Civil Remedy Notice of Insurer Violations
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Filing Number:     808352
Filing Accepted:  2/25/2025
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Complainant
Last/Business Name *  
GREENE VICTORY, LLC   First Name  
Street Address * 6737 TOWER DRIVE
City, State Zip * HUDSON, FL 34667
Email Address * GREENEVICTORYLLC@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   GREENE VICTORY, LLC   First Name  
Policy # * DNAPF014111-02 Claim #* 1156536
Attorney
Attorney is Applicable
Last Name* O'NEIL First Name * JONATHAN Initial
Street Address* 203 FORT WADE ROAD, SUITE 260
City, State Zip* PONTE VEDRA , FLORIDA 32081
Email Address * JONATHAN@WOOLSEYMORCOM.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):* THOMAS MANCHESTER (FLA. AD, LIC. # P103546) AND GARY HORTH (FLA. AD, LIC. # A123405)
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Delay
Other : Wrongful claim denial
Unfair Trade Practice
Other : Unfair claim settlement practices
Other : Unreasonable investigation
Other : Failure to act on claim
Other : Failure to conduct a reasonable investigation based on available information
Other : Failure to maintain proper complaint handling procedures
Other : Misrepresenting the insurance policy provisions to the insured
Other : Misrepresenting Florida statutory provisions to the insured
Other : Misrepresenting facts to the insured
Other : Failure to acknowledge and act promptly upon communications with respect to claims
Other : Denying claims without conducting reasonable investigations based upon available information
* 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)(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)(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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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.

SECTION III – PROPERTY COVERED A. COVERAGE A - BUILDING PROPERTY We insure against direct physical loss by or from flood to: 1. The building described on the Declarations Page at the described location. If the building is a condominium building and the named insured is the condominium association, Coverage A includes all units withinthe building andthe improvements within the units, provided the units are owned in common by all unit owners. 2. We also insure building property for a period of 45 days at another location as set forth in III.C.2.b., Property Removed to Safety. 3. Additions and extensions attached to and in contact with the building by means of a rigid exterior wall, a solid load-bearing interior wall, a stairway, an elevated walkway, or a roof. At your option, additions and extensions connected by any of these methods may be separately insured. Additions and extensions attached to and in contact with the building by means of a common interior wall that is not a solid load-bearing wall are always considered part of the building and cannot be separately insured. 4. The following fixtures, machinery, and equipment, which are covered under Coverage A only: a. Awnings and canopies; b. Blinds; c. Carpet permanently installed over unfinished flooring; d. Central air conditioners; e. Elevator equipment; f. Fire extinguishing apparatus; g. Fire sprinkler systems; h. Walk-infreezers; i. Furnaces; j. Light fixtures; k. Outdoor antennas and aerials attached to buildings; l. Permanently installed cupboards, bookcases, paneling, and wallpaper; m. Pumps and machinery for operating pumps; n. Ventilating equipment; o. Wall mirrors, permanently installed; and p. In the units within the building, installed: (1) Built-in dish washers; (2) Built-in microwave ovens; (3) Garbage disposal units; (4) Hot water heaters, including solar water heaters; (5) Kitchen cabinets; (6) Plumbing fixtures; (7) Radiators; (8) Ranges; (9) Refrigerators; and (10) Stoves. 5. Materials and supplies to be used for construction, alteration, or repair of the building or a detached garage while the materials and supplies are stored in a fully enclosed building at the described location or on an adjacent property. **** 8. Items of property in a building enclosure below the lowest elevated floor of an elevated post-FIRM building located in Zones A1-A30, AE, AH, AR, AR/A, AR/AE, AR/AH, AR/A1- A30, V1-V30, or VE, or in a basement, regardless of the zone. Coverage is limited to the following: a. Any of the following items, if installed in their functioning locations and, if necessary for operation, connected to a power source: (1) Central air conditioners; (2) Cisterns and the water in them; (3) Drywall for walls and ceilings in a basement and the cost of labor to nail it, unfinished and unfloated and not taped, to the framing; (4) Electrical junction and circuit breaker boxes; (5) Electrical outlets and switches; (6) Elevators, dumbwaiters, and related equipment, except for related equipment installed below the base flood elevation after September 30, 1987; (7) Fuel tanks and the fuel