Civil Remedy Notice of Insurer Violations
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Filing Number:     808563
Filing Accepted:  2/26/2025
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Complainant
Last/Business Name *  
SANTIAGO   First Name   MARIANO AND MARIA
Street Address * 927 SE 19TH TERRACE
City, State Zip * CAPE CORAL, FL 33914
Email Address * EMAIL@AVELAWFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SANTIAGO   First Name   MARIANO AND MARIA
Policy # * PFL420783-02 Claim #* CFL22592107
Attorney
Attorney is Applicable
Last Name* GONZALEZ First Name * MAYLE Initial
Street Address* 3001 TAMIAMI TRAIL NORTH
City, State Zip* NAPLES , FLORIDA 34103
Email Address * EMAIL@AVELAWFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   PEOPLE'S TRUST INSURANCE COMPANY
NAIC Company Code 13125
 
Name of individual responsible for violation (if any):* JOHNETTA DIXON
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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.
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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

COVERAGE A-DWELLING
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

To whom it may concern: Pursuant to Florida Statutes §624.155, and in compliance with Florida Statutes §624.155(3)(b)2 & (3)(b)4, please allow this correspondence to serve as Maria Santiago and Mariano Santiago’s (the “Insureds” or the “Complainants”) formal notice to pursue a bad faith action against Peoples Trust Insurance Company (“PEOPLES TRUST”), relating to, and stemming from, a multitude of statutory violations associated with PEOPLES TRUST’S handling of the Insureds’ aforementioned insurance claim. In Florida, the profession of adjusting insurance claims involves a special relationship of trust with the public. As such, insurance adjusters and insurance company claim representatives are imposed with a duty of good faith during the settlement process. An insurance policy is obtained by homeowners to protect against unknown disasters, catastrophes, and misfortunes, which may or may not ever occur. The policyholder, after paying premiums and expecting protection against a loss, is in an especially vulnerable economic and personal position when an unexpected loss occurs. The entire purpose of insurance is defeated if those involved with insurance adjustment can refuse or delay the prompt and full payment of monies due under the policy/contract. The facts and/or circumstances presented below affirmatively corroborate the Insureds’ contention that PEOPLES TRUST violated the Florida Statues at issue, which include but are not limited to: improper claim handling, inadequate investigation, improper delay without justification, failing to adequately and promptly communicate, failing to provide reasonable explanations, making misrepresentations, general business practices, unfair or deceptive trade practices, and unsatisfactory settlement offers or practices. By way of brief background, on or about September 28, 2022, the Complainants’ property sustained significant damage (the “Loss”) as a result of Hurricane Ian. Specifically, the Property’s roof sustained significant damage, multiple flying debris hit the property’s interior sustained damage from water intrusion, and the property’s exterior elevations sustained significant damage. The Complainants reported the Loss to PEOPLES TRUST, and PEOPLES TRUST sent Kenneth Taylor to inspect the subject property on or about November 9, 2022. At the time of the inspection, a tarp had been requested by the Insureds to address the extensive roof damage and the water intrusion in the main living area. For reasons unknown, the carrier did not ever provide emergency mitigation services for the property despite the Insureds’ request. Following Mr. Taylor’s inspection, the carrier issued its coverage determination letter advising the Insureds that the property sustained hurricane damage, accompanied by Mr. Taylor’s estimate totaling $23,493.17 for a roof replacement and some exterior elevation repairs to the pool cage, etc. The carrier, in an attempt to rid itself of the claim, mailed a check to the Insureds for the claim less their deductible with the caveat that should they deposit the check, the claim would be considered settled. Please note that no allotment was made for the interior damage of the home that had started forming and emergency services were never offered. The Insureds attempted to get an explanation from the carrier regarding the initial decision, but to no avail. They found themselves having to secure their own tarp for the property and later had to retain the undersigned counsel to assist with the loss. On August 16, 2023, once a comprehensive