Civil Remedy Notice of Insurer Violations
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Filing Number:     805915
Filing Accepted:  2/10/2025
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Complainant
Last/Business Name *  
PARKWOODS V HOA INC.   First Name  
Street Address * SANDLEWOOD LANE & MALT DR.
City, State Zip * FORT MYERS, FL 33907
Email Address * TIMHOAV@HOTMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PARKWOODS V HOA INC.   First Name  
Policy # * AMC-36216-03 Claim #* 4198053
Attorney
Attorney is Applicable
Last Name* LOCKARD First Name * DAVID Initial J.
Street Address* 9240 BONITA BEACH RD. SE
City, State Zip* BONITA SPRINGS , FLORIDA 34135
Email Address * PAUL@MYCHAMPIONLAWYER.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN COASTAL INSURANCE COMPANY
NAIC Company Code 12968
 
Name of individual responsible for violation (if any):* JIM CRESSE, SCLA, IA, LIC#A057611 OF SEDGWICK DELEGATED AUTHORITY
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)(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.

1. Coverage A - Building Property: o "We will pay for direct phyisical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from a Covered Cause of Loss.” 2. Duties After Loss: o Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. 3. Loss Payment Provision: Loss Payment a. In the event of loss or damage covered by this Coverage Form, at our option, we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property, subject to b. below; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality, subject to b. below. We will determine the value of lost or damaged property, or the cost of its repair or replacement, in accordance with the applicable terms of the Valuation Condition in this Coverage Form or any applicable provision which amends or supersedes the Valuation Condition. 4. Increased Cost of Construction Coverage: o With respect to the building that has sustained covered direct physical damage, we will pay the increased cost to: (1) Repair or reconstruct damaged portions of that building; and/or (2) Reconstruct or remodel undamaged portions of that building, whether or not demolition is required; when the increased cost is a consequence of enforcement of the minimum requirements of the ordinance or law.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In addition to the statutory violations referenced above, the Insureds state that the carrier violated the following Florida Administrative Code Sections: 69B-220.201(3)(b) An adjuster shall treat all claims equally. An adjuster shall not provide favored treatment to any claimant. Adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(b)2. An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the Insureds. 69B-220.201(3)(d) – An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(m) An adjuster shall not knowingly fail to advise a claimant of their rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. Facts and Circumstances Giving Rise to the Violation In Florida, the work of adjusting insurance claims engages the public trust. This Insurance Company has breached the public’s trust by its improper adjustment of the “Insured’s” claim of loss. American Coastal has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervising employees and attorneys, resulting in statutory violations, as set forth above. This carrier has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the Insureds insurance claim for damages in good faith. The handling of this claim by American Coastal Insurance Company has been a portrait of systematic delay, intentional underpayment, and corporate indifference to the plight of its insured. The consequences of the carrier’s actions have been devastating for Parkwoods V HOA Inc., leaving its residents to endure financial strain, uninhabitable conditions, and emotional distress—a textbook example of bad faith claims handling designed to erode the will of the insured and minimize the carrier’s financial exposure. Deliberate and Unreasonable Delays From the outset, American Coastal has displayed a blatant disregard for its statutory and contractual obligations. Florida Statute §627.70131(5)(a) mandates that an insurer make a coverage determination within 90 days of receiving a claim. In this case, the carrier not only failed to meet this deadline but then took well over a year to render its final estimate. During this time, the insured provided all requested documentation, including detailed repair estimates, photographs, and mitigation logs, yet these submissions were met with silence or cursory acknowledgments. The carrier’s September 12, 2023 letter is emblematic of its strategy of deflection and obfuscation. Despite receiving damage estimates exceeding $4 million in January 2023, the letter falsely claimed that necessary documentation had not been provided. Even after these estimates were resubmitted multiple times—and acknowledged in an August 16, 2023 email—the carrier failed to take any substantive action, perpetuating a cycle of delay that forced the HOA to shoulder escalating remediation costs and left residents in squalid conditions. Intentional Underpayment American Coastal’s use of Xactimate software to generate its estimate was not merely negligent; it was a calculated attempt to undervalue the claim. The carrier’s own report, as analyzed by Xactimate expert Stephen Harmon, reveals a consistent pattern of omitted overhead and profit (O&P) for both roofing and exterior work. Specifically: • For all 22 roofs, the carrier excluded $266,438.48 in O&P, resulting in an egregious undervaluation of the actual cost of repairs on what was already a clear underpayment, even by the carrier’s own admission as evidenced by subsequent additional payments. • For all 22 building exteriors, an additional $25,513.84 in O&P was omitted, bringing the total shortfall to $291,952.32. Moreover, the depreciation applied—10 years for materials such as HVAC units—was arbitrary and unsupported, as