Civil Remedy Notice of Insurer Violations
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Filing Number:     808386
Filing Accepted:  2/25/2025
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Complainant
Last/Business Name *  
REMY FLEURIDOR AS PR FOR THE ESTATE OF FLEURIDOR, REMY   First Name  
Street Address * 1611 NW 175H TERRACE
City, State Zip * MIAMI GARDENS, FL 33169
Email Address * PROPERTY@VG.LAW
Complainant Type: * Insured
Insured
Last/Business Name*   FLEURIDOR   First Name   REMY
Policy # * 1501-1503-0945 Claim #* FL24-0136765
Attorney
Attorney is Applicable
Last Name* GIRALDO First Name * OMAR Initial
Street Address* 8751 W BROWARD BLVD SUITE 200
City, State Zip* PLANTATION , FL 33324
Email Address * PROPERTY@VG.LAW
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):* GRACE PEREZ, SUE FLORES, DAVID DOMINGUEZ
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
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.

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

The Insurer’s adjuster(s) assigned to this claim were/are: Grace Perez, Sue Flores, David Dominguez. Hereinafter referred to as the “Adjuster” or “Adjusters”. The Insured suffered a loss due to a fire, which occurred on or about October 19, 2024. The Insured’s covered property was damaged by the loss. Due to the fire the property was not habitable, and an ALE claim was made. The carrier issued a single check for ALE that encompassed three separate bills. The check was in the amount of $9,395.63 and issued on or about 10/19/24. The check was made payable to the named insured. The named insured passed away on or about September 3, 2022. Probate documents were sent to the carrier on or about 12/16/24 requesting reissuance of the check made payable to the personal representative of the Estate of Remy Fleuridor. To date the checks have not been reissued. The carrier requested an EUO of the personal representative of the estate. This EUO request included a document request. All documents were provided to the carrier prior to the EUO which took place January 31, 2025. After the EUO a follow up was sent to the carrier on February 14, 2025 to determine if a coverage determination had been made. No response was received despite primary communication with the carrier had been via email. A letter dated February 12, 2025 was received by the insureds representative on February 20, 2025. The letter indicated that the claim is continuing to be investigated under a reservation of rights because the carrier “has not received the insured and/or the insured’s representative’s cooperation to obtain the following material documents and information…” The letter then enumerates 8 items that the carrier purports had not been provided by the insured. The most nonsensical request was proof of payment of homeowners insurance for the last 12 months seeing as the property has only been insured by the current carrier. Additionally, all other documents had already been provided to the carrier. The only new request was a new Personal Property Inventory Form (PPIF). The insured had previously provided a PPIF on a form provided by the carrier. The insured reported the claim on or about 10/23/2025. To date the carrier has not made a coverage determination. In violation of FS 627.70131 (7)(a) the carrier has failed to make a coverage determination within 60 days. Additionally, the EUO was first requested outside the 60 day time frame. The carrier is delaying making a coverage determination in bad faith and is failing to adhere to the statutory guidelines set forth by the legislature. In this way, the Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. The insurer violated Florida Statute § 627.70131(7)(a) by failing to make a coverage determination within 60 days of an initially reported claim. Additionally, the carrier did not provide any reason why making a coverage determination was out of its control. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(c) by failing to acknowledge and act promptly upon communications with respect to claims. To cure the conduct giving rise to the violations described herein, insurer must: (i) pay the total replacement cost value of the Insured’s Dwelling Coverage Claim in the amount of $144,650.00, less the deductible; (ii) reissuance of the $9,395.63 ALE check with interest; (iii) extension of the TPS housing by the insurer; (iv) make payment of any pre-judgment interest owed under Florida law; (v) make payment for the additional expense incurred by the Insured in hiring an attorney; and (vi) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this Claim.
