select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. Frustrated by the lack of progress with Heritage, the insured was forced to retain legal counsel to assist them with its claim in October of 2024. The insured’s attorney, in an attempt to reach an equitable solution with Heritage, coordinated a settlement conference to take place on January 23, 2025, at the insured’s property. Heritage’s legal counsel was present but a representative from Heritage failed to appear.. Conveniently for Heritage, the conference did not result in resolution and THE NEXT DAY, Heritage sent the insured a non-renewal letter. Heritage’s notification the day after an unsuccessful settlement conference can only be construed as an attempt to pressure the insured to take a low ball settlement offer as this non-renewal has essentially put a hard deadline on the insured to close the claim. Heritage is well aware that the insured will be unable to acquire new insurance until the current claim is resolved. 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. Heritage has been provided all information needed to move forward with rendering a fair payment to the insured. Despite complying with all duties, Heritage continues to withhold payments. Furthermore, their nonrenewal of the Policy pressures the insureds into a low ball settlement. Knowing that they cannot obtain new insurance with an open claim, while still not having paid for the UNDISPUTED interior of the property. Their own adjuster has found that damage to the interior. Yet, Heritage used those numbers as prior payments for the roof. This is not in the best interest of the insureds and this is neither fair or honest. FLORIDA - CLAIM PAYMENT PROVISION- CONDOMINIUM The following (4.g.(3)) is added to the Loss Payment section of CP 00 17 10 00 – Condominium Association Coverage Form. (3) Within 90 days of receiving notice of claim, unless we deny the claim during that time or factors beyond our control reasonably prevent such payment. If a portion of the claim is denied, then the 90- day time period for payment of claim relates to the portion of the claim that is not denied. Paragraph (3) applies only to the following: (a) A claim under a policy covering residential property; (b) A claim for building or contents coverage if the insured structure is 10,000 square feet or less and the policy covers only locations in Florida; or (c) A claim for contents coverage under a tenant's policy if the rented premises are 10,000 square feet or less and the policy covers only locations in Florida. This is a clear violation of Florida Statute 626.9541(1)(i)(3)(a) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. 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. The acts described herein, upon information and belief, are performed with such frequency so as to be a general business practice. The Insurer and its agent adjusters through the actions above violated sections of the Florida Adjuster’s Code of Ethics at F.A.C. 69B-220.201, including sections which require them to place the duty for fair and honest treatment of the claimant above the adjuster’s own interests, require them to handle every adjustment and settlement with honesty and integrity, and to provide truthful and unbiased reports of the facts after a complete investigation. Every breach of the Code constitutes an unfair claims settlement practices as a matter of law. The Insurer’s investigation of this claim was not performed in a manner fair to the Insured. The Insurer has forced the Insured to notify the Insurer of the insured’s intent to litigate this matter through the assistance of counsel because there was no other possible course of action that would obtain a fair result. In order to properly adjust claims in the state of Florida the Insurer should always fully indemnify the Insured. This Notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. § 624.155. Nothing herein should be read as a waiver of any of the Insureds’ rights under the Policy or at law, including but not limited to any right to receive damages, attorney’s fees, costs, or other relief in any pending or forthcoming legal action. To cure the allegation herein, Heritage must tender the full amount remaining under the estimate from Anderson International Inc., in the amount of $12,010,411.10.
