Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 804833

Filing Accepted: 2/3/2025

Print Filing

Complainant

Last/Business Name *

GENEST

First Name

MYRIAH ; DANIEL

Street Address *

418 SW BLUE SPRING CT,

City, State Zip *

PORT SAINT LUCIE, FL 34986

Email Address *

MGENEST49@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		GENEST		First Name		MYRIAH ; DANIEL
Policy # *		12-1053522-02		Claim #*		12-3023226-24

Attorney

Attorney is Applicable

Last Name*	BRAZ First Name * TAMARA Initial
Street Address*		8865 COMMODITY CIR. STE. 12
City, State Zip*		ORLANDO , FL 32819
Email Address *		TBRAZ@THELAWGICALFIRM.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):* ? VERONICA QUINONES, CLAIMS EXAMINER ON BEHALF OF GRISTON CLAIM MANAGEMENT A SUBSIDY OF TYPTAP INSURANCE COMPANY; ? DUANE WIMBLEY, CLAIMS EXAMINER ON BEHALF OF GRISTON CLAIM MANAGEMENT A SUBSIDY OF TYPTAP INSURANCE COMPANY; ? DEAVIN HOPPAS, INDEPEN
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Claim Denial
	Unfair Trade Practice
	Other : Improper Investigation

* 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.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	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.

POLICY FORM: TTIC HO3 04 20 *** SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling. 1. We cover: a. The dwelling on the “residence premises” shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the “residence premises” used to construct, alter or repair the dwelling or other structures on the “residence premises”[.] *** SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling and Coverage B – Other Structures. We insure against direct physical loss to property described in Coverages A and B[.] ***