damage assessment was completed, the Insureds provided PEOPLES TRUST with a comparative estimate of damages for $80,967.02 and provided it along with a Sworn Statement in Proof of Loss. Subsequently, a Notice of Intent to Litigate was filed due to the carrier’s representatives failing to understand the scope of the loss in its entirety. PEOPLE’S TRUST responded to the Notice of Intent to Litigate offering $20,000.00 to settle the claim in its entirety or appraisal in the alternative to that. The parties engaged in negotiations and the Insureds’ counsel provided extensive evidence of the damage to the property that was not properly considered during the initial claim adjustment. To make matters worse, the insurers are currently unable to insure the property in its current condition and have been without an active insurance policy since the subject policy expired. On December 8, 2023, PEOPLES TRUST, sued the Insureds for breach of contract, falsely claiming that repairs had been completed at the property in violation of the Option to Repair endorsement on the subject policy. This is not PEOPLE TRUST’s first tilt suing its own customers. The Sun Sentinel has written extensively on this carrier and the hundreds of lawsuits it filed against its own customers following Hurricane Irma and Hurricane Ian. The extensive litigation history of PEOPLE’S TRUST would support the notion that litigation is used as a strong-arm tactic against policyholders to allow for the carrier to continually underpay claims and/or force insureds to accept pennies on the dollar of what their claims are worth to avoid drowning in legal fees to defend themselves in these predatory actions. The parties entered into the carrier elected appraisal process on June 12, 2024. As the carrier’s dilatory tactics continued for close to two years following the loss, and the property’s roofing system was severely compromised, the living room ceiling completely collapsed on September 26, 2024, causing additional damage to the property’s interior, flooring, front door, and baseboards. This could have been avoided had PEOPLE’S TRUST properly adjusted the claim following the date of loss, allowing for the Insureds to complete their repairs and be prepared for the rainy seasons to follow. During the appraisal process, the carrier retained an engineer, Jaime Collantes PE with Omega Forensic, to inspect the property’s flooring as the comparative estimate on behalf of the Insureds accounted for the extensive water damage to the flooring and baseboards. This inspection took place on August 23, 2024 and Mr. Collantes was at the property for nine (9) minutes before hurriedly leaving. Not surprisingly, Mr. Collantes opined that the clearly visible and undeniable evidence of damage to the flooring, baseboard, and wood front door was not related to Hurricane Ian, despite it never having existed or been present at the property prior to the storm. As a result of the carrier sending an engineer, the Insureds retained Edwin Witty PE to perform a forensic inspection of the flooring and expended over $4,000.00 in order to have an expert opinion in relation to damage that could be seen with the naked eye. On February 7, 2025, the appraisal panel rendered its award totaling $133,137.87 replacement cost value, $109,644.70 over the carrier’s initial pricing and scope of damages for the property of $23,493.17, and $52,170.85 over the insureds’ initial comparative estimate. At this juncture, it appears the carrier is stalling or attempting to continue to stone wall the Insureds, who have been attempting to resolve this claim for almost three (3) years and are eager to move on with their lives and complete the necessary repairs, especially considering the heavy rains and forecasts for the 2025 hurricane season. The Insureds have been met with scare tactics and threats under the guise of settlement checks at the onset of their claim; they never received the requested and desperately needed emergency services from the carrier; their comparative estimate of damages was ignored and only nominal offers were made to resolve their claim; the carrier sued them, forcing them to expend out of pocket costs to defend themselves in a frivolous action filed solely to intimidate and terrify them; and as if that wasn’t enough, the carrier now contends that the insureds should participate in the Option to Repair program managed by this unscrupulous carrier and expecting the insureds to trust PEOPLE’S TRUST after everything they have been put through and endured over their loss. The carrier is required to properly investigate and adjust claims and cannot place that burden upon the insured. This was made clear by 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 