Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 804683

Filing Accepted: 2/1/2025

Print Filing

Complainant

Last/Business Name *

ZINNA AND MURCH

First Name

ZOEB AND YANJANE

Street Address *

1719 REFLECTION LN

City, State Zip *

ST CLOUD, FL 34771

Email Address *

DUBBLEZ83@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		ZINNA AND MURCH		First Name		ZOEB AND YANJANE
Policy # *		OH-372855384		Claim #*		11000000400

Attorney

Attorney is Applicable

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		FIRST PROTECTIVE INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10897

Name of individual responsible for violation (if any):* KAREN AGOSTINIS AND ALL OTHER OPENHOUSE EMPLOYEES, REPRESENTATIVES, AGENTS, AND VENDORS WHO HANDLED THIS CLAIM
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Unsatisfactory Settlement Offer
	Unfair Trade Practice
	Claim Denial

* 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)(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.

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

AGREEMENT We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. COVERAGES This insurance applies to the Described Location, COVERAGES for which a limit of liability is shown and PERILS INSURED AGAINST for which a premium is stated. A. Coverage A – Dwelling 1. We cover: a. The “dwelling” on the Described Location shown in the Declarations, used principally for “dwelling” purposes, including structures attached to the “dwelling”; b. Materials and supplies located on or next to the Described Location used to construct, alter or repair the “dwelling” or other structures on the Described Location; and c. If not otherwise covered in this policy, building equipment and outdoor equipment used for the service of and located on the Described Location. PERILS INSURED AGAINST We insure for direct physical loss to the property covered caused by a peril listed below unless the loss is excluded in the GENERAL EXCLUSIONS. 1. Fire Or Lightning 2. Windstorm Or Hail

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Zoeb Zinna and Yanjane Murch (“the insureds”) are homeowners insured under an all-risks policy issued by First Protective Insurance Company d/b/a OpenHouse Insurance (“OpenHouse”). The insured property is located at 1719 Reflection Ln, Saint Cloud, FL 34771. On June 6, 2024, a severe weather event involving hail and wind caused significant damage to the insureds’ property, including hail impacts to shingles, damaged screens, wind-damaged shingles, and interior leaks. The insureds promptly reported the loss and complied with all post-loss obligations under the policy. Despite this, OpenHouse failed to comply with its statutory obligations under Florida law. Furthermore, Florida Statute § 627.70131(7)(a) mandates that insurers pay or deny claims within 60 days after notice of loss unless factors beyond their control prevent timely action; however, OpenHouse took 75 days to make a coverage determination, exceeding the statutory timeframe. OpenHouse ultimately undervalued the loss, issuing an estimate of only $404.90, which is grossly inadequate and fails to restore the insureds’ property to its pre-loss condition. The insureds submitted a comprehensive estimate for $59,928.25, accurately reflecting the necessary cost of repairs. Despite overwhelming evidence, including a weather report confirming large hail on the date of loss and extensive photographic documentation, OpenHouse refused to acknowledge the full extent of the damage and improperly denied the need for a full roof replacement. Florida Statute § 624.02 defines insurance as a contract to indemnify policyholders for damages based on determinable contingencies, requiring insurers to act in good faith, timely adjust claims, and make payments promptly. By failing to issue a timely decision, undervaluing the damages, and disregarding clear evidence, OpenHouse has breached its contractual and statutory obligations. To cure this civil remedy notice and avoid further legal action, OpenHouse must immediately acknowledge full coverage under the insureds’ policy, issue payment based on the amount of the insureds’ estimate of $59,928.25. Failure to act accordingly will result in additional damages, including potential punitive awards, and may necessitate legal action for bad faith.

Comments

User Id		Date Added		Comment
kaley@bcflalaw.com		04-02-2025		April 2, 2025 VIA EMAIL: Yanjane Murch and Zoeb Zinna c/o David Djukic Florida Public Insurance Adjusters david@flpublicinsuranceadjusters.com office@flpublicinsuranceadjusters.com RE: Policyholders: Yanjane Murch and Zoeb Zinna Claim Number: 11000000400 Policy Number: OH-372855384 CRN Filing Number: 804683 Dear Mr. Djukic: This is the formal response of First Protective Insurance Company D/B/A OpenHouse Insurance (“OpenHouse”) to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that was filed on behalf of Yanjane Murch and Zoeb Zinna. The Florida Department of Financial Services accepted the Purported Notice, in form only, on February 1, 2025. The Purported Notice was filed in connection with the above-referenced claim for property damage. The Purported Notice names OpenHouse and alleges unsatisfactory settlement offer, unfair trade practice, and claim denial, supposedly in violation of Sections 624.155(1)(b)(1), 626.9541(1)(i)(3)(a), and 626.9541(1)(i)(3)(c), Florida Statutes. The Purported Notice is a legal nullity for the reasons discussed below. OpenHouse reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. 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; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added); The Florida Supreme Court has held that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10-363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. Deficiency #1 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice appears to be a boilerplate document which lacks specific facts. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to unsatisfactory settlement offer, unfair trade practice, and claim denial, supposedly in violation of Sections 624.155(1)(b)(1), 626.9541(1)(i)(3)(a), and 626.9541(1)(i)(3)(c), Florida Statutes. Deficiency #2 Section 624.155(3)(b)(3), Florida Statutes requires that the name of any individual involved in the violation be stated with specificity. While the Purported Notice lists a single name, it also references “all other Openhouse employees, representatives, agents, and vendors who handled this claim,” making it impossible to identify other individuals with knowledge of the facts giving rise to the alleged violations. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(3), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to unsatisfactory settlement offer, unfair trade practice, and claim denial, supposedly in violation of Sections 624.155(1)(b)(1), 626.9541(1)(i)(3)(a), and 626.9541(1)(i)(3)(c), Florida Statutes. Deficiency #3 Section 624.155(3)(b)(4), Florida Statutes, requires the CRN to reference 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. Your clients are not third-party claimants; therefore, the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. It does not. Rather, the Purported Notice cites numerous vague headings and coverage sections without referencing specific policy language at issue. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to unsatisfactory settlement offer, unfair trade practice, and claim denial, supposedly in violation of Sections 624.155(1)(b)(1), 626.9541(1)(i)(3)(a), and 626.9541(1)(i)(3)(c), Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875 (Fla. 4th DCA 2021). In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy, as follows: Coverage A - Dwelling Coverage B - Other Structures Coverage C - Personal Property Coverage D - Loss of Use / Additional Living Expenses All Optional Coverage provisions All Additional Coverage provisions All Coverage(s) provided by Endorsement or Rider The Declarations Page Loss Payment or Settlement provision Duties in Event of Loss Policy provision The insurance policy's definition section The insurance policy's exclusion of coverage provisions All insurance policy provisions that provide coverage to the insured property All policy provisions. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Purported Notice fails to “state with specificity” the policy language at issue. Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, OpenHouse denies any wrongdoing. It specifically denies that it violated the insurance policy or Florida Statutes, as alleged in the Purported Notice. Please be advised, by this letter, OpenHouse neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, OpenHouse hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/ Andrew L. Bickford Andrew Bickford BICKFORD & CHIDNESE, LLP 1860 N. Avenida Republica de Cuba Tampa, FL 33605

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