Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 807595

Filing Accepted: 2/20/2025

Print Filing

Complainant

Last/Business Name *

LUQUIS

First Name

KEITH AND SANDRA

Street Address *

872 N LAKE CLAIRE CIRCLE

City, State Zip *

OVIEDO, FL 32765

Email Address *

KEITH0969@YAHOO.COM

Complainant Type: *

Insured

Last/Business Name*		LUQUIS		First Name		KEITH AND SANDRA
Policy # *		1553707544		Claim #*		01000132296

Attorney

Attorney is Applicable

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		FIRST PROTECTIVE INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10897

Name of individual responsible for violation (if any):* MICHELLE PERKINS AND ALL OTHER FRONTLINE EMPLOYEES, REPRESENTATIVES, AGENTS, AND VENDORS WHO HANDLED THIS CLAIM
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Unsatisfactory Settlement Offer

* 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)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PERILS INSURED AGAINST Paragraph A.1. in Form HO 00 03 is deleted and replaced by the following: 1. We insure for sudden and accidental direct physical loss to covered property described in Coverages A and B unless the loss is otherwise excluded in this policy.

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Keith and Sandra Luquis (“the insureds”) are homeowners insured under a policy issued by Frontline Insurance. The insured property is located at 872 N Lake Claire Circle, Oviedo, FL 32765. On February 4, 2024, a severe hailstorm caused significant damage to the insureds’ property, including hail impacts to the roof, damage to window screens, and resulting leaks into the interior of the home. The insureds promptly reported the loss and complied with all post-loss obligations under the policy. Frontline has acknowledged the interior damages but has wrongfully denied coverage for the full extent of the hail damage to the roof and exterior. The insurer’s estimate for damages stands at $2,830.61, an amount that fails to account for the full scope of necessary repairs, while the insureds’ comprehensive estimate for restoration totals $47,379.88. Frontline’s failure to properly assess and indemnify the insureds violates Florida Statute § 624.02, which requires insurers to act in good faith, and Florida Statute § 627.70131, which mandates timely and fair claim handling. By refusing to acknowledge the full extent of the hail damage, disregarding evidence of roof and exterior impacts, and failing to act in good faith, Frontline has breached its contractual and statutory obligations. To cure this civil remedy notice and avoid further legal action, Frontline must immediately acknowledge full coverage under the insureds’ policy, issue payment based on the amount of $47,379.88, and ensure compliance with Florida Statutes in the adjustment and handling of all claims moving forward. Failure to act accordingly will result in additional damages, including interest, attorney fees, and potential punitive awards, and may necessitate legal action for bad faith.

