Civil Remedy Notice of Insurer Violations
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Filing Number:     806118
Filing Accepted:  2/10/2025
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Complainant
Last/Business Name *  
FRANCO, TERESA AND FERNANDEZ, MARIO   First Name  
Street Address * 1736 RANGER HIGHLANDS ROAD
City, State Zip * KINDRED, FL 34744
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   TERESA FRANCO AND MARIO FERNANDEZ   First Name  
Policy # * 000988843764 Claim #* 0730997003
Attorney
Attorney is Applicable
Last Name* GRICHENER First Name * ULYANA Initial
Street Address* 800 E BROWARD BLVD, SUITE 510
City, State Zip* HOLLYWOOD , FLORIDA 33001
Email Address * UG@WEKLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CASTLE KEY INDEMNITY COMPANY
NAIC Company Code 10835
 
Name of individual responsible for violation (if any):* AMANDA ROBINSON, TOM FRANK
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
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.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
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.

Losses We Cover Under Coverages A and B: We will cover sudden and accidental direct physical loss to property described in Coverage A – Dwelling Protection and Coverage B – Other Structures Protection except as limited or excluded in this policy. Losses We Do Not Cover Under Coverages A and B: We do not cover loss to the property described in Coverage A–Dwelling Protection or Coverage B–Other Structures Protection consisting of or caused by: . . . 15. a) wear and tear, aging, marring, scratching, deterioration, inherent vice or latent defect; b) mechanical breakdown; . . . g) settling, cracking, shrinking, bulging or expansion of pavements, patios, foundations, walls, floors, roofs or ceilings; . . . 22. Planning, construction or maintenance, meaning faulty, inadequate or defective: . . . b) design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; Section I - Conditions 3. What You Must Do After A Loss In the event of a loss to any property that may be covered by this policy, you must: . . . a) promptly give us or our agent notice Section I - Conditions 3. What You Must Do After A Loss In the event of a loss to any property that may be covered by this policy, you must: . . . g) within 60 days after the loss, give us a signed, sworn proof of the loss. Section I- Your Property Losses We Do Not Cover Under Coverages A And B: 24. Mold, fungus, wet rot, dry rot or bacteria. This includes any loss which, in whole or in part, arises out of, is aggravated by or results from mold, fungus, wet rot, dry rot or bacteria. This exclusion applies regardless of whether mold, fungus, wet rot, dry rot or bacteria arises from any other cause of loss, including, but not limited to, a loss involving water, water damage or discharge, which may otherwise be covered by this policy, except as specifically provided in Section I Conditions, Mold, Fungus, Wet Rot And Dry Rot Remediation As A Direct Result Of A Covered Water Loss. 6. Reasonable Emergency Measures a) We will pay up to the greater of $3000 or one percent of the limit of liability shown on the Policy Declarations for Dwelling Protection-Coverage A for the reasonable and necessary costs incurred by you for measures taken solely to protect covered property from further covered loss following a loss we cover. b) We will not pay more than the amount in 6a) above, unless we agree within 48 hours of your request to us to exceed that limit. If we agree to exceed that limit, we will pay only up to the additional amount for the measures we authorize. If we fail to respond to you within 48 hours of your request to us to exceed that limit, and the damage or loss is caused by a peril insured against, you may exceed the limit indicated in 6a) above only up to the cost incurred by you for the reasonable and necessary emergency measures necessary to protect the covered property from further covered loss. c) If however a covered loss occurs during a hurricane the amount we pay under this additional protection is not limited to the amount in 6.a) above. d) A reasonable measure under this provision may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To the degree reasonably possible, any damaged property must be retained by you for our inspection. This protection does not increase the limit of liability applying to the covered property. Section I - Conditions 11. Suit Against Us No suit or action may be brought against us unless there has been full compliance with all policy terms. Any suit or action must be brought within five years after the date of loss.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Teresa Franco and Mario Fernandez (the "Insureds") purchased an insurance policy ("Policy") from Castle Key Indemnity Company ("Castle Key"), with effective coverage on the date of the loss, on or about May 22, 2023, and policy number000988843764 to insure the property located at 1736 Ranger Highlands Road, Kindred, Florida 34744 (the "Property"). On or about May 22, 2023, the Property suffered damage to the roof and interior of their property (the "Loss"). Castle Key was notified of the Loss. Castle Key acknowledged the claim and assigned claim number 0730997003 ("Claim") to the Loss. Castle Key had the property inspected by Tom Frank of Ryze Claim Solutions on October 25, 2023. Mr. Frank had just become a Florida licensed adjuster in July 2021. Mr. Frank has no experience or education in roofing, construction, engineering, water mitigation or mold remediation. Yet, Mr. Frank was the only person that Castle Key sent to the property, before denying the coverage for the loss in full on November 18, 2023 based solely on his inspection. The denial was that there was no damage. The Insureds