Civil Remedy Notice of Insurer Violations
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Filing Number:     807957
Filing Accepted:  2/21/2025
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Complainant
Last/Business Name *  
POTTER   First Name   TODD
Street Address * 6316 FOXBROOK TRAIL
City, State Zip * PARRISH, FL 34219
Email Address * MMELLI@ITSABOUTJUSTICE.LAW
Complainant Type: * Insured
Insured
Last/Business Name*   POTTER   First Name   TODD
Policy # * 59-C1-X304-6 Claim #* 59-P916-3F8
Attorney
Attorney is Applicable
Last Name* MELLI First Name * MICHAEL Initial C
Street Address* 350 NORTH LAKE DESTINY ROAD
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * MMELLI@ITSABOUTJUSTICE.LAW
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):* MULTIPLE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Unfair Trade Practice
Claim Denial
Claim Delay
* 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)(d) Denying claims without conducting reasonable investigations based upon available information.
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.

Based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1— Coverage A—Dwelling and Coverage B—Other Structures –“We insure against risk of direct loss in Coverages A and B only if that loss is a physical loss to property.” Section 1— Conditions - Loss Settlement—“Covered property losses are settled as follows: Buildings under Coverage A or B at replacement cost without deduction for depreciation…” Section 1— Conditions - Loss Payment –“We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment.”
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Civil Remedy Notice Insureds’ Name: Todd & Beverly Potter Insureds’ Address: 6316 Foxbrook Trail, Parrish FL 34219 Policy Number: 59-C1-X304-6 Claim Number: 59-P916-3F8 DOL: Hurricane Milton On or about October 9th, 2024, Todd and Beverly Potter (“The Insureds”) suffered severe damage to their home caused by Hurricane Milton. Before the loss, State Farm Florida Insurance Company a/k/a State Farm Fire and Casualty Company (“State Farm”) issued a homeowner’s insurance policy (policy no. 59-C1-X304-6) for the insureds’ home. The policy was in full force and effect on the date of loss and afforded coverage for damage caused by a Hurricane. After providing prompt and dutiful notice of loss, the Insureds fully cooperated with State Farm’s adjustment of the claim, including making the home available for inspection and providing assistance as they could in the investigation. The Insureds were so dedicated to working with State Farm through the claims process that they would go on to request a list of preferred vendors State Farm works with, seeking to use a roofer State Farm endorsed and trusted. State Farm would acknowledge coverage existed for the claim but would ultimately refuse to tender full payment and coverage as owed under the policy. State Farm would incorrectly posit the damaged roof to be repairable. State Farm was made aware this position was incorrect repeatedly. Indeed, State Farm’s failure to adjust the claim properly and in good faith forced their own Insureds to attempt to assist in the claims process for them. The Insureds continually advised State Farm the roof was not able to be repaired and a full replacement was needed. Jarringly, the roofing vendor the Insureds retained, endorsed and recommended by State Farm, also confirmed this to the Insureds. State Farm’s own endorsed roofer was making clear there was no way to effectuate the coverage decision State Farm rendered, and that the decision itself was fundamentally flawed. Needless to say, State Farm did not care. State Farm would go on to attend mediation wherein State Farm again was made aware of these issues and still failed to correct their fundamentally flawed coverage materials. It is clear that State Farm did not act honestly or fairly toward their own Insureds. State Farm forced their Insureds to constructively adjust the claim for them and still refused to reevaluate and adjust the claim in good faith. This refusal to engage by State Farm forced the Insureds to retain counsel. Indeed, State Farm has apparently chosen to implement improper claims handling procedures by rendering a defective coverage determination letter. State Farm has utilized adjusters that routinely ignore or intentionally misidentify relevant evidence, and to refuse to settle claims in good faith when under all circumstances it should have. This is made clear as State Farm attended a mediation, to discuss settlement, was advised their endorsed roofers could not effectuate their defective coverage decision, and still refused to engage in settlement discussions in good faith. State Farm regularly undervalues claims in order to avoid issuing payment on losses that it knows are covered under the policy. State Farm’s practice of not adjusting losses in good faith in accordance with section 627.70131, Florida Statues unnecessarily delays resolution of its claims and leaves claimants with no choice but to incur further time and expense just to be fully indemnified pursuant to the terms of their contracts with State Farm. In order to cure this Civil Remedy Notice, State Farm must immediately acknowledge in writing their mistake and issue the funds they have refused to issue with statutory interest. State Farm must apologize in writing for needless and unjustified claim delay and for forcing their own Insured to retain Counsel. State Farm must compensate their Insured for counsel’s fees and costs out of pocket as State Farm’s inaction, delay, and pattern of neglect forced their Insured to retain counsel. The written acknowledgment and funds should be tendered to the Insureds attorney, Michael Melli, Esq. at 350 N. Lake Destiny Road, Suite 300, Maitland, FL 32751. Based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1— Coverage A—Dwelling and Coverage B—Other Structures –“We insure against risk of direct loss in Coverages A and B only if that loss is a physical loss to property.” Section 1— Conditions - Loss Settlement—“Covered property losses are settled as follows: Buildings under Coverage A or B at replacement cost without deduction for depreciation…” Section 1— Conditions - Loss Payment –“We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment.” State Farm is believed to have violated the following statutory provisions: 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)(d): Denying claims without conducting reasonable investigations based upon available information; and 626.9541(1)(i)(4): Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 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 an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed.