Comments

User Id		Date Added		Comment
dmontgomery@kelleykronenberg.com		03-13-2025		Dear Keith and Sandra Luquis: Please accept this correspondence as First Protective Insurance Company D/B/A Frontline Insurance (“Frontline") response to the Civil Remedy Notice ("CRN"), filed on behalf of complainants Keith and Sandra Luquis (“the Insureds”), dated February 20, 2025. At the outset, First Protective denies any of its actions taken with regard to the Insureds’ claim that has resulted in a violation of Florida's bad faith laws, including §624.155 and §626.9541, as alleged in the CRN. Instead, First Protective has acted at all times in good faith in its investigation and handling of this claim and concerning the best interest of the Insureds. While First Protective welcomes the opportunity to respond to this CRN and denies explicitly every allegation contained in the CRN referenced above, First Protective requests the CRN be rejected as it fails to comply with several of the requirements of the Civil Remedy Notice of Insurer Violation document provisions as outlined in Florida Statute §624.155, and Florida case law. Under Florida law, a first-party bad faith action is not recognized at common law. Baxter v. Royal Indemnity. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). In 1982, the Florida Legislature enacted § 624.155, which created a statutory first-party bad-faith cause of action by an insured against the insurance carrier. See § 624.155, Fla. Stat.; First Protective Mut. Auto. Ins. Co. v. Laforet, 658 So. 2d 55, 59 (Fla. 1995). As a derogation of common law, this statute is strictly construed. Nowak v. Lexington Ins. Co., 464 F. Supp. 2d 1248 (S.D. Fla. 2006); Aetna Cas. & Sur. Co. v. Buck, 594 So. 2d 280, 281 (Fla. 1992) (stating that a person seeking the benefit of a statutorily created remedy had to strictly comply with the requirements of the statute because the remedy is “purely a creature of statute”). The Florida Supreme Court has specifically applied this rule of construction to section 624.155. See Talat, 753 So. 2d at 1283-84. As stated by the Florida Supreme Court, the purpose of a Notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). The purpose of Fla. Stat. Section §624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003). The statute requires this notice to: [S]tate with specificity the following information . . . (1) the statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated[;] (2) the facts and circumstances giving rise to such violation[;] (3) the name of any individual involved in the violation[;] (4) reference the specific policy language that is relevant to the violation, if any . . . [;] (5) a statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Fla. Stat. § 624.155(3)(a). This statute has been interpreted to require that the Notice must be sufficiently specific to provide the insurer with an opportunity to cure the alleged violations. This would include i) identifying the specific policy provision(s) at issue, ii) citing the specific language of the statutory provision(s) the insurer allegedly violated, and iii) specifically identifying what actions the insurer must take to remedy the alleged violations. Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. August 13, 2010); Heritage Corp. of S. Fla. v. Nat’l Union Fire Ins. Co. of Pittsburg, PA, 580 F. Supp. 2nd 1294, 1299-1300 (S.D. Fla. 2008). In addition, providing vague reference to the policy is insufficient to put the insurer on notice of its alleged policy violation. See Julien v. United Prop. & Cas. Ins. Co., 2020 Fla. App. LEXIS 13520, *7 (Fla. 4th DCA September 23, 2020). In contravention of these requirements, the subject Notice is vague and lacks fundamental information to allow First Protective to respond. Specifically, the CRN contains "cures" that are improper pursuant to Florida case law. The Florida Supreme Court in Talat Enterprises, Inc. v. Aetna. Talat provides the scope of what can be "cured" is limited to the alleged non-payment of the contractual amounts due to an insured holding "the contractual amount due the insured is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled..." Here, the Insureds demand: 1) First Protective must immediately acknowledge full coverage under the policy; 2) First Protective must issue payment based on the amount of $47,379.88. The Insureds’ vague and ambiguous demands within the Notice fail to provide First Protective with a clear method to cure. Given the vague cure, even if First Protective were to seek a cure, it would have to speculate what the Insured believes are their owed fees, costs, and interest. Even if First Protective pays what the Insureds demand, whether the Insured is entitled to it or not, the Insured can continue to claim additional damages such as attorney’s fees and litigation over what the Insureds believe are adequate guidelines and standards which it demands. Thus, even with First Protective’s adequate claim handling guidelines and procedures the InsuredS can still claim a failure to cure pursuant to their subjective position on adequate procedures. This is squarely what the Supreme Court of Florida rejected in Talat. 