had retained the assistance of Restoration Control, a licensed company that performs restoration work, water mitigation, tarping services and mold remediation. Restoration Control tarped the roof for the Insureds to prevent further water intrusion, performed water mitigation services and had a mold test with mold assessment report completed. Documentation of all services that Restoration Control performed at the property were provided to and received by Cast Key. Restoration Control also took a plethora of photographs of the property before, during and after its services, and prepared an estimate of damages to put the property back into its pre-loss condition in the amount of $68,210.78. From the onset, it was clear to the Insureds that Castle Key had one goal - to reduce or eliminate its liability in the claim. Castle Key delivered a coverage determination that misrepresented the material facts of the claim and relied on a faulty and disingenuous inspection. This is made clear by the fact that it was not until the Insured forced to retain legal counsel submitted a Notice of Intent to Litigate, that Castle Key sought a re-inspection of the property. It was during this re-inspection on January 18, 2024 that Castle Key for the very first time inspected the portion of the roof that was tarped during Mr. Frank’s October 2023 inspection. Surprisingly enough, for its re-inspection, Castle Key chose to send out Mr. Frank yet again instead of retaining the likes of a general contractor, a licensed roofer or a forensic engineer. Castle Key continued to deny the claim for no damage. Despite multiple requests from the Insureds pleading that Castle Key reconsider their position, Castle Key refused to provide the Insureds with the funds needed to return the property to its pre-loss condition. The Insureds have fully complied with all applicable policy provisions requiring cooperation with the investigation, however Castle Key is unjustifiably and unreasonably denying payment to the Insureds. Rather than paying the actual damages and/or trying to settle with the Insureds, Castle Key is delaying a prompt resolution of the claim. Additionally, Castle Key has not attempted, in good faith, to settle this claim when, under the circumstances, it could and should have done so had it acted fairly and honestly toward the policyholder and with due regard to the policyholder’s interests. As a direct consequence of Castle Key’s failure to adjust this loss in good faith and make any payment, the Insureds continue to be without adequate compensation for the damages sustained at their Property. By stating the above detailed facts, it is clear that Castle Key has violated the following Florida Statutes: • 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 Insureds and with due regard for their interest; when Castle Key denied coverage on the Insureds’ claim without even inspecting an entire portion of the roof. • 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims; when Castle Key sent out an adjuster with barely 2 years experience of adjusting, no background in general contracting or roofing to inspect the property. • 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information; when Castle Key denied coverage on the Insureds’ claim without even inspecting an entire portion of the roof. To date, Castle Key has in bad faith failed to provide a sufficient coverage determination to the Insureds. The Insureds unable to wait any longer were forced to enter into a roofing contract and replace their roof out of pocket for $22,620.00 in order to protect their home and their family. As a direct result of Castle Key’s denial of coverage and breach of Florida Statutes, the Insureds were forced to seek the help of licensed professionals to assist them, including a Restoration Control and legal counsel. Due to the amount of time that has passed since the date of loss, the information discussed above is irrefutable evidence that Castle Key knowingly and intentionally, and in bad faith delays the claims process in order to further disadvantage the Insureds. The financial detriment caused to the Insureds is a direct result of Castle Key’s reckless treatment of the claims process. The Insureds submitted all documents requested in a timely fashion, made their property available for inspection, submitted supplemental invoices, estimates and requests. However, Castle Key failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim. To deny the Insureds the benefit clearly due and owing under the Policy, for which they have time and time again been making premium payments for and after they have satisfied all their obligations is morally and ethically reprehensible, and reeks of Unfair Claims Practice and Bad Faith. Upon information and belief, the aforementioned actions complained of, among others, were made by Castle Key so often as to constitute a general business practice, evidencing a motive to enhance Castle Key’s profits, and designed to cause a detrimental effect to its policyholders. The above clearly shows that Castle Key adjusted this claim in bad faith and that Castle Key is in direct violation of Unfair Claims Practices. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Castle Key fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Castle Key must: (1) Immediately tender all proceeds due and owing to the Insureds that are fairly owed to the Insureds under the insurance policy that would reasonably compensate the Insureds in order to put the loss property back to its pre-loss condition; (2) Agree to reimburse the Insureds reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Agree to reimburse the Insureds for interest on the amount of benefits that was found to be due and owing to the Insureds, relating back to the date of loss.