in them; (8) Furnaces and hot water heaters; (9) Heat pumps; (10) Non-flammable insulation in a basement; (11) Pumps and tanks used in solar energy systems; (12) Stairways and staircases attached to the building, not separated from it by elevated walkways; (13) Sump pumps; (14) Water softeners and the chemicals in them, water filters, and faucets installed as an integral part of the plumbing system; (15) Well water tanks and pumps; (16) Required utility connections for any item in this list; and (17) Footings, foundations, posts, pilings, piers, or other foundation walls and anchorage systems required to support a building. b. Clean-up. B. COVERAGE B - PERSONAL PROPERTY 1. If you have purchased personal property coverage, we insure, subject to B.2., 3., and 4. below, against direct physical loss by or from flood to personal property inside a fully enclosed insured building: a. Owned solely by you, or in the case of a condominium, owned solely by the condominium association and used exclusively in the conduct of the business affairs of the condominium association; or b. Owned in common by the unit owners of the condominium association. We also insure such personal property for 45 days while stored at a temporary location as set forth in III.C.2.b., Property Removed to Safety. 2. When this policy covers personal property, coverage will be either for household personal property or other than household personal property, while within the insured building, but not both. a. If this policy covers household personal property, it will insure household personal property usual to a living quarters, that: (1) Belongs to you, or a member of your household, or at your option: (a) Your domestic worker; (b) Your guest; or (2) You may be legally liable for. b. If this policy covers other than household personal property, it will insure your: (1) Furniture and fixtures; (2) Machinery and equipment; (3) Stock; and (4) Other personal property owned by you and used in your business, subject to IV. Property Not Covered 3. Coverage for personal property includes the following property, subject to B.1.a and B.1.b above, which is covered under Coverage B only: a. Air conditioning units installed in the building; b. Carpet, not permanently installed, over unfinished flooring; c. Carpets over finished flooring; d. Clothes washers and dryers; e. "Cook-out" grills; f. Food freezers, other than walk-in, and food in any freezer; g. Outdoor equipment and furniture stored inside the insured building; h. Ovens and the like; and i. Portable microwave ovens and portable dishwashers. 4. Coverage for items of property in a building enclosure below the lowest elevated floor of an elevated post-FIRM building located in Zones A1-A30, AE, AH, AR, AR/A, AR/AE, AR/AH, AR/A1-A30, V1-V30, or VE, or in a basement, regardless of the zone, is limited to the following items, if installed in their functioning locations and, if necessary for operation, connected to a power source: a. Air conditioning units, portable or window type; b. Clothes washers and dryers; and c. Food freezers, other than walk-in, and food in any freezer. 5. Special Limits. We will pay no more than $2,500 for any one loss to one or more of the following kinds of personal property: a. Artwork, photographs, collectibles, or memorabilia, including but not limited to, porcelain or other figures, and sports cards; b. Rare books or autographed items; c. Jewelry, watches, precious and semiprecious stones, or articles of gold, silver, or platinum; d. Furs or any article containing fur which represents its principal value. 6. We will pay only for the functional value of antiques. 7. If you are a tenant, you may apply up to 10 percent of Coverage B limit to improvements: a. Made a part of the building you occupy; and b. You acquired or made at your expense, even though you cannot legally remove them. This coverage does not increase the amount of insurance that applies to insured personal property 8. If you are a condominium unit owner, you may apply up to 10 percent of the Coverage B limit to cover loss to interior: a. Walls; b. Floors; and c. Ceilings; that are not covered under a policy issued to the condominium association insuring the condominium building. This coverage does not increase the amount of insurance that applies to insured personal property. 