the carrier failed to verify the age, make, or condition of these items. This systematic manipulation of claim data is tantamount to an economic sleight of hand, designed to deny the insured the full benefits owed under the policy. This is not an isolated incident. There are documented instances involving the same insurance company and its third-party hires engaging in nearly identical practices, including deliberate software manipulation. This pattern points to a systemic approach aimed at reducing claim payouts and increasing profits at the expense of policyholders. Misrepresentation and Bad Faith Tactics The carrier’s correspondence is riddled with factual inaccuracies and misrepresentations, which appear to be deliberate attempts to confuse and mislead the insured. For instance, the September 12, 2023 letter asserted that the carrier had been denied access to certain buildings. This claim is directly contradicted by an affidavit signed by Tim Kornell, who testified that Sedgwick’s Field Adjuster, Jim Cresse, stated unequivocally, “I’ve seen enough,” acknowledging that adequate inspections had been completed. Additionally, the carrier’s insistence on re-requesting documentation that had already been submitted—and in some cases acknowledged—exposes its strategy of procedural stonewalling. These tactics serve no legitimate purpose other than to wear down the insured and delay the resolution of the claim. The carrier has even refused to allow their own general contractor, Compass Building Services, to perform the services they themselves quoted on behalf of the carrier. The rug was pulled out from underneath the insured who requested Compass conduct the interior work and drywall putback they quoted in their estimate. Upon request, AmCoastal refused to honor their end and instead requested the insureds find their own contractor to complete the work. This is in direct violation of §626.9541(1)(i)(3)(b). Human and Financial Toll The consequences of American Coastal’s actions have been catastrophic for Parkwoods V HOA Inc. and its residents. The delay in issuing a reasonable ACV payment forced the HOA to resort to temporary, stopgap measures, exacerbating the financial burden on the association. Residents, many of whom are elderly or on fixed incomes, have been forced to endure uninhabitable conditions, including damaged roofs, water intrusion, and mold growth. The emotional toll of living in such conditions is immeasurable, and the financial strain has jeopardized the HOA’s ability to fulfill its obligations to its members. American Coastal’s failure to act in good faith—by issuing timely payments, conducting thorough and honest evaluations, and adhering to its statutory obligations—is not just a breach of contract; it is a moral failing that has left a vulnerable community to suffer the consequences of the carrier’s greed and indifference. The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute § 624.02 defines "insurance" as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the Insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. SUMMARY OF STATUTORY VIOLATIONS: This intentional, willful, wanton, and malicious conduct referenced above is a clear violation of multiple Florida Statutes, including § 624.155(1)(b)(1), and shows that the carrier did not attempt in good faith to settle the Insureds claim(s) when, under all the circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for the Insureds interests. Am Coastals’s refusal and/or failure to settle the claim when under all circumstances it could have and should have done so had it acted fairly and honestly toward the Insureds is wrongful conduct. THEREFORE: This Insurance Company, American Coastal Insurance, must: (1) create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees, which will avoid future statutory violations. (2) create and implement adequate guidelines for the proper investigation and evaluation of these type of claims and for the training and supervision of employees and attorneys with regard to these types of claims to ensure that the claims handling procedure with regard to these type of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; and (3) immediately tender all undisputed insurance proceeds to the Insured while continuing to adjust the loss with the Insureds; and (4) tender to the Insureds full policy limits under all coverages and waive or repay all deductibles; and (5) pay statutory interest on untimely payments from the date of loss; and (6) payment of the Insureds attorney’s fees and costs; and (7) payment of all fees, costs, and expenses related to the hiring and use of experts, professionals, and other consultants used by the Insured. (8) exercise good faith efforts to resolve these claim(s) by acting fairly and honestly towards the Insureds and with due regard for their interests in attempting to settle its Insureds claim(s). Cure to Remedy the Violations To cure these violations, American Coastal Insurance Company must: 1. Pay the remaining amount of the insured’s incurred costs associated with the mitigation invoices from both United Environmental ($575,000.00 ) & Rapid Response ($445,877.85), temporary roofing repairs conducted by Apple Roofing ($308,820.00) & CFS Roofing ($11,896.59), and roof replacements conducted by Kelly Roofing ($2,508,849.00.) $3,850,443.44 total. 2. Reimburse the insured for attorney’s fees and costs incurred as a result of the carrier’s delays. 3. Pay the insureds for the remaining work to be completed as a result of Hurricane Ian Damage (including interior repairs) OR allow the carrier's General Contractor, Compass Building Services to come in and complete the required work per their estimate. 4. Acknowledge in writing the insurer’s failure to meet statutory deadlines and commit to reviewing and correcting claims handling practices to avoid future violations. Failure to cure these violations within 60 days from the filing of this notice may result in further legal action.
