Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 804557

Filing Accepted: 1/31/2025

Print Filing

Complainant

Last/Business Name *

STEVIE PAULSON

First Name

SANDRA PAULSON AND

Street Address *

5379 FOXHOUND DRIVE

City, State Zip *

NAPLES, FL 34104

Email Address *

STEVIEPAULSON@YAHOO.COM

Complainant Type: *

Insured

Last/Business Name*		STEVIE PAULSON		First Name		SANDRA PAULSON AND
Policy # *		12-1057019-02		Claim #*		12-3013208-22

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
Insurer Name*		TYPTAP INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 15885

Name of individual responsible for violation (if any):* TERRY BLEVINS, BRITTANY ABERCROMBIE, CHAVANNES ADE, LATOYA LAPOINTE, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, TYPTAP INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unfair Trade Practice
	Other : Not treating the Insured with good faith claims conduct
	Other : Looking for ways to deny full recovery to the Insured
	Other : Looking for ways to delay full recovery to the Insured
	Other : Failing to properly investigate the Insured's loss
	Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
	Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made,
	Other : Not adjusting claims and evaluating loss properly
	Other : Shifting the burden of insuring the loss to the Insured
	Other : Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
	Other : Failing to implement proper standards for the adjustment and investigation of claims

* 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)(i)		Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or Insured that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed 627.4137(1)(e) - Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: a copy of the policy. 627.70131 (7)(a) - 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. 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 shall 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. However, failure to comply with this subsection does not form the sole basis for a private cause of action. 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.

