Civil Remedy Notice of Insurer Violations
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Filing Number:     806380
Filing Accepted:  2/11/2025
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Complainant
Last/Business Name *  
STERLING BREEZE OWNERS ASSOCIATION, INC.   First Name  
Street Address * 16701 FRONT BEACH ROAD
City, State Zip * PANAMA CITY BEACH, FL 32413
Email Address * MARK@RERENT.COM
Complainant Type: * Insured
Insured
Last/Business Name*   STERLING BREEZE OWNERS ASSOCIATION, INC.   First Name  
Policy # * CERTAIN UNDERWRITERS AT LLOYD'S, LONDON: LWH001177 Claim #* SSIC-18-0095
Attorney
Attorney is Applicable
Last Name* DODGE First Name * LAUREN Initial
Street Address* 314 MAGNOLIA AVENUE
City, State Zip* PANAMA CITY , FLORIDA 32401
Email Address * LAUREN@MANUELTHOMPSON.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* MICHAEL HARGRAVE; DOMINICK FLOURNOY; JIM DOBSON; BROOKE ADKINS
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Not conducting full and prompt investigation
Other : Not treating insured with good faith claims conduct
Other : Holding back portions of claim clearly owed
Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made
* 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)(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)(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).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Form CAT7011 (01/17) Pg. 1 of 5 – Common Policy Conditions – Appraisal If you and we disagree on the values of the covered property, your Business Income, Extra Expense or the amount of any loss or damage, either may make written demand for an appraisal of such values. In this event, each party will select a competent and impartial appraiser. The two appraisers will select an umpire. If they cannot agree, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the value of the property, the amount of Business Income, Extra Expense and amount of loss or damage. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will: a. Pay its chosen appraiser; and b. Bear the other expenses of the appraisal and umpire equally.” Form CP OO 17 10 12 Page 1 of 15 - A. Coverage “We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.” Form CP OO 17 10 12 Page 11 of 15 – “4. 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. b. The cost to repair, rebuild or replace does not include the increased cost attributable to enforcement of or compliance with any ordinance or law regulating the construction, use or repair of any property. c. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. d. We will not pay you more than your financial interest in the Covered Property. e. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the Covered Property. f. We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. g. We will pay for covered loss or damage to Covered Property within 30 days after we receive the sworn proof of loss, if you have complied with all of the terms of this Coverage Part, and: (1) We have reached agreement with you on the amount of loss; or (2) An appraisal award has been made. If you name an insurance trustee, we will adjust losses with you, but we will pay the insurance trustee. If we pay the trustee, the payments will satisfy your claims against us. Form CP OO 17 10 12 Page 12 of 15 – Valuation
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The insured's (Sterling Breeze Owner’s Association, Inc., hereinafter referred to as “SBOA”) commercial property was damaged by Hurricane Michael on October 10, 2018. At the time of the loss, the property was mutually insured by Safety Specialty Insurance Company (“Safety Specialty”) and Certain Underwriters at Lloyd’s, London (collectively, the “Insurers”) under policy numbers SSW000412, LWH00117. The address for the insured property is 16701 Front Beach Road, Palm Beach, FL 33413. The claim was promptly reported to the insured’s insurer, Safety Specialty which dispatched one or more adjusters to the insured location for the purpose, allegedly, of determining the scope and amount of loss. Safety Specialty and Certain Underwriters at Lloyd’s, London assigned Jim Dobson of Crawford & Company, on behalf of Precise Adjustments, Inc., to inspect the property. Mr. Dobson inspected the property on October 25, 2018. Mr. Dobson’s inspection revealed water damage; however, the amount of the repairs as determined by Mr. Dobson with Crawford & Company, on behalf of the Precise Adjustments, Inc., the third party claims administrator, was $3,348.57. The insurer declined to issue payment on the claim, based on the Insurers' determination that the repair costs were in the amount of $3,438.57, which was less than the policy deductible. On September 15, 2021, Michael Hargrave, Executive General Adjuster, wrote to SBOA regarding SBOA’s claim for property damages. Mr. Hargrave stated that the insurers were investigating the claim under a reservation of rights. Mr. Hargrave then