Comments
User Id Date Added Comment
rlacayo@kelleykronenberg.com 03-21-2025 Sent Via Email Alejandro E. Lopez 7000 W. Palmetto Park Road, Suite: 210 Boca Raton, FL 33433 Alex@tarnovskylaw.COM RE: RESPONSE TO CIVIL REMEDY NOTICE NUMBER 804260 Insured: Maria Manor Association, Inc. Policy Number: HCP006891 Claim Number: H103854 Date of Loss: 9/28/2022 Property: 4158 Tamiami Trail, Port Charlotte, FL 33952 Nature of Loss: Hurricane Irma CRN Number: 804260 CRN Acceptance Date: 1/30/2025 Dear Mr. Lopez: Please accept this letter as Heritage Property & Casualty Insurance Company (“Heritage”) response to the Civil Remedy Notice of Insurer Violations, Filing Number 804260 (“CRN”) filed by your office on behalf of Maria Manor Association, Inc. (“Complainant” or “Insured”) relating claim for property damage occurring on or about September 28, 2022, bearing claim number H103854 (the “Loss” or “Claim”) made under Policy Number HCP006891, which insured 20 two-story condominium buildings, 3 carports, a clubhouse, and a pumphouse located at 4158 Tamiami Trail, Port Charlotte, FL 33952 (the “Property”). As an initial matter, Heritage denies that any of its actions taken with regard to the Insured’s Claim resulted in a violation of Florida’s bad faith laws as alleged in the CRN. Rather, at all times, Heritage has acted in good faith in its investigation and handling of the Claim and with regards to the best interest of our Insured. Heritage rejects the Insured’s allegations that it acted in bad faith with respect to any aspect of its handling or investigation of the Claim. Heritage specifically denies each and every allegation contained in the CRN. Heritage requests the CRN be rejected as it fails to comply with several of the requirements of the Civil Remedy Notice of Insurer Violation document provisions as set forth in Florida Statutes § 624.155 and Florida case law. Substantively, the CRN is deficient because it fails to “reference specific policy language that is relevant to the violation”, as required by Florida Statute § 624.155(3)(b)(2). Contrary to the intent of the statute, the Notice filed by Complainant contains overbroad, inaccurate, and misleading allegations that do nothing to enable Heritage to cure the alleged violations. For example, the Notice inaccurately alleges that Heritage’s has failed to release payment for all undisputed damages. However, to the contrary, Heritage has issued payments exceeding the undisputed damages and an increased scope of repairs. Claimant relies on a inflated estimate and misapplication of the facts as the basis for the alleged violations, and is requesting to essentially replace the entire structure of all the buildings based on a flawed understanding of the Policy’s coverage and Heritage’s obligation to indemnify the Insured for the covered damages relating to the Claim. Therefore, the CRN must be rejected due to its procedural and substantive deficiencies. I. THE CRN ALLEGATIONS The CRN asserts the following reasons for the notice: • Non-renewal • Claim Delay • Unsatisfactory Settlement Offer • Unfair Trade Practice In the CRN, the Claimant alleges that Heritage violated the following statute and applicable language (as taken from the CRN): • 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)(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. The purpose of Fla. Stat. Section 624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003); Julien, 311 So. 3d 875 (Fla. 4th DCA 2021); Heritage Corp., 580 F. Supp. 2d 1294, 1298 (S.D. Fla. 2008). Without setting forth facts or circumstances of the alleged violation of policy language, Heritage cannot address the alleged violations or properly respond. See id. Here the Claimant failed to strictly comply with the Florida Statute § 624.155 CRN. In direct contravention to the explicit, strictly construed requirements of Florida Statute § 624.155(3)(a), Plaintiff's CRN failed to: 1) identify the language in the Policy related to the alleged violation; 2) correctly identify the Insured’s property address; 3) reference to any policy language relevant to the alleged violation; & 4) provide any factual narrative describing the facts and circumstances giving rise to the alleged violation. The CRN fails to comply with the Florida Statute § 624.155. This is in direct contravention to the explicit, strictly construed requirements of Florida Statute § 624.155(3)(b). Here, the CRN requires the Complainant to “reference to specific policy language that is relevant to the violations, if any.” The Complainant does not cite to any policy language. Let alone any relevant to the baseless statutory violations cited to by the Insured. Without reference to the specific policy at issue or providing further details the CRN fails to put Heritage on notice as to the alleged violation and cannot properly respond to the CRN. These deficiencies deprive Heritage of fair notice of the alleged violations and, therefore, does not provide Heritage with any opportunity to cure or address the alleged violations. These deficiencies are fatal to the Claimant’s CRN. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. Dist. Ct. App. 2021); Heritage Corp. of S. Florida v. Nat’l Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1298 (S.D. Fla. 2008), aff’d, 361 Fed. Appx. 986 (11th Cir. 2010). Thus, the CRN is purposefully drafted in a manner which does not provide Heritage the required notice of the allegations or any meaningful opportunity to respond and/ or evaluate the claims being asserted. Based upon the foregoing, the CRN is insufficient on its face and should be rejected. See Talat, 753 So. 2d 1278 (Fla. 2000); Lane, 862 So. 2d 744 (Fla. 5th DCA 2003). Accordingly, the CRN is legally insufficient and must be rejected. II. FACTUAL BACKGROUND As an initial matter, Heritage denies each and every one of the alleged facts and circumstances referenced in the CRN. Insured’s CRN is rife with factual inaccuracies and baseless accusations. Below we provide the correct factual background for the Claim. On October 3, 2022, Heritage received notice of Insured’s Claim related to Hurricane Ian that occurred on September 28, 2022. The Insured reported damages to several buildings and the units, as well as the pool and pumping station. However, full extent of the damages was not provided. Thereafter, Heritage promptly acknowledged the Claim and the commenced its investigation. On October 13, 2022, Heritage requested additional information and documentation from the Claimant. Claimant provided a contract from Restore Masters dated October 2, 2022 and an invoice dated October 11, 2022 totaling $248,160.00 for tarping work. This work was completed prior to Heritage’s inspection of the Property. On October 20, 2022, independent field adjuster, Kurt Woodward (the “FA”), inspected the Property on behalf of Heritage. Based on his findings Heritage retained engineer Intertek opinions as to causation and extent of damages related to the Claim and MC Consultants per estimates per Intertek’s findings. MC Consultants inspected the Property on October 26, 2022, and Intertek inspected the on October 31 and November 1, 2022. Intertek found that several roofs were required full replacement because of the Loss, while others only need partial repairs. Some tarping may have been excessive and may have further damaged roof that were not significantly impacted by the Claim. Exterior and interior components—including siding, soffits, gutters, columns, windows, and drywall—also showed varying degrees of damage. Intertek also noted that certain items, such as screen damage and window balances, may not be related to the storm and that some of the damage was likely pre-existing. Further, Intertek confirmed that many first-floor units were affected and damaged by flooding, not wind. On December 6, 2022, inspected the Property for the purposes of providing roof quotes for the repairs and roof replacements per Intertek’s findings. On July 21, 2023, Heritage issued its first payment for the Claim in the amount of $478,431.66 which reflected the actual cash value (ACV) of the loss less the Policy’s deductible as contemplated by the estimate prepared by MC Consultants, which also relied on the totals for the roof quotes prepared by Tornado Roofing and scope of damages provided by Intertek. Importantly, this payment also included the full amount of the Restore Masters invoice totaling $248,160.00. Heritage notes that the Policy provides an ACV coverage limitation for covered damages related to the roof. Additionally, from the time of reporting through this first payment Heritage was in constant contact with the Insured and communicating the process and the status of the investigation. After, the initial payment Heritage received an estimate from the Insured’s roofer totaling $678,206.99. This estimate included replacement of the roofs that Heritage agreed needed to be replaced as result of the Claim, as well as the remaining roofs that Heritage covered for repairs only. Despite the estimate contemplating a scope that exceeded Heritage’s coverage determination, Heritage issued a second payment to reflect the difference between the prior payment and the totaling $590,574.51 (ACV) – as of this date Heritage had paid $1,069,006.17 for the covered damages. Even after issuing its second payment, Heritage remained in contact with the Insured to ensure the resolution and closure of the Claim. On about September 11, 2023, Heritage paid the Insured again for the Restore Masters invoice totaling $248,160.00, despite this already included in the initial payment. For reasons unknown to Heritage, the Insured did not release Restore Master’s portion of the initial payment to Restore Masters. Nevertheless, in an effort to continue its good faith efforts to resolve the claim Heritage issued the additional payment. Therefore, to recap Heritage’s good faith attempts to settle and resolve the claim: it issued payments for full roof replacements to all the roofs despite its engineer only recommended replacement for some; it issued payment for the same Restore Masters invoice twice; & continued to communicate with the Insured and attempt to resolve