Civil Remedy Notice of Insurer Violations
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Filing Number:     806320
Filing Accepted:  2/11/2025
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Complainant
Last/Business Name *  
PITNER   First Name   TODD & YANA
Street Address * 19405 WHISPERING BROOK DRIVE
City, State Zip * TAMPA, FL 33647
Email Address * IMTODDP@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   PITNER   First Name   TODD
Policy # * 59-EC-Q167-2 Claim #* 59-75F9-4ZP
Attorney
Attorney is Applicable
Last Name* LASCOLA First Name * STEPHANIE Initial J.
Street Address* 220 ALHAMBRA CIRCLE, SUITE 500
City, State Zip* CORAL GABLES , FL 33134
Email Address * SLASCOLA@MORGANLAWGROUP.NET
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FIRE AND CASUALTY COMPANY
NAIC Company Code 25143
 
Name of individual responsible for violation (if any):* JUSTIS WESTFALL
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.
 
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.

Coverage A, Coverage B, and the Loss Settlement Provision under the Policy.
 
* 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 Hurricane Milton property damage insurance claim. The carrier initially attempted to low-ball the claim. Subsequently, the insureds prepared a loss package in the amount of $91,482.08 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 $15,214.99 only, leaving a remainder in the amount of $76,267.09 to be paid in order to cure the breach, less any applicable policy deductible. Additionally, the carrier did not appropriately address the need for the replacement of the insureds’ roof due to the tiles being discontinued, allegedly relying on the wrongful findings of a representative who it is believed was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of wind damage to the roof, for the purpose of wrongfully low-balling the claim as a whole. The insureds have 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 one hundred and twenty (120) 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 insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds 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 insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds 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 insureds, 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 $$76,267.09, less any prior payments and less any applicable policy deductible; 2.) Pay the Insureds’ attorneys’ fees and costs as they have been forced to retain counsel; 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 sent to the carrier. Please do not hesitate to contact the undersigned or Ayleen Valdes (305) 569-9900 if you have any questions or concerns. Sincerely, Stephanie Lascola Attorney at Law
Comments
User Id Date Added Comment
jrodriguez@molhemfraley.com 04-09-2025 MOLHEM & FRALEY, P. A. ATTORNEYS AT LAW 320 WEST KENNEDY BOULEVARD SUITE 620 TAMPA, FLORIDA 33606 TELEPHONE (813) 251-6868 FACSIMILE (813) 254-0444 April 9, 2025 VIA E-MAIL ONLY TO: slascola@morganlawgroup.net Todd Pitner and Yana Pitner c/o Stephanie J. Lascola, Esquire 220 Alhambra Circle, Suite 500 Coral Gables, FL 33134 Re: Complainants : Todd Pitner and Yana Pitner Insured : Todd Pitner Claim No. : 59-75F9-42P Policy No. : 59-EC-Q167-2 Date of Loss : October 9, 2024 Our File No. : 0650-250206 DFS File Date : February 11, 2025 DFS File No. : 806320 Dear Mr. and Ms. Pitner: Please allow this correspondence to serve as State Farm Florida Insurance Company’s (“State Farm”) response to your Civil Remedy Notice of Insurer Violations, filing number 806320. State Farm specifically denies each and every allegation set forth in the Civil Remedy Notice of Insurer Violations. At all times, State Farm has acted in good faith. State Farm believes that the Civil Remedy Notice of Insurer Violations you filed fails to comply with the specific notice and information requirements as set forth in Florida Statute §624.155 and Florida case law. According to the Florida Supreme Court, Florida Statute §624.155 must be strictly construed. See Talat Enterprises Inc. v. Aetna Cas. And Sur. Co., 753 So.2d 1278, 1283 (Fla. 2000). Specifically, the Civil Remedy Notice of Insurer Violations fails to comply with §624.155 (b)(4), which states that a Civil Remedy Notice of Insurer Violations shall state with specificity, references to the specific policy language that is relevant to the violation. Your Civil Remedy Notice of Insurer Violations references violations of “Coverage A, Coverage B, and the Loss Settlement Provision.” Invoking the vast majority of the relevant policy cannot be construed as “referring to specific policy language” as defined in the statute. This non-compliance with §624.155 (b)(4) is more than a mere technical defect. See Julien v. United Property & Casualty Insurance Company, 311 So.3d 875, 879 (Fla. 4th DCA 2021). Because of the failure to identify specific policy provisions in the Civil Remedy Notice of Insurer Violations, State Farm is not able to properly respond. Therefore, the Civil Remedy Notice of Insurer Violations should be rejected. Lastly, the Civil Remedy Notice of Insurer Violations requests improper cures by demanding State Farm pays for attorneys’ fees and interest. These cures are improper according to Florida law and Florida Statute §624.155. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278, 1281 (Fla. 2000). The Talat decision provides that a “cure” must be limited to contract damages, not attorney’s fees or alleged extra contractual damages. On October 11, 2024, State Farm received notice of a loss that reportedly occurred on October 9, 2024, due to the passage of Hurricane Milton. Specifically, the policyholder reported roof damage in the form of missing shingles, fence damage, and damage to a permaculture food forest. The policyholder hired RRCA Roofing and Reconstruction to perform repairs and the company placed a tarp on the roof to prevent further damage. There was no interior damage reported in connection with this claim. As an initial matter, the policy of insurance does not provide coverage for trees, shrubs or landscaping that was damaged by a storm event. The coverage only extends to damage caused by fire, lightning, explosion, riot, aircraft, vehicles, vandalism, or theft. As such there is no coverage for the damaged permaculture food forest which was reportedly damaged on the date of loss. The policy of insurance states in the pertinent part: SECTION I- PROPERTY COVERAGES ... 