Civil Remedy Notice of Insurer Violations
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Filing Number:     807992
Filing Accepted:  2/23/2025
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Complainant
Last/Business Name *  
BRILUS   First Name   MILTON AND BEATRICE
Street Address * 1409 NORTH WAY
City, State Zip * HOLLYWOOD, FL 33024
Email Address * BMILTONCHERY@YAHOO.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BRILUS   First Name   MILTON AND BEATRICE
Policy # * 1501-1706-3661 Claim #* FL19-0137221
Attorney
Attorney is Applicable
Last Name* ALTMAN First Name * ALEXIS Initial
Street Address* 925 SOUTH FEDERAL HIGHWAY, 7TH FLOOR
City, State Zip* BOCA RATON , FL - FLORIDA 33432
Email Address * AALTMAN@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* TODD BRANT
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This loss was clearly covered under the following provision of Section 1- Perils Insured Against. A. Coverage A- Dwelling and Coverage B- Other Structures. 1. We insure against direct physical loss to property described in Coverages A and B. However, loss does not include and we will not pay for any “diminution in value”. 2. We do not sure however, for loss: (5) Constant or repeated seepage or leakage of water or steam or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years, unless such seepage or leakage of water or steam or the presence or condensation of humidity, moisture or vapor, and the resulting damage is unknown to all “insureds” and is hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure; The Policy further provides: However, unless otherwise excluded or limited elsewhere in the policy, we will cover loss to property covered under Coverage A or B resulting from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the residence premises. This includes the cost to tear out and repair only that part of a building or only that part of another structure covered under Coverage A or B on the residence premises, necessary to access and repair the system or appliance from which the water or steam escaped. Loss Settlement In this Condition D., the terms cost to repair or replace and replacement cost do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in Additional Coverage 11. Ordinance Or Law under Section I – Property Coverages. Additionally, the valuation of any covered property losses does not include and we will not pay any amount for “diminution in value”.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

As discussed in greater detail in the notice, the carrier has not attempted in good faith to settle the insureds’ 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. The carrier has done everything possible to delay the claim and refuses to pay the complete covered loss amount due under the policy. Furthermore, the carrier is required to properly investigate and adjust claims and cannot place that burden upon the insureds. This was made clear by the appellate court and the Florida Supreme Court in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005)(“The Legislature has clearly chosen to impose on the insurance companies a duty to use good faith and fair dealing in processing and litigating the claims of their insureds…”). The carrier was put on notice of Mr. and Mrs. Milton Brilus’ (insured) water damage claim which was a result of a cast iron system break. Rather than sending a plumber out to the home to evaluate the damages from day one, as it was reported as a leak from a pluming break, the carrier requested several documents from the insured including videos of the plumbing lines, which were provided. An adjuster Deion McNair was assigned to the claim. Deion was tasked with inspecting the insureds home and taking a recorded statement. Mr. McNair went to the home and took photographs of the damages but failed to ask the homeowner one question about the loss, although Mr. Brilus was at the inspection. After the inspection, Mr. McNair then sent an email to have a recorded statement taken. Although under the policy, the carrier has 90 days to make a coverage determination, after 90 days Universal started sending letters that a plumber needed to go to the home to inspect. Universal sent its plumber to the home, but the plumber left because the insured’s public adjuster was not at the home, even though the insured’s mother-in-law, who lives at the home, allowed the plumber access. The carrier thereafter denied the claim stating they were unable to determine the health of the sanitary lines because their plumber was denied entry. What made this most ludicrous was that the insured provided a video of the lines, and that was all the plumber needed to look at. This claim was litigated for two years until it went to trial. During litigation the deposition of Mr. Milton Brilus was taken by an attorney Anthony Peyton. At Mr. Brilus’ deposition, Mr. Peyton stated on the record that he wanted to get this resolved for the family and that he would have Universal send someone out to do an inspection, but that was never done, and Mr. Peyton ended up leaving Universal. Additionally, Universal denied the claim two years ago for failure to comply with post loss conditions, but then in the middle of trial was allowed to add the exclusions of wear and tear and long-term leakage and seepage. They supported this defense with their expert from Rimkus, who has been paid beyond millions doing expert work for Universal in the last three years. Mr. Marsenison lied on the stand and stated that the photographs from the insured’s expert plumber were taken before the field adjuster ever went out there to support their theory that this had been a problem that Mr. Brilus had been aware about for years. At trial, Mr. Jimmy Casas was the corporate representative who testified on behalf of Universal. Under