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

On or about November 10, 2022, Myriah Genest and Daniel Genest (Complainant(s)) suffered a loss to their Property, located at the address listed above due to Hurricane Nicole. After discovering the damage, Complainant(s) reported the loss to TypTap Insurance Company (“Insurer”) on or about July 12, 2024. Throughout the Insurer’s investigation, Complainant(s) have fully cooperated with the Insurer and fully performed all duties and obligations under the policy by providing all information within Complainant(s) custody, possession and control. The Insurer, however, has failed to fulfill its duties under the Policy and Florida law. Prior to reporting the claim, Complainant retained Ask An Adjuster, a Public Adjuster (hereinafter “Public Adjuster”), to conduct an inspection on or about June 7, 2024, during which 172 photographs were taken. Public Adjuster subsequently conducted two additional inspections on or about June 11, 2024, and June 21, 2024, and took further photographs. On or about July 7, 2024, Complainant and Public Adjuster entered into a contract. Shortly thereafter, on or about July 12, 2024, Public Adjuster submitted a Letter of Representation (“LOR”) to Insurer. Later that same day, Insurer issued a correspondence acknowledging Public Adjuster’s representation. Public Adjuster, later that day produced an estimate valuing the damages at $147,051.02 in actual cash value and provided a wind report indicating wind speeds of 72 miles per hour from Hurricane Nicole. On or about July 16, 2024, Insurer issued a Request for Information (“RFI”), seeking the LOR, any estimates, and other relevant documents, including a Sworn Statement in Proof of Loss (“SPOL”), which was requested in a separate letter the same day. On or about July 24, 2024, Insurer notified Complainant of a field adjuster inspection scheduled for July 31, 2024, and referenced the field adjuster’s attempts to contact Complainant. Later that day, Complainant and their agents submitted an email attaching the requested inspection photographs, estimate, wind report, and LOR. Complainant and their agents further indicated that the SPOL was in progress and would be submitted to Insurer shortly. On or about July 25, 2024, Insurer acknowledged receipt of the RFI response and noted that the SPOL was still pending, advising that the review process would take approximately 7 to 14 days. On or about July 29, 2024, Complainant and their agents provided Insurer with additional photographs related to the claim. Insurer acknowledged receipt of these photographs the following day. Later on or about July 30, 2024, Complainant and their agents submitted the executed SPOL. On or about July 31, 2024, Deavin Hoppas, an independent field adjuster, conducted an inspection of the property and took photographs. On or about August 2, 2024, Complainant entered into a contract with Air Quality Experts to perform a mold inspection, which was conducted the same day, with accompanying photographs. On or about August 7, 2024, Air Quality Experts submitted the inspection report and photographs to Insurer, confirming the presence of mold throughout the property, along with an invoice for services totaling $2,550.00. On the same day, Complainant and their agents sent an email to Insurer formally demanding an estimate from the inspection that occurred seven days prior. From July 31, 2024 to August 7, 2024, Insurer has blatantly ignored its obligation and failed to make any effort to contact Complainant regarding the claim or the status request following the inspection. On or about August 8, 2024, Insurer was obligated to review Public Adjuster’s estimate as promised, which was submitted on or about July 24, 2024. Despite Insurer’s own correspondence dated July 25, 2024, in which it committed to reviewing the Public Adjuster’s estimate within 7 to 14 days, Insurer has egregiously failed to honor this commitment and has deliberately delayed the claim. Even more so, Pursuant to Fla. Stat. 627.70131(1)(a), Insurer is legally required to acknowledge and respond to communications from Complainant regarding claims within a 7-day timeframe. This statutory deadline expired on August 14, 2024, following Complainant and their agent’s email correspondence on or about August 7, 2024. Yet, Insurer continued to disregard its responsibilities, even after receiving a formal request from Complainant and their agents regarding receiving an estimate or coverage determination. On or about August 15, 2024, Insurer finally issued a coverage determination letter. Instead of providing a substantive explanation for the coverage determination, Insurer issued an evasive and inadequate response, which failed to justify the prolonged inaction. The letter contained nothing more than the following statements: "Policy does not cover loss caused by wear and tear, marring, deterioration; inherent vice, latent defect or mechanical breakdown, or rust, decay or other corrosion." This response is not only insufficient but a deliberate misrepresentation of the claim. Insurer has improperly relied on an unqualified field adjuster to assess causation. This reliance is unacceptable and constitutes a gross failure of duty, as field adjusters lack the necessary expertise to determine causation, an assessment that requires a qualified professional such as an engineer. Insurer’s failure to conduct a proper investigation and its sole reliance on an unqualified field adjuster violates Fla. Stat. 626.9541(1)(i)(3)(a), which mandates that insurers adopt proper standards for claim investigations. Furthermore, Insurer's denial letter fails to provide specific details supporting its baseless assertion of "wear and tear." Insurer, even if qualified to make such claims, has completely neglected to furnish any supporting documentation or identify the specific areas or components allegedly affected. Insurer's failure to provide a reasonable basis for denial is a direct violation of Fla. Stat. 626.9541(1)(i)(3)(f). Additionally, Insurer has continuously ignored Complainant and their agent’s estimates, photographs, and wind report, failing to address them in its denial letter or any subsequent correspondence. Complainant and their agents raised this issue in an email dated August 19, 2024, explicitly notifying Insurer that nearly a month had passed without any review of the estimate or supporting documents. Insurer’s continued neglect and failure to act upon the estimate, despite acknowledging receipt, constitute a violation of Fla. Stat. 626.9541(1)(i)(3)(c). On or about October 30, 2024, Complainant retained Lawgical for legal representation, and a Letter of Representation (LOR) was sent the same day. Insurer acknowledged Lawgical’s representation the same day, yet continued its pattern of blatant disregard by failing to address the mold documentation, Public Adjuster’s inspection photographs, estimate, and has yet even affirmed or denied the amounts listed on Complainant's executed SPOL. In fact, prior to litigation, Insurer did not even conduct an additional inspection or retain a qualified engineer to provide a professional assessment other than the initial inspection from months ago. Insurer’s persistent refusal to reconsider its denial, while relying solely on the unqualified field adjuster’s findings and willfully ignoring Public Adjuster’s estimate, constitutes a flagrant violation of Fla. Stat. 626.9541(1)(i)(3)(d). Based on the events described above, it is clear that Insurer conducted an improper investigation to intentionally minimize its liability, contrary to the policy and Florida law’s requirements. Moreover, Insurer has misrepresented pertinent facts and/or insurance policy provisions relating to coverages at issue, and delayed the resolution of the claim by engaging in conduct to deny or reduce recovery to the Insureds. These tactics are believed to be the general business practices of this Insurer. Insurer can cure its bad faith conduct by: 1) accepting the Insureds’ damage claim as compensable, and agreeing to pay the claim in accordance with the policy in the amount of $140,951.02, plus interest, prior to the expiration of the cure period, 2) reviewing and responding to all communications from the Insureds and their agents, including the request for a complete copy of the Policy. PLEASE GOVERN YOURSELF ACCORDINGLY.

Comments

User Id		Date Added		Comment
claims@typtap.com		04-04-2025		This is TypTap Insurance Company’s (“TypTap”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Tamara Braz, Esq. on behalf of Myriah and Daniel Genest (“Insured”). TypTap reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Under the relevant facts and circumstances, the applicable insurance contract did not provide coverage for the claim. Ultimately, 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). The CRN cannot serve as the basis of a bad-faith action against TypTap. 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 case, 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. 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