Comments
User Id Date Added Comment
kahansen@mdwcg.com 04-21-2025 This correspondence constitutes State Farm Florida Insurance Company’s (“State Farm”) response to the Civil Remedy Notice of Insurer Violation you filed on behalf of the above captioned Complainant regarding the claim listed above. State Farm welcomes the opportunity to respond to this Civil Remedy Notice of Insurer Violation and specifically denies each and every allegation contained in the Civil Remedy Notice filed in relation to this claim. With that said, State Farm believes that the Civil Remedy Notice you filed fails to comply with the specific notice and information requirements as set forth in the Civil Remedy Notice of Insurer Violation document provisions, Florida Statute §624.155, and Florida Case law. The Notice fails to name all of the individuals involved in the alleged violation as required by Florida Statute §624.155(3)(b)3. The Notice does not mention any of the individuals involved with the evaluation, investigation, or adjusting of the claim related to this alleged violation. Rather, the Notice states “MULTIPLE” but does not identify any specific individual involved in handling Complainant’s claim. This failure to identify any of the specific individuals allegedly involved to the purported violations prevents State Farm from addressing any issues regarding these individuals and is one of the reasons why the Notice does not comply with F.S. § 624.155. Additionally, Florida Statutes require the Complainants, pursuant to section 624.155(3)(b)(4), to include “reference to specific policy language that is relevant to the violation, if any.” However, the Notice does not cite to any specific policy provisions whatsoever but rather merely lists broad generic headers such as “Section 1 Property Coverages- Coverage A- Dwelling and Coverage B- Other Structures- ‘We insure against risk of direct loss in Coverages A and B only if that loss is a physical loss to property”. This failure to cite any specific applicable policy language impedes State Farm’s ability to investigate or properly respond in addition to failing to satisfy the requirement of section 624.155(3)(b)(4) or Florida law (see Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 878 (Fla. Dist. Ct. App. 2021). Florida Statutes also require the Complainant, pursuant to § 624.155(3)(b)(1) to include “[t]he statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated”. The Notice filed in this matter cites statutory provisions regardless to their applicability to the instant claim. The statutes cited in the Notice appear wholly irrelevant or inapplicable to the cited reasons for the Notice. • The Notice first states that State Farm has allegedly violated § 624.155(1)(b)(1) by “[n]ot 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 to her or his interests” however State Farm affirmatively contends that it, amongst other things, timely and thoroughly investigated the claim, dealt fairly with its insureds, and evaluated all relevant information in a reasonable, professional, and honest manner in order to attempt, in good-faith, to resolve the claim while in continued communication with Complainant and/or Complainant’s representatives. Specifically, * On or about October 15, 2024, upon receiving Complainant’s report of the alleged loss, State Farm promptly acknowledged the report, assigned a claim number, and explained the claims handling process. State Farm also mailed Complainant a letter advising Complainant of their post-loss obligations, a letter outlining Complainant’s rights, and a letter detailing Complainant’s right to mediation regarding their claim * On or about October 24, 2024, State Farm’s representative conducted a thorough on-site inspection of the property. * On or about November 11, 2024, State Farm again mailed Complainants a letter advising Complainant of their post-loss obligations, a letter outlining Complainant’s rights, and a letter detailing Complainant’s right to mediation regarding their claim. * On or about December 5, 2024, State Farm sent Complainant a letter acknowledging the submission of additional documentation regarding the claim and requesting additional information. * On or about December 6, 2024, State Farm sent Complainant a letter outlining their coverage determination including the facts and policy language to support it. * On or about December 18, 2024, State Farm sent Complainant a letter acknowledging Complainants submission of additional documentation regarding their claim and requesting additional information. * On or about February 11, 2025, State Farm attended mediation in a good-faith effort to resolve the claim with Complainant. * On or about February 25, 2025, State Farm sent Complainant’s counsel a letter acknowledging their representation with regard to the claim. * And, on or about March 7, 2025, State Farm sent Complainant’s counsel a letter in response to Complainant’s purported Notice of Intent to Litigate. • The Notice states that State Farm has allegedly violated § 624.155(1)(b)(3) by “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 settlement under other portions of the insurance policy coverage” yet as highlighted above, noticeably absent from the Notice are any references to specific policy provisions or relevant policy language whatsoever to justify this baseless contention and issued its coverage determination letter approximately 15 days after