9. If you are a tenant, personal property must be inside the fully enclosed building. C. COVERAGE C - OTHER COVERAGES 1. Debris Removal a. We will pay the expense to remove non-owned debris on or in insured property and owned debris anywhere. b. If you or a member of your household perform the removal work, the value of your work will be based on the Federal minimum wage. c. This coverage does not increase the Coverage A or Coverage B limit of liability. **** D. COVERAGE D – INCREASED COST OF COMPLIANCE 1. General: This policy pays you to comply with a State or local floodplain management law or ordinance affecting repair or reconstruction of a structure suffering flood damage. Compliance activities eligible for payment are: elevation, floodproofing, relocation, or demolition (or any combination of these activities) of your structure. Also refer to: Coverage A provision, coverage B provision, coverage C provision, coverage D provision, all additional coverages provisions, all coverages provided by endorsement or rider, the declarations page, loss payment or settlement provision, duties in event of loss policy provision, all terms and conditions of section I of the insurance policy, the insurance policy definitions section, the insurance policy‘s exclusion of coverage provisions, all insurance policy provisions that provide coverage to the insured property, and all policy provisions.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

624.155(1)(a)(1) – violating 626.9541(1)(i) 626.9541(1)(a)(1) -- misrepresenting the terms of an insurance policy. 626.9541(1)(i) -- unfair claim settlement practices. Facts of the case: Underwriters at Lloyd’s, London (syndicate list for B0572NA23DU01: SYNDICATE 2987 BRT, SYNDICATE 1200 AMA, SYNDICATE 2121 ARG, SYNDICATE 1969 APL, SYNDICATE 5000 TRV, SYNDICATE 0318 CIN, SYNDICATE 1618 KII) (hereinafter “UNDERWRITERS”) has committed the following in handling the insured’s claim: 1) failure to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder and claimant; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of UNDERWRITERS; 5) looking for ways to delay benefit payments and otherwise “low ball” or “stone wall” claims; 6) looking for ways to deny the insured’s claim; 7) looking for ways to reduce recovery to the insured; 8) failure to perform a reasonable investigation; 9) misrepresenting Florida statutory provisions to its insured; 10) misrepresenting insurance policy provisions to the insured; 11) UNDERWRITERS has failed and refused to acknowledge coverage and promptly pay the benefits due and owed to the insured; 12) the reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the insured. The insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring. In Florida, the work of adjusting insurance claims engages the public trust. UNDERWRITERS has breached this duty by its adjustment of the insured’s claim of loss. UNDERWRITERS has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in violations as set forth above. UNDERWRITERS has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. Despite the insured’s timely notification to UNDERWRITERS of their insurance claim, UNDERWRITERS has failed and refused to acknowledge the covered loss and pay all amounts due and owing to the insured under the policy of insurance. UNDERWRITERS has failed to promptly settle the insured’s insurance claim, when the obligation to settle the claim had become reasonably clear, under one portion of the insurance, in order to influence settlements under other portions of the insurance policy coverage. Despite the insured’s pleas otherwise, UNDERWRITERS has failed and refused to acknowledge its obligation to tender all insurance proceed monies due and owing the insured or assist the insured in mitigation of the damages. In exchange for a premium paid by the insured, UNDERWRITERS issued the subject insurance policy which provided coverage from July 12, 2023, through July 12, 2024, for the insured property for “direct physical loss by or from flood to” the insured building and personal property. As such, the subject flood Policy contains coverage for all direct physical losses to the insured property due to flood unless the Policy expressly limits or excludes the loss from coverage. On or about August 30, 2023, the insured property suffered a sudden and accidental flood loss from Hurricane Idalia and the insured immediately submitted a claim to UNDERWRITERS for property damage, i.e., flood damage throughout the insured property. Hence, the insured suffered a substantial loss regarding the real property and continue to suffer such loss. Having suffered such substantial damage, the insured promptly notified UNDERWRITERS of the loss in an effort to mitigate the current damage and prevent the exacerbation of any additional losses. The desired result did not follow. UNDERWRITERS since being presented the Insured’s claim has misrepresented policy provisions to avoid paying the insured what they are owed under the policy. Ultimately, UNDERWRITERS has failed and refused to properly settle the insured’s claim in good faith. The insured has requested that UNDERWRITERS conduct an investigation, admit coverage, and pay damages; UNDERWRITERS has failed and refused to do so. In short, UNDERWRITERS has failed to handle its insured’s claim in good faith in violation of Fla. Stat. 624.155(1)(b)(1), 624.155(1)(b)(3), and 626.9541(1)(i). Based upon UNDERWRITERS investigation and property inspection, which confirmed covered damage, UNDERWRITERS nevertheless sent correspondence to the insured dated December 7, 2023, (signed by adjuster, Thomas Manchester) confirming partial coverage, denying the remainder, issuing payment for $76,099.25 (building) and $20,000.00 (contents), totaling only $96,099.25, and failing and refusing to pay all amounts due and owing under the Policy for the loss. In regard to insurance contracts, a specific refusal to pay a claim is the breach which triggers the cause of action. Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 892 (Fla. 2003); Donovan v State Fam Fire and Cas. Co., 574 So. 2d 285, 286 (Fla. 2nd DCA 1991) (finding that a breach of contract takes place at the moment the insurance company refuses to pay a claim). Therefore, UNDERWRITERS breached the Policy. Questioning the propriety of UNDERWRITERS’s delay and coverage denial, and given the extensive nature of the physical damage, the insured retained a loss consultant, Aviva Insurance Adjusters, Corp. (“AVIVA”), to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on its investigation, AVIVA determined that a flood on or about August 30, 2023, from Hurricane Idalia caused damage throughout the interior and exterior of the insured property. Moreover, AVIVA determined that at least $194,908.87 worth of repairs would be required to return the property to its pre-loss condition as a result of the flood loss. Additionally, the insured suffered $81,841.09 in damage to personal property. Hence, the insured suffered at least $276,749.96 in damages as a result of the flood loss. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy. Thereafter, the insured sent correspondence to UNDERWRITERS enclosing the supporting AVIVA report outlining the cause, scope, and cost of the loss along with other supporting documents and requested UNDERWRITERS to reconsider its coverage denial. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy. Questioning the propriety of UNDERWRITERS’s continued coverage denial, and given the extensive nature of the physical damage, the insured retained a licensed contractor, Tom Gannon, with LSC Construction Consultants, LLC (“LSC”), to perform an investigation and damage evaluation in accordance with industry standards and Florida law. Based on his investigation, Mr. Gannon concluded that a flood on or about August 30, 2023, from Hurricane Idalia caused damage throughout the exterior and interior of the insured property. Moreover, Mr. Gannon determined that at least $121,504.78 worth of repairs would be required to return the property to its pre-loss condition as a result of the flood loss, which is in addition to the $81,841.09 in damage to personal property. Nevertheless, UNDERWRITERS failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy. On February 25, 2025, the insured sent correspondence to UNDERWRITERS enclosing the Sworn Statement in Proof of Loss, the supporting AVIVA report and LSC report outlining the cause, scope, and cost of the loss along with other supporting documents, the Notice of Intent to Initiate Litigation, and requested UNDERWRITERS to reconsider its coverage denial. To date, UNDERWRITERS has failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy. Therefore, UNDERWRITERS breached the Policy. As such, UNDERWRITERS’ coverage denial is a blatant misrepresentation of the available coverages under the Policy in direct violation of Fla. Stats. 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), 626.9541(1)(a)(1), and 626.9541(1)(i)(2) and is nothing more than a mere pretext to wrongfully deny and delay this claim. As a result, UNDERWRITERS has materially misrepresented the coverages under the subject policy to the insured for the purpose and with the intent of effecting settlement of the insured’s claim on less favorable terms than those provided in, and contemplated by, the subject policy in direct violation of Fla. Stat. § 626.9541(1)(i)(2). Further, UNDERWRITERS is in violation of Florida statutes §§ 626.9541(1)(a)(1), 626.9541(1)(i)(3)(b), and 626.9541(1)(a)(1) by misrepresenting pertinent facts and insurance policy provisions relating to coverages at issue; and also in violation of Fla. Stat. 626.9541(1)(i)(3)(d) by denying the insured’s claim without conducting a reasonable investigation based upon available information. In summary, the insured’s loss is clearly covered by the terms of the policy of insurance with UNDERWRITERS. However, UNDERWRITERS chose to deny coverage for the insured’s loss. Despite clear evidence that the damage was covered and caused by a covered peril, the claim was denied. To date, UNDERWRITERS continues to deny its insured full indemnity for the claim. While UNDERWRITERS refuses to honor this claim, a jury in Pasco County will likely do what UNDERWRITERS has refused; exercise the benefit of doubt in favor of the insured in finding full coverage for this loss. Indeed, the insured will undoubtedly meet the burden of proof at trial, under the UNDERWRITERS flood policy, to show that, while UNDERWRITERS provided insurance coverage, flood damage