Civil Remedy Notice of Insurer Violations
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Filing Number:     806211
Filing Accepted:  2/11/2025
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Complainant
Last/Business Name *  
ALEXIS   First Name   CLAUDE AND MARIE
Street Address * 7104 NW 83RD ST.,
City, State Zip * TAMARAC, FL 33321
Email Address * INSURED@MCDONALDBARNHILL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ALEXIS   First Name   CLAUDE AND MARIE
Policy # * 1501-1800-2760 Claim #* FL23-0140805-F423
Attorney
Attorney is Applicable
Last Name* GONTRUM First Name * RYAN Initial L
Street Address* 505 S. MAGNOLIA AVENUE
City, State Zip* TAMPA , FL 33606
Email Address * TAL@MCDONALDBARNHILL.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):* GERRI DETOMMASO AND ARDIT DULLOVI
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
626.9541(1)(i)(1) Attempting to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured.
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)(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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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.
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.
626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
626.9541(1)(i)(3)(j) Altering or amending an insurance adjuster’s report without: (I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and (II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or (III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

***ADDITIONAL STATUTORY PROVISIONS ALLEGED TO HAVE BEEN VIOLATED AS FOLLOWS:*** §624.155(1)(a) Any person may bring a civil action against an insurer when such person is damaged: By the commission of any of the following acts by the insurer: 1. Section 626.9541(1)(i), (o), or (x); §624.155(1)(a) Any person may bring a civil action against an insurer when such person is damaged: By the commission of any of the following acts by the insurer: 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 towards its insured and with due regard for his interests; 2. Making claims payments to insures or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made; or 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. §624.155 (5) No punitive damages shall be awarded under this section unless the acts giving rise to the violation occur with such frequency as to indicate a general business practice and these acts are: a. Willful, wanton, and malicious; b. In reckless disregard for the rights of any insured; or c. In reckless disregard for the rights of a beneficiary under a life insurance contract; (8) The damages recoverable pursuant to this section shall include those damages which are a reasonably foreseeable result of a specified violation of this section by the authorized insurer and may include an award or judgment in an amount that exceeds the policy limits. §627.70131 Insurer’s duty to acknowledge communications regarding claims; investigation (1)(a) Upon an insurer’s receiving a communication with respect to a claim, the insurer shall, within 14 calendar days, 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 prevent such acknowledgement. If the acknowledgement is not in writing, a notification indicating acknowledgement shall be made in the insurer’s claim file and dated. A communication made to or by an agent of an insurer with respect to a claim shall constitute communication to or by the insurer. (b) As used in this subsection, the term “agent” means any person to whom an insurer has granted authority or responsibility to receive or make such communications with respect to claims on behalf of the insurer. (c) This subsection shall not apply to claimants represented by counsel beyond those communications necessary to provide forms and instructions. (2) Such acknowledgement shall be responsive to the communication. If the communication constitutes a notification of a claim, unless the acknowledgement reasonably advises the claimant that the claim appears not to be covered by the insurer, the acknowledgement shall provide necessary claim forms, and instructions, including an appropriate telephone number. (3) Unless otherwise provided by the policy of insurance or by law, within 10 working days after an insurer receives proof of loss statements, the insurer shall begin such investigation as is reasonably necessary unless the failure to begin such investigation is caused by factors beyond the control of the insurer which reasonably prevent the commencement of such investigation. (4) For purposes of this section, the term “insurer” means any residential property insurer. (5) Within 90 days after an insurer receives notice of a property insurance claim from a policyholder, the insurer shall pay or deny such claim unless the failure to pay such claim is caused by factors beyond the control of the insurer which reasonably prevent such payment. Failure to comply with this subsection constitutes a violation of this code. ***Specific policy language that is relevant to the violation*** Universal Property & Casualty Insurance Company (Universal) failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, Universal failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Claude and Marie Alexis’ claim results from wind damage from a storm which occurred on or about November 16, 2023, to their property located at 7104 NW 83rd St., Tamarac, FL 33321. The property was insured under policy number 1501-1800-2760. The Insureds’ home experienced heavy wind that resulted in damage to the roof and exterior of the property. The exterior damage allowed water to permeate the interior of the home resulting in water damage throughout the property and ultimately led to mold despite repeated efforts by the Insureds to keep a tarp on the roof. The claim was reported to Universal Property & Casualty Insurance Company (Universal) and was assigned the claim number FL23-0140805-F423. Universal assigned Gerri DeTommaso as the desk adjuster and Ardit Dullovi as the field adjuster for the claim. The Florida Department of Financial Services Licensee Database indicates that Mr. Dullovi never made the qualifying appointment to adjust insurance claims in Florida. Nonetheless, he inspected the property and prepared an estimate of damage that severely under scoped the loss. Mr. Dullovi’s estimate failed to include anything for the roof and missed entire rooms, such as the second bedroom, that were damaged. His adjustment also did not account for mold or mold testing. This estimate totaled $5,411.14, and after deductible and depreciation, Universal paid only $1,901.87 