cited multiple provisions of the property, without any clarity as to why the sections were referenced. The sections cited included: duties of the insured; exclusions; limitations. The insurers then issued a request for a sworn Proof of Loss (“SPOL”) and requested 37 different categories of documents pertaining to the claim. The insurers requested the copious amounts of documents to be provided no later than thirty days. On December 14, 2021, the insurers wrote to the SBOA formally acknowledging receipt of the insured’s SPOL, but stating the insurers disagreed with the amount of claimed damages. The insurers stated that the claim and evaluation of damage was still under investigation at that time. On November 7, 2022, the Executive General Adjuster for the Insurers, Michael Hargrave, issued a Statement of Loss in the amount of $461,171.10 RCV for the building damage. After application of the deductible, this resulted in a net ACV claim of $148,799.49 since no payments had been issued on the claim. The insured obtained an estimate of repairs in the amount of $1,281,119.88 and provided same to the Insurers. The insured demanded appraisal pursuant to the policy, named their appraiser, and demanded the Insurers name their appraiser. The insured repeatedly objected to the amount of loss as determined by the Insurers and continued to request payment of the undisputed amount of loss to no avail. On February 17, 2023, the insured, via its public adjuster, Jeffrey L. Evans, demanded payment of the undisputed funds in the amount of $148,799.49, invoked the appraisal clause under the subject insurance policy, and named its appraiser. Mr. Evan’s February 17, 2023, letter stated that the property had sustained damages from a named peril, Hurricane Michael, and that the Insurers’ initial and subsequent inspection of the property were deficient in noting the extent of damage as well as the cost of the repairs. On March 7, 2023, the Insurers issued its response to the appraisal demand, stating that the policy required a dispute as to the value of the loss before the claim could be submitted to appraisal. Despite receiving the insured’s estimate of loss, the Insurers adamantly refused to name its appraiser, stating that there had been no meaningful exchange of information. The Insurers attempted to classify the Statement of Loss and issuance of a release as a “negotiated settlement” and claimed that it did not realize the insured no longer intended to proceed with what is characterized as a “settlement” until February of 2023. On April 27, 2023, the Insurers wrote to SBOA regarding their March 7, 2023, letter requesting another SPOL (despite having already received one from the insured). The insurers April 27, 2023 correspondence reiterated that the Insurers had determined that appraisal was not ripe, and contained a complete reservation of rights letter. Due to the Insurers unwillingness to issue the undisputed payment and refusal to submit to appraisal (as required once invoked under the policy) the Insured was forced to hire counsel. On May 22, 2023, the Insured’s counsel wrote to the Insurers reiterating the request for payment of the undisputed amount of $148,799.49, reiterating the appraisal demand, and further stating as follows: “We disagree with your assessment that appraisal is not yet ripe, that the insured has not complied with policy conditions, and that the Insurers have not received information to determine an actual dispute exists. The insured has provided an estimate of repairs to the Insurers in the amount of $1,281,119.88 RCV (subject to application of deductible). An additional copy of the estimate is attached hereto. Therefore, it is clear there is a dispute as to the values of the covered property, and as such, this claim is ripe for appraisal.” On July 26, 2023, Michael Hargrave wrote to the Insured to advise the insured that the Insurers were invoking their right to conduct an Examination Under Oath of the persons with “the most knowledge” of subject matters delineated as (a) through (j) in the letter. Additionally, Michael Hargrave requested the insured to provide “any and all documents of any kind or nature that will support any aspect of its supplemental claim as soon as possible, but at least ten days prior to the Examination”. The Insurers issued twenty-one (21) different requests (of which one request alone had 5 subparts). The Insurers’ letter went so far as to request the insured assist the Insurers and cooperate with obtaining voluntary sworn statements of anyone who might have relevant and material information regarding the loss. Notably, the insurers did not cite the specific policy language which required this of the Insured. Finally, Michael Hargrave’s July 26, 2023, correspondence stated that the Insurers incorporated the September 27, 2021 Reservation of Rights letter. In response to the Insurers’ July 26, 2023, letter requesting the EUO, the insured’s counsel wrote