Civil Remedy Notice of Insurer Violations
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Filing Number:     804572
Filing Accepted:  1/31/2025
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Complainant
Last/Business Name *  
REAMS   First Name   SUZANNE
Street Address * 2101 MOHAWK TRAIL
City, State Zip * MAITLAND, FL 32751
Email Address * GOTEAMREAMS@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   REAMS   First Name   SUZANNE
Policy # * P000345379 Claim #* 168413
Attorney
Attorney is Applicable
Last Name* SHEA First Name * THOMAS Initial E
Street Address* 570 CROWN OAK CENTRE DRIVE
City, State Zip* LONGWOOD , FL 32750
Email Address * TSHEA@NATIONLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SECURITY FIRST INSURANCE COMPANY
NAIC Company Code 10117
 
Name of individual responsible for violation (if any):* GERARDO AGUILAR, JASON KERN, AND THE ADJUSTERS, CLAIMS EXAMINERS, MANAGERS, REPRESENTATIVES, AND EMPLOYEES THAT WERE INVOLVED IN THE HANDLING AND ADJUSTMENT OF THE INSUREDS’ CLAIM ON BEHALF OF SECURITY FIRST INSURANCE COMPANY
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.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 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 factors beyond the control of the insurer as defined in s. 627.70131(5).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I - PERILS INSURED AGAINST Coverage A – Dwelling and Coverage B – Other Structures 1. We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. * * * SECTION I – EXCLUSIONS 2. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not otherwise excluded or excepted in this policy is covered. . . . c. Faulty, inadequate or defective: (1) Planning, zoning, development, surveying, siting; (2) Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; (3) Materials used in repair, construction, renovation or remodeling; or (4) Maintenance; of part or all of any property whether on or off the "residence premises.” * * * At all relevant times, Security First Insurance Company insured Suzanne and Bernard Reams’ property, located at 2101 Mohawk Trail, Maitland, Florida 32751, pursuant to an “all risk” homeowner’s insurance policy, bearing policy number P000345379. The insuring agreement in the policy provides coverage to the insureds for direct physical loss to their property during the applicable policy period. Section I – Perils Insured Against, and the above policy language, provides coverage for the loss and the loss is not excluded under the terms and conditions of the policy. The insurer has failed to provide coverage and issue full payment pursuant to the Loss Settlement and Loss Payment provisions of the policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

1. Complainant Name: Suzanne Reams and Bernard Reams 2. Complainant Address: 2101 Mohawk Trail, Maitland, Florida 32751 3. Complainant E-mail Address: goteamreams@gmail.com 4. Complaint Type: Insureds 5. Insured Name: Suzanne Reams and Bernard Reams 6. Insurance Policy Number: P000345379 7. Insurance Claim Number: 168413 8. Attorney’s Name: Thomas E. N. Shea, Esquire 9. Attorney’s Address: 570 Crown Oak Centre Drive, Longwood, Florida 32750 10. Attorney’s E-mail Address: tshea@nationlaw.com 11. Type of Insurer: Authorized Insurer/Non-Surplus/Florida Property & Casualty Insurer 12. Name of Insurer: Security First Insurance Company 13. Address of Insurer: 1001 Broadway Avenue, Ormond Beach, Florida 32174 14. Type of Insurance: Residential Property & Casualty Insurance 15. Reason for Notice: Please see violations described below. 16. Persons with Knowledge: Gerardo Aguilar, Jason Kern, and the adjusters, claims examiners, managers, representatives, and employees that were involved in the handling and adjustment of the insureds’ claim on behalf of Security First Insurance Company. In submitting this description of facts and circumstances, Suzanne Reams and Bernard Reams are doing so without the benefit of Security First Insurance Company’s claim file. The insurer’s claim file contains detailed facts and circumstances relevant to the violations contained in this Civil Remedy Notice; however, Security First Insurance Company has refused to produce its claim file. All of the facts and circumstances giving rise to this Civil Remedy Notice are well known to Security First Insurance Company. Suzanne Reams and Bernard Reams suffered a direct physical loss to the Property during the policy period of June 12, 2018 to June 12, 2019. The insurer has the burden to prove that the cause of all of the direct physical loss to the insureds’ Property, which occurred during the time the insurer insured the property, is