Comments
User Id Date Added Comment
ry0419@universalproperty.com 04-16-2025 April 16, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 808386 Filing Date: 2/25/2025 Complainant(s): Remy Fleuridor as PR for the Estate of Fleuridor, Remy Insured: Remy Fleuridor Policy No.: 1501-1503-0945 Claim No.: FL24-0136765 DFS File No.: 814714 Filing Date: 4/4/2025 Complainant(s)(s): Remy Fleuridor as PR for the Estate of Remy Fleuridor Insured: Remy Fleuridor Policy No.: 1501-1503-0945 Claim No.: FL24-0136765 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, Omar Giraldo, on behalf of Complainant(s), Remy Fleuridor as PR for the Estate of Fleuridor, Remy and Remy Fleuridor as PR for the Estate of Remy Fleuridor. The Notices allege violations of Secs. 624.155, 626.9541 and 627.70131 Fla. Stat. Universal specifically denies each allegation contained in the Notices. Additionally, Universal denies that it violated these or any statutes, Florida law or policy provisions regarding the adjustment of this claim. With that said, Universal asserts that the Notices fail to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Sec. 624.155, Fla. Stat., and Florida law. The Notices are deficient as a matter of law as they fail to comply with Sec. 624.155, Fla. Stat. 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). Pursuant to Sec. 624.155(3)(b), Fla. Stat., the Notices “shall state with specificity” the following information: 1. The statutory provision, including the specific language 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...; and 5. a statement that the Notice is given to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Florida Department of Financial Services (“DFS”) created form DFS-10-363, which sets out fifteen (15) requirements that the Complainant(s)(s) must respond to with specificity. The Florida Supreme Court holds that Sec. 624.155, Fla. Stat. “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. 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 Complainant(s) 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). The Notices fail to meet the requirements of Fla. Stat. § 624.155 on several grounds. First, the Notices fail to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. To comply with the requirements of Sec. 624.155, Fla. Stat., the Complainant(s) must name the individual(s) involved with specificity as it relates to the purported violation to allow Universal to properly investigate the allegations. Here, the Notice No. 808386 states “GRACE PEREZ, SUE FLORES, DAVID DOMINGUEZ” and Notice No. 814714 states “GRACE PEREZ, SUE FLORES, DAVID DOMINGUES,” without more. The Complainant(s) fails to specify what, if anything, the named individuals are knowledgeable about and/or what, if anything, the named individuals did or failed to do regarding the claim at issue. Therefore, the Notice does not have the requisite specificity as to what, if anything, these individuals have knowledge of and/or how the individuals relate to any allegation in the Notice. The failure to provide the requisite specificity precludes Universal from taking any corrective action and potentially curing any purported allegations. Accordingly, Complainant(s)’s Notices are insufficient as a matter of law. Second, the Notices fail to satisfy Fla. Statute § 624.155(3)(b)(4) in that they fail to reference any specific policy language relevant to any alleged violation. Instead, Notice No. 808386 states “Valuation[,] Coverage[,] Notice[,] Payment[, and] Investigation” and Notice No. 814714 states “Valuation[,] Death[,] Coverage[,] Definitions[,] Notice[,] Payment[, and] Investigation.” The Complainant(s) fails to identify where, if at all, the above referenced language is located in the policy or how it applies to the claim at issue. The Notices lack the requisite specificity to put Universal on notice of any alleged policy violations. The Complainant(s) provides no guidance or explanation, such that Universal is left to wonder what policy language Complainant(s) believes were allegedly violated or breached and why. General, vague and overbroad references to potential or possible policy language does not satisfy the specificity required by § 624.155(3)(b)(4), Fla. Stat. As such, the Notices are deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Third, regarding the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notices fail to specify any facts that would put Universal on notice that it violated any policy provision or statute. The Notices assert general allegations consisting largely of conclusory and inaccurate statements rather than providing facts to support any allegation. For example, Notice No. 808386 alleges “the Insurer violated the provisions of Florida Statute § 624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim 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 his interests. The insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. The Insurer violated the provisions of Florida Statute § 626.9541(1)(i)(3)(f) by 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 the offer of a compromise settlement. The insurer violated Florida Statute § 627.70131(7)(a) by failing to make a coverage