occurred to the insured property. See Jones v. Federated Nat'l Ins. Co., 235 So. 3d 936, 942 (Fla. 4th DCA 2018). With the data presented within UNDERWRITERS’ investigation, AVIVA’s investigation, and LSC’s investigation, UNDERWRITERS’ burden to demonstrate by the greater weight of the evidence that all the physical damage to the insured property was caused solely by excluded perils under the policy and not in combination with a covered peril has not and cannot be met. See Sebo v. Am. Home Assurance Co., Inc., 208 So. 3d 694 (Fla. 2016). Despite clear indicators of covered damage, UNDERWRITERS nevertheless inexplicably denied the insured’s claim. As of today, UNDERWRITERS has failed and refused to inform the insured of their rights under the policy of insurance and Florida statutes, has improperly delayed the insured’s claim, has wrongfully denied the insured’s claim, and has failed and refused to adequately indemnify the insured for the loss and defiantly continues to do so. Indeed, from the time of receiving the claim, UNDERWRITERS has purposely and maliciously delayed in adjusting the subject claim in an effort to either avoid paying the claim altogether or, at the very least, avoid paying the full extent of the loss. Notably, under Florida law, “[t]he filing of a lawsuit does not extinguish the insurer’s obligations under the policy to adjust and pay the claim.” Tristar Lodging, Inc. V. Arch Specialty Ins. Co., 434 F. Supp. 2d 1286, 1289 (M.D. Fla. 2006). To date, the insured has made a good faith effort to comply with all of the requirements under the subject policy of insurance, and it is only fair that UNDERWRITERS do the same. Yet, that is not the case. The insured feel that the insured property is a valuable asset, and, by continuously delaying the proper handling of this claim, UNDERWRITERS is putting the insured property at risk. As responsible property owners, the insured purchased insurance to protect the property, paid all of the premiums, and have kept up to date with the responsibilities under the policy. Yet, when the insured needed to rely on the insurance because of this unforeseen loss, UNDERWRITERS turned its back and delayed and wrongfully denied coverage that the insured are rightfully owed. Ultimately, UNDERWRITERS has failed and refused to properly investigate the loss. The insured has requested that UNDERWRITERS admit coverage and pay damages, UNDERWRITERS has failed and refused to do so, and continues to refuse to fully indemnify the insured for the loss and pay the amounts necessary to properly repair the insured’s property, despite knowing it is required to do so. In short, UNDERWRITERS has failed to handle its insured’s claim in good faith. In Florida, the work of adjusting insurance claims engages the public trust; UNDERWRITERS has breached this duty by its insufficient adjustment of the insured’s claim. UNDERWRITERS has failed to create and implement adequate guidelines for proper investigation to evaluate claims handling and for training and supervision of employees resulting in statutory violations set forth above. UNDERWRITERS has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the insured’s insurance claim for damages. 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 upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insured may mitigate their damages to put them back into the position they were prior to loss as quickly as possible. UNDERWRITERS breached this duty. The actions taken by UNDERWRITERS in the handling / adjustment of the insured’s claim were willful, wanton, and with complete disregard for the rights of its insured and occur with such a frequency as to indicate a general business practice and are in violation of Fla. Stat. 624.155 and 626.9541. UNDERWRITERS’ actions amount to but are not limited to the following: 1. Claim delay 2. Wrongful claim denial 3. Unfair trade practice 4. Unfair claim settlement practices 5. Unreasonable investigation 6. Failure to act on claim 7. Failure to conduct a reasonable investigation based on available information 8. Failure to maintain proper complaint handling procedures 9. Misrepresenting the insurance policy provisions to the insured 10. Misrepresenting Florida statutory provisions to the insured 11. Misrepresenting facts to the insured 12. Failure to acknowledge and act promptly upon communications with respect to claims 13. Denying claims without conducting reasonable investigations based upon available information 14. Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. 15. 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. 16. Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 17. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 18. 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. Therefore, to cure the defects outlined in this civil remedy notice, UNDERWRITERS must: (1): Admit full coverage for the insured’s loss; and (2): Tender all insurance monies due and owing to the insured for the loss under the subject Policy; A copy of this form submitted to the FDFS has been emailed and/or uploaded and also printed out and mailed to the following parties providing them notice of the filing of this civil remedy notice: Underwriters at Lloyd’s, London (syndicate list for B0572NA23DU01: SYNDICATE 2987 BRT, SYNDICATE 1200 AMA, SYNDICATE 2121 ARG, SYNDICATE 1969 APL, SYNDICATE 5000 TRV, SYNDICATE 0318 CIN, SYNDICATE 1618 KII) c/o Johns Eastern Company, Inc P O Box 110259 Lakewood Ranch, FL 32211 jetpaclaims@JohnsEastern.com tmanchester@JohnsEastern.com