own insureds…”). The Insureds have complied with all requests made by PEOPLES TRUST and provided all the information available to them with respect to the loss. The Insureds have received neither a request for additional information nor an explanation from PEOPLES TRUST for its delay in settling their claim nor its insistence on blocking the true assessment of damages. To date, PEOPLES TRUST has failed and/or refused to provide the Insureds with the insurance benefits due and owing, undisputed or otherwise, despite knowing that the property has sustained damage as a result of a covered peril. Despite the Insureds’ repeated pleas, PEOPLES TRUST has not tendered the full amount needed to return the property to its pre-loss condition. PEOPLES TRUST was bound to conduct itself with the utmost good faith for the benefit of their Insured. However, PEOPLES TRUST failed to comply with the obligations in connection with this claim. PEOPLES TRUST has demonstrated an established pattern of retaining individuals who continuously fail to adjust and evaluate the present claim in good faith or who are prevented from doing so by the carrier itself, which is a clear violation of the aforementioned Florida Statutes. Specifically, PEOPLES TRUST’s refusal to consider the Insured’s consultant’s findings during its investigation of the subject claim; the dangling of a nominal funds by way of a “settlement check” for the undisputed amount of damage to the property; suing the insureds; and demanding that they continue to spend thousands of dollars to confirm damage that is visible to the common lay person. Though liability is clear, and despite multiple demands to resolve this matter, PEOPLES TRUST has failed to act honestly and fairly towards the Insureds regarding settlement. This not only violates the foregoing cited statutes, but also Fla. §626.9541(1)(i)(2). PEOPLES TRUST’s handling and adjustment of the Insureds’ claim, and the conduct of the adjusters, supervisors, management and individuals associated with or retained by PEOPLES TRUST is evidence that it has failed to create and implement adequate guidelines for proper investigation and claims handling and for training and supervision of employees. PEOPLES TRUST has failed to adopt and implement standards for the proper investigation of claims as required by Florida Statutes §626.9541(1)(i)(3)(a). To date, the Insureds have incurred and continue to incur significant damages as a result of PEOPLES TRUST’s actions. Based on the foregoing violations, it is clear that PEOPLES TRUST’s actions, including but not limited to: 1) failure to pay the claim in full; 2) failure to promptly investigate the claim; 3) failure to properly investigate the claim; 4) failure to adjust the loss; 5) failure to act in due diligence and good faith to resolve the claim; 6) placing the financial interest of Insurer before that of policy holders and claimants; 7) failure to properly train, evaluate and manage adjusters; and 8) looking for ways to deny coverage, pay less, delay payment and otherwise "low ball" or "stone wall" the claim support the Insured’s position that proper systems are not in place to investigate claims. Therefore, to cure the defects outlined in this Civil Remedy Notice, PEOPLES TRUST must: (1) Create and implement adequate guidelines for proper investigation and evaluation as to claims handling and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and to avoid this from occurring in the future; (2) Create and implement adequate guidelines for the proper investigation and evaluation of these types of claims, and for the training and supervision of employees with regard to these types of claims to ensure PEOPLES TRUST’s claim handling procedures with regard to these types of losses are adequate to stop further Insured from being treated unfairly and wrongfully; (3) Assist the Insureds in mitigating their damages; (4) Immediately tender all undisputed insurance proceeds to the Insureds totaling $133,137.87, less the subject deductible, while continuing to adjust the loss with the Insureds; (5) Immediately tender all insurance benefits due and owing to the Insureds under the policy pursuant to the relevant policy provisions provided therein that would reasonably place the Insureds back to their pre-loss condition, to include the estimate of damages amount of $133,137.87, less the applicable deductible, and including, but not limited to all interest due and owing under applicable Florida Statutes. Sincerely, Mayle Gonzalez, Esq.
Comments
User Id Date Added Comment
email@avelawfirm.com 04-24-2025 The parties reached a global resolution in the instant matter, and as a result, the Insureds withdraw this CRN. Dwight Walker, Esq.
