Civil Remedy Notice of Insurer Violations
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Filing Number:     805483
Filing Accepted:  2/6/2025
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Complainant
Last/Business Name *  
MARIE SAINT JEAN AND CLAUDE SAINT JEAN   First Name  
Street Address * 14919 REDCLIFF DR
City, State Zip * TAMPA, FL 33625
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   MARIE SAINT JEAN AND CLAUDE SAINT JEAN   First Name  
Policy # * MLR739791407 Claim #* 00201805136
Attorney
Attorney is Applicable
Last Name* MARCUS First Name * IRA Initial M
Street Address* 501 E. LAS OLAS BLVD SUITE 200/300
City, State Zip* FORT LAUDERDALE , FLORIDA 33301
Email Address * IRA@KWGLEGAL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN SECURITY INSURANCE COMPANY
NAIC Company Code 42978
 
Name of individual responsible for violation (if any):* UNKNOWN
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Unsatisfactory Settlement Offer
* 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)(d) Denying claims without conducting reasonable investigations based upon available information.
* 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 has not attempted in good faith to settle the claimant’s claim when, under all circumstances, it could and should have done so, had it acted fairly and honestly toward its claimant and with due regard for its interests. The carrier has done everything possible to delay the claim and refuses to provide any sort of status of the claim. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). The carrier was put at proper notice of the insureds’ Hurricane Ian claim. On December 17, 2024, the carrier valued the claim at $3,865.54, which is below the deductible of $5,964.00; it was clear that the damage exceeded the deductible. Thus it is obvious that the carrier is not attempting to pay for the clearly covered damages owed under the policy. The insureds have complied with all of the carrier’s requests to date. The carrier has still refused to pay the fully covered amount owed under the policy. It is clear that the carrier is not treating the claimant 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 claimant; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the claimant’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the insureds despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insureds; and refusing to provide coverage for the claimant’s loss in a timely manner. 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)(d), and Fla. Stat. §627.7152(9)(b) making a carrier’s response to a 10-day letter with a pre-suit settlement offer, request for mediation, or demand for appraisal mandatory. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay the complete covered loss in the amount of $137,461.51 less the applicable policy deductible; 2) Pay the claimant’s attorneys’ fees and costs as they have been forced to retain counsel; and 3) 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 printed out and mailed. Please do not hesitate to contact the undersigned or Rylee Lopez at (754) 231-8107 if you have any questions or concerns. Sincerely, Ira M. Marcus Ira M. Marcus Attorney at Law
Comments
User Id Date Added Comment
Joseph@kwglegal.com 05-14-2026 MARIE SAINT JEAN AND CLAUDE SAINT JEAN through its attorney, Ira Marcus hereby withdraws this Civil Remedy Notice.
jbrown@burr.com 04-07-2025 April 7, 2025 Via Upload to DFS Website Florida Department of Financial Services Division of Insurance Regulation Consumer Assistance / Civil Remedy Section Larson Building, 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DOI File No.: 805483 Complainant: Marie Saint Jean and Claude Saint Jean Claim No.: 00201805136 Filed By: Ira M. Marcus, Esq. Date of Loss: September 28, 2022 Response to Civil Remedy Notice of Insurer Violation To Whom This May Concern: Please consider this the formal response of American Security Insurance Company (“American Security”) to the Civil Remedy Notice of Insurer Violation (“CRN”) filed by the homeowners Marie Saint Jean and Claude Saint Jean (“Complainant”) on their lender-placed insurance policy (“Policy”). The Florida Department of Financial Services accepted the CRN on February 6, 2025. The CRN relates to an insurance claim regarding the real property located at 14919 Redcliff Drive, Tampa, FL 33625 (“Property”). The Policy was issued to Complainant’s lender Select Portfolio Servicing, Inc. (“Lender”) as the Named Insured, with Complainant designated as a Borrower with rights to file a claim. American Security issued the Policy at the direction of the Lender after Complainant failed to maintain hazard insurance on the Property as required by Lender’s mortgage. A. FACTUAL BACKGROUND The Property is a single-family home that’s a three-bedroom, two-bathroom built in 1996 and is 2,620 sq ft (2,081 under air). Complainant has owned the Property since 2001, and the undersigned could not locate any permit records related to a replacement of the Property’s shingle roof during Complainant’s ownership. Complainant first made a September 10, 2017 windstorm claim with American Security, but this claim was later closed because Complainant failed to cooperate and show the Property after the reporting of the loss. The subject insurance claim relates to alleged damage to the Property resulting from a windstorm event with a date of loss of September 28, 2022 (“Windstorm Claim”). Complainant waited about twenty-one (21) months after the alleged date of loss and on June 27, 2024 to report the Windstorm Claim. On the same date, American Security promptly assigned an in-house claims examiner Mike Carson (“Claims Examiner”) to adjust the Windstorm Claim and evaluate the loss. Claims Examiner promptly engaged independent field adjuster Marquise Santiago of Pilot Catastrophe Services, Inc. (“Field Adjuster”). Field Adjuster met with Complainant at the Property to inspect the loss on or about July 24, 2024. Based on the historical weather report, the wind speeds at the Tampa Airport in close proximity to the Property only gusted to sixty-eight (68) miles per hour with sustained up to thirty-six (36) miles per hour. Field Adjuster reported that the Property’s shingle roof was at least twenty (20) years old and there were no gutters present. Field Adjuster observed granular loss and wear and tear with minimal storm-related damages. Furthermore, Complainant stated there was no storm damage to the Property’s interior. The observed water damage to the flooring was not due to the windstorm