Civil Remedy Notice of Insurer Violations
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Filing Number:     807765
Filing Accepted:  2/20/2025
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Complainant
Last/Business Name *  
JOHN YEPES AND ANDRES YEPES   First Name  
Street Address * 2708 PISCES DRIVE
City, State Zip * ORLANDO, FL 32837
Email Address * CLAY@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   JOHN YEPES AND ANDRES YEPES   First Name  
Policy # * 0766364668 Claim #* 7007720053-1
Attorney
Attorney is Applicable
Last Name* KUHN First Name * CLAYTON Initial
Street Address* 2110 WEST PLATT STREET
City, State Zip* TAMPA , FLORIDA 33606
Email Address * CLAY@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   TRUCK INSURANCE EXCHANGE
NAIC Company Code 21709
 
Name of individual responsible for violation (if any):* ANY AND ALL PERSONS ASSOCIATED WITH THE CLAIMS HANDLING FROM TRUCK INSURANCE EXCHANGE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE POLICY LANGUAGE RELEVANT TO THE VIOLATIONS INCLUDES ALL APPLICABLE LOSS PAYMENT AND COVERAGE PROVISIONS OF POLICY NUMBER 0766364668 INCLUDING THE DECLARATIONS PAGE AND ALL ENDORSEMENTS TO THE POLICY, WITH RESPECT TO COVERAGES A, B, C, AND D. ADDITIONALLY, ANY SECTIONS RELIED UPON BY THE INSURER IN ITS DENIAL TO FULLY PAY THE CLAIM, INCLUDING THE DUTIES IN THE EVENT OF LOSS PROVISIONS AND THE POLICY'S EXCLUSION OF COVERAGE PROVISIONS.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

John Yepes and Andres Yepes (hereinafter “Insureds”) are homeowners/property owners with an all-risk policy issued by Truck Insurance Exchange (hereinafter “Carrier”). On or about April 29, 2023, Insureds’ home located at 2708 Pisces Drive, Orlando, Florida 32837 sustained significant damage as a result of a hail event. Specifically, a hailstorm event created multiple openings to the roof of Insureds’ property. This resulted in interior water damage to various areas of the interior of Insureds’ property including but not limited to, multiple bedrooms, entryway, living room, dining room, and kitchen. The Loss is covered under Insureds’ policy issued by Carrier. The Insureds mitigated damages by contacting Loss Restorations LLC who performed mitigation services and placed a tarp on the roof of the subject property. All of the relevant documents were provided to Carrier. Insureds promptly reported the claim and fully cooperated with all requests for inspections. Carrier assigned Claim No. 7007720053-1 to the loss. The Insureds have fully cooperated with Carrier’s investigation of the claim, including providing all requested documentation and complying with all post-loss policy conditions. Specifically, the Insureds, with assistance from their public adjuster, submitted an estimate for $52,672.52, which was a fair and reasonable assessment for the repair/replacement of damages. Loss Restorations LLC has an outstanding balance in the amount of $13,700.31 for their mitigation services and tarp placement. Carrier failed to retain qualified experts necessary to identify the repairs necessary to restore the property to its pre-loss condition. Despite Insureds providing Carrier with a detailed estimate, Carrier failed to pay Insureds the amount necessary to repair/replace the damaged property, less the applicable deductible. Instead, Carrier denied full coverage for the loss. This has become a common business practice for Carrier. Under the circumstances surrounding this claim, had Carrier acted fairly and honestly toward the Insureds and with due regard for the Insureds’ interests, Carrier could and should have attempted in good faith to settle this claim. Carrier did not and, instead, dishonestly, and unfairly placed its own interests well ahead of those of the Insureds. In doing so, Carrier violated Section 624.155(1)(b)(1), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to adopt and implement standards for the proper investigation of claims in violation of Section 626.9541(1)(i)(3)(a), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to conduct a reasonable investigation based upon available information. In denying full coverage for this claim without conducting reasonable investigations based upon available information, Carrier has violated Section 626.9541(1)(i)(3)(d), Florida Statutes. By representing to Insureds that the Policy does not afford full coverage for this loss, Carrier is misrepresenting pertinent facts and/or insurance policy provisions relating to coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes. When applying the facts present here to Florida law, it is clear that Carrier is acting in bad faith. Florida Statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Carrier has breached this duty by refusing to properly and timely adjust the loss. Moreover, Section 69B-220.201 of the Florida Administrative Code defines Carrier’s adjusters conduct here as an unfair claims settlement practice. Specifically, Section 69B-220.201(3) provides that “[a]n adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured” and that “[a]n adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.” As detailed above, Carrier’s investigation and adjustment of this claim was done in a manner prejudicial to Insureds, was incomplete, and lacked truthful and unbiased reports of the facts. Carrier has more than enough information and is still refusing to accept coverage for the Insureds’ claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Carrier can cure the defects outlined in this Civil Remedy Notice and avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Insured’s estimate of $52,672.52, and Loss Restorations LLC in the amount of $13,700.31, less applicable deductible, which is the reasonable amount of the covered loss pursuant to the policy. A copy of this form has been submitted to the Florida Department of Financial Services who has transmitted the same to the following parties providing them notice of the filing of this Civil Remedy Notice: Truck Insurance Exchange
Comments
User Id Date Added Comment
capacheco@mdwcg.com 04-28-2026 The parties have reached a resolution as to all issues in dispute.