Anthony.Casimini@csklegal.com 04-08-2025 Dear Sir/Madam: This correspondence serves as People’s Trust Insurance Company’s (“People’s Trust”) response to the Civil Remedy Notice of Insurer Violations (hereinafter referred to as the “Notice”) filed by Mayle Gonzalez, Esq. on behalf of Maria Santiago and Mariano Santiago(“Complainants”) bearing filing number 808563. The law firm of Cole, Scott & Kissane, P.A. has been retained to represent People’s Trust in this matter, which concerns a property damage claim alleged by the Complainants and associated with claim number CFL22592107. The subject property is located at 927 SE 19th Terrace, Cape Coral, FL 33914 (the “Property”). People’s Trust welcomes this opportunity to respond to the Notice and denies each and every allegation contained therein. People’s Trust does not consider there to have been any manner of violation and questions the validity of the Notice as it fails to meet the requirements set forth in Section 624.155, Florida Statutes and Florida law and thus fails to perfect the Complainants’ right to pursue civil remedies under Florida Statutes. As set forth below, People Trust investigated/inspected and determined the extent of the alleged damage to the Property. Following a thorough evaluation of the loss, People’s Trust adjusted the claim pursuant to the terms, conditions, exclusions, and endorsements of the policy and in accordance with Florida Law. PTI timely issued a determination letter, which informed the Complainants of People’s Trust Insurance Company’s invocation to repair the property with their preferred contractor, Rapid Response Team. Complainants requested indemnity payments, but they were never entitled to monetary payment for the subject claim pursuant to the Preferred Contractor Endorsement and People’s Trust’s election-to-repair. There was a patent dispute as to the scope and price of covered damage, and Complainants failed to respond to People’s Trust request for appraisal. I. Purpose and Specificity Requirement For CRNs Notwithstanding the foregoing, the Complainants’ Civil Remedy Notice violates multiple requirements set forth in Florida jurisprudence. In addition, it fails to meet even the most basic requirements of the Statute. Accordingly, People’s Trust respectfully requests the Department return the Civil Remedy Notice and insist the Complainant provide the specific facts required for civil remedy notices. See Section §624.155(3)(c), Florida Statutes. These requirements arise from the following provisions of Section 624.155: (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days' written notice of the violation. If the department returns a notice for lack of specificity, the 60-day time period shall not begin until a proper notice is filed. (b) 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, he 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. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F. Supp. 2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad faith actions, the Legislature provided this sixty-day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1284 (Fla. 2000). Thus, the CRN cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So. 2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insurer of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F. Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”). In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiffs’ counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiffs’ counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. (Emphasis added.) This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be clearer. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. II. The Elements of a Valid Civil Remedy Notice There are at least eight requirements for a valid civil remedy notice. Pursuant to Section 624.155(3)(c)’s requirement that a civil remedy notice must set forth the “facts and circumstances giving rise to the violation,” a valid civil remedy notice must contain the following: 1. “[E]xplain how the [insurer] violated [the statutes],” Heritage Corp., 580 F.Supp. 2d at 1299; 2. “[E]xplain the amounts of damage at issue caused by the [insurer’s] alleged statutory violations,” rather than caused by the loss itself, Id.; 3. Provide the facts showing “knowledge and/or delay on the insurance company’s part,” 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1192 (N.D. Fla. 2008); 4. Provide the facts supporting the specific contractual damages allegedly owed rather than merely the policy limits, Id. at 1193; 5. If an inadequate investigation is alleged, the civil remedy notice must be specific enough to allow the insurer to conduct an additional investigation, Nowak v. Lexington Ins. Co., 464 F. Supp.2d 1248, 1252 (S.D. Fla. 2006). Additionally, subsections (3)(a)1., 3. and 4. require: 6. “The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated;” 7. “The name of any individual involved in the violation;” and 8. “Reference to specific policy language that is relevant to the violation.” Section 624.155(3)(b); see Talat Ents., 753 So. 2d 1278, 1283 ("We find that the requirements of written notice to the Department of Insurance and the defendant are conditions precedent to bringing an action