TypTap Insurance Company and their agents (the "Insurer") has committed the following in handling the Insured'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 policyholder and the Insured; 3) looking for ways to deny benefit payments and otherwise "low ball" or "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; 8) treating represented and unrepresented Insured differently; 9) failing to render a claims determination within ninety (90) days; 10) requesting a re-inspection despite no changes to the above-referenced insured property; 11) requesting a re-inspection only after the Insured retained a public adjuster; 12) failing to acknowledge and act promptly upon communications with respect to claims; and 13) artificially inflating Insured's recoverable depreciation. On or about September 28, 2022, while the subject policy was in full force and effect, the Insured's property was severely damaged by Hurricane Ian. The tile roofing system, modified bitumen roofing system, stucco, exterior painting, gutters, lamp post, living room, entry/foyer, master bedroom, kitchen, dining room, lanai, garage, and back porch were impacted by the storm. The Insured timely submitted a claim to the Insurer for hurricane damages and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number 12-3013208-22 to the loss and sent a field adjuster to inspect the property on November 15, 2022. The field adjuster prepared an estimate severely underestimating the scope and cost of the Insured's damage. The field adjuster calculated the replacement cost value of the damage under the dwelling coverage at $8,120.86 and the replacement cost value of the damage under the other structures coverage at $534.65. Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from Hurricane Ian, the Insured retained a public adjuster. On February 10, 2023, the public adjuster sent the insurer a letter of representation and requested acknowledgement of her letter of representation, a status update, and certified copy of the insurance policy. She also instructed the Insurer to advise her whether it needed anything additional to investigate the claim. On February 12, 14, 16, 2023, the public adjuster sent an email to the Insurer requesting acknowledgment of her letter of representation, a status update, and the Insurer's estimate. On February 17, 2023, the public adjuster repeated her request for a copy of the insurance policy. On February 18, 20, 22, 24, and 26, 2023, the public adjuster again sent an email to the Insurer requesting acknowledgment of her letter of representation, a status update, and the Insurer's estimate. On February 24, 2023, the public adjuster repeated her request for a copy of the insurance policy. On February 27, 2023, the Insurer finally acknowledged the public adjuster's letter of representation. On February 28 and March 2, 2023, the public adjuster sent an email to the Insurer requesting a status update on the claim and a copy of the Insurer's estimate. On March 3, 2023, the public adjuster repeated her request for a copy of the insurance policy. On March 4 and 6, 2023, the public adjuster sent an email to the Insurer requesting a status update on the claim and a copy of the Insurer's estimate. On March 6, 2023, the public adjuster sent the Insurer a claims package, including photographic evidence of the damage and an estimate dated February 6, 2023, calculating the replacement cost value of the loss under the dwelling coverage at $157,838.76 and the replacement cost value of the loss under the other structures coverage at $404.07. On the same day, a representative from the Insurer called the public adjuster requesting to inspect the Insured's roof, which the public adjuster authorized. The next day the Insurer sent a request for information. On March 10, 2023, the public adjuster again repeated her request for a copy of the insurance policy. On March 20, 2023, the public adjuster sent the Insurer an executed sworn proof of loss. On March 22, 2023, the public adjuster spoke with the Insurer's representative who inspected the roof and he advised the roof needed to be replaced based on the age of the tiles and the damage he observed. On March 24, 2023, the public adjuster again repeated her request for a copy of the insurance policy. On March 26, 2023, the public adjuster sent a response to the Insurer's request for information. On March 28, 2023, the public adjuster emailed the desk adjuster requesting a status update and the results from the roof inspection. On March 31, and April 7, 2023, the public adjuster again repeated her request for a copy of the insurance policy. On April 12, 2023, the Insurer reinspected the interior of the property. On April 21, 28, May 5, 12, 19, and 26, 2023, the public adjuster again repeated her request for a copy of the insurance policy. On June 1, 2023, the public adjuster emailed the desk adjuster again requesting a status update on the claim in light of the two reinspections of the property. The Insurer subsequently issued a second coverage determination letter, dated September 1, 2023, in which it notified the Insured that it was extending additional coverage for the loss. However, the Insurer continued to wrongfully undervalue the amount of covered damage in the subject claim, resulting in a $40,500.61 payment under Coverage A, and a $512.47 payment under Coverage B to the Insured. As this amount does not fully indemnify the Insured for their loss, further delays an already unnecessarily drawn-out claims process, and frustrates the Insured's ability to have their property restored to its pre-loss condition, the Insurer has proven it places its own financial interest over the health and safety of its Insured. The Insurer unreasonably inflated the amount of recoverable depreciation in this case, thereby artificially lowering the Insured's recoverable value, to the detriment of the Insured. The Insurer withheld almost thirty (30) percent of the net claim determined by the Insurer as recoverable depreciation. The Insurer has attempted to gain an unreasonable financial benefit by inflating the recoverable depreciation because it knows that it is unlikely, or at least less likely, that the Insured can actually complete the repairs which is a condition precedent to the recovery of the depreciation withheld under the claim. In other words, the Insurer pays an unreasonable amount less on the front end of a claim, which makes it more difficult for the Insured to restore the property to its pre-loss condition and recover the withheld depreciation from the Insurer. Only after Insured pays to restore the property out of pocket, if he can, will the Insurer fully pay its Insured under the policy. Withholding an inflated amount of depreciation is a creative, sneaky, and deceptive practice that is employed as to limit the amount the Insurer will ever have to pay out on a claim and essentially make the homeowner a self-insured. The Insurer is hoping that the Insured is unaware of her right to recover the recoverable depreciation so that it can pay Insured less than it is obligated. The Insurer is shifting the cost and the burden of investigating the loss onto the Insured. The Insurer has the duty to inspect the loss and provide the Insured with the full benefits under the policy. The Insurer has breached that duty by not providing the Insured with the full value of the loss and caused the Insured to take on the burden of investigating the loss. The Insurer upon the Insured's loss had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return her home to its pre-loss condition. Despite the obvious covered damage under this policy, the Insurer here placed its financial interest over the health and safety of the Insured. The initial investigation by the Insurer's field adjuster was inadequate. As a result of the inadequate investigation and surrounding circumstances, it is apparent that the Insurer significantly underestimated the scope of the loss to the Insured's property. The Insurer's estimate of the Insured property's loss simply would not restore the property to its pre-loss condition which is Insurer's duty under its own contract of insurance. Rather than the Insurer pay for a roof replacement consistent with all laws and ordinances, the Insurer contends the roof is repairable which is not true. All repairs to the roofing system must be done in accordance with applicable Florida Building Codes which require all repairs be done consistent with the manufacturer's specifications and warranties which this Insurer clearly did not account for. The Insurer's estimate of the insured property's loss resembles that of a classic "low-ball" offer and would not restore the property to its pre-loss condition which is Insurer's duty under the contract of insurance issued by it. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of the Insurer over those of the Insured, to delay the Insured's claim, and to delay the Insured in restoring the property to its pre-loss condition. Moreover, Insurer shifted the burden and cost of investigating and insuring the loss onto the Insured. The Insurer upon the Insured's loss had the duty to provide the full benefits under the policy. This includes providing the Insured with the proper investigation and the funds necessary to return their home to its pre-loss condition. The Insurer is placing its financial interest over the health and safety of the Insured. The Insurer has placed obstacles to its Insured's ability to have the claim adjusted promptly to begin restoring the home by waiting more than ninety (90) days after receiving notice of the Insured's supplemental claim to make a claims determination. Under Fla. Stat. 627.70131(5)(a), "[w]ithin 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." There are currently no factors outside of the Insurer's control. The Insurer has inspected the property three times. It has received an estimate, photographic evidence of the damage, an executed sworn proof of loss, and a response to its request for information. Furthermore, the Insurer's representative communicated to the public adjuster in March that he believed the Insured's tile roof needed to be replaced. As the Insurer has failed to make a timely determination, it has violated this code. As such, in addition to the below requirements to cure this CRN, any payment made to the Insured must contain interest for the damage as a result of the loss from the date the Insurer received first notice of the loss. The Insurer continued to delay and frustrated the Insured's ability to have her claim adjusted promptly to begin restoring her property by failing to timely provide the Insured with the policy after requested by the Insured through her representatives. As noted above, the Insured, through her representatives, requested the policy several times with no response. The policy was not received within 30 days of the first written request of the Insured, and indeed has not yet been provided. Each Insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the Insured, a statement, under oath, of a corporate officer or the insurer's claims manager or superintendent, a copy of the policy. Fla. Stat. Ann. 627.4137(1)(e). Further, the Insurer failed to respond within 14 days to the Insured, and her agents' requests. As noted above, the Insured's public adjuster sent several email requests for a status update, which the Insurer ignored. Upon an Insurer's receiving a communication with respect to a claim, the Insurer is required, within fourteen (14) calendar days, to review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer which reasonably prevents such acknowledgement. There has been no response within the fourteen (14) calendar days of receipt of the Insured's communication and the Insurer has not alleged any factors beyond its control that would make such communication impossible. Insurers have a duty to settle claims in good faith when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for her interests. The Insurer has failed or refused to promptly acknowledge the Insured's communications in an attempt to frustrate and delay the resolution of Insured's claim. Additionally, although there was interior water damage the adjuster did not use a water meter. A water meter can be purchased online from Amazon for around $40 before tax. The Insurer could purchase a water meter and assess thousands of properties with one meter. Instead, the Insurer would rather place its financial interests over those of the Insured by failing to provide the adjuster with the necessary tools to correctly inspect the loss. As a result of the inadequate investigation and surrounding circumstances it is apparent that Insurer significantly underestimated the scope of the loss to the Insured's property. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of Insurer over those of the Insured, to delay the Insured's claim, and to delay the Insured in restoring her property to its pre-loss condition. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer's claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured's interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully continue to undervalue the amount of covered damage to the dwelling. Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer's actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer's actions amount to but are not limited to the following: 1. Claim delay 2. Not treating the Insured with good faith claims conduct 3. Looking for way to reduce recovery to the Insured 4. Looking for ways to deny recovery to the Insured 5. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 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 Insured's' interests 7. Placing the financial interest of the Insurer over that of the health and safety of the Insured 8. Shifting the burden of investigating onto the Insured 9. Conducting inadequate investigations 10. Failing to render a written claims determination to the Insured within 90 days pursuant to Florida Statute 627.70131 11. Requesting a re-inspection despite no changes to the above-referenced insured property 12. Treat represented and unrepresented Insured differently 13. Failing to provide a copy of the insurance policy within 30 days 14. Failing to acknowledge and act promptly upon communications with respect to claims. 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 the Insured under the insurance contract. (3) Pay interest on any claim payments made 90 days after the Insured submitted her supplemental claim. A copy of this form submitted to the FDFS has been sent via e-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 Electronic Mail: Attorney for TypTap Insurance Company Marni Newma, Equire mnewman@hcpci.com