excluded under the terms of the insurance policy. See Citizens Prop. Ins. Corp. v. Munoz, 158 So. 3d 671, 674 (Fla. 2d DCA 2014); Universal Prop. & Cas. Ins. Co. v. Secu Godiciu, 159 So. 3d 389 (Fla. 4th DCA 2015); Sawgrass Mut. Ins. Co. v. Moné, 199 So. 3d 284 (Fla. 5th DCA 2016); and Tower Hill Prime Ins. Co. v. Newell, 183 So. 3d 1247 (Fla. 5th DCA 2016). The insurer cannot prove that the loss is due to a cause excluded under the policy. Although the insured is not required to prove the cause of the loss, Mr. and Mrs. Reams have provided the insurer with documentation showing that the cause of the loss and all of the damage is not excluded by the terms and conditions of the Policy. The insurer is also aware that Mr. and Mrs. Reams have incurred significant costs to repair their Property following the loss, and that Mr. and Mrs. Reams incurred additional living expenses during the repairs. The cause of the loss is known and uncontroverted, and the insurer knows, or should know, that the insured’s claim is covered. The insurer has not denied the insured’s claim on the basis of fraud, lack of cooperation, or intentional misrepresentation regarding the claim, and there are no “factors beyond the control of the insurer,” as defined by section 627.70131(5)(a), Florida Statutes, that prevent the payment of benefits. Based on the documents and information submitted by the insureds, the insurer has failed to pay amounts of partial or full benefits that it knows, or should know, are owed under the insurance policy applicable to the subject claim. Despite having this information, the insurer has not attempted in good faith to settle this claim when, under all circumstances it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her interests. The insurer failed to conduct an adequate and reasonable investigation of the claim. The insurer sent a representative to the insured’s property to perform a cursory inspection; however, the insurer’s representative failed or refused to consider all the damage at the property covered by the policy. As a result, the insurer improperly denied the insured’s claim when covered damages were present at the property. The insurer also misrepresented certain facts and provisions contained in Mr. and Mrs. Reams’ insurance policy. Specifically, the insurer is aware that the policy provides coverage for ensuing losses caused by faulty, inadequate, or defective design, workmanship, repair, construction, renovation, remodeling, grading, compaction, materials used in repair, construction renovation or remodeling, or maintenance; however, the insurer has ignored this coverage and instead represented to Mr. and Mrs. Reams that there policy does not provide coverage for the ensuing losses to their property from these things. The insurer’s misrepresentation regarding the above coverage language is believed to have been made for the purpose and with the intent of attempting to induce Mr. and Mrs. Reams to settle her claim on less than favorable terms than those provided in, and contemplated by, the policy. The insurer’s failure to properly apply the language of its own policy is a misrepresentation of facts and/or insurance policy provisions related to coverages available to Mr. and Mrs. Reams and has led to non-payment of a significant portion of Mr. and Mrs. Reams’ claim as well as substantial delay. The insurer has separately engaged in each of the above bad faith violations willfully, wantonly, and maliciously toward Mr. and Mrs. Reams, or in reckless disregard for the rights of its insureds, including Mr. and Mrs. Reams. The insurer has also separately engaged in each of the above bad faith violations with such frequency as to indicate a general business practice. This notice is given in order to perfect the right to pursue the civil remedy authorized by section 624.155, Florida Statutes. The conduct described in this Civil Remedy Notice is the type of conduct and actions that occur with such frequency as to indicate a general pattern and practice of business in violation of section 624.155(5), Florida Statutes. The insurer can cure its bad faith conduct by: 1) accepting the insured’s claim as compensable, and agreeing to pay the claim in accordance with its Section I – Loss Settlement provisions of the policy prior to the expiration of the cure period; or 2) reaching an amicable settlement of the pending claim prior to the expiration of the cure period. By doing either of these two things, the insurer will cure its bad faith in this case, and extinguish any and all of its liability for all bad faith damages which could be sought pursuant to this Civil Remedy Notice.