Comments
User Id Date Added Comment
ccambo@camboferry.com 04-11-2025 VIA EMAIL ONLY Parkwoods V HOA Inc. c/o Champion Legal Group Attn: David J. Lockard, Esq. 9240 Bonita Beach Rd. SE Bonita Springs, Florida 34135 Paul@mychampionlawyer.com RE: Date of Loss: 09/28/2022 Insured's name: Parkwoods V. HOA, Inc. Carrier Name: American Coastal Insurance Company Claim Number: 4198053 Policy Number: AMC-36216-03 CRN Filing Number: 805915 Dear Mr. Lockard, As you know, my firm represents American Coastal Insurance Company (“AmCoastal”) with respect to the above matter. This correspondence constitutes AmCoastal’s response to the Civil Remedy Notice of Insurer Violation (“CRN”) with filing number 805915, you filed on behalf of Parkwoods V. HOA, Inc. (“Parkwood”). The Notice is void because it is legally invalid. Beyond that, the allegations in the Notice have no merit. I. The Civil Remedy Notice is legally invalid. The filing of a valid Civil Remedy Notice is a condition precedent to an action brought pursuant to section 624.155, Florida Statutes. Talat Enter., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Because the statute is in derogation of the common law, it must be strictly construed. Id. “[A]ny statute in derogation of the common law requires strict compliance with its provisions by one seeking to avail himself of its benefits.” Florida Steel Corp. v. Adaptable Devs., Inc., 503 So. 2d 1232, 1234 (Fla. 1986). Section 624.155, Florida Statutes, requires a civil remedy notice to provide specific information to put the AmCoastal on notice of the alleged violation. Additionally, a civil remedy notice must be “specific enough to provide Insurer notice of the wrongdoing so the Insurer can cure the same within sixty days.” Valenti v. Unum Life Ins. Co. of Am., 8:04CV1615T-30TGW, 2006 WL 1627276, at *2 (M.D. Fla. 2006). Here, the Notice is invalid because it does not contain all of the information required by section 624.155. Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Also, it is invalid because it lacks sufficient specificity to provide notice to AmCoastal of the alleged wrongdoing, as discussed below. First, the Notice is invalid because it does not list a specific cure for the alleged violations and instead lists alleged amounts incurred by Parkwood and requests that AmCoastal pay the remaining amount. AmCoastal is left to search and demand records supporting the actual numbers listed, and guess as to what the remaining amount to cure would be, which is improper. Moreover, based upon the information provided, as outlined below, Parkwoods has misrepresented the amounts spent to date in an attempt to get AmCoastal to issue greater payment. In Talat, the Florida Supreme Court said that to “cure” a Notice, an Insurer must pay the amount owed pursuant to the express terms and conditions of the policy.” However, no cure amount of any kind is provided here. Instead, false amounts spent are provided, demands for reimbursement of attorney’s fees and costs, and demands for payment remaining work are made but such general and illusory statements make it impossible for AmCoastal to determine an amount to “cure.” It is improper for a civil remedy notice to not contain a cure, therefore the CRN is invalid. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002). Second, the Notice is invalid because it conditions AmCoastal’s ability to “cure” by requiring AmCoastal to pay for things and do things that are not required under Talat. In Talat, the Florida Supreme Court said that to “cure” a Notice, an Insurer must pay the amount owed pursuant to the express terms and conditions of the policy.” However, the Notice here demands payment of money that is not owed pursuant to the policy, such as attorney’s fees and costs. It is improper to demand such items as a cure for a civil remedy notice. Talat, 753 So. 2d at 1282–83; see also Francois v. Illinois Nat. Ins. Co., 01-CV-8070, 2002 WL 33760405, at *4 (S.D. Fla. 2002) aff'd, 49 Fed. Appx. 290 (11th Cir. 2002) (discussing whether a demand of attorneys’ fees in a civil remedy notice is proper). Third, the boilerplate CRN lacks sufficient specificity to provide notice of the alleged bad-faith conduct. The CRN lists 11 different statutes/subsections/administrative codes which AmCoastal allegedly violated. However, the CRN fails to provide any relevant facts supporting the alleged violations or relating these alleged violations to the 11 cited statutes/subsections/administrative codes. The