to the Insurers clarifying that the duties of the insured are set out in the policy and that “cooperation” does not equal everything which can be conjured up by the Insurers, such as the request to provide any and all documents of any kind or nature that will support any aspect of its supplemental claim as soon as possible. Further, the Insured’s counsel clarified that pursuant to the EUO provision, the Insurers have the right to examine the insured under oath, but that the Insurers’ Request for Examination appeared to go far and wide from the policy provision by requiring the insured’s representative “with the most knowledge” to sit for the EUO. Finally, the insured’s counsel provided responses and documents in response to the 21 different requests for information/documentation. Subsequently, the insured cooperated with the Insurers’ request for an EUO, which was held on September 28, 2023. To date, the Insurers have refused to issue any payments whatsoever on this claim, including the $148,799.49 undisputed payment, as reflected in the Statement of Loss prepared by the Insurers. The insurer violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to settle this claim 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 interests. At all material times, the insurers involved in this claim acted in their own self interest to minimize what is clearly substantial damage to the insured’s structure. Had the insurers acted fairly and honestly toward their insureds with a due regard for their interests, they would have fairly valued the loss and would have prepared a scope and amount of loss which was consistent with the value of the loss experienced by the insureds. These insurers consistently failed to do so. Further, the insurers failed to timely pay undisputed funds consistent with the policy provisions regarding same. The insurer violated the provisions of Florida Statute §626.9541(1)(i)(2) by making one or more material misrepresentations to the insureds 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. Here, the Insurers attempted to effectuate a settlement of the insured’s claim on terms less favorable than those possibly provided in the policy, by misrepresenting to the insureds the actual scope of damage and the cost to repair such damage by grossly and intentionally under-scoping the amount of insured damage caused by Hurricane Michael. The Insurers were motivated by minimizing payments it had to make to its insured to its own benefit, and to the detriment of its insured. Instead of issuing payment for the undisputed amount as reflected in the statement of loss, the insurers demanded the insured sign a release of claim in exchange for payment of the undisputed amount. The insured, of course, did not agree with the amount of the loss as determined by the Insurers in its Statement of Loss, and therefore did not sign a release of all claims, which the Insurers attempted to coerce the insured to do. The insurer violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The insurers failed to adopt and implement standards for the proper investigation of claims. In fact, it clearly appears the insurers acted purposefully with the intent to minimize the insureds’ claim by understating the amount of loss. The insurers tried to force the insured to sign a release of all claims in exchange for receiving the undisputed payment amount listed in the statement of loss. This appears to clearly have been a claim settlement practice designed to utilize economic pressure to force the insureds to accept significantly less in insurance proceeds than that to which the insureds were due. The insurer violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. This has been substantially covered hereinabove and relates to the misrepresentations regarding the scope and amount of loss, and is restated herein as if it were set forth verbatim. The insurer violated the provisions of Florida Statute §626.9541(1)(i)(4) by 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. This has been substantially covered hereinabove and relates to the failure to pay the undisputed partial amount owed, and is restated herein as if it were set forth verbatim. NOTE: Certain Underwriters at Lloyd's, London and Safety Specialty Insurance Company (the Insurers) can remedy these violations by issuing the undisputed payment in the amount of $148,799.49 and paying the insured’s claim properly within 60 days of the acceptable date of this notice and abiding by the terms and conditions of the said policy of insurance prior to the expiration of the 60-day remedy time period. Further, Certain Underwriters at Lloyd's, London and Safety Specialty Insurance Company must agree to pay applicable interest, attorneys’ fees and costs as agreed by the parties or ordered by a court having jurisdiction over this matter.
Comments
User Id Date Added Comment
lauren@manuelthompson.com 04-11-2025 This Civil Remedy Notice has been withdrawn.