Comments
User Id Date Added Comment
sade.oyinloyejackson@csklegal.com 02-18-2025 This correspondence is in response to the Civil Remedy Notice of Insurer Violations (hereinafter referred to as the “CRN”) filed by Thomas E. Shea on behalf of his client, Suzanne Reams (hereinafter referred to as “Insured”). Please be advised that the undersigned represents the interests of Security First Insurance Company (hereinafter referred to as “Security First”) with respect to the above-referenced matter. The Florida Department of Financial Services (hereinafter referred to as “Department”) assigned this CRN an acceptance date of 01/31/2025 and DFS File No.: 804572. This matter concerns a property damage claim made by the Insured pursuant to a homeowners’ insurance policy provided by Security First Policy No. P000345379 and assigned Claim No. 168413. As the basis for filing the CRN against Security First, Suzanne Reams asserts in the “Reasons for Notice” section violations such as Claim Denial, Claim Delay, Unsatisfactory Settlement Offer and Unfair Trade Practice, along with the following statutory violations: 624.155(1)(b)(1), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), and 626.9541(1)(i)(4). Security First welcomes this opportunity to respond to the CRN and denies each allegation contained therein. The allegations made in the CRN are premature, as the insured has failed to perfect the claim for bad faith and the CRN does not meet the specificity requirement of Section 624.155, Florida Statutes. This CRN does not sufficiently support the allegations stated above. As is standard procedure, upon the first notice of the claim, the subject property was dutifully inspected by an SFIC representative which was documented through photographs. I. Perfecting a Claim for Bad Faith SFIC specifically denies all allegations set forth in the Notice. SFIC contends that the Notice should be rejected and returned by the Department of Financial Services as it is premature. Pursuant to statute, there is no potential violation until a breach of contract is established. § 624.1551, Florida Statutes. Accordingly, any Notice filed prior to a finding that SFIC has breached the terms of the policy, is not ripe and is premature and thus fails to perfect Suzanne Reams’ Beverly Crawford’s rights to pursue civil remedies under Florida Statutes. II. Specificity Requirement The Insured’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for Civil Remedy Notices. In addition, it fails to meet even the most basic requirements of the Statute. Pursuant to the terms of the statute, (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. a. The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require (emphasis added): b. (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the e-mail address designated by the insurer under s. 624.422. i. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. ii. The facts and circumstances giving rise to the violation. iii. The name of any individual involved in the violation. iv. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third-party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. v. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad- faith actions, the Legislature provided this sixty-day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1284 (Fla. 2000). Thus, the Notice cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So. 2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”) See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017) (sufficiency means specificity). In Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875, 879 (Fla. 4th DCA 2021), the Honorable Court stated: The Middle District of Florida was confronted with a civil remedy notice that was similarly broad in scope and concluded that listing nearly all policy provisions on the notice did not satisfy the statute. Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). The court explained that “[i]f the statute contained no specificity requirement, [then] the [insureds’] casual ‘reference’ to the entire insurance policy undoubtedly would suffice.” Id. But, the court continued, “the Legislature included ‘specific’ or a variant not once but twice in the statute.” Id. As a result, the insureds’ listing of whole sections of the insurance policy “appear[ed] to lack specificity.” Id. In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiffs’ counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiffs’ counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be more clear. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. Here, the Insured’s Civil Remedy Notice includes nothing more than conclusory allegations with no supporting facts or includes information which completely mischaracterizes the facts. For example, the Insured first asserts that Security First failed to conduct an adequate and reasonable investigation of the claim and sent “a representative” to the property to perform a “cursory inspection.” However, prior to denying coverage for the claim, Security First actually retained four (4) individuals to inspect the property and determine the cause of the damage including field adjuster, Jason Kern, and a technician from Leak Doctor to perform leak detection, a technician from Specialist Pipe Technologies to inspect the plumbing system and Professional Engineer, Bryan J. Morrison to opine on the cause and origin of the damages. Then, Insured alleges that Security First “ignored” the fact that the policy provides coverage for losses which ensues from faulty workmanship and maintenance and misrepresented that the policy does not provide coverage for such ensuing losses. However, as Security First informed Insured within its denial letter dated March 13, 2019, the policy carries a Water Damage Exclusion endorsement which excludes coverage for the ensuing water damage which affected the property. The Insured alleges that Security First’s denial was made in bad faith because the cause of the loss is “known and uncontroverted,” and because the Insured provided Security First with documentation showing that the cause of the loss and all of the damage is not excluded by the terms and conditions of the Policy. However, the documentation provided by the Insured, including from the Insured’s inspector, Indoor Air Quality Solutions mirrored Security First’s conclusion – that the crawlspace was poorly maintained, and the water damage was caused by the accumulation of surface water. The Insured provides no facts in the Civil Remedy Notice to support that the loss should have been covered, as the Insured has not specified any alternative cause of the ensuing water damage which is not excluded by the policy. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 941 (Fla. 4th DCA 2018) (explaining that once the insurer establishes that the cause of the loss is excluded under the policy, the insured must provide evidence that the loss was caused by a peril which is not excluded by the policy.) This failure to identify any alternative cause of loss and to simply allege that it is “known” constitutes a flagrant failure to place Security on sufficient notice to reconsider its position, if warranted and does not comply with the requirements of 624.155 Fla. Stat. III. Conclusion At all times, Security First has acted in good faith in its handling of the claim and it has acted fairly, honestly, and with due regard for the Insured’s interest and in determining obligations to Insured. Specifically, Security First has complied with its obligations under the applicable Florida Statutes and the applicable Security First Insurance policy. Security First specifically denies any claim for bad faith and argues that the insured’s claim for bad faith is premature. Security First continues to reserve all its rights under the policy, at law and in equity. Regardless, Insured’s conclusory allegations fail to place Security First on notice of any purported violations. Furthermore, the Civil Remedy Notice fails to identify how to cure the allegations set forth. The allegations are without basis. It is clear Security First properly handled and adequately investigated the claim. We hope that this response has answered any concerns regarding this matter. If the Department has any question concerning this matter, please do not hesitate to contact me. Sincerely, Sade S. Oyinloye Jackson, Esq. Counsel for Security First Insurance Company
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