bad faith statutes alleged either relate to failure to settle in good faith, failing to properly investigate, misrepresenting facts and denying claims without proper investigation. As outlined below, none of these provisions are applicable as AmCoastal has provided coverage in amounts in excess of those spent by Parkwood., engaged in a thorough investigation using multiple consultants, and the only misrepresentation comes from Plaintiff and the over $700k in amounts included in this Notice that have not been incurred. Because the Civil Remedy Notice fails to identify any specific statutes or any facts to support why the Insured believes AmCoastal violated the statutes, AmCoastal is unable to properly respond, and the Notice is invalid and should be rejected and returned. Lastly, the CRN fails to sufficiently allege any specific policy provision which AmCoastal has violated. Instead, it engages in a kitchen sink approach, citing Coverage A (generally), duties after a loss, loss payment provision and increase cost of construction, but fails to provide any relation between AmCoastal’s coverage determination and the same. In addition, the citations to these provisions coincidentally leave out the exceptions, conditions, and endorsements that exclude or limit coverage for Parkwood. The CRN does not even consider whether the Insured has coverage under some of these option provisions cited. Nonetheless, this approach is categorically insufficient for AmCoastal to determine what portion of the policy the Insured is alleging has been violated and therefore the Notice is invalid and should be rejected and returned. Because the CRN fails to comply with the information requirements promulgated by the Department of Financial Services, it is legally invalid. See Pin-Pon Corp. v. Landmark Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Prop. & Cas. Ins. Co., 4D19-2763 (September 23, 2020); Demase v. State Farm Fla. Ins. Co., 2022 Fla. App. LEXIS 7760 (Fla. 5th DCA 2022). Again, in serving this response, AmCoastal reserves all rights under Florida law to be served with a properly completed and statutorily compliant CRN. As the CRN fails to strictly comply with the requirements of section 624.155, Florida Statutes, it is legally insufficient and should be rejected. II. The Civil Remedy Notice Lacks Merit The Notice also lacks merit. AmCoastal issued a commercial policy to the Insured, insuring the various properties located on Sandlewood Lane and Malt Drive in Fort Myers, Florida 33907 for the policy period from April 1, 2022, through April 1, 2023. On September 30, 2022, Parkwood reported alleged damage as a result of Hurricane Ian on or about September 28, 2022. To date, AmCoastal has continued its obligations to properly adjust this loss and indemnify its insured for their covered damages. To that end, it has continued to collect materially relevant information, including the costs of the continued repairs, engaged engineers to determine the cause and origin of damages, and retained contractors to prepare bids for repair on the property to ensure that all the damage was covered and up to code. In fact, the May 26, 2024, coverage determination letter resulted in a total of $3,654,572.44 (inclusive of deductible) being issued to Parkwood for covered repairs. Thereafter, AmCoastal continued to follow up with multiple requests for information on June 24, 2024, July 24, 2024, February 18, 2025. The responses to these requests trickled in over the months and each one took one to three months to receive complete responses. All of this information provided all support the fact that AmCoastal properly adjusted and paid this loss pursuant to the terms and conditions of the policy. If we look more into this, the February 18, 2025, request for information was sent out by counsel seeking invoices, checks, and bank statements to support the fact that Parkwood is alleging $3,850,443.44 in incurred costs. However, based upon the information provided these alleged incurred costs are inaccurate or a blatant misrepresentation of the damage in an attempt to collect greater than what’s due under the policy’s terms and conditions. For instance, Apple Roofing was alleged to have spent $308,820.00 but the documentation from Parkwoods accounting only support $298,990 in payments, for a misrepresentation of $9,830. Then, Parkwoods is alleging to have incurred $445,877.85 from Rapid Restoration. It was during this request that AmCoastal was made aware