Comments
User Id Date Added Comment
nicholas.freeman@wilsonelser.com 04-23-2025 This correspondence serves as a response to the Civil Remedy Notices of Insurer Violations (“CRN” or “Notice”) that were filed against Certain Underwriters at Lloyd's, London Subscribing to Policy Number DNAPF014111-02, Great Lakes Insurance SE, and HDI Global Specialty SE (hereinafter “Insurers”). Insurers are represented by Nicholas D. Freeman, Wilson Elser Moskowitz Edelman & Dicker, LLP, 111 North Orange Ave., Suite 1200, Orlando, Florida 32801, 407.203.7557 (phone), 407.648.1376 (facsimile), nicholas.freeman@wilsonelser.com. The CRN filed by the Insured, Greene Victory, LLC, generally alleges that Insurers engaged in claim delay, wrongful claim denial, unfair trade practice, unfair claim settlement practices, unreasonable investigation, failure to act on claim, failure to conduct a reasonable investigation based on available information, failure to maintain proper complaint handling procedures, misrepresenting the insurance policy provisions to the Insured, misrepresenting Florida statutory provisions to the Insured, misrepresenting facts to the Insured, failure to acknowledge and act promptly upon communications with respect to claims, and denying claims without conducting reasonable investigations based upon available information. In addition, the CRN alleges that Insurers violated several sub-sections of Florida Statutes § 624.155 and §626.9541. Please refer to the CRN for a more detailed recitation of the specific statutory provisions cited. However, the allegations contained in the CRN do little to place Insurers on notice of the alleged violations. Notwithstanding the failure to provide sufficient information to properly place Insurers on notice of the alleged violations, Insurers deny any and all allegations of violations of Florida law or policy provisions regarding the claim adjustment of this matter. It is Insurers’ position that the CRN filed by the Insured is deficient as a matter of law as it fails to comply with § 624.155, Fla. Stat. Specifically, § 624.155(3)(b), Fla. Stat., provides in pertinent part: The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 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 the violation. 3. The name of any individual involved in the violation. 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. § 624.155(3)(b), Fla. Stat. (emphasis added) The CRN does not contain the information as required by statute. First and foremost, the Notice fails with respect to the Insured’s obligation to set forth with specificity the “facts and circumstances giving rise to the violation.” The Notice asserts general allegations consisting of little more than conclusory statements and complaints that the Insured has not been paid all of the money sought, and Insurers did not properly investigate the claim. The statement of facts falls short of the specificity required by Fla. Stat. § 624.155. In this regard, the CRN did not explain how Insurers violated the statutory provisions. A written notice that is vague and “shotgun” in nature or is written in general terms fails the specificity requirement of the statute. See Heritage Corp. of South Fla. v. National Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294, 1300 (S.D. Fla. 2008); 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193; Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. 2010); Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). Nonetheless, Insurers deny any bad faith claims handling in connection with the above-referenced matter. Furthermore, Insurers deny that they violated any of the terms and conditions of the policy, including but not limited to, those identified by the Insured in the CRN section titled Reason for Notice, and deny any other allegations, acts, omissions, or statutory or ethical violations as may be set forth in the CRN. Insurers reject the Insured’s assertions that they acted in bad faith or otherwise failed to act properly in the manner in which they have adjusted this claim. The following discussion of the claim will provide you with the accurate facts and circumstances regarding this matter and shall demonstrate that Insurers has not violated any Policy or statutory provisions. On September 13, 2023, the Insured reported the loss, citing flooding damage with a date of loss of August 30, 2023. On September 25, 