ccapeles@wshblaw.com 04-08-2025 We write on behalf of Certain Interested Underwriters at Lloyd's London Subscribing to Policy No. LWH001177("Underwriters") in response to the Civil Remedy Notice of Insurer Violation bearing DFS File No. 806380 (the "Notice") which was submitted to the Florida Department of Financial Services by Sterling Breeze Owners Association, Inc. (the "Insured") in connection with the property located at 16701 Front Beach Road, Panama City Beach, FL 33413 (the "Subject Property"). Underwriters insured the Subject Property under Policy No. LWH001177, which was effective from December 1, 2017 to December 1, 2018 (the "Policy"). The Notice bears a filing acceptance date of February 11, 2025, making this response due on April 12, 2025. The purpose of a civil remedy notice is to provide an opportunity for the insurer to cure the alleged violation and thereby avoid civil litigation. Section 624.155, Florida Statutes, requires that the insurer must "have been given 60 days’ written notice of the violation." According to Section 624.155(3), the notice “shall be on a form provided by the department and shall state with specificity . . . information as the department may require[.]” The Department provides Form DFS-10-363, which is the form used by the Insured to create the Notice. Among other things, Form DFS-10-363 requires the “Insurer Name.” As such, when an insurer is not specifically named in a civil remedy notice, the notice requirement of Section 624.155, Florida Statutes, is not met as to that insurer. Sandalwood Estates Homeowner's Ass'n, Inc. v. Empire Indem. Ins. Co., 665 F. Supp.2d 1355 (S.D. Fla. 2009); Lopez v. Geico Casualty Co., 968 F. Supp.2d 1202 (S.D. Fla. 2013). Here, the “Notice Against” section simply names “UNDERWRITERS AT LLOYD’S, LONDON.” The Insurers under the Policy reserve all rights on this issue. THE NOTICE IS LEGALLY DEFICIENT At the outset, the Notice should be deemed legally deficient, on the most basic level, as it fails to conform with many of the requirements of Section 624.155, Florida Statutes. Since Section 624.155 creates a remedy, it must be strictly construed. See Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. 2010). Section 624.155 mandates that a notice "shall state with specificity… the facts and circumstances giving rise to the violation" (emphasis added). Indeed, a civil remedy notice must be specific enough to provide the insurer notice of the wrongdoing so that the insurer can cure the same within 60 days. Underwriters respectfully state that the Notice should be deemed legally deficient for its failure to state with specificity the facts and circumstances giving rise to the alleged violations, as required by Section 624.155, Florida Statutes. The Insured alleges five statutory violations; however, the Insured fails to link the alleged statutory violations to any facts that would support the claim that Underwriters allegedly violated those statutes. Instead, the Insured states generally that violations of these statutes occurred, but provides no specific facts to substantiate these conclusory claims. For instance, the Notice alleges that Underwriters violated Florida Statute §626.9541(1)(i)(3)(a). This provision pertains to the failure to adopt and implement adequate investigation standards. The Notice, however, despite asserting a violation of this provision, fails to point to any specific instances in which Underwriters failed to adopt and/or implement investigation standards for the proper investigation of claims. In fact, Underwriters investigated the Loss with a field adjuster, building consultant and engineer, subsequently agreeing to a negotiated settlement in an effort to resolve the Insured's claim. The Notice attempts to characterize the negotiated settlement as an "undisputed payment"; however, the record evidence, detailed below, clearly contradicts this assertion. This is just one example of the Notice's deficiencies. The Notice also alleges violations of Florida Statutes §626.9541(1)(i)(3)(b). This provision is for allegedly misrepresenting facts. However, to the contrary, after Underwriters received notice of the claim, it promptly assigned a third-party administrator to conduct an investigation of the Loss. As part of this investigation, Underwriters inspected the Property with a field adjuster, building consultant and engineer. Based upon Underwriters' investigation, Underwriters determined that covered damages fell below the Policy's applicable deductible. Regardless of the below deductible coverage determination, Underwriters agreed to a negotiated settlement with the Insured to resolve the claim. In contradiction to the negotiated settlement agreement, the Insured ultimately reneged on same. Even further, the Notice alleges that Underwriters are in violation of Florida Statutes §626.9541(1)(i)(4). This provision relates to failing to pay undisputed amounts of partial or full benefits owed. However, Underwriters issued a final coverage determination letter on February 15, 2019, detailing Underwriters' coverage decision and the basis for same. As explained in detail below, following a