that they are currently in litigation with Rapid Restoration and resolved this matter for significantly less than the alleged amounts incurred, of which they have only paid $50k. This leaves $395,877.85 grossly inflated above the amount actually spent. Next, no documentation could be found supporting the CFS roofing amounts incurred in the amount of $11,896.59, making this total amount a misrepresentation. Lastly, of the contract they have with Kelly Roofing for $2,508,849.00, only $2,177,132.81 has been paid, leaving $331,716.19 that was misrepresented in this Notice. In total, based upon the terms and conditions of this policy which require payment based upon the amounts spent, Plaintiff’s alleged damages that they represent in this Notice as being spent are exaggerated and misrepresented to the amount of $749,320.63. Not only is this important because it shows that AmCoastal has properly adjusted this loss and provided coverage in excess of the 3,101,122.81 spent by Parkwood, but it also shows that Parkwood continues to misrepresent their damage in an attempt to collect more than what they’re due and owing under their policy with AmCoastal. Nonetheless, on April 10, 2025, AmCoastal issued a supplemental coverage determination, in good faith, to assist its insured in finalizing all of the repairs to the property by returning the recoverable depreciation in the amount of $288,923.01. This makes the total amounts paid to date $3,943,495.45 inclusive of the deductible. This amount is in excess of the misrepresented damage presented by Parkwood in this Notice and cures any violations that may be alleged. Parkwood also refers to violations of general provisions of the policy including “direct physical loss,” “duties after loss- keep records of expenses,” “loss payment,” and “increase cost of construction.” The general reference to direct physical loss provides no backdrop for bad faith against AmCoastal. The citation to keeping records of expenses only goes to point out the failures on Parkwoods behalf in not keeping track of their expenses, budget, and reserves as is their fiduciary duty on behalf of their association. That is a duty of the Insured and not the carrier, therefore no bad faith can be implicated to AmCoastal based upon that provision. Lastly, Parkwood cites to the wrong loss settlement provision and fails to mention that the AmCoastal policy covers an amount spent in excess of our actual cash value payment. It also fails to mention that the provision for increased costs of construction is not applicable because they are past the policy’s two- year limitation and no requests to exceed that timeline were made or granted by AmCoastal. So based on the foregoing, none of the policy provision cited by Parkwood implicate any bad faith on the part of AmCoastal and no way assist AmCoastal in responding to this Notice. Based on the foregoing, this CRN is improper and invalid. At the outset, Plaintiff’s representation has placed settlement ahead of a proper investigation of the loss and compliance with policy’s terms and conditions. An insurance company is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. Florida law continually affirms the principle that an insurer has the right to investigate claims presented for payment. An insurance company is expressly afforded an opportunity to evaluate its rights and liabilities. AmCoastal stands behind its coverage determination but will continue to work with the Insured to ensure an amicable resolution. As outlined above, AmCoastal has abided by the policy and stands by its decision on this claim. As such, AmCoastal has complied with all policy provisions and applicable Florida law regarding the adjudication of this matter. Coverage was properly afforded for the Insured’s loss and payment was issued for covered damages for the subject claim pursuant to the terms, conditions, exclusions, limits, recoverable depreciation, and deductible of the subject policy. Based on the foregoing, AmCoastal agrees that it will continue evaluating this claim and issue any payments for which coverage is confirmed but denies any and all allegations of bad faith in connection with the claim submitted by the Insured and considers this matter cured based upon the allegations within this CRN. If you have any questions, please do not hesitate to contact me. Warmest regards, CAMBO FERRY, PLLC Joshua D. Strudwick, Esq. jstrudwick@camboferry.com
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