under § 624.155] (1)(a) or (b)"); see also Allstate Ins. Co. v. Clohessy, 32 F. Supp. 2d 1328, 1333 (M.D. Fla. 1998) (same). As noted, the first five requirements mandate the insured to provide specific facts and circumstances of the alleged violations. This would necessitate the inclusion of specific facts regarding the method of the investigation, the reasons the investigation was improper or otherwise inadequate, the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. Moreover, to allege an inadequate investigation, the Notice must include specific facts regarding the method, rather than merely the results. Valenti, 2006 WL 1627276, at *1. Florida law does not allow an insured, without providing any facts, to allege that the insurer’s only option to avoid bad faith is paying whatever the insured demands. 316, Inc., 625 F. Supp. 2d at 1194. Requirements two and four regarding the alleged damages must also be specifically provided in civil remedy notices. Importantly, the Talat court held that payment of undisputed damages within the cure period is sufficient to preclude a statutory bad faith action. In that circumstance, the insurer has “timely paid ‘the damages’ and has corrected ‘the circumstances giving rise to the violation’ within the meaning of [Section 624.155(2)(d), Florida Statutes].” Id., at 1281. The insurer is not required to pay any compensatory damages that flow from any alleged delay in settling the claim. Importantly, only the contractual benefits are owed during the 60 day cure period. To provide an insurer with the notice of the contractual and extra-contractual damages, Florida law clearly requires facts supporting the amount. Merely requesting policy limits without any basis renders the civil remedy notice invalid. If the civil remedy notice does not satisfy each of the eight elements, it cannot be considered valid pursuant to the Florida case authority cited above. III. Factual Background This case arises from Complainants’ claim for wind damage to the subject Property alleging the damage was due to Hurricane Ian. On October 6, 2022, People’s Trust received notice of the claim and promptly assigned the claim to a desk adjuster and field adjuster. On November 8, 2022, the field adjuster inspected the property on behalf of People’s Trust. On December 29, 2022, the Complainants were timely notified in writing of People’s Trust’s coverage for the loss and invocation of election-to-repair the covered loss pursuant to the scope of repair prepared by People’s Trust’s designated inspection agent with repairs to be performed by People’s Trust’s preferred contractor Rapid Response Team, LLC. The same item of December 29, 2022, correspondence also notified the Complainants of the request for proof of loss if there is a disagreement regarding the scope of covered repair. The same item of December 29, 2022 correspondence notified the Complainants of People’s Trust’s request to return an executed work authorization and enclosed a proposed work authorization for the Complainants signature and return pursuant to the subject policy’s post-loss conditions. The same December 29, 2022, item of correspondence also notified the Complainants of People’s Trust’s request for payment of the hurricane deductible or for making arrangements to finance the deductible amount, if necessary, pursuant to the subject policy’s post-loss conditions. The same item of December 29, 2022 correspondence also notified the Complainants of People’s Trust’s request for cooperation with election-to-repair project logistics, pursuant to the subject policy’s post-loss conditions. The same item of December 29, 2022 correspondence also notified the Complainants of the availability of DFS Mediation as a mechanism for resolution of disputes. On March 28, 2023, People’s Trust issued a claim settlement letter, advising the Complainants that it is standing by its election to repair the property with Rapid Response Team. Further, the claim settlement letter proposed that in the event the Complainants did not wish for Rapid Response Team to complete the repairs, a claim settlement check was enclosed with the letter as an offer to settle the entire claim. Importantly, the letter stated in pertinent part: “your endorsement of the enclosed check means you accept this payment as full and final settlement of your entire claim and that no further benefits are owed under your policy for your claim.” The claim settlement letter further stated that in the event that the Complainants chose not to accept the settlement offer, to notify People’s Trust immediately so that People’s Trust could proceed with the repair process as per its election under the policy. The Complainants refused to accept the settle offer from People’s Trust. On or about July 21, 2023, People’s Trust received the Complainants estimate for repairs. On or about August 16, 2023, People’s Trust executed a sworn proof of loss setting forth the Complainants claimed amount and scope of loss required to restore the insured’s dwelling and property to its pre-loss condition. The Sworn Proof of Loss was material to the post-loss obligations under the policy and Complainants sworn proof of loss was due on or around February 27, 2023. The policy required the