Civil Remedy Notice of Insurer Violations
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Filing Number:     804974
Filing Accepted:  2/4/2025
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Complainant
Last/Business Name *  
YOUNG   First Name   CHARLES
Street Address * 812 GLEN ARDEN WAY
City, State Zip * ALTAMONTE SPRINGS, FL 32701
Email Address * CYUBUYRE@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   YOUNG   First Name   CHARLES
Policy # * 1501-1705-2307 Claim #* FL22-0110926
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):* BRET BLANCHFIELD AND ANY INDIVIDUAL FROM UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unfair Trade Practice
Other : Not treating the policyholder with good faith claims conduct
Other : Looking for ways to deny full recovery to the Insureds
Other : Looking for ways to delay full recovery to the Insureds
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made
Other : Failing to provide the Insureds with the full benefits awarded under the contract of insurance in
* 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)(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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an Claimant within 15 calendar days after an individual or entity designated by the insurer receives the Claimant's written request, either: A loss run statement . 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 Insureds' 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) not adjusting the claims promptly and fairly; 4) not attempting in good faith to settle claims; 5) looking for ways to delay benefit payments; 6) shifting the burden of investigating the loss onto the Insureds; 7) conducting inadequate investigations; and 8) making material misrepresentations of the coverages afforded under the insurance policy; and 9) shifting the burden of investigating onto the Claimant. The Claimant timely submitted a claim to the Insurer for damage sustained to the above-referenced insured property as a result of a sudden and accidental water loss to the interior of the property that occurred on March 23, 2022. Specifically, the Insurer failed to substantively respond. Subsequently, the Insured observed water seeping through the walls and floors from the bathroom into an adjacent bedroom. A plumber was called, and the plumber determined that there were cracks in the pipes. When the water got into his bedroom carpeting through the walls, the Insured mitigated the damage by removing it. Despite same, the Insurer responded with a wrongful denial letter, dated June 17, 2022 incorrectly alleging there was no physical damage to the property caused by the water loss. Given the nature and scope of the damage, the Insured retained a public adjuster who, in an estimate dated July 26, 2022, revealed $159,477.87 in covered damage to the dwelling and $1,523.22 to contents. Still, to date, the Insurer has failed to substantively respond to the claim, the estimate and the clear covered nature of the continuing damage. Subsequently, agents of the Insured requested a Loss Run Report from the Insurer which was not acknowledged by the Insured. The Insurer also failed to respond within 14 days to the request, nor indeed to provide the report. 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 Insureds' communication and the Insurer has not alleged any factors beyond their 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 their interests. The Insurer has failed or refused to promptly acknowledge the Claimants' communications in an attempt to frustrate and delay the resolution of Claimants' claim. Subsequently, the Insurer has elected not to renew the Claimant's policy due to "deferred maintenance" despite the fact that this involves a covered, documented loss that is the responsibility of the Insurer. The nonrenewal is in fact is the result of 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 terminating policies shortly after they anticipate litigation. The Insurer is aware that other insurers will not provide coverage, or at best will require an exorbitant increase in rates for any coverage on insurable property. Here, this created a perilous position for the Claimant as she is forced to choose between two challenging situations. The first being the pursuit of a proper recourse via litigation knowing that, for an extended period time, the property will be without insurance. The second is foregoing her right to proper recourse only to prevent the property from being without insurance. With this struggle in mind, the Insurer will continue to delay litigation and benefit from its methodology. The Insurer is tactically dropping insureds that expose it to risk. The foregoing tactics only frustrate the claim and remove the safety-net that insurance is supposed to provide. The Insurer is aware that not having insurance can result in a greater or total loss of the property and the Insurer is using this fact to its advantage. As this property resides in Florida, the foregoing risks are increased. In other words, the Insurer's new system is allowing it to deny and underpay claims only to discourage its insureds from pursuing the logical recourse of litigation because of the adverse effects that will surely result in a property without insurance. Therefore, the Insurer is not acting with due regard for the Claimant's interests and has placed its financial interest over the health and safety of the Claimant. Here, the Insurer shifted the burden and cost of investigating and insuring the loss onto the Claimant. 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 investigation and the funds necessary to return their home to its pre-loss condition. In short, 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. Insurers have a duty to treat all Claimant equally and the Insurer has breached this duty. The Insurer has conducted poor and inadequate investigations and has significantly underestimated the replacement costs of Insured's property to further frustrate and delay the Claimant's claim. The Insurer is placing their financial interests over those of the Claimant and the Claimant's safety. The foregoing has only delayed the Claimant's ability to begin restoring their home to its pre-loss condition. The Insurer's actions amount to but are not limited to the following: 1. Claim denial 2. Not treating the policyholder with good faith claims conduct 3. Looking for ways to reduce recovery to the Insureds 4. Looking for ways to deny recovery to the Insureds 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 policyholder's interests 7. Placing the financial interest of the Insurer over that of the Insured 8. Shifting the burden of investigating the loss onto the Insureds 9. Conducting inadequate investigations 10. Making material misrepresentations of the coverages afforded under the insurance policy. 