capacheco@mdwcg.com 04-21-2025 Mr. John Yepes and Mr. Andres Yepes c/o Clayton Kuhn, Esquire Kuhn Raslavich, P.A. 2110 West Platt Street Tampa, FL 33606 clay@thekrfirm.com RE: DFS No.: 807765 DFS Acceptance Date: February 20, 2025 Complainant: John Yepes and Andres Yepes Insured: John Yepes and Andres Yepes Insurer: Truck Insurance Exchange Policy No.: 76636-46-68 Claim No.: 7007720053-1 Alleged DOL: April 29, 2023 Our File No.: 40608.01364 Dear Mr. Yepes and Mr. Yepes: We have been retained by Truck Insurance Exchange (“Truck”) to respond to the Civil Remedy Notice of Insurer Violation (“CRN”) filed with the Department of Financial Services on February 20, 2025 on your behalf under filing number 807765. While Truck welcomes the opportunity to respond to this CRN and specifically denies each and every allegation contained in the CRN referenced above, Truck requests the CRN be rejected by The Department as it fails to comply with several of the requirements of the Civil Remedy Notice of Insurer Violation provisions as set forth in Florida Statute §624.155 and Florida case law. For these reasons, the CRN is insufficient on its face and should be rejected. Contrary to the requirements of Section 624.155, Florida Statutes and The Department’s request, the CRN does not specifically describe the facts or circumstances giving rise to each specific violation alleged against Truck. The CRN fails to identify a single fact in support of its contentions that Truck did not attempt to resolve the claim in good faith and engaged in unfair trade practices. The CRN only asserts these allegations in a conclusory fashion and provides no facts in support of the bare allegations. Further, chapter 626.9541 requires any action to be performed "with such frequency as to be a general business practice" in order to be a violation. The case law is clear that a general business practice means more than "acting in the proscribed manner in the Plaintiff's own claim." Shannon R Ginn Construction Co. v. Reliance Ins. Co., 51 F. Supp. 2d 1347, 1353 (S.D. Fla. 1999). There is no evidence of any of these alleged actions happening in your claim, nor in any other insured's claim. THE CRN ALLEGATIONS The CRN asserts the following reasons for the notice: • Claim Denial • Unfair Trade Practice Further, the CRN alleges Truck Insurance Exchange violated the following Florida statutes: 624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its 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)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Truck’s actions in handling the claim were prompt, thorough, conducted in accordance with the Policy and Florida law, and, most importantly, done in good faith. Furthermore, Truck complied with all obligations under the Policy and Truck's claim was properly adjusted under the Policy. Consequently, Truck is not subject to liability under Florida Statute §624.155 pursuant to Florida law. DISCUSSION A proper CRN must specifically identify Policy language that is relevant to the violation. A valid CRN “shall state with specificity the following information…(4) reference to specific policy language that is relevant to the violation, if any.” Fla. Stat. § 624.155(3)(b)(4). The CRN merely states: “The Policy language relevant to the violations includes all applicable loss payment and coverage provision of Policy Number 0766364668 including the declaration page and all endorsements to the policy… .” On its face, the CRN fails to state with specificity the specific policy language that is relevant whether the subject property was damaged by a covered loss. Furthermore, the CRN fails to state with specificity the relevant exclusions to coverage and how the amount of the insurance payment is determined if the subject property was damaged by a covered loss. Therefore, the CRN is statutorily deficient. See Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 879 (Fla. 4th DCA 2021) (upholding the dismissal of an insured’s bad faith lawsuit because the CRN failed to state with specificity the specific policy language at issue). Furthermore, a proper CRN requires the complainant describe the facts and circumstances giving rise to the insurer’s violation as they understand them at the time of filing to enable the insurer to investigate and resolve their claim. Fla. Stat. § 624.155(3)(b)(4). As can be seen, the CRN fails to provide any specific facts or circumstances giving rise to each specifically alleged violation and merely makes conclusory statements that Truck acted in bad faith. For example, the Complainant claims “Carrier