sworn proof of loss be provided within 60 days of the coverage determination letter. The policy states in pertinent part: NOTE: THIS WILL REQUIRE ACTION ON YOUR PART What if you disagree with what we believe needs to be repaired? It is important that you understand that if you are not in agreement with the Estimate and Scope of Repairs which we provided you, we must be made aware of the disagreement. In order to assess whether there is a disagreement as to Estimate and Scope of Repairs, or specifically what the disagreement is if there is one, and to the extent that we have not already requested your Sworn Proof of Loss (“POL”) by previous correspondence, we are at this time hereby requiring that you provide us within sixty (60) days of the original request letter, requesting your executed Sworn Proof of Loss (“POL”), which provides the details of what you believe the proper scope to be, including, but not limited to, a scope prepared by you or on your behalf. The details of what must be contained in a Sworn Proof of Loss are shown in your policy, and a copy of a Sworn Proof of Loss which we commonly use, is attached for your convenience. The sooner we receive that document, the sooner we can begin and complete repairs to your home. See, SECTION I – CONDITIONS; Paragraph C.9. of your policy for the precise requirements of a POL This untimeliness constitutes a material breach of the insuring agreement that subsequently warrants relief from People’s Trust’s coverage obligations. See Shivdasani v. Universal Prop. & Cas. Ins. Co., 306 So. 3d 1156, 1158 (Fla. 3d DCA 2020) (holding that an insured’s failure to submit a sworn proof of loss is a material breach of a post-loss contractual condition precedent); See also Rodrigo v. State Farm Florida Insurance Company, 144 So. 3d 690, 692 (Fla. 4th DCA 2014)(finding that a failure to submit a sworn proof of loss is a material breach of condition precedent, and the insurer is not obligated to pay)(emphasis added). In light of the patent scope dispute, on or about August 16, 2023, People’s Trust demanded appraisal of the loss pursuant to the terms of the policy. Per the policy terms, the parties were required to provide the name of their respective appraiser within 20 days of written request from the other party. The Complainants never provided People’ Trust with their named appraiser. People’s Trust has suffered material prejudice by way of the Complainants’ refusal and repudiation of its election-to-repair which is an integral component of the insuring agreement as read in pari materia with the included the Preferred Contractor Endorsement, and as such, a material term and condition of the insuring agreement. As a result of the Complainants’ material breach and failure to cure, People’s Trust is entitled to voidance of its coverage obligations arising from the subject. Ganzemuller v. Omega Ins. Co., 244 So. 3d 1189 (Fla. 2d DCA 2018) (carrier entitled to voidance of coverage for the loss arising from the insured's failure to comply with election-to-repair and deductible obligation; People's Trust Ins. Co. v. Franco, 305 So.3d 579 (Fla. 3d DCA 2020) (PTI stated cause of action for declaratory judgment and material breach based upon anticipatory repudiation); Castro v People's Trust Ins. Co., 568 So. 3d 483 (Fla.4th DCA 2021) (the insured in material breach in failing to sign work authorization and comply with deductible citing Franco Ganzemuller Arguello). As such, the Complainants’ allegations that People’s Trust adjusted this claim in bad faith are baseless. People’s Trust made a prompt coverage decision and abided by the terms of the Policy. Rather, it was the Complainants that failed to provide the name of their appraiser, which thereby deprived People’s Trust of the benefit of its bargain under the policy. In light of the aforementioned, it is clear that People’s Trust has investigated the claim in good faith and in accordance with the Florida Statutes. As such, People’s Trust unequivocally denies any and all allegations of bad faith in its handling of this claim. IV. Inaccuracy of Statutory Allegations in Civil Remedy Notice With the above-referenced facts established, it is clear the alleged statutory violations are also unsupported. In our factual analysis provided in this Response, we provided facts that implicitly address many of the allegations in the Notice. The Notice alleges the following statutory violations by People’s Trust, we address each as follows: • 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all 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 – This allegation is denied. People’s Trust attempted to effectuate appraisal but was prevented by the insureds’ failure to comply with People’s Trust’s policy. • 624.155(1)(b)(2): Making claim payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. This allegation is denied. There have been no facts provided to sustain such an allegation. People’s Trust has dealt with the insureds honestly and fairly in evaluating the claim. Thus, documentation to support this allegation should be provided to the extent that any exists. • 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle the 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. This allegation is