11. Shifting the burden of investigating onto the Claimant Therefore, to cure the defects outlined in this Civil Remedy Notice, the Insurer must: (1) Admit full coverage for the Insureds' loss. (2) Tender full benefits owed to the Insureds under the insurance contract. (3) Pay all attorney's fees, costs, and interest. 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 Electronic Mail: Attorney for Universal Property & Casualty Insurance Company P. Alejandro Perez, Esquire Upciceservice05@universalproperty.com
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jr0405@universalproperty.com 03-26-2025 March 26, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 804974 Filing Date: 2/4/2025 Complainant: Charles Young Insured: Charles Young Policy No.: 1501-1705-2307 Claim No.: FL22-0110926 DFS File No.: 805703 Filing Date: 2/7/2025 Complainant: Charles Young Insured: Charles Young Policy No.: 1501-1705-2307 Claim No.: FL22-0110926 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, Grant W. Krapf, on behalf of Complainant, Charles Young (also referenced as “Insured.”) As a preliminary matter, attorney Grant Krapf filed prior Civil Remedy Notices on the same claim referenced above on July 21, 2023, and May 29, 2024, with the Florida Department of Financial Services (“DFS”) under File Numbers 706838 and 762165 (“Prior Notices”). The instant Notices are essentially identical to the Prior Notices. On September 8, 2023, and July 18, 2024, Universal properly responded to the Prior Notices outlining the legal deficiencies. None of the legal deficiencies noted in the Prior Notices have been rectified in the subject Notices. The Notices allege violations of Florida Statutes, Sections 624.155, 626.9541, and 627.444. Universal specifically denies each allegation contained in the Notices. Additionally, Universal denies that it violated these or any statutes, Florida law or policy provisions regarding the claim adjudication of this matter. With that said, Universal asserts that the Notices fail to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Florida Statute §624.155 and Florida law. The Notices are deficient as a matter of law as they fail to comply with Fla. Stat. §624.155. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Fla. Stat. §624.155(3)(b), the Notices “shall state with specificity” the following information: 1. The statutory provision, including the specific language, 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...; and 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Florida Department of Financial Services (“DFS”) created form DFS-10-363, which lays out 15 requirements that the Complainant(s) must respond to with specificity. The Florida Supreme Court holds that Fla. Stat. § 624.155 “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). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant(s) has specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). The Notices fail to meet the requirements of Fla. Stat. § 624.155 on several grounds. First, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notices fail to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Complainant provides eight (8) reasons for submitting the Notices, however, the Complainant’s allegations regarding these “Reasons for Notice” have no factual support anywhere in the Notices. The Notices assert general allegations consisting largely of boilerplate, conclusory and inaccurate statements rather than specifying facts regarding any alleged misconduct or statutory violations. For example, the Notices state Universal “committed the following” actions: “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) not adjusting the claims promptly and fairly; 4) not attempting in good faith to settle claims; 5) looking for ways to delay benefit payments; 6) shifting the burden of investigating the loss onto the Insureds; 7) conducting inadequate investigations; and 8) making material misrepresentations of the coverages afforded under the insurance policy; and 9) shifting the burden of investigating onto the Claimant.” The Notices are replete with vague and generic conclusory assertions unsupported by facts and do not provide the requisite specificity as to how Universal allegedly violated any policy provision or statute. Further, at no time has Universal placed the burden to investigate the claim on the Insured. In addition, the Notices do not state any facts to support the Complainant’s misrepresentation allegations or any of the allegations contained therein. The Notices fail to specify any facts regarding any misrepresentations made by Universal and fail to identify any person or persons who made such misrepresentations nor to whom any misrepresentations were made. The Notices further allege “the Insurer has elected not to renew the Claimant’s policy due to ‘deferred maintenance’ despite the fact that this involves a covered, documented loss that is the responsibility of the Insurer… this Insurer has created a systemic business practice of terminating policies shortly after they anticipate litigation.” The Complainant fails to specify facts to support these conclusory and speculative allegations. The Complainant is required to specify the facts and circumstances giving rise to the alleged violation strictly related to the Complainant’s allegations, not conjecture or speculation of the carrier’s business practices. Moreover, contrary to these allegations, Universal did not non-renew the Insured’s policy at issue in the Notices. It is evident that the statements of facts fall short of