to indemnify the Insured for her unfortunate loss. This amount was insufficient to complete any significant repairs, and over time additional mold ensued from the water damage, which has significantly affected the health of the insureds’ children, especially their 9-year-old daughter. Mr. and Mrs. Alexis hired Stellar Public Adjusting Services, Inc. (Stellar) to represent their interests in the claim. Ms. Alexis also hired ASAP Restoration Corp. (ASAP) to perform water mitigation services, which cost $9,982.31. Stellar inspected the property and prepared an estimate of the damage totaling $166,762.73. Stellar submitted their estimate, ASAP’s invoice, along with photos and other relevant documentation to Universal, and requested supplemental payment and/or appraisal. Unfortunately, Universal refused to agree to appraisal, and there is no evidence Universal has ever actually considered the information provided by Stellar or did anything further to adjust the loss. Universal has failed to pay anything for mitigation or tarping, failed to pay anything for mold, and severely underpaid the wind and water damage to the home. Universal’s course of action has continuously delayed indemnification while the Insured’s costs continue to rise. In Florida, the work of adjusting insurance claims engages the public trust. Universal has breached this duty in the adjustment of this loss by refusing to provide proper indemnity, unnecessarily delaying resolution of the claim, and failing to take into consideration documentation provided to them which would support further compensation. Universal has failed to create and implement adequate guidelines for proper investigation of claims handling and for training and supervision of employees and representatives which have resulted in some of the statutory violations set forth above. Universal charged Mr. and Mrs. Alexis a substantial premium for these coverages but has refused to tender proper payment when under all circumstances it could have and should have done so had it acted fairly and honestly. Additionally, it appears this is done companywide. The Insureds have been forced to retain legal counsel to protect their interests. Therefore, to cure the defects outlined in this Civil Remedy Notice, Universal must: 1. Immediately tender $12,000 as a compromised amount of the loss. 2. Act fairly and honestly towards the Insureds and with due regard for their interests in attempting to settle the claim; 3. Pay statutory interest on the amount of unpaid contractual damages from the date the claim was reported; 4. Cease and desist all present and future bad faith actions with regard to the Insureds’ claim; Failure to cure all defects during the 60-day safe harbor period may result in additional extra-contractual damages.
Comments
User Id Date Added Comment
jr0405@universalproperty.com 04-02-2025 April 2, 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.: 806211 Filing Date: 2/11/2025 Complainant(s): Claude and Marie Alexis Insured(s): Claude and Marie Alexis Policy No.: 1501-1800-2760 Claim No.: FL23-0140805-F423 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by attorney, Ryan L. Gontrum, on behalf of Complainants, Claude and Marie Alexis (also referenced as “Insureds.”) The Notice alleges violations of Florida Statutes, Sections 624.155, 626.9541, and 627.70131. Universal specifically denies each allegation contained in the Notice. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notice fails 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 Notice is deficient as a matter of law as it fails 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 Notice “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 sets 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) 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 Notice fails to meet the requirements of Fla. Stat. § 624.155 on several grounds. First, the Civil Remedy Notice requires the Complainant(s) “pursuant to section 624.155, Florida Statutes, please indicate all statutory provisions alleged to have been violated.” The Notice filed by the Complainants in this matter includes almost every statutory provision that could be claimed against an insurance company. The Notice, however, fails to specify any facts to support when or how or by whom any of these statutes were violated. Because the Notice fails to provide the requisite specificity, it does not comply with Section 624.155, Florida Statutes. The Notice fails to provide Universal with the necessary notice of what needs to be corrected, if anything at all. Second, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notice fails to specify any facts that would put Universal on notice that it violated any policy provision or statute. The Complainants provide four (4) separate reasons for submitting the Notice, including claim denial, claim delay, unsatisfactory settlement offer, and unfair trade practice. However, the Complainants’ allegations regarding these “Reasons for Notice” have no factual support anywhere in the Notice. In addition, the Notice asserts general allegations consisting of inaccurate and conclusory statements rather than providing specific facts to support any allegation. For example, the Notice states, in reference to the field adjuster, that “[t]he Florida Department of Financial Services Licensee Database indicates that Mr. Dullovi never made the qualifying appointment to adjust insurance claims in Florida.” The Complainants fail to provide any facts to support the conclusion that the field adjuster was not qualified to inspect the property or prepare an estimate. Moreover, Sec. 624.155, Fla. Stat., does not enumerate a statutory provision wherein an inspection conducted by an unlicensed adjuster is a basis for a bad faith suit. Further, the Notice generally states: “In Florida, the work of adjusting insurance claims engages the public trust. Universal has breached this duty in the adjustment of this loss by refusing to provide proper indemnity, unnecessarily delaying resolution of the claim, and failing to take into consideration documentation provided to them which would support further compensation. Universal has failed to create and implement adequate guidelines for proper investigation of claims handling and for training and supervision of employees and representatives which have resulted in some of the statutory violations set forth above. Universal charged Mr. and Mrs. Alexis a substantial premium for these coverages but has refused to tender proper payment when under all circumstances it could have and should have done so had it acted fairly and