supplemental investigation, Underwriters agreed to a negotiated settlement in exchange for an executed release agreement and was not reflective of an undisputed amount of loss. Finally, the Notice alleges that Underwriters are in violation of Florida Statutes §§624.155(1)(b)(1), which requires insurers to settle claims in good faith and promptly when the obligation has become reasonably clear. Despite the requirement that notices must state with specificity the circumstances giving rise to the allegation, the Insureds, as noted above, rely on, at best, conclusory statements to support its assertion that Underwriters violated the quoted statutory provisions. As explained in further detail below, Underwriters attempted several times to resolve the Insured's claim; however, the Insured in its own actions has delayed the claim investigation and appraisal process. The above cited allegations are nothing more than a recitation of the mentioned statutes without any facts supporting the same. Ultimately, the Notice does not put Underwriters on notice of any specific actions or omissions to support the alleged violations. In sum, the Notice simply indicates that the Insured is not happy with the coverage decision that it received for its insurance claim. Furthermore, civil remedy notices are required to cite to specific policy provisions and specific policy language. In this case, the Notice cites the Policy's appraisal and loss payment provisions. However, the Notice fails to provide any detail or factual basis to how these provisions are relevant to the alleged violations included within same. In fact, this matter has been in appraisal since January 29, 2024, during which time the Insured has changed appraisers three times, intentionally delaying the appraisal process. Ultimately, the exclusion of necessary policy language fails to provide Underwriters with notice as to the Insured's specific concerns with Underwriters' claim investigation; and therefore, the Notice fails to comply with the requirement of Section 624.155. Instead of providing Underwriters with actual notice of the Insured's concerns about the claim, the Notice is essentially a "shotgun-blast effort to hit a lot of targets with a single salvo." Rousso v. Liberty Surplus Insurance Corp., 2010 WL 7367059 at *5 (S.D. Fla. 2010). This type of approach is disfavored by Florida courts because it is contrary to the purposes of Section 624.155. "The civil remedy notice must reflect a good-faith effort to inform the insurers of how it has fallen short of its obligations under the policy and what it can do to fix its shortcomings. The civil remedy notice is not the place for posturing or advocacy, and an effort to overstate a claim in a civil remedy notice may end up undermining it." Id. As a result of the "shotgun-blast approach" taken with respect to this Notice, Underwriters are left without reasonable means to respond to the alleged violations. As a result, Underwriters cannot respond to the litany of the alleged violations. Accordingly, the Insured's Notice is deficient because it does not state with specificity the facts and circumstances giving rise to the alleged violations in a manner specific enough to provide Underwriters notice of the alleged wrongdoings, as required by the law. For these reasons, Underwriters respectfully request that the Notice be deemed deficient and insufficient. Finally, the Notice should be deemed deficient because it does not provide Underwriters with a reasonable opportunity to "cure" the alleged defects. Section 624.155 mandates that "[n]o action shall lie if, within 60 days after filing notice, the damages are paid or the circumstances giving rise to the violation are corrected." (emphasis supplied). The Florida Legislature enacted the sixty-day cure window to provide "a last opportunity for insurers to comply with their claim-handling obligations." 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1192 (N.D. Fla. 2008) (quoting Talat Enters., Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000)). "[T]he purpose of the civil remedy notice is to give the insurers one last chance to settle the claim with its insured and avoid unnecessary bad faith litigation." 316, Inc., 625 F. Supp. 2d at 1192. Here, the Insured demands that Underwriters: Certain Underwrites at Lloyd's, London and Safety Specialty Insurance Company (the Insurers) can remedy these violations by issuing the undisputed payment in the amount of $148,799.49 and paying the insured's claim properly within 60 days of the acceptable date of this notice and abiding by the terms and conditions of the said policy of insurance prior to the expiration of the 60-day remedy time period. Further, Certain Underwriters at Lloyd's, London and Safety Specialty Insurance Company must agree to pay applicable interest, attorneys; fees and costs as agreed by the parties or ordered by a court having jurisdiction over this matter. The cure demand therefore appears to be different things, none of which are offered with sufficient specificity and many of which require Underwriters to exceed their obligations under the insurance contract and