the specificity required by Fla. Stat. §624.155. As a result, the Complainant fails to comply with the requirements provided in Section 624.155(3)(b)(2), Fla. Stat. Second, the Notices fail to satisfy Fla. Statute § 624.155(3)(b)(4), in that they fail to reference specific policy language relevant to the alleged violation. Instead, the Notices state, “627.444(2)(a) Notwithstanding any other law, an insurer shall provide to an [sic] Claimant within 15 calendar days after an individual or entity designated by the insurer receives the Claimant’s written request, either: A loss run statement . . . [sic]” Notably, Sec. 627.444, Fla. Stat., is not enumerated within Section 624.155, Fla. Stat., as a potential basis for a Civil Remedy Notice nor is Sec. 627.444 or the language referenced within it contained in the Insured’s Policy. Further, the Loss Run Statement can be obtained from the Insured directly or the Insured’s agent. In addition, the Notices state, “Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language.” Thus, the Complainant admits that Universal in fact did not violate any specific policy language but fails to provide any specificity as to how any statutes were violated. As such, the Notices are deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Third, the Notices fail to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. To comply with the requirements of Sec. 624.155, Fla. Stat., the Complainant must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to properly investigate the allegations. The Notices lack the requisite specificity as required by Sec. 624.155, Fla. Stat., because the Notices state “BRET BLANCHFIELD…” However, the Notices fail to include any specificity as to what facts Mr. Blanchfield has knowledge of that gave rise to any purported allegation(s) and/or what, if anything, he did or failed to do as it relates to the claim at issue. The Complainant also attempts a “catch-all” by stating “any individual from [Universal] who was involved in the claim,” which significantly prejudices Universal, as Universal has not been properly notified by Complainant of the individuals that purportedly committed statutory violations or the specific statutory violations any individual purportedly committed. Further, the statement clearly defeats the requirement in the DFS form to provide specificity in order to put the carrier on notice and provide an opportunity to investigate any allegation with a specific individual. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainant alleges that Universal “[made] material misrepresentations of the coverages afforded under the insurance policy.” The Notices, however, fail to include the requisite specificity as to whom made any misrepresentations or when any of these misrepresentations occurred. Accordingly, the Notices are insufficient as a matter of law. Fourth, the Notices do not provide a proper means whereby Universal can “cure” the alleged defects, without paying benefits which are not due and owing to the Insured. The purpose of a Civil Remedy Notice is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). However, Section 624.155, Florida Statute, does not impose on an insurer the obligation to pay whatever an insured demand. Talat, 753 So. 2d at 1282. To the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. Notice 804974 demands, among other things, that to cure the alleged defects, Universal must “[p]ay all attorney’s fees, costs, and interest.” As such, Notice 804974 is deficient as it does not provide Universal an opportunity to “cure” the alleged violations without imposing obligations on Universal that are not owed under the Policy, including but not limited to, paying extra-contractual damages. Universal is only obligated to pay contractual amounts owed to cure a civil remedy notice. See id. at 1278. Also, Universal submits that by initiating litigation before filing the Notices, Complainant further prejudiced Universal’s ability to cure any purported allegations in the Notices, as there is no actual cure period wherein Universal could cure without paying extra-contractual damages. In summation, the Complainant failed to respond to each of the fields set forth on the DFS Forms with the requisite specificity as stated herein including, but not limited to, failing to reference specific policy language relevant to any alleged violation, failing to identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notices, failing to provide sufficient facts and circumstances giving rise to the alleged violations, and failing to allow Universal to cure the Notices without imposing an obligation to pay extra-contractual damages. Therefore, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. See Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notices are deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notices. On April 5, 2022, Universal was untimely notified by the Insured’s public adjuster, Five Star Claims Adjusting, that the insured location was damaged on March 23, 2022. Thereafter, Universal was finally permitted to inspect the property and document any visible damage. Pursuant to the terms of the Policy, Universal advised the Insured that there was no available coverage for the claim. On October 5, 2022, the Insured initiated litigation against Universal in the Circuit Court in and for Seminole County, under Case No. 2022CA002369. Thus, at the time of the instant Notices, the parties were and continue to litigate their disputes to determine what, if any, available coverage exists under the terms of the Policy. At no time has Universal breached any duty to its Insured. An Insurer is not required to pay whatever amount an insured demands. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. As outlined above, the alleged statutory violations set forth in the Notices lack factual support and are without merit. Therefore, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjudication of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the alleged violations in the Notices filed by the Complainant. Sincerely, /s/ Jonathan Rodriguez Jonathan Rodriguez, Esq. Associate General Counsel
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