honestly. Additionally, it appears this is done companywide.” However, there are no facts asserted to support these or any of the allegations in the Notice. The Complainants fail to specify any facts or circumstances giving rise to any of the conclusions contained in the Notice. The Notice also generally alleges that Universal violated Sec. 626.9541(1)(i)(2), Fla. Stat., by making “[a] material misrepresentation … to an insured or any other person having an interest in the proceeds payable under such contract or policy” and Sec. 626.9541(1)(i)(3)(b), Fla. Stat., by “[m]isrepresenting pertinent facts or insurance policy provisions relating to the coverages at issue.” However, the Notice does not specify any facts regarding any misrepresentations made by Universal, does not identify the person or persons who made such misrepresentations nor does it identify to whom any misrepresentations were made. It is evident that the statement of facts falls short of the specificity required by Fla. Stat. §624.155. As a result, the Complainants fail to comply with the requirements provided in Section 624.155(3)(b)(2), Fla. Stat. Third, the Notice fails to satisfy Fla. Statute § 624.155(3)(b)(4), in that it fails to reference specific policy language relevant to the alleged violation. Instead, the Notice references “additional statutory provisions” under Fla. Statutes §§ 624.155 and 627.70131, which are not contained within the Policy and the inclusion here is improper as they fail to put Universal on notice as to any alleged Policy language relevant to any purported violation. The Notice does not reference any specific policy language allegedly violated, but instead states in pertinent part the following: “Universal Property & Casualty Insurance Company (Universal) failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, Universal failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.” No specific, relevant Policy language is included at all in the Complainants’ statement. Instead, the Notice consists of references to broad sections of the policy which provide no guidance or explanation, such that Universal is left to wonder what policy provisions Complainants believe were allegedly violated or breached and why. General, vague, and overbroad references to possible or potential policy provisions does not satisfy the specificity required by § 624.155(3)(b)(4), Fla. Stat. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Fourth, the Notice fails 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. In order to comply with the requirements of Section 624.155, Florida Statutes, the Complainants 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 Notice lacks the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Notice states “GERRI DETOMMASO AND ARDIT DULLOVI.” Other than identifying the named individuals as the purported desk adjuster and field adjuster on the claim, the Notice does not sufficiently state what each named individual did or failed to do. Therefore, the Notice does not have the requisite specificity as to whom the Complainants are asserting has knowledge as to each specific allegation contained in the Notice. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainants allege “[a] material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy” by Universal and that Universal “misrepresent[ed] pertinent facts or insurance policy provisions relating to coverages at issue.” The Notice, however, fails to include the requisite specificity as to whom made any misrepresentations or when any of these misrepresentations occurred. Accordingly, Complainants’ Notice is insufficient as a matter of law. Lastly, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects. 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). 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. Here, Complainants demand vague and amorphous cures unrelated to payment of contractual amounts due to the Insureds. As such, the Notice is deficient as it does not provide Universal an opportunity to “cure” the alleged violations without imposing obligations on Universal not contemplated by the Policy. Universal is only obligated to pay contractual amounts owed to cure a civil remedy notice. See id. at 1278. Universal also submits that by initiating litigation prior to filing the Notice, the Insured further prejudiced Universal’s ability to cure any purported allegations in the Notice, as there is no actual cure period. In summation, the Complainants failed to respond to each of the fields set forth on the DFS Form with the requisite specificity as stated herein, including but not limited to, failing to sufficiently allege facts and circumstances giving rise to any violation, failing to reference specific policy language relevant to any alleged violation, failing to sufficiently identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notice, and failing to provide a proper cure. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. See Julien, 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notice is 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 Notice. On November 28, 2023, Universal was notified by the Insureds’ public adjuster, Stellar Public Adjusting Service, that the insured location was damaged on November 16, 2023. Universal inspected the property and documented any visible damage. Universal, in accordance with the terms and conditions of the Policy, issued payment in the full amount of its estimate for the interior dwelling damages observed, less depreciation and applicable deductible. Additionally, Universal advised the Insureds that the roofing property damage was not covered under the terms of the Policy. Under the terms of the Policy, Universal will initially pay at least the actual cash value of the insured loss, less any applicable deductible. It will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. On May 16, 2024, the Insureds initiated litigation against Universal in the Circuit Court in and for Broward County under Case No. CACE-24-006845. Thus, at the time of the Notice, the parties were and continue to litigate their disputes to determine what, if any, additional available coverage exists under the Policy. At no time has Universal breached any duty to its Insureds. An Insurer is not required to pay whatever amount its insureds demand. 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 Notice lack factual support and are without merit. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjustment 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 Notice filed by the Complainants. 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