oath Mr. Casas misrepresented the provisions of the policy that would allow coverage for the loss. This included when Mr. Casas was asked about the provisions allowing for the ensuing loss that occurred as a result of the pipes. Mr. Casas under oath testified that the policy did not cover the ensuing loss from the water from the damaged pipes. Every time he was questioned about a provision such as the fact that a leak would be covered if hidden, he would testify that the provision did not apply or could not be read like it. It was truly appalling to see someone outright lie about what the policy said to win a trial. Mr. and Mrs. Brilus are of Haitian descent. They are both extremely hard workers. Their home was built in 1960s with cast iron pipes. Universal’s attorneys tried to villainize the insureds for requesting a re-piping of their home, which was the only way to bring the home back to its pre-loss condition. The jury saw through the attorneys’ attempts and continued to ask questions as to what research did Universal do before insuring this home. Mr. Casas responded to a jury question that they Universal does absolutely no research before insuring a home other than making sure the home exists. Universal’s tactic is just a gambling on homes, it insures a home from 1960 and then when the pipes deteriorate as expected and a water loss occurs, they find any way to deny the claim. Here it was under the guise of a failure to comply with post loss conditions. Universal has continued to treat the Haitian community poorly and fails to cover their losses that are clearly covered under the policy. The jurors saw right through Universal’s practices and awarded Mr. and Mrs. Brilus $168,168.77. This was the amount of the sworn proof of loss, which Universal brought into evidence as an attempt to make the Mr. and Mrs. Brilus look greedy. Rather than pay the award and allow its insureds to use its kitchen. While the insureds continue to pay their premium, Universal appealed the verdict leaving the insureds two more years of not being able to use their kitchen, for a total of 5 years. Policy Violation: This loss was clearly covered under the following provision of Section 1- Perils Insured Against. A. Coverage A- Dwelling and Coverage B- Other Structures. 1. We insure against direct physical loss to property described in Coverages A and B. However, loss does not include and we will not pay for any “diminution in value”. 2. We do not sure however, for loss: (5) Constant or repeated seepage or leakage of water or steam or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years, unless such seepage or leakage of water or steam or the presence or condensation of humidity, moisture or vapor, and the resulting damage is unknown to all “insureds” and is hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure; The leak at issue here started behind a block wall. Mr. Brilus testified that he was unaware of the leak until he saw paint pealing on the block wall. Universal’s Expert however testified based on pure speculation that Mr. Brilus had known about the leak prior to the day that he testified he had discovered it. The Policy further provides: However, unless otherwise excluded or limited elsewhere in the policy, we will cover loss to property covered under Coverage A or B resulting from an accidental discharge or overflow of water or steam from within a plumbing, heating, air conditioning or automatic fire protective sprinkler system or household appliance on the residence premises. This includes the cost to tear out and repair only that part of a building or only that part of another structure covered under Coverage A or B on the residence premises, necessary to access and repair the system or appliance from which the water or steam escaped. Loss Settlement In this Condition D., the terms cost to repair or replace and replacement cost do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in Additional Coverage 11. Ordinance Or Law under Section I – Property Coverages. Additionally, the valuation of any covered property losses does not include and we will not pay any amount for “diminution in value”. CLAIM INVESTIGATION/ADJUSTMENT VIOLATIONS: The carrier’s actions are in violation of the Loss Settlement provision of the policy as well as 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. The first inspection done by Universal, Universal should not have sent out just their field adjuster since he was not qualified to determine a cause of loss, they should have sent out a plumber. After 90 days they then requested to send a plumber. Thereafter, denied the claim based on the insured’s public adjuster not being at the residence when Universal’s plumber went out to inspect the property. The insured’s mother-in-law was at the home and provided full access to the home, there was no need for the public adjuster to be at the property. Furthermore, the insured provided videos of the pipes. This video was utilized by Universal’s own expert at trial in coming to his opinion. However, Universal could not testify whether anyone ever reviewed the video of the plumbing lines prior to trial. It was clear that this was a covered loss, and Universal had all the information it needed but instead denied the claim. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Clearly the field adjuster was not equipped to investigate a simple plumbing case. The carrier received the invoice from the insured’s plumber who did a temporary repair and a video of the insureds’ cast iron pipes. Noone on behalf of Universal reviewed those documents. What was the purpose of requesting these documents if no one is going to review them. This is all part of Universal’s failure to adopt and implement standards for the proper investigation, which includes actually having someone review the documents that are provided by the insured. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Defendant has misrepresented to the Insured and the Court in its filings that the Plaintiff did not comply with their post loss duties. Universal stated that the insureds refused to permit their plumber at their property, however the evidence showed that the plumbers had full access to the home and instead chose not to enter because the public adjuster was not at the house. Furthermore, Mr. Casas misrepresented that the policy does not cover ensuing losses, and that hidden leaks are not covered under the policy when confronted with both provisions. Fla. Stat 626.9541 (i) (3) (f)Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement; Here, the Defendant attempted in litigation to allege affirmative defenses based on exclusions in the policy, for the first time, years after its coverage decision. The above provision requires the carrier to explain portions of the claim it will cover and not and link those reasons to the policy. Its clear the coverage decision in this case did no such thing as it simply provided coverage for the claim. Universal has a pattern and practice of attempting to go back and “re-write” its coverage decision in litigation as means of leveraging settlement or retaliation for the underlying breach of contract lawsuit. This notice is provided in order to perfect a right to pursue the civil remedy authorized by Florida Statute §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1) Pay the verdict awarded to the insureds in the amount of $ 96,150.00. 2) Pay the post judgment interest due and owed until the day of payment 3) Pay the insureds attorneys’ fees and costs as they have been forced to retain counsel and litigate this case unnecessarily; 4) Pay the statutory interest on the amount of unpaid damages from the date of the loss to the date payment is finally made. Should you have any questions, please do not hesitate to contact me at (561)-892-9988. Thank you for your attention to this matter. Sincerely, Alexis Altman
Comments
User Id Date Added Comment
aduke@flalawyer.net 04-08-2025 Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by attorney, Alexis Altman, on behalf of Complainants, Milton and Beatrice Brilus (also referenced as the “Insureds”). The Notice alleges violations of Florida Statute §§ 624.155(1)(b)(1) & (3); Florida Statute §§ 626.9541(1)(i)(3)(a)–(d); and Florida Statute § 626.9541(1)(i)(3)(f). Universal specifically denies each allegation contained in the Notice and denies that it violated these or any statutes, Florida law, or any policy provisions regarding the adjustment of the subject insurance claim. Moreover, Universal states that the Notice is statutorily deficient and prejudices Universal’s ability to thoroughly investigate the alleged violations within 60-days because the Notice fails to comply with the specificity requirements set forth by Florida Statute § 624.155 and Florida bad faith jurisprudence. Moreover, the Notice does not provide Universal with proper means to “cure” the alleged defects without paying extra-contractual benefits that are not due and owing to the Insureds. For example, the Notice requests the advanced payment of “attorneys’ fees and costs.” Not only does this curative demand explicitly contravene the precedent established by Florida Supreme Court’s opinion in Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000), as of the date of this response, neither the Plaintiffs’ entitlement to fees and costs nor the lodestar amount reasonably awardable have been determined in the Insureds’ Broward County lawsuit against Universal, Case No. CACE-21-020760, which still remains actively litigated. A Civil Remedy Notice aims to provide the insurer a final opportunity to “cure” the alleged wrongdoing by complying with the contractual obligations of the policy and/or paying the amounts contractually due and owed to its’ insureds. See Talat Enterprises, Inc., 753 So. 2d at 1278. However, Florida Statute § 624.155 does not impose an obligation on an insurer to pay whatever amount its insureds demand. Id., at 1282. On the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice is limited to contractual amounts due to the insureds under the terms and conditions of subject policy of insurance. Id., at 1281. Here, the Complainants demand extra-contractual damages as a means to cure, including (1) payment of $96,150.00; (2) payment of post- and pre-judgment interest; and, (3) payment of the insureds attorneys’ fees and costs that have yet to be determined in Case No. CACE-21-020760. Universal is only obligated to pay contractual amounts owed to its Insureds as determined by the terms and conditions of the subject policy in order to facilitate a legal “cure.” Accordingly, as a good faith measure to cure this Notice, and without waiving any rights, Universal states that it has issued three (3) payments to the Insureds on or about April 7, 2025, in the following amounts: (1) $93,650.00 in accord with the March 28, 2025 Second Amended Final Judgment entered in Case No.: CACE-21-020760; (2) $32,441.92 for the amount of prejudgment interest owed from the date of loss, November 12, 2019, through the date of said payment; and, (3) $129.62 for the amount of post-judgment interest owed from the date of entry of the Second Amended Final Judgment through the date of said payment. As such, Universal has cured this Notice within 60-days as intended by the Florida Legislature, as all policy benefits due and owed to the Insureds have been paid––rendering this Notice moot as a matter of Florida law. As for the Notice’s demand for payment of the Insureds’ attorneys’ fees and costs, Universal states that this curative demand is invalid under Florida law, and nonetheless, Plaintiffs’ entitlement to fees and costs, as well as the lodestar amount reasonably owed, have yet to be determined in Case No.: CACE-21-020760. As such, not only is this curative demand invalid under Florida law, the demand for attorneys’ fees and costs also places Universal in a Valenti guessing game as to what amounts would be owed to the insureds as the prevailing party in Case No.: CACE-21-020760 once entitlement to fees and costs are determined. See Sully v. Scottsdale Ins. Co., 2024 WL 1857456, at *5 (S.D. Fla. Apr. 29, 2024)(citing Valenti v. Unum Life Ins. Co. of Am., 2006 WL 1627276, at *2 (M.D. Fla. June 6, 2006)). With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth by Florida law and Florida Statute § 624.155. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). The Florida Supreme Court holds that § 624.155 “must be strictly construed” because it is a statute in derogation of Florida’s common law. Talat Enterprises, Inc., 753 So. 2d at 1283. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainants specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Here, the Notice fails to meet the requirements of Florida law on several grounds. First, regarding the requirement to set forth the specific “facts and circumstances giving rise to the violation,” the Notice fails to specify sufficient facts stated with specificity that would put Universal on notice that it violated any policy provisions or statutes. The Notice alleges the following non-exclusive conclusory statements without specifying any facts: (1) “the carrier has not attempted in good faith to settle the insureds’ claim . . . [and] has done everything possible to delay the claim and refuses to pay the complete covered loss amount due under the policy; (2) “Universal has a pattern and practice of attempting to go back and “re-write” its coverage decision in litigation as means of leveraging settlement or retaliation for the underlying breach of contract lawsuit.” The Insureds are required by Florida law to list the facts and circumstances with the requisite specificity that gives rise to the purported violations, not conjecture or speculation of the carrier’s business practices. Moreover, the Notice purports conclusory allegations regarding that solely relate to Universal’s defense of the lawsuit filed against it by the Insureds, Case No.: CACE-21-020760. The Parties’ litigation strategies are not a proper subject for a Civil Remedy Notice and therefore not relevant in this forum. Furthermore, the Notice generally alleges that Universal violated Florida Statute § 626.9541(1)(i)(3)(b) but fails to identify who made the misrepresentation in order to facilitate Universal’s proper investigation into the allegation. The Notice solely lists “Todd Brant” as the person representing the insurer who are most responsible for and/or knowledgeable of the facts giving rise to the allegations in the Notice, however, the Notice completely fails to list any facts to support the conclusory allegation. The Notice does not describe in any way how Mr. Brant was involved in any of the alleged conclusory allegations of statutory violations and policy breaches or how he is the person with most knowledge of the allegations in the Notice. In addition, the Notice fails to satisfy Florida Statute § 624.155(3)(b)(4) because the Insureds fail to reference the specific policy language relevant to Notice’s alleged violations. Instead, the Notice references several policy provisions but fails to specify any facts regarding how the cited provisions apply to the Insureds’ claim and/or how they were allegedly violated. The Notice is extremely broad in scope and fails to identify “specific policy language” relevant to any alleged violation. Lastly, and as previously referenced, the Notice does not provide a proper means whereby Universal can “cure” the alleged defects without paying extra-contractual benefits that are not due and owed to the Insureds. Here, the Notice demands extra-contractual benefits including, but not limited to, payment of the insureds attorneys’ fees and costs. These are the precise type of extra-contractual demands that were discussed in the Florida Supreme Court’s precedent of Talat Enterprises, Inc. and held to be invalid. Accordingly, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following facts and circumstances are known to Universal based on available information and demonstrates that Universal did not act in bad faith as purported in the Notice. At the time this Notice was filed, there was an active appeal taken on the October 17, 2023, final judgment entered in Plaintiffs’ favor. Universal had timely filed its Notice of Supersedeas Bond, automatically staying execution of the final judgment pending this appeal. On or about March 12, 2025, the Fourth (4th) District Court of Appeals of Florida reversed the final judgment and directed the trial court on remand to issue a remittitur of damages to $96,150.00, consistent with the Fourth District Court of Appeals’ mandate. On March 28, 2025, the trial court entered the Second Amended Final Judgment in favor of the Insureds for the amount of $93,650.00. This represented the post-remittitur damages of $96,150.00 minus the subject Policy’s deductible of $2,500.00. On or about April 7, 2025, Universal issued three (3) payments to the Insureds in full accord with the Second Amended Final Judgment. As such, this Notice has been rendered moot and has been fully resolved by said payments. We trust that the foregoing is sufficient to advise you of Universal’s position with regard to this matter and fully responds to the alleged violations in the Notice filed by the Complainants. Sincerely, Adam A. Duke* Adam A. Duke For the firm *electronically signed to avoid delay.
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