the Claim with the Insured. Even after the Insured replaced the roofs with Storm Force and continued occupation of the majority of the units. The Insured submitted and estimate totaling $13,849,422.22 (RCV) essentially contemplating complete replacements of the exterior elevations and interiors of every building and unit at the Property. In support of this estimate, Claimant submitted a report from its engineer, Byron K. Anderson from SEI Engineering. The report states that there are “unsafe” and “dangerous” conditions present at the Property. Furthermore, he states “the buildings have sustained Substantial Damage…”. Because of the substantial damage and unsafe conditions the Insured is claiming that they need to rebuild the buildings, that is after already performing numerous repairs and replacing the roofs. Heritage has reviewed the estimate and the Insured’s engineer report and disagrees with the scope of repairs claimed as well as the engineer’s conclusions. Nevertheless, Heritage, in good faith, has and continues to make efforts to resolve this Claim. Here, the facts surrounding this Claim unquestionably establish that Heritage acted promptly, diligently, and fairly towards the Insured throughout the entirety of the investigation and, in good faith, taken all efforts to resolve the dispute. Accordingly, Heritage fulfilled its duties and obligations under the policy and, importantly, always acted in good faith. Heritage expressly reserves all rights and/or defenses that it has under the policy and/ or Florida and Federal law. III. RESPONSE TO THE CRN’S ALLEGATIONS In response to each statutory violation alleged in the CRN, Heritage states as follows: • 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Response: Heritage strictly denies this allegation. As evidenced by the facts Heritage and its adjusters acted promptly, reasonably, and properly. Heritage denies improperly investigated or handling the claim as the facts clearly demonstrate otherwise. Therefore, no violations of § 626.9541(1)(i)(3)(a) have occurred. • 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. Response: Heritage strictly denies this allegation. Heritage promptly acknowledged and remained in constant contact with the insured throughout the investigation. Heritage, pursuant to the policy, issued payments for all undisputed damages. Heritage promptly acknowledged the claim, issued numerous payments and remained in constant contact with the Insured and its representatives. Therefore, no violations of § 626.9541(1)(i)(3)(c) have occurred. • 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. Response: Heritage strictly denies this allegation. Heritage promptly issued multiple payments as additional information became available. Further, at the time the Insured submitted a proof of loss additional documentation and investigations were necessary in order to indemnify the Insured for the undisputed damages. As noted in the facts, Heritage has issued payments above and beyond the undisputed damages. Therefore, no violations of § 626.9541(1)(i)(3)(e) have occurred. • 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. Response: Heritage strictly denies this allegation. Heritage strictly denies this allegation. Heritage promptly acknowledged and remained in constant contact with the insured throughout the investigation. Heritage, pursuant to the policy, issued payments for all undisputed damages. Heritage promptly acknowledged the claim, issued numerous payments and remained in constant contact with the Insured and its representatives. Therefore, no violations of § 626.9541(1)(i)(3)(f) have occurred. IV. CONCLUSION Heritage requests that the CRN be rejected for its failure to comply with Florida Statutes § 624.155 and Florida case law, as outlined above. It is clear that the CRN is procedurally deficient and substantively insufficient. Notwithstanding the CRN’s rejection, it is evident that Heritage has acted in good faith, with due diligence, and in accordance with the terms of the subject insurance policy and Florida Statutes with respect to the requests made by its Insured and its representatives. Here, Heritage complied with all obligations under the insurance policy and Florida Statutes. Throughout its investigation of the Claim, Heritage evaluated the claimed damages based on the information available and attempted to obtain all additional facts and information necessary to process the claim. As evidenced by the facts, Heritage’s actions in handling the Claim were prompt, thorough, and conducted in accordance with the subject policy and Florida law, most importantly, in good faith. In closing, Heritage denies each and every allegation contained in the CRN. We trust this response adequately addresses the allegations of violation alleged in the CRN. In addition, you will find a copy of the response submitted to the Florida Department of Financial Services on its website. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Best Regards, /s/Ronald A. Lacayo Ronald A. Lacayo, Esq.
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