Civil Remedy Notice of Insurer Violations
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Filing Number:     805427
Filing Accepted:  2/6/2025
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Complainant
Last/Business Name *  
LINDSAY ANNE JOHNSON   First Name  
Street Address * 3174 SW ESPERANTO STREET
City, State Zip * PORT SAINT LUCIE, FL 34953
Email Address * LJOHNSON922@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   LINDSAY ANNE JOHNSON   First Name  
Policy # * 0769814179 Claim #* 7007424408-L
Attorney
Attorney is Applicable
Last Name* NORTON First Name * DANIEL Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * DNORTON@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   TRUCK INSURANCE EXCHANGE
NAIC Company Code 21709
 
Name of individual responsible for violation (if any):* JUDITH WELKER
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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.
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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
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.

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

The carrier was put on notice of the insured’s property damage sustained due to water infiltrating the premises claim. The carrier initially attempted to low-ball the claim. Subsequently, the insured prepared a loss package in the amount of $129,890.00 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $5,000.00 only, leaving a remainder in the amount of $124,890.00 to be paid in order to cure the breach, less any applicable policy deductible. The insured has complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About two hundred and seventy-five days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insured’s property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insured’s interests; refusing to pay the full amount owed to the insured despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insured, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $124,890.00, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Maria Victoria Pescador at (561)-892-9842 if you have any questions or concerns. Sincerely, Daniel Norton Attorney at Law
Comments
User Id Date Added Comment
cheryl.perez@farmersinsurance.com 03-18-2025 March 18, 2025 Via E-Mail Law Offices of Kanner & Pintaluga PA 925 S. Federal Hwy 6th Floor Boca Raton, FL 33432 Delivered by email to: dnorton@KPattorney.com RE: Lindsay Johnson Claim No.: 7007424408-1 Dear Daniel Norton: This correspondence is Truck Insurance Exchange’s (“Truck”) response to the Civil Remedy Notice of Insurer Violation No. 805427 filed on behalf of Complainant Lindsay Anne Johnson on February 6, 2025. Complainant alleges that Truck violated various subsections within Sections 624.155 and 626.9541, Florida Statutes, pertaining to Claim No. 7007424408-1 under an insurance policy issued by Truck to Complainant. Truck welcomes the opportunity to respond to the Notice’s allegations. On the merits, Truck avers it handled Complainant’s claim correctly, fairly, in good faith and with due regard for their interests under Complainant’s policy. On April 9, 2024, Truck received notice of the subject claim, damage to the Complainant’s property as a result of water damage from a sewer backup that same date. Truck conducted a prompt and thorough investigation into this claim. Truck promptly contacted the insured to gather information and schedule the inspection. Our claim representative completed the inspection as scheduled on April 10, 2024 in the presence of the insured. The inspection revealed covered damage to multiple rooms from the city’s failed sensor. The City of Port St. Lucie has accepted liability for this loss. We assisted the insured and provided temporary housing through ALE Solutions. We also advised the policy is endorsed with the FL073 1st – Water Back-Up and Sump Discharge or Overflow Endorsement which affords a limit of $5,000.00 for water back-up. On April 12, 2024 we provided a letter of explanation along with the policy limit payment of $5,000.00. On May 1, 2024 we received a letter of representation from the public adjuster Soleil Claims LLC. We promptly acknowledged the letter and provided the certified policy May 16, 2024. On July 15, 2024 we issued a payment to the insured and public adjuster for Personal Property in the amount of $4,501.98 and an ALE Deposit of $500.00. In addition, a payment for the amount of $18,402.04 was paid directly to ALE Solutions for the period 4/25 – 6/11/2024. Although the policy limit of $5,000.00 applies to all coverage, additional payments were issued to honor items previously communicated to our insured in error. On December 26, 2024 we received your letter of representation. We promptly acknowledged your letter and provided the requested documentation. Currently the City of Port St. Lucie is responding to the remainder of the insured’s claim as presented by the public adjuster, Soleil Claims LLC. This claim is assigned to Teresa Loffredo of Relation Insurance Services, claim number GC0502024149978. Complainant has failed to provide any evidence to support their assertion that Truck failed to properly adjust this claim. The only fact that Complainant alleges to support her allegations that Truck violated Florida law and handled Complainant’s claim in bad faith is that Truck’s adjustment of the claim did not result in payment of Complainant’s exorbitant demand. Truck’s policy only covers accidental direct physical loss or damage to the property that is not otherwise excluded, which is further limited by the deductible, conditions, limits, and other terms of the policy. In accordance with these terms, Truck properly adjusted this claim as outlined above. Therefore, contrary to Complainant’s contention, Truck’s coverage determination was made in good faith. Truck denies any breach of any statutory or contractual duties in the handling of Complainant’s claim. Your notice alleges “the carrier initially attempted to low-ball the claim” and “furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment”. We respectfully disagree, as our settlement paid the policy limit with no deductible withheld. While this response is meant to be comprehensive, Truck’s response is based on the limited information provided in the Notice filed by Complainant. Also, this letter or any act or failure to act on the part of Truck or any agent or representative of Truck should not be construed as a waiver of any rights or defenses, including but not limited to proper notice and service, available to it by contract or at law as all such right and defenses are hereby specially reserved. We trust that this response addresses the allegations raised in the Notice. Please contact us if you have any questions or should you wish to discuss this matter further. Sincerely, Cheryl Perez, Company Employee Adjuster General Claims Adjuster (913) 274-0230 Truck Insurance Exchange
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