753 So.2d at 1284. According to Talat, the only amount properly sought within the remedy is the contractual amount due. Id. at 1283. Accordingly, the Department should strike the Notice and consider it a nullity for failing to comply with §624.155. The notice filed in this matter includes multiple statutory provisions regardless of whether they are relevant or applicable to the alleged facts contained in the Civil Remedy Notice. Specifically, the Insured alleges that First Protective violated the following statutes and applicable language (as taken from the Notice of Insurer Violations): 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 towards 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)(c) Failing to acknowledge and act promptly upon communications with respect to claims. First Protective adamantly denies each and every allegation set forth in the CRN of insurer violation. The Insureds also fail to state any factual basis for bad faith. A review of the CRN narrative fails to set forth any specific acts of misconduct or otherwise advise First Protective of specific facts underlying the alleged insurer violations. The facts reveal that First Protective promptly and properly investigated the Insureds’ claim. Additionally, the CRN is insufficient on its face and should be rejected since, contrary to the requirements of Section 624.155 of Florida Statutes, the CRN does not specifically describe the facts or circumstances giving rise to each specific violation alleged against First Protective. Further, the CRN misrepresents the facts and mischaracterizes the actions of First Protective regarding the claims asserted by the Insureds. The CRN makes generalized, unsupported, and incorrect statements without specifically identifying the facts that give rise to each of the allegations pursuant to the cited statutory provisions. Notwithstanding the deficiencies, First Protective denies that it acted in any manner that would have violated the statutes cited, or any other statutory provisions, and it asserts this is another reason why the CRN should be rejected. The allegations of the CRN intentionally mischaracterize First Protective’s actions to elicit a sympathetic response to the Insureds. However, the facts show that First Protective did nothing wrong. The allegations of the CRN create inferences that First Protective purposefully delayed resolution of the claim. On or around December 26, 2024, a claim for hail damage was reported by the Insureds to Frontline. The Insureds reported that hail impacted the gutter downspouts and roof, along with interior leaking. First Protective was able to make contact with Keith Luquis later that same day. He noticed water leaking from the living room ceiling, kitchen ceiling, and along the bay window. He reported roof damage. On or around January 3, 2025, an independent adjuster inspected the property on behalf of First Protective. On or around January 9, 2025, an engineer inspected the property on behalf of First Protective. The inspections did not reveal any wind or hail damage consistent with the date of loss. On January 31, 2025, First Protective issued a coverage determination letter to the Insureds. Payment was issued for interior damage. The alleged roof damage was denied for wear, tear, deterioration, and inadequate/improper maintenance. Notwithstanding above-mentioned deficiencies, the following are First Protective’s responses to each of the alleged violations noted in the Civil Remedy Notice: Fla. Stat. §624.155(1)(b)(1): Denied. First Protective conducted a complete, thorough, and timely investigation of the loss utilizing an independent adjuster and engineer to inspect the property. Based on the inspections, First Protective determined there was no coverage for the roof or exterior under the Insureds’ Policy as there was no wind or hail damage consistent with the date of loss. First Protective did open coverage for the interior of the property and issued payment to the Insureds. First Protective has acted fairly and honestly to Insureds. Therefore, no violations of §624.155(1)(b)(1) have occurred. Fla. Stat. §626.9541(1)(i)(3)(a): Denied. First Protective has adopted all proper and best practices and standard operating procedures for claims-handling with regard to §626.9541(1)(i)(3)(a). First Protective conducted a complete, thorough, and timely investigation. First Protective has acted fairly and honestly to Insureds. Fla. Stat. §626.9541(1)(i)(3)(c): Denied. This allegation is unsupported by the facts of this case. First Protective made immediate contact with the Insureds. An inspection performed by an independent adjuster took place one week after the claim was reported to First Protective. Thus, this allegation is wholly without merit. As can be seen from the facts of this claim, the allegations in the CRN are baseless and wholly without merit. Thus, the CRN is purposely drafted in a manner which does not allow First Protective proper notice of the allegations or any meaningful opportunity to respond and/or evaluate the claims being asserted. Based on the forgoing, the CRN is insufficient on its face and should be rejected. Talat Enterprises Inc. vs. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000); Lane v. Westfield Ins. Company, 862 So. 2d 744 (Fla. 5th DCA 2003). In closing, First Protective’s actions in handling the Insureds’ claim were prompt, thorough, conducted in accordance with the Policy and Florida law and most importantly, in good faith. Furthermore, First Protective complied with all obligations under the Policy and the Florida Statutes. Therefore, First Protective denies each and every allegation contained in the Notice. First Protective first requests the CRN be rejected due to its failure to comply with Florida Statute §624.155 and Florida case law. Regardless of the rejection, as demonstrated above, First Protective has, at all times, acted in good faith, with due diligence, and in accordance with the terms of its insurance policy and Florida Statutes with respect to the requests made by the Insureds, and their representatives. First Protective respectfully disagrees with all of the assertions made and expressly denies all allegations contained in the CRN. We trust this response adequately addresses the allegations of violation alleged in the CRN. In addition, you will find a copy of the response submitted to the Florida Department of Financial Services on its website. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Sincerely, By: /s/ Scott T. McCloskey, Esq. Kelley Kronenberg, P.A.

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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008