determination within 60 days of an initially reported claim. Additionally, the carrier did not provide any reason why making a coverage determination was out of its control. The insurer violated the provisions of Florida Statute § 626.9541(1)(i) (3)(c) by failing to acknowledge and act promptly upon communications with respect to claims.” However, The Complainant(s) fails to specify any facts or examples to support the above referenced boilerplate statutory violations in Notice No. 808386. The Complainant(s) is required specify the facts and circumstances giving rise to the alleged violations. As an additional example, in Notice No. 814714, the Complainant(s) allege: “Bad Faith and Breach of Contract Allegations: • The insurer is alleged to have acted in bad faith by: o Failure to attempt in good faith to resolve the claim. o Failure to adopt and implement proper investigation standards. o Failure to provide a reasonable explanation of the basis for settlement offers. o Failure to make a timely coverage determination (as per Florida Statute § 627.70131(7)(a)). o Failure to acknowledge communications promptly (Florida Statute § 626.9541(1)(i)(3)(c)).” The Complainant(s) fails to provide any factual support for these alleged statutory violations. Further, the Complainant(s) fails to assert any facts or circumstances to support any alleged breach. It is evident that the statement of facts in each Notice falls short of the specificity required by Sec. 624.155, Fla. Stat. As a result, the Complainant(s) fails to comply with Sec. 624.155(3)(b)(2), Fla. Stat. Fourth, the Notices do not provide a proper means whereby Universal can “cure” the alleged defects. A Civil Remedy Notice aims to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000). However, Section 624.155, Florida Statute, does not impose on an insurer the obligation to pay whatever amount its insureds demand. Talat, 753 So. 2d 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. See Talat, 753 So. 2d at 1281. The Complainant(s) demands extra-contractual damages. In Notice No. 808386, the Complainant(s) demands that Universal “make payment for the additional expense incurred by the Insured in hiring an attorney.” In Notice No. 814714, the Complainant(s) seeks “[p]ayment for attorney fees incurred in pursuing the claim” from Universal. The Notices fail to provide Universal an opportunity to “cure” any alleged violation without paying extra-contractual damages. Additionally, the Complainant(s) demands “cures” which are not available under any policy of insurance or the Civil Remedy Statute. As such, the Notices are deficient as they do not provide Universal an opportunity to “cure” the alleged violations without imposing obligations on Universal that are not owed under a policy of insurance, including but not limited to, extra-contractual damages. Universal is only obligated to pay contractual amounts owed to cure a civil remedy. See id. at 1278. In summary, as outlined above, the Complainant(s) fails to respond to each of the fields set forth on the DFS Forms with the requisite specificity as stated herein, including but not limited to, failing to identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notices, failing to provide specific policy language relevant to any alleged violation, failing to provide sufficient facts and circumstances giving rise to the alleged violations, and failing to provide a proper cure. Therefore, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. See Julien, 311 So. 3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notices are deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notices. On October 20, 2024, Universal was notified by Remy Fleuridor that the insured location was damaged on October 19, 2024. Universal inspected the property and documented any visible damage. Universal also requested material documents and information. As conceded in Notice No. 808386, the named insured, Remy Fleuridor, passed away on or about September 3, 2022. However, Universal was not provided this information until on or about December 16, 2024. Further, as conceded in Notice No. 808386, Universal did not receive notice of probate, including the order appointing Remy Yvon Fleuridor as personal representative for the Estate of Remy Fleuridor, until December 16, 2024. Universal requested additional material documents and/or information. To date, Universal has not yet received the material documents and/or information requested which are factors beyond its control. Universal awaits receipt of the requested material documents and information in order to complete its investigation. At no time has Universal breached any duty to its Insured. As outlined above, the alleged statutory violations set forth in the Notices are devoid of substantiating facts and without merit. Thus, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjustment of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this claim and fully responds to the alleged violations in the Notices filed by the Complainant(s). Sincerely, /s/ Rose Y. Valentine Rose Y. Valentine, Esq. Senior Managing Associate General 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