claim but rather an air conditioner handler leak originating in the garage. Field Adjuster prepared an estimate for this damage totaling $3,865.54 (“Field Adjuster Estimate”), which included without limitation, a minimum roof repair. On August 3, 2024 and about five weeks after Complainant reported the Windstorm Claim, Claims Examiner sent an explanation of benefits letter to Complainant on behalf of American Security (“EOB Letter”) with coverage totaling $3,865.54 which was below the $5,964.00 windstorm deductible, and that enclosed the Field Adjuster Estimate. In connection with the Windstorm Claim, on or about August 21, 2024, Complainant then hired Beacon Adjuster Group (“Public Adjuster”). Public Adjuster then submitted an estimate totaling $137,461.51 (“PA Estimate”). Public Adjuster seeks about $49,100 to replace a 32 square shingle roof despite that the cost should be about half this sum; about $7,100 to replace seven windows and two doors as if this relatively-low wind speed event caused this significant damage; approximately $4,700 to re-stucco the exterior walls and paint the Property for reasons unknown; about $71,700 to replace almost every wall, ceiling and floors in every room of the Property despite that a wind event did not cause significant intrusion to the interior; and approximately $4,900 for absurd general expenses and labor minimums that no general contractor would ever charge. In response to the PA Estimate, Claims Examiner re-engaged Field Adjuster to evaluate the loss. Field Adjuster reported that the PA Estimate includes coverage for damages related to the air conditioner leak, and not the wind-related peril. Public Adjuster appeared to apply coverage for every room throughout dwelling including, flooring, drywall and baseboards without basis to do so. American Security then responded to Public Adjuster by sending a letter standing on its coverage decision. About three (3) months later, on February 6, 2025, Counsel for Complainant Ira Marcus, Esq. filed the CRN for Complainant and a statutory notice of intent to initiate litigation for the Windstorm Claim. In a kitchen-sink approach, Complainant files this CRN citing a multitude of alleged statutory violations and blaming American Security’s process in adjusting the Windstorm Claim simply because Complainant did not agree with the coverage decision. American Security wholly rejects each of these assertions as explored below. B. RESPONSE TO CRN American Security promptly and fairly investigated and adjusted the Windstorm Claim. As for the statutes mentioned by Complainant in the CRN, each of these citations are improper in light of the above-referenced facts. Namely, American Security abided by Fla. Stat. § 624.155(1)(b)(1) and Fla. Stat. § 624.155(1)(b)(3) as it promptly investigated the Windstorm Claim and made a timely coverage decision. American Security immediately appointed Claims Examiner that engaged the Field Adjuster on the same day. The inspection of the Property for the Windstorm Claim occurred shortly after the reported loss. Claims Examiner then evaluated the Windstorm Claim with Field Adjuster’s documents and conclusions, and agreed to provide coverage in connection with the Field Adjuster Estimate. The coverage decision occurred well within the sixty-day timeframe to adjust the Windstorm Claim too. At no point was American Security obligated to settle the Windstorm Claim given the circumstances. Public Adjuster’s Estimate was over-scoped and patently absurd, and he never actually made a counter after the initial coverage decision. Nor did Public Adjuster provide any reports or documents in an effort to influence and increase the coverage for the loss, or that acknowledged how the air handler leak actually caused the interior water damage to the Property. American Security met its obligations promulgated by Fla. Stat. § 626.9541(1)(i)(3)(a) as it implemented proper standards and conducted a reasonable investigation of the Windstorm Claim by promptly assigning the Claims Examiner that immediately engaged the Field Adjuster, and who timely investigated the loss. The investigation and American Security’s decision resulted in coverage that correctly indemnified Complainant for the loss based on the observed damage to the Property. After receipt of the supplemental claim from Public Adjuster, American Security had the Windstorm Claim re-evaluated by Field Adjuster, and his conclusions remained the same based on the statements of Complainant and cause of the interior water damage observed during the initial Property inspection. American Security also abided by Fla. Stat. § 626.9541(1)(i)(3)(d) as it did not deny the Windstorm Claim without conducting a reasonable investigation. The Windstorm Claim was actually covered, and not denied, after the detailed investigation explored above. American Security met its obligations promulgated by Fla. Stat. § 626.9541(1)(i)(3)(b) as it did not misrepresent facts or the policy in covering the Windstorm Claim below the deductible. The interior water damage was caused by an air conditioner leak and not the windstorm per Complainant and Field Adjuster. Public Adjuster’s decision to not acknowledge the interior’s cause of loss is the only misrepresentation here. Complainant, next, cites a few general statements without citing specific facts in support, such as American Security failed to properly investigate the Windstorm Claim or implement proper guidelines to investigate the loss. The adjustment occurred in accordance with the terms of the Policy and Florida law. The Claims Examiner exercised integrity in covering the Windstorm Claim based on the Field Adjuster’s evaluation and investigation. Complainant’s efforts to seek over-scoped and improper coverage for the roof, exterior and interior of the Property at inflated and unrealistic amounts with bogus general expenses violates the Policy. Complainant’s general lack of awareness of both Florida law and the Policy is apparent after a review of the CRN. To the contrary of the assertions in the CRN, at all times material to the Windstorm Claim, American Security promptly and diligently investigated the loss and adjusted same in accordance with the terms of the Policy and Florida law. American Security has acted reasonably and in good faith at all times in adjusting the Windstorm Claim and believes that Complainant’s allegations stated in the CRN are without merit. . Sincerely, /s/ Jonathan Brown Jonathan Brown, Esq. cc: Ira M. Marcus, Esq.
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