law. The Notice purports to require payment of the Insured's claim or payment of damages, attorneys' fees and interest, which are not considered part of the contract cure amount under Florida law. See Talat, 753 So. 2d at 1281. This inconsistency makes it difficult for Underwriters to determine the actual "cure" amount, as the Notice makes no reference in its cure demand to Underwriters' deductible. In an attempt to clear up the ambiguity regarding the damages being claimed, in accordance with the Policy, on March 5, 2025, Underwriters sent written correspondence to Insured's counsel requesting a "cure" amount as the Notice is deficient. The notice also provides Underwriters explanation of the investigation and welcomes the Insureds' clarification of its cure demand and requests information and documentation in support of same. Again, the Insured and its legal counsel failed to provide the requested "cure" amount and/or further requested information/documentation. As such, the Notice is legally deficient because it denies Underwriters a reasonable opportunity to “cure” the defects alleged, in plain contravention of well-settled Florida law. UNDERWRITERS ACTED IN GOOD FAITH Notwithstanding the fact that the Notice is legally deficient, Underwriters respectfully deny that they have acted in bad faith. To the contrary, Underwriters have acted at all times in good faith and with due consideration of the Insured's interests. The actual facts of this claim establish that the Insured's Notice is unfounded, as Underwriters resolved the Insured's claim as expeditiously as possible and in accord with the terms of coverage afforded by the Policy. The Insured reported the Loss in October 2018. Underwriters' Field Adjuster, Jim Dobson of Crawford Global Technical Services ("Crawford"), inspected the Subject Property on October 25, 2018. Following receipt and review of Mr. Dobson's estimate of damages, on or about February 15, 2019, Underwriters issued a coverage determination letter advising that the loss fell below the Policy's $312,371.61 Hurricane Deductible. Approximately two years later, a letter and contract of representation from the Public Adjusters, Inc ("PA") was received on or about February 17, 2021. In response, Joseph Killian of Precise Adjustments provided the PA with the prior February 15, 2019 coverage determination letter sent to the insured noting the damages observed fell below the Policy's $312,371.61 Hurricane Deductible. Additionally, Mr. Killian requested any further evidence of damage the Insured may have. On July 6, 2021, Mr. Killian received a Preliminary Determination Report from DSI dated April 15, 2021. Additionally, on July 22, 2021, the Insured's representative, Mr. Gary Martin of Advanced Restoration Technologies LLC, provided an infrared report dated June 3, 2021. Upon receipt of the additional documentation, Underwriters reassigned the supplemental claim to Crawford in July 2021. The assigned adjuster, Micheal Hargrave of Crawford immediately contacted the Insured's PA to discuss the claim. A Request for Information / Reservation of Rights letter was issued by Mr. Hargrave to the Insured's PA on September 27, 2021. No response was received for several months. A response was finally received from the PA on November 9, 2021, approximately four months later, when a proof of loss with supporting PA estimate in the total amount of $1,281,119.88 RCV was received. The Insured's estimate included costs to replace the Insured's roof and perform interior repairs to unidentified interior units. On December 14, 2021, Underwriters issued a letter to the Insured rejecting the proof of loss and requesting additional information in light of the substantial supplemental claim. Underwriters retained an engineer, MKA International, Inc. ("MKA"), to perform a cause and origin investigation of the Loss. MKA inspected the Property on January 11, 2022. At the inspection, MKA was provided access to the roof and two interior units of the Property, units 2305 and 2306. Further MKA was in attendance for an infrared drone inspection on February 20, 2022, and roof core sampling inspection on February 21, 2022. A call was held on March 25, 2022 with Adjuster Michael Hargrave, Engineer Andre Slintak of MKA, Building Consultant J. Katz of MKA, PA JL Evans, Roofer Larry McAllister and Insured’s Contractor, Gary Martin, in attendance. During the call, MKA discussed its conceptual scope of repair, which consisted of a possible repair to the roof. According to MKA, during the call, the insured’s representatives generally agreed with MKA’s proposed scope of repair. The call concluded with the Insured’s contractor agreeing to bid the scope of the work in detail for MKA to review the scope of the estimate and offer a recommendation related to the reasonableness of the bid. The insured’s roofer was to provide the estimate by April 2, 2022. Ultimately, MKA advised Underwriters that there was no visual evidence to support uplift of the roof covering as a result of negative wind pressure. Although MKA found that the roof system sustained limited sporadic damage due to the effect wind during Hurricane