Civil Remedy Notice of Insurer Violations
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Filing Number:     804465
Filing Accepted:  1/30/2025
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Complainant
Last/Business Name *  
GRABOWSKI   First Name   STEPHEN
Street Address * 2813 SHIPSTON AVE
City, State Zip * NEW PORT RICHEY, FL 34655
Email Address * MOMDACPA@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GRABOWSKI   First Name   STEPHEN
Policy # * 1501-1500-0075 Claim #* FL20-0123418
Attorney
Attorney is Applicable
Last Name* KRAPF First Name * GRANT Initial W
Street Address* 2790 SUNSET POINT RD
City, State Zip* CLEARWATER , FL 33759
Email Address * GRANT@KRAPFLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* DARRELL YEAGER, BRUCE WOODS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unfair Trade Practice
Other : not treating the policyholder with good faith claims conduct
Other : looking for ways to deny full recovery to the Claimant
Other : not adjusting claims and evaluating loss properly
Other : failing to implement proper standards for the adjustment and investigation of claims
Other : looking for ways to delay full recovery to the Claimant
Other : failing to properly communicate with the Claimant
Other : not training, supervising, or managing adjusters properly so that prompt and full payments are made
* 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)(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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

627.70131 (5)(a) failing to make 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. Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Universal Property & Casualty Insurance Company (the "Insurer") has committed the following in handling the Claimant's claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of insurer before that of the Policy Holder and Claimant; 3) looking for ways to deny benefit payments and otherwise "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) looking for ways to delay benefit payments; and 7) conducting inadequate investigations. The Claimant timely submitted a claim to the Insurer for water and ensuing mold and other damage sustained at the above-referenced property. Given the scope and nature of the damage, the Insured retained a public adjuster, obtained estimates for repairs, and prepared a Sworn Statement in Proof of Loss, dated August 6, 2020, showing $148,371.39 in damage after application of the policy deductible. The Insurer's response was a letter dated October 15, 2020 stating that they would pay only "our undisputed Actual Cash Value estimate in the amount of $20,478.53." Clearly this amount is inadequate to repair the covered damage. The Insurer, upon the Claimant's loss, had the duty to provide the full benefits under the policy. This includes providing the Claimant with the proper funds necessary to return the home to its pre-loss condition. The Claimant has not only the damage, but continuing damage to his property resulting from the Insurer's delay in making full payment of the claim. The Insurer is placing its financial interest over the health and safety of the Claimant. Insurer has breached their duty by not providing the Claimant with the full value of his loss, failing to conduct a thorough investigation, and, as a result, caused the Claimant to take on the burden of insuring his loss. The Insurer wrongfully underpaid on Claimant's claim of significant property damage which resulted from the covered peril. Further, the Insurer knows or should know that when independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine. Sebo v. Am. Home Assurance Co., 208 So. 3d 694, 697 (Fla. 2016). The concurring cause doctrine states that coverage may exist where an insured risk constitutes a concurrent cause of the loss even when it is not the prime or efficient cause. Id. at 698. A covered peril that meets with an uncovered peril may still provide for coverage under a policy when the covered peril triggered the events that eventually led to the loss. Id. at 697. The Insurer intentionally ignored covered damage to deny the reported loss and wrongfully fail to pay the Claimant. This is an underhanded attempt to place the financial interests of the Insurer over those of the Claimant and to delay and frustrate the Claimant's ability to have his claim adjusted promptly to begin restoring his property. In addition, the Insurer further delayed and frustrated Claimant's ability to have this claim adjusted promptly to begin restoring the home by waiting more than ninety (90) days after receiving notice of the Insured's claim to issue a payment. Pursuant to Florida Statute 627.70131 (5)(a), "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." The Insurer has failed to pay any interest on this claim. The purpose of this section of the Florida Statutes was to set a time limit in which to resolve policyholder's claims. Upon information and belief, the Insurer has failed to do this. Because the Insurer has delayed the Claimant's resolution of the above-referenced claim, it is obligated to pay the interest on the claim, in addition to the money it owes the Claimant to restore the property to its pre-loss condition. In an apparent effort to avoid the 90-day statutory requirement, the Insured relayed correspondence that Insured allegedly failed to provide all documentation requested by the Insurer. This is a directed ongoing effort by the Insurer to avoid paying for damages covered under the