2023, an independent adjuster inspected the property. The independent adjuster, Gary Horth, thoroughly inspected the property. On December 7, 2023, Insurers accepted coverage for the claim. Insurers conducted a prompt and thorough investigation of the Insured’s claim. Insurers issued payment of $96,099.25. Insurers’ payment included the policy’s full personal property limit ($20,000). For the building, Insurers afforded coverage of $81,099.25 (ACV) and issued payment of $76,099.25 after removal of the $5,000 deductible. In addition, the Insured failed to provide requested information regarding additional damages following the coverage determination. The December 7, 2023, coverage determination letter stated the following: “This estimate is based on the covered damages identified at the time of the inspection. However, we understand that items could have been missed or that additional damages may be later identified. If this does occur, please notify us in writing and we will arrange a re-inspection to verify any additional damages and coverages for same. We will be happy to meet with you and/or your contractor in an effort to resolve any issues that may arise.” Despite this request, the Insured failed to provide its repair estimates until February 25, 2025—the day the Insured filed this CRN. Insurers cannot be accused of acting in bad faith for failing to consider estimates that were never provided during adjustment of the claim. Furthermore, the Insured admits it sent Insurers a sworn proof of loss, public adjuster estimate, and contractor estimate “outlining the cause, scope, and cost of the loss along with other supporting documents” on February 25, 2025. The Notice then states that to date, Insurers “failed and refused to acknowledge the covered loss and pay all amounts due and owing under the Policy.” It is noteworthy that the CRN was filed on February 25, 2025, the same date the above documents were provided to Insurers. The documents were submitted along with the Insured’s Notice of Intent to Initiate Litigation, which was also filed on February 25, 2025. Insurers cannot be accused of failing to consider documents that were never provided during adjustment of claim. In fact, it is impossible for Insurers to review documents that are not in their possession. Given that the Notice was filed on the same date the Insured submitted those documents, any bad faith allegations regarding Insurers’ failure to consider same is unwarranted. Furthermore, the CRN alleges Insurers denied the claim. This is false. Insurers accepted coverage; and issued full payment for the claim based upon the independent adjuster’s inspection. A competing estimate was not provided until the date this Notice was filed. Also, the Insured alleges that it has damages totaling $276,749.96. This includes a public adjuster estimate of $194,908.87 and personal property damages of $81,841.09. First of all, the policy’s limit on personal property is $20,000, which Insurers have paid. Therefore, the Insured cannot recover any more for damage to personal property. Second, the estimate of $194,908.87 includes $10,288.00 for personal property damage. Again, Insurers have paid the full policy limits for personal property. Also, the Insured submitted a contractor estimate of $147,053.19 to repair the building. For the building, Insurers afforded coverage of $81,099.25 (ACV) and issued payment of $76,099.25 after removal of the deductible. The Insured’s contractor estimate totals $147,053.19. Accordingly, there is $65,953.94 in dispute. Despite Insurers’ prompt and professional inspection of the property, the Insured alleges Insurers acted in bad faith. Specifically, that Insurers did not conduct a proper investigation of the claim. Insurers reiterate that they specifically deny any bad faith claims in the handling of this matter. To the contrary, Insurers have properly and promptly investigated the claim and otherwise complied with all applicable policy provisions and Florida law. This matter appears to have been a bona fide dispute between Insurers and the Insured regarding coverage of the alleged damages. Insurers are of the position that they promptly provided the Insured with a professional inspection of the property, conducted a thorough investigation, and acted in good faith in the adjustment of the claim. Furthermore, Insurers are of the position that the issues contained within the CRN are cured as a result of Insurers’ actions as described herein. Insurers do not intend, by this response or any aspect of the investigation of this claim, to waive any defenses, rights or terms and conditions of the dwelling policy and/or the Florida Statutes. We trust that this correspondence will serve as a suitable response to the Civil Remedy Notice. If, however, you need additional information or require an additional response, please do not hesitate to contact the Insurers’ counsel.
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