failed to retain qualified experts necessary to identity the repairs necessary to restore the property to its pre-loss condition” but fails to provide any facts about the field adjuster’s investigation that could support this conclusion. Additionally, the Complainant claims that Truck denied the claim in full without conducting a reasonable investigation, but again fails to provide any facts to support this allegation. Moreover, this allegation misrepresents the coverage decision made by Truck. That is, Insured reported a hailstorm claim with a date of loss of April 29, 2023 to Truck on June 13, 2024. Truck inspected the property and investigated the loss and determined that only certain damages were subject to coverage under the Policy. Based on its inspection findings, Truck made a payment of $2,392.50 ACV to Insured. Truck provided correspondence dated July 6, 2024 detailing its coverage decision to Insured supported by facts and policy language, well within the statutory period. It appears what really caused the Complainant to file this CRN is a dispute over the money owed to the Complainant related to their homeowner’s claim. However, a dispute over insurance proceeds does not necessarily rise to the standard of bad faith. See Fortune v. First Protective Ins. Co., 302 So. 3d 485, 490 (Fla. 2nd DCA 2020) (“Of course, a mistaken denial of payment does not necessarily mean that the insurer acted in bad faith.”); 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1195 (N.D. Fla. 2008) (Under Florida law, “mere inability to agree to a dollar amount does not prove bad faith on the part of the insurer. So long as the insurer exercised good faith in attempting to adjust the claim, the insurer will not be held to have violated § 624.155.”). Insured’s allegations that there were Rule violations is also without support and is contradicted by the facts. Regarding Insured’s allegation that Rule 69B-220.201(3) was violated, the allegations are completely without merit. No facts are provided in support of these allegations. Truck denies any allegations suggesting biased behavior of the adjuster and asserts that the claim was in no matter approached in any way that was prejudicial to Insured. Regarding Insured’s allegation that any subsection under Rule 69B-220.201(3) was violated, this allegation is without any support. Truck asserts that all adjusters involved were more than competent and knowledgeable of the coverage involved and the loss at issue and further, Truck denies all allegations that its adjusters lacked truthful and unbiased investigation and reporting of the facts related to the loss. Finally, the CRN merely quotes general statutory language and fails to allege the specific actions or inactions by Truck which correspond to each alleged statutory violation. Instead, the CRN alleges in a general and conclusory nature Truck failed and/or refused to properly adjust the loss and failed to pay the claim. As will be seen from the facts of this claim, these allegations are baseless and wholly without merit. Instead, the CRN is purposefully drafted in a manner which does not allow Truck proper notice of the allegations or any meaningful opportunity to respond and/or evaluate the claims being asserted. Based upon the foregoing, the CRN is insufficient on its face. See, Talat Enterprises Inc., vs. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000); Lane v. Westfield Ins. Co., 862 So. 2d 744 (Fla. 5th DCA 2003); Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276, 2 (MD Fla. June 6, 2006); Longpointe Condominium Ass’n v. Allstate Ins. Co., 2005 WL 1315810 (MD Fla. June 2, 2005). Notwithstanding these deficiencies, Truck denies it committed the alleged acts or violated the statutes cited and asserts this is another reason why the CRN should be rejected. Setting forth the factual background, Truck issued a homeowners insurance policy, identified by number 76636-46-68, with effective dates of June 17, 2022 through June 17, 2023, (the “Policy”) to Andres Yepes and John Yepes, for property located at 2708 Pisces Drive, Orlando, Florida 32837 (the “Property”). The Policy includes Coverage A – Dwelling limit of $252,000.00; Coverage B – limit of $5,040.00; Coverage C – Personal Property limit of $126,000.00; and Coverage D – Loss of Use limit of $25,200.00. The Policy includes an all other peril deductible of $500.00. On or about June 13, 2024, Insured’s Public Adjuster Trust Public Adjusters reported to Truck that the Insured’s property suffered damage as result of a hailstorm on or about April 29, 2023. Truck