Comments

User Id		Date Added		Comment
claims@typtap.com		04-01-2025		This is TypTap Insurance Company’s (“TypTap”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of Stevie & Sandra Paulson (“Insured”). TypTap reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, TypTap issued payments for it on the information available to TypTap and the circumstances at the time of such payments. TypTap handled the claim in accordance with the policy and all statutory and regulatory requirements. TypTap denies each allegation of bad faith and improper conduct in the CRN. At all times, TypTap acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Otherwise, the CRN is deficient. Generally, pursuant to Florida Statutes, Section 624.155, CRNs must identify and set forth statutory provisions insurers allegedly violated in handling insureds’ insurance claims along with specific, relevant insurance contract language and facts and circumstances. The foregoing provides insurers with notice of alleged statutory violations AND the opportunity to cure such alleged violations. Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; and relied on inaccurate and conclusory statements. The Insured’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Furthermore, the Insured’s attorney filed a lawsuit based on the claim prior to the filing of this CRN. Regardless of the fact there were no violations in this claim, any action by TypTap to cure violations alleged in the CRN could have been used against TypTap in the lawsuit. The foregoing shows abuse by the Insured and the Insured’s attorney of the CRN and legal processes. Also and generally, the CRN constitutes an abuse of the CRN process, contravenes the purpose of CRNs, which is to promote resolution of issues in insurance claims. The CRN must be rejected, and it cannot serve as the basis of any action against TypTap. Upon request by the Florida Department of Financial Services, TypTap will provide to the DFS detailed correspondence TypTap provided regarding the claim.

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