3. Property Not Covered. We do not cover: ... b. trees, shrubs, live or artificial plants, lawns, or artificial grass except as provided in SECTION I- ADDITIONAL COVERAGES, Trees, Shrubs, and Landscaping; ... SECTION I- ADDITIONAL COVERAGES ... 3. Trees, Shrubs, and Landscaping: We will pay for accidental direct physical loss to outdoor: a. trees, shrubs, live or artificial plants, and lawns; b. artificial grass; and c. hardscape property used for aesthetic purposes not permanently affixed to reality; on the residence premises, caused by the following perils: Fire or lightning, Explosion, Riot or civil commotion, Aircraft, Vehicles..., Vandalism or malicious mischief, or Theft. State Farm’s inspection occurred on October 22, 2024. From the results of that inspection, State Farm extended coverage for roof repairs only, which fell below the policy’s hurricane deductible of $17,632.00. As such, on November 3, 2024, State Farm sent coverage correspondence which advised that the covered loss fell below the policy’s hurricane deductible. The policy of insurance states in the pertinent part: HURRICANE DEDUCTIBLE ENDORSEMENT ... HURRICANE DEDUCTIBLE The deductible for loss caused by hurricane is the Hurricane Deductible amount shown in the Declarations. In the event of a single loss caused by hurricane during the calendar year, this deductible will apply in place of any other deductible stated in the policy. Following the initial coverage determination, the policyholders objected to the determination, advising that the damage sustained in the storm was beyond State Farm’s estimate and that a full roof replacement was necessary. Upon this request, State Farm requested additional documentation to re-evaluate the claim. On November 22, 2024, State Farm received additional documentation from RRCA Roofing and Reconstruction. This production included a competing estimate of repair and photographs of the damages. The estimate of repair, in the amount of $91,482.08, included a full roof replacement, fence repairs, stucco repairs to the right elevation, compensation for the permaculture food garden, and removal and replacement of solar panels. Upon review of the documents provided by the policyholders, State Farm created a new estimate of repair. This estimate included repairs to the fence, stucco repair, painting of the right elevation of the property, gutter reset charges, and a replacement of the entire rear slope of the roof. This second estimate of repair, in the total amount of $15,214.99, also fell below the policy’s hurricane deductible. After receiving the coverage decision letter, the policyholders objected again, advising that replacement shingles were not available. In response State Farm requested that the policyholders or their contractor provide a sample shingle for State Farm to pick up and determine if replacement shingles were available. Over the next month, State Farm, the policyholders, and the policyholders’ contractor were in communication, but State Farm was never provided a sample shingle for pickup. As such, in correspondence dated January 16, 2025, State Farm sent a new coverage decision letter with an updated estimate which advised that the newly extended coverage still fell below the policy’s deductible. The second estimate of repair was not updated as State Farm was never provided a sample shingle to confirm whether or not proper replacements were available. During this time, the policyholders’ contractors provided photographs showing that they attempted to find matching shingles for repair, but the color did not match the surrounding undamaged shingles. State Farm reviewed these photographs and determined that the roof required a total replacement due to the lack of matching shingles. As such, State Farm created a third estimate of damages which included a full roof replacement as well as other repairs that were included in the previous estimates. The total amount of State Farm’s estimate was $53,913.86. After subtracting the hurricane deductible, State Farm issued payment in the amount of $36,281.86 which is the replacement cost value of the loss according to the estimate. State Farm sent correspondence on February 13, 2025, which included the third estimate of damages and an explanation of the payment made in this matter. The Civil Remedy Notice of Insurer Violations alleges violations under Florida Statute §624.155 and Florida Statute §626.9541. State Farm specifically denies these allegations. • State Farm specifically denies violating Fla. Stat. §624.155(1)(b)(1): At no point did State Farm fail to, in good faith, settle this claim when it could and should have done so, had it acted fairly and honestly toward the policyholder. • State Farm specifically denies violating Fla. Stat. §624.155(1)(b)(3): At no point did State Farm fail to promptly settle the instant claim when the obligation to settle a claim has become reasonably clear, under one portion of the subject policy. • State Farm specifically denies violating Fla. Stat. §626.9541(1)(i)(3)(a): State Farm implements proper standards to investigate its claims. • State Farm specifically denies violating Fla. Stat. §626.9541(1)(i)(3)(b): At no point did State Farm misrepresent any policy provisions relating to the coverage at issue. This allegation does not apply to the facts of this claim as there is no allegations of a misrepresentation from the policyholders to State Farm’s knowledge. • State Farm specifically denies violating Fla. Stat. §626.9541(1)(i)(3)(c): State Farm timely responded to all communications with respect to the instant claim. • State Farm specifically denies violating Fla. Stat. §626.9541(1)(i)(3)(f): At no point did State Farm fail to provide an explanation in writing a denial of claim or for the offer of a compromise settlement. At all times, State Farm Florida Insurance Company has acted in good faith in investigating and handling the claim. State Farm Florida Insurance Company has not breached any duty owed to you. If you have any questions or if you wish to discuss this matter in further detail, please do not hesitate to contact our office. Sincerely, MOLHEM & FRALEY, P.A. /s/ Alexandra Bajo David W. Molhem DWM/AMB
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