Michael, an appropriate repair would include scraping a total of 30 sq.ft. of the existing roof coating and reapplying a new 3-layer system over the 30 sq.ft. MKA also noted a couple missing/displaced vents due to the Loss. On April 14, 2022, the insured’s roofer, LJB Restoration Services, LLC, provided an estimate for roof repair in the total amount of $461,171.10. Upon receipt of the Insured’s roof estimate, Underwriters retained a second engineer, Michelle Feuccia, PE of J.S. Held, LLC to inspect the property and provide supplemental causation opinion. J.S. Held inspected the Property on June 27, 2022. J.S. Held's opinions were in line with MKA's observations. MKA likewise opined that the roof did not sustain uplift damage due to winds during Hurricane Michael. J.S. Held also indicated that there was minor sporadic damage that could have resulted from wind / wind-blown debris and/or during the installation and/or replacement of HVAC condenser units. Likewise, MKA identified three (3) goose necks that were displaced due to wind. Although MKA and J.S. Held both concluded it was not the claimed wind damage as discussed above, Underwriters' adjuster, Michael Hargrave, attempted to negotiate a settlement of the claim with the Insured's representative despite the different opinions on causation and covered damages between the two parties. Mr. Hargraves and the Insured's PA reached a settlement agreement on or about November 7, 2022. This settlement agreement was memorialized in an e-mail correspondence from Mr. Hargrave to the Insured's PA on November 7, 2022. The e-mail correspondences states: Hi Mr. J.L. Evans, As discussed, please see attached policy holder release in the amount of $148,799.49. Please review and ask that the letter be executed by an authorized officer of the COA, notarized and returned to me via email. As stated in the e-mail, a policy holder release was attached for the Insured's authorized representative's execution. The policy holder release is titled "Full and Final Receipt, Release and Settlement of All Claims and Indemnity Agreement" ("Release") and includes language memorializing a complete and final settlement of all claims related to the Loss. Additionally, the settlement amount referenced in the Release ($148,799.49) is calculated by taking the Insured's roofer's repair estimate ($461,171.10) less the Policy's Hurricane Deductible ($312,371.61), further evidencing a negotiated settlement. This payment was entirely conditioned on the execution of the Release and was not an undisputed payment due to the Insured. In contradiction to the mutually agreed settlement, Underwriters received a written correspondence from the Insured's PA on February 21, 2023 (letter was dated February 17, 2023) demanding appraisal. The February 17, 2023 letter enclosed a December 16, 2022 letter prepared by the Insured's legal counsel, Manual & Thompson, P.A. ("M&T"), that incorrectly stated that "insurer[s] determined the amount of loss was $461,171.10." As explained above, Underwriters engaged in a mutual settlement discussion with the Insured's PA and agreed to a full and final settlement of the claim conditioned on the execution of the Release. On March 7, 2023, Crawford issued written correspondence to the Insured's PA acknowledging the demand for appraisal. Crawford's letter memorializes ongoing communications with the PA including the receipt of the $461,171.10 roof repair estimate and the withdrawal of a claim for interior damages as being unrelated to the Loss. The letter further identifies the Release that was provided for the Insured's execution and the Insured's failure to respond to same for approximately three months. With an unidentified amount in dispute, Underwriters advised the Insured that the matter was not ripe for appraisal. In the absence of a response from the PA to the March 7, 2023 letter and in an effort to determine if an actual dispute existed, Crawford issued a letter to the PA on April 27, 2023 requesting the Insured to submit an updated Sworn Proof of Loss pursuant to the Duties of the Named Insured in the Event of Loss or Damage provisions of the Policy. On May 19, 2023, Crawford received a letter of representation from M&T. Shortly thereafter, on May 22, 2023, M&T issued another letter to Crawford incorrectly characterizing and demanding payment of the $148,799.49 "undisputed amount". The May 22, 2023 letter rejects Underwriters' assessment that appraisal was not yet ripe and directs Underwriters to the Insured's November 9, 2021 Sworn Proof of Loss provided prior to the mutual settlement agreement. In response, Underwriters demanded the Examination Under Oath ("EUO") of the Insured via written correspondence on July 26, 2023. As part of the July 26, 2023 letter, Underwriters requested that the Insured produce any and all invoices and/or proposals for repair related to the Loss. On September 7, 2023, the Insured responded to Underwriters' July 26, 2023 letter by providing responsive documentation. Among the documents, and for the first time seen by Underwriters, the Insured submitted an April 27, 2022 proposal from Panama Cool for the