denied. People’s Trust timely inspected the claim, timely provided a coverage determination, and timely elected to repair the subject property. People’s Trust also attempted to effectuate appraisal but was prevented by the Insureds’ failure to comply with People’s Trust’s policy. • 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims- This allegation is denied. There have been no facts provided to sustain such an allegation. People’s Trust has dealt with the insureds honestly and fairly in evaluating the claim. Thus, documentation to support this allegation should be provided to the extent that any exists. • 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. – This allegation is denied. People’s Trust timely inspected the claim, timely provided a coverage determination, and timely elected to repair the subject property. People’s Trust also attempted to effectuate appraisal but was prevented by the Insureds’ failure to comply with People’s Trust’s policy. • 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims- This allegation is denied. There are no facts provided to sustain such an allegation. Further, People’s Trust has dealt with the insureds honestly and fairly in evaluating the claim. Furthermore, People’s Trust has promptly communicated with the insureds at all times. • 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information – This allegation is denied. People’s Trust found coverage for the subject claim after a reasonable investigation. Furthermore, after conducting a reasonable investigation, People's Trust provided the insureds with a determination letter stating that the claim was covered. People’s Trust also attempted to effectuate appraisal but was prevented by the Insureds’ failure to comply with People’s Trust’s policy. • 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.- This allegation is denied. People’s Trust found coverage for the subject claim after a reasonable investigation. Furthermore, after conducting a reasonable investigation, People's Trust provided the insured with a determination letter stating that the claim was covered. That coverage determination letter outlined the basis for it’s coverage determination and included a scope and price estimate for the repairs to be completed by Rapid Response Team. What’s more, People’s Trust also attempted to effectuate appraisal but was prevented by the Insureds’ failure to comply with People’s Trust’s policy. • 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim.- This allegation is denied. There have been no facts provided to sustain such an allegation. Thus, documentation to support this allegation should be provided to the extent that any exists. • 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. This allegation is denied. People’s Trust found coverage for the subject claim after a reasonable investigation. Furthermore, after conducting a reasonable investigation, People's Trust provided the insured with a determination letter stating that the claim was covered. That coverage determination letter outlined the basis for it’s coverage determination and included a scope and price estimate for the repairs to be completed by Rapid Response Team. What’s more, People’s Trust also attempted to effectuate appraisal but was prevented by the Insureds’ failure to comply with People’s Trust’s policy. V. Conclusion The options presented to People’s Trust to cure all statutory violations are invalid because the insureds failed to provide the name of their appraiser, and therefore, the insureds materially breached the insurance agreement. Accordingly, as a result of the insureds’ material breach and failure to cure, People’s Trust is entitled to voidance of its coverage obligations arising from the subject. Ganzemuller v. Omega Ins. Co., 244 So. 3d 1189 (Fla. 2d DCA 2018) (carrier entitled to voidance of coverage for the loss arising from the insured's failure to comply with election-to-repair and deductible obligation; People's Trust Ins. Co. v. Franco, 305 So.3d 579 (Fla. 3d DCA 2020) (PTI stated cause of action for declaratory judgment and material breach based upon anticipatory repudiation); Castro v People's Trust Ins. Co., 568 So. 3d 483 (Fla.4DCA 2021) (the insured in material breach in failing to sign work authorization and comply with deductible citing Franco Ganzemuller Arguello). Notwithstanding the forgoing, People’s Trust specifically denies each and every allegation contained within the Civil Remedy Notice of Insurer Violation including, but not limited to, those allegations contained within “Reason for Notice” including any claim for bad faith. There are no benefits due or owing at this time and, as such, no attorneys’ fees are due or owing. People’s Trust will provide a further response and consider same if and when any additional information is provided relative to any alleged violation. People’s Trust continues to reserve all of its rights. We trust this fully and adequately responds to any inquiry regarding the claim. If you have any questions or require further clarification with regard to the above, please do not hesitate to contact us. Sincerely, /s Anthony J. Casimini Ron M. Campbell, Esq. Anthony J. Casimini, Esq.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008