Comments
User Id Date Added Comment
cmatc@allstate.com 03-06-2025 March 06, 2025 VIA CRN ONLINE SYSTEM Florida Department of Financial Services Consumer Assistance/Civil Remedy Section Larson Building, 200 Gaines Street Tallahassee, FL 32399-0322 Re: Complainant: Teresa Franco and Mario Fernandez DFS Letter: 806118 Insured: Teresa Franco and Mario Fernandez Insurance Company: Castle Key Indemnity Company Claim No.: 0730997003.1 Dear Sir or Madam: This letter is Castle Key Indemnity Company’s (“Castle Key”) response to the above-referenced Civil Remedy Notice. This response is provided on behalf of Castle Key and all of its employees, agents, officers and affiliates. The Department accepted the CRN on 02/10/2025. Therefore, this response has been timely filed within the statutory deadline. As a preliminary matter, Castle Key at all times during the handling of this claim acted fairly and honestly toward its insured. Castle Key fully and fairly considered information in regard to the matters at hand and fully observed its contractual, statutory and administrative obligations. Castle Key has carefully reviewed, considered, and evaluated the alleged violations charged and believes they are completely without merit. Castle Key wholly denies any and all allegations of wrongdoing, claim delay, claim denial, unfair claims handling, unsatisfactory settlement offer, unfair trade practice, misrepresentation or bad faith in connection with the above claim. Additionally, the CRN is defective and either does not sufficiently state the circumstances at hand or does so inaccurately. Accordingly, the CRN should be rejected Complainants’ CRN violates the requirements set forth in the Florida courts’ jurisprudence for civil remedy notices. It fails to meet even the most basic requirements of the statute. Accordingly, Castle Key respectfully requests the Department return the CRN and insist Complainants provide the specific facts required for civil remedy notices. See Section 624.155(3)(c), Florida Statutes. These requirements arise from the provisions of Section 624.155(3)(a) & (b), Florida Statutes. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the statute. Allstate Ins. Co. v. Clohessy, 32 F. Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. Thus, the CRN cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida statutes must be strictly construed. Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1284 (Fla. 2000) (citing Baxter v. Royal Indem. Co., 285 So.2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996). Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. There are requirements for a valid civil remedy notice. Section 624.155(3), Florida Statutes. Section 624.155 mandates Complainants to provide specific facts and circumstances of the alleged violations. This would necessarily include specific facts regarding the method of the investigation, the reasons the investigation was improper or otherwise inadequate, the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. Florida law does not allow an insured, without providing any facts, to allege that the insurer’s only option to avoid bad faith is paying whatever the insured demands. 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008). Complainants’ CRN violates the specificity requirement. As such, Castle Key would like this opportunity to set forth an accurate factual background, and thereby correct omissions in Complainants’ CRN. Castle Key received its first notice of loss on October 02, 2023, for damages sustained by a wind/hailstorm to the property located at 1702 Lake Roberts Lndgs Dr. Winter Garden, FL 34787. Furthermore, this matter has been amicably resolved by the parties and mutually agreeable release has been executed. Castle Key Indemnity Company is awaiting the Voluntary Dismissal with Prejudice from Plaintiffs in this matter as the checks have been forwarded to their office. Castle Key reserves all of its rights. If anyone at the Department has any questions concerning this matter, please contact Castle Key at our office for a further response. Sincerely, /s/Christopher Martin Christopher J. Martin E-mail: cmatc@allstate.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