replacement of A/C condenser units totaling $1,212,504.97. On September 19, 2023, the Insured filed a Notice of Intent to Initiate Litigation ("NOI") with Florida's Department of Financial Services. Underwriters responded to the NOI on September 27, 2023 demanding mediation pursuant to 627.70152, Florida Statutes. The EUO was conducted on September 28, 2023. The Insured designated its property manager, Mark Huebner, as its representative for the EUO. The following exchange occurred when trying to investigate the Panama Cool invoice: Q. We received, I believe it's a - - a work proposal from Panama Cool. Are you aware of that proposal? A. No. Q. I'll obviously show you that proposal. Would you have any information pertaining to it? A. None. Huebner EUO, 79:2-8. To date, the Insured has failed to provide any information supporting how or why the five-year delayed $1,212,504.97 Panama Cool proposal should be considered as part of the Hurricane Michael insurance claim. Following the EUO, mediation was set for December 13, 2023. Prior to mediation. M&T provided for the first time an estimate from Bruce's Heating & Cooling for the removal and replacement of the roof top HVAC condenser units and electrical conduit totaling $1,888,595.88. Notably the estimate states "replacement of 50% of systems that will not survive a move due to conditions" expressly indicating that the units would suffer damage five years after the Loss and unrelated to Hurricane Michael. On January 29, 2024, Underwriters issued written correspondence to M&T agreeing to proceed to appraisal and naming Underwriters' appraiser, Greg Lingerfelt. Upon information provided by Mr. Lingerfelt, he immediately reached out to the Insured's appraiser, Mr. Jason Juday. Mr. Lingerfelt issued an initial written correspondence to Mr. Juday on or about February 2, 2024, attempting to agree upon an Umpire pursuant to the appraisal provision of the Policy. An Umpire was never agreed upon. Mr. Lingerfelt and Mr. Juday coordinated and conducted an inspection of the Property for June 12, 2024. During the site inspection, Mr. Juday informed Mr. Lingerfelt that he was in possession of a PA estimate totaling $4.6M. On June 24, 2024, Mr. Lingerfelt issued a written correspondence to Mr. Juday requesting the alleged estimate. The requested estimate was not provided. On September 6, 2024, Mr. Lingerfelt issued another written correspondence to Mr. Juday again requesting a copy of the alleged $4.6M estimate. In October 2024, Mr. Juday produced for the first time an estimate prepared by Insured's PA totaling $4,168,846.31. The estimate is dated September 7, 2024 and is a complete departure from the damages claimed during the Insurers' adjustment of the Claim. Following receipt of the PA's new estimate, Mr. Juday advised Mr. Lingerfelt that he was unsure if he would continue as the Insured's appraiser. Mr. Lingerfelt memorialized this conversation via a written correspondence on November 18, 2024. Between November 18, 2024 and January 2025 Mr. Juday failed to respond to any of Mr. Lingerfelt's attempts to communicate regarding the appraisal. On January 9, 2025, M&T advised Underwriters that the Insured had named a new appraiser, Mr. Luke Irwin. Mr. Lingerfelt attempted to reach Mr. Irwin's via telephone but was unsuccessful. Mr. Lingerfelt issued a written correspondence to Mr. Irwin on January 20, 2025, attempting to continue the appraisal process. On February 11, 2025, the Insured filed a CRN against Underwriters with Florida's Department of Financial Services. Shortly thereafter, on February 12, 2025, M&T advised Underwriters that the Insured has again changed appraisers, opting to proceed with Mr. Jeff Whittington in lieu of Mr. Irwin. To date, the appraisal process is ongoing. On March 5, 2025, Underwriters issued a letter to the Insured seeking clarification of the Insured's CRN demand, providing Insurers' explanation of the claim investigation, and seeking additional information/documentation in support of the Insured's claim. To date, Underwriters have not received a response to their March 5 letter. As drafted, the Notice is essentially a contention that Underwriters acted in "bad faith" because they did not pay what the Insured believed it was owed. This is not "bad faith," and out of step with the governing law and purpose behind the Civil Remedy Notice practice. See 316, Inc., 625 F. Supp. 2d at 1194. 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. Neither the Policy nor does Florida law provide that an insurer must accept whatever demand for repairs it is provided by its insureds as the amount necessary to repair a loss. In the instant case, the violations alleged by the Insured all revolve around the contention that Underwriters did not accept and pay the Insured's full demand for repair. In sum, if the Notice is not found to be legally deficient for the various reasons referenced above, Underwriters respectfully emphasizes that they hav done nothing other than act in utmost good faith and applied the terms of coverage as clearly and unambiguously stated in the Policy.
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