policy in the claims it adjusts. Specifically, this Insurer has created a systemic business practice of attempting to avoid providing coverage or in this matter avoid timely providing coverage, by lengthy and unnecessary requests for documentation that are either entirely irrelevant or, due to the relative lack of complexity of the claim involved, entirely unnecessary for a claims determination. Therefore, the Insurer is not acting with due regard for the Insured's interests and has placed its financial interest over the health and safety of the Claimant. Subsequently, in litigation over the claim, the Insurer is doing everything it can to delay the legitimate payment of this claim. By way of example, the Claimant is trying to obtain more information about the Insurer's apparent bad faith in responding to this claim by the Insurer, and as such is trying to take the deposition of the corporate representative of the Insurer. Twice the deposition has been set, and twice the Insurer's agent has failed to attend to explain their actions. In both instances a certificate of non -attendance was issued, and now the Insurer is seeking to delay it further, indeed after the discovery deadline in the case. In short, Insurer is not acting with due regard for the Insured's interests. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this duty. The Insurer has intentionally misrepresented the Claimant's loss so that it may render less than the full benefits due under the contract of insurance. The insurer's actions amount to but are not limited to the following: 1. Not treating the policyholder with good faith claims conduct 2. Looking for ways to reduce recovery to the Insured 3. Looking for ways to deny recovery to the Insured 4. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the insured 5. Failing to implement proper standards for the adjustment and investigation of claims 6. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the policyholder's interests 7. Conducting inadequate investigations 8. Denying a claim which it knew or should have known the policy and Florida law provided coverage for. Therefore, to cure the defects outlined in this civil remedy notice, the insurer must: (1) Admit full coverage for the Insured's loss. (2) Tender full benefits owed to Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via electronic mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via ClaimPath Portal: Universal Property and Casualty Insurance Company
Comments
User Id Date Added Comment
aantos@gspalaw.com 03-04-2025 To Whom It May Concern: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by Attorney Joshua Brownlee on behalf of the Insureds, Edward and Danielle Rorabaugh. The Notice alleges violations of Florida Statutes, including Sections 624.155 and 626.9541. Universal specifically denies each and every allegation contained in the Notice filed in relation to this claim. Additionally, Universal denies that it violated these or any statutes, Florida law or policy provisions and disputes any and all allegations regarding the claim adjudication of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements set forth in the Civil Remedy Notice of Insurer Violation document provisions, Florida Statute §624.155 and Florida law. Here, the Notice fails to meet the requirements of Fla. Stat. § 624.155 on several grounds. First, the Notice fails to allege sufficient facts to notify Universal of the alleged violations. Second, the Notice fails to satisfy Fla. Statute § 624.155(3)(b)(4) in that it fails to reference specific policy language relevant to the alleged violation, instead citing vast portions of the policy. Third, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects, without paying additional benefits which are not due and owing to the insured. Finally, the Complainant fails to respond to each of the fields set forth on the DFS Form with the requisite specificity, therefore the Notice is insufficient and fails to satisfy the condition precedent to filing a bad faith action. See Pin-Pon Corp. v. Landmark American Ins. Co., 2020 WL 6588379 (S.D. 2020); see Julien v. United Property & Casualty Ins. Co., 2020 WL 5652364. Notwithstanding the above referenced deficiencies, the parties have reached an amicable resolution of the disputed claim in exchange for a full Release of Claims. Universal is pending receipt of the Insureds’ original executed Release, thus curing any alleged violations. Throughout the handling of the Insureds’ claim, Universal acted in good faith toward the interests of its Insureds. Universal has timely and fairly investigated the reported loss in accordance with Florida law, the policy provisions, and standard claims handling practices. Notwithstanding, any alleged dispute between the parties has been resolved via an amicable resolution in exchange for a full Release of Claims. Universal is pending receipt of the original executed Release by the Insureds. Thus, it is Universal’s best understanding that the subject claim has been fully adjusted and concluded. Accordingly, the alleged statutory violations and factual allegations of wrongdoing set forth in the Notice is without merit. Universal has complied with all policy provisions and applicable Florida law regarding the adjudication of this matter. Very truly yours, GROELLE & SALMON, P.A. /s/ Ann S. Antos Ann S. Antos, Esq. 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.

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DFS-10-363
Rev. 10/14/2008