receiving notice of the alleged loss. • Additionally, the Notice states that State Farm has allegedly violated § 626.9541(1)(i)(3)(a) by “failing to adopt and implement standards for the proper investigation of claims”, however the allegations in the Notice fail to provide any facts whatsoever to support this alleged violation other than to summarily conclude that State Farm supposedly “hire(s) consultants that routinely ignore or intentionally misidentify relevant evidence.” No actual objective details are provided as to how State Farm’s standards, guidelines, or investigations are allegedly improper to support these baseless conclusions with regard to this alleged loss. • Likewise, the Notice alleges that State Farm has violated §626.9541(1)(i)(3)(b) by “misrepresenting pertinent facts or insurance policy provisions” but, as noted above, no actual insurance policy provisions are cited anywhere in the Notice much less any alleged misrepresentations regarding them. With regard to allegedly misrepresenting facts, the Notice is again silent as to what misrepresentations were allegedly made, or when, or by whom. • Likewise, the Notice alleges that State Farm has violated §626.9541(1)(i)(3)(c) by “failing to acknowledge and act promptly upon communications with respect to claims” but, as outlined in the timeline above herein, State Farm maintained continued contact with Complainant throughout the handling of the claim and continues to do so. • The Notice further states that State Farm has allegedly violated § 626.9541(1)(i)(3)(d) by “[d]enying claims without conducting reasonable investigations based upon available information” however, as noted above, outside of repeating the same broad generic conclusions, the Notice contains no legitimate or accurate objective facts or circumstances to support this meritless allegation. • Lastly, the Notice states that State Farm purportedly violated F.S. § 626.9541(1)(i)(4) by “[f]ailing to pay undisputed amounts of partial or full benefits owed…within 60 days after an insurer receives notice of a …claim, determined the amounts of the partial or full benefits, and agrees to coverage…”; however, the facts here clearly show the opposite. Namely, State Farm received notice of Complainant’s alleged loss on or about October 8, 2022, and had issued a letter to Complainant less than twenty days later on or about October 23, 2022, outlining their coverage determination. Therefore, because the Notice fails to properly identify relevant applicable statutes, State Farm is unable to properly respond and the Notice does not comply with F.S. § 624.155 or Florida law (see Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 878 (Fla. Dist. Ct. App. 2021). Finally, contrary to the statutory requirement “to state with specificity… the facts and circumstances giving rise to the violation” as set forth in §624.155(3)(b)(2), the purpose of which is “to enable the insurer to investigate and resolve [the] claim”, the Notice only provides boilerplate, broad, conclusory, unsupported and incorrect allegations with no basis in fact or circumstances. For example, the Notice alleges that State Farm’s investigation practices are improper and unreasonable, but the Notice does not provide any facts to support this allegation. Additionally, outside of indicating that the loss was related to Hurricane Milton and the need for State Farm to “compensate their Insured for counsel’s fees and costs out of pocket” and “apologize in writing”-1, the Notice does not provide a total amount to cure. This overall failure to provide relevant specific facts or circumstances in the Notice is another example of why it does not comply with F.S. § 624.155. In closing, State Farm first believes that the Civil Remedy Notice does not comply with F.S. § 624.155, and regardless of its lack of the compliance, State Farm denies all allegations contained in the Civil Remedy Notice and submits there are no violations. Lastly, while this response is meant to be comprehensive, State Farm’s response above is based upon the limited information provided in the Civil Remedy Notice and the information we have to date. If the Complainant feels that we are not in possession of all the facts, please inform us immediately. Please note that State Farm’s response is not necessarily exhaustive and does not preclude us from asserting any other valid reason for the lack of compliance with F.S. § 624.155. Also, this letter, or any act or failure to act on the part of State Farm, or any agent or representative of State Farm, should not be construed as a waiver of any rights or defenses, including but not limited to proper notice and service by Complainant, or any other rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this response addresses the allegations of insurer violation 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. Regards, Jennifer L. Hutchins, Esquire Marshall Dennehey, P.C. _____________________________________ 1-Furthermore, under Florida law, F.S. § 624.155 cannot reasonably be construed to require payment of extra-contractual damages to avoid bad-faith litigation until the conditions for payment under the policy have been fulfilled and the insurer has failed to cure within the sixty-day statutory period for cure after notice is filed in accord with the statute. Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000).
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