acknowledged receipt of the claim on June 13, 2024 via correspondence to Insured. Truck also sent out the Florida Homeowner Bill of Rights to the Insured. On June 17, 2024, Truck sent its Acknowledgement of Letter of Representation to Insured’s Public Adjuster Trust Public Adjusters. Along with its Letter of Representation, Trust Public Adjusters provided an estimate for water mitigation services by Loss Restorations. Truck coordinated its inspection of the property with Insured’s Public Adjuster. On June 18, 2024, Truck sent Insured correspondence advising of Insured’s Duties After Loss under the Policy. On June 28, 2024, Truck sent Insured’s Public Adjuster a copy of Insured’s Policy. On July 1, 2024, Truck inspected the subject property. The inspection included the roof and other exterior elevations of the subject property as well as the interior based on reported water intrusion damage. Truck observed damage to the shingle roof consistent with wear and tear and deterioration. Notably, no wind or hail damage was observed on the roof surface. Truck found no collateral storm or hail damage to the screens, windows, or soft metals on the property. Further, prior repairs were apparent on all slopes of the roof. The interior damage to the property was observed to be dry out holes from the water mitigation vendor in the living room and bedroom as well as warping of the flooring in the living room from repeated exposure to moisture which appeared unrelated to the alleged water leaks from the ceiling. Insured provided water mitigation documentation from Loss Restoration which showed that dry out and tarp efforts were not commended until June 10, 2024, over a year after the alleged date of loss. On or about July 6, 2024, Truck sent its coverage determination letter partially denying coverage under the Policy. Truck made its payment to Insured totaling $2,392.50, after applicable deductible and depreciation withheld. Truck also denied certain claimed damage to the property per the exclusionary language in the Policy including claims for damage to the roof and delayed mitigation efforts. The correspondence to Insured included reference to the applicable language within the Policy, including exclusions for Wear and Tear and Deterioration and Settlement. At this time, neither Insured nor Public Adjuster have provided Truck with proof of repairs or any documentation demonstrating repairs have begun or been completed. On or about July 13, 2024, Truck received an estimate of damages for full roof replacement and repairs to the interior from Insured’s Public Adjuster totaling $52,672.52 w/ O&P dated July 13, 2024. Subsequently, the same repair estimate was provided along with Insured’s Notice of Intent to Initiate Lawsuit on February 20, 2025. On July 14, 2024, Truck sent email correspondence to Insured’s Public Adjuster acknowledging receipt of its estimate and advised that the claimed damages therein fell outside the scope of work covered under the Policy. As such, no additional payments was made for the loss. On February 20, 2025, Truck received this CRN and on March 13, 2025, Truck was served with a breach of contract lawsuit filed by the Insured on March 7, 2025. As demonstrated in detail above, Truck performed a timely and full investigation of the Insured’s claim. After Truck’s inspection, it was determined the damage to the roof of the property was not covered under the Policy. Truck’s inspection discovered only certain damage to the property that would be covered under the Insured’s Policy. However, Truck also observed damage to the Insured’s property that was caused by wear and tear and other excluded causes over time. Truck has at all times investigated the Insured’s claim in good faith. Therefore, as reflected above, there is simply no basis for the claims made by the Insured. Truck thoroughly investigated the Insured’s claim and Truck was in constant communication with the Insured and/or their representatives about the status, progression, and ultimate claim outcome. In closing, Truck first requests the CRN be rejected due to its failure to comply with Florida Statute §624.155 and Florida case law, and regardless of the rejection, as demonstrated above, Truck 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 handling of the Insureds’ claim. Truck expressly denies all allegations contained in the CRN. We trust this response addresses the allegations of violations alleged in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very truly yours, Carolin A. Pacheco, Esq.
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