Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 808635

Filing Accepted: 2/26/2025

Print Filing

Complainant

Last/Business Name *

DEGENNARO

First Name

BRITT

Street Address *

800 E BROWARD BLVD, SUITE 510

City, State Zip *

FT LAUDERDALE, FL 33301

Email Address *

BD@WEKLAW.COM

Complainant Type: *

Third Party

Insured

Last/Business Name*		WILLIAMS		First Name		VICKI
Policy # *		FLA341866		Claim #*		1382241

Attorney

Attorney is Applicable

Last Name*	DEGENNARO First Name * BRITT Initial
Street Address*		800 E BROWARD BLVD, SUITE 510
City, State Zip*		FT LAUDERDALE , FL 33301
Email Address *		BD@WEKLAW.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		AMERICAN STRATEGIC INSURANCE CORP.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10872

Name of individual responsible for violation (if any):* TRAVIS MURPHY (FL ADJUSTER LICENSE NO. W872444)
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unsatisfactory Settlement Offer
	Unfair Trade Practice

* Statutory provision(s) which the insurer allegedly violated.

	624.155(1)(b)(1)		Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
	624.155(1)(b)(3)		Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(b)		Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(d)		Denying claims without conducting reasonable investigations based upon available information.
	626.9541(1)(i)(3)(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.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

LOSS PAYMENT PROVISION ADJUSTMENT PROVISION

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

VICKI WILLIAMS, THE INSURED, RESIDES AT 8295 GOLDEN BAMBOO DRIVE, JACKSONVILLE, FL 32219. SHE HOLDS A HOMEOWNER’S INSURANCE POLICY WITH PROGRESSIVE, UNDERWRITTEN BY AMERICAN STRATEGIC INSURANCE CORP. (POLICY NO. FLA341866). ON MAY 15, 2024, A WINDSTORM CAUSED DAMAGE TO HER PROPERTY’S ROOF, SPECIFICALLY AFFECTING THE SHINGLES AND GUTTERS. THE HOME, BUILT IN 2015, RETAINED ITS ORIGINAL ROOF AND HAD NO PRIOR CLAIMS. THE LOSS WAS REPORTED TO THE INSURER ON JULY 10, 2024, APPROXIMATELY TWO MONTHS AFTER THE INCIDENT, AND A CLAIM WAS SUBSEQUENTLY FILED UNDER CLAIM NO. 1382241. THE INSURED NOTICED MISSING SHINGLES IN HER YARD THE DAY AFTER THE STORM BUT DID NOT REPORT ANY INTERIOR DAMAGE. INITIAL CLAIM HANDLING AND REPRESENTATION UPON REPORTING THE CLAIM, THE INSURER ASSIGNED FIELD ADJUSTER TRAVIS MURPHY (FL ADJUSTER LICENSE NO. W872444) TO ASSESS THE DAMAGES. THE INSURED, SEEKING LEGAL REPRESENTATION, RETAINED THE LAW FIRM OF WEISSER, ELAZAR & KANTOR, PLLC. A LETTER OF REPRESENTATION (LOR) WAS SENT TO PROGRESSIVE ON JULY 10, 2024, REQUESTING A CERTIFIED COPY OF THE INSURANCE POLICY, ALL CLAIM-RELATED CORRESPONDENCE, AND CLARIFICATION ON ANY ADDITIONAL DOCUMENTATION REQUIRED FOR PROCESSING THE CLAIM. COVERAGE DETERMINATION AND DISPUTE FOLLOWING THE INVESTIGATION, THE INSURER DETERMINED THAT THE COVERED DAMAGES DID NOT EXCEED THE INSURED’S POLICY DEDUCTIBLE OF $7,080. THE INSURER’S ESTIMATE FOR ROOF REPAIRS WAS $6,250.00, WHICH FELL BELOW THE DEDUCTIBLE, MEANING NO PAYMENT WAS ISSUED FOR THE LOSS. ON JULY 25, 2024, THE INSURED’S LEGAL REPRESENTATIVES SUBMITTED A SUPPLEMENTAL REQUEST FOR ADDITIONAL DAMAGES, ATTACHING AN INDEPENDENT REPAIR ESTIMATE TOTALING $59,628.00—FAR EXCEEDING THE INSURER’S DETERMINATION. CONTRACTOR AND MITIGATION EFFORTS THE INSURED ENGAGED ECO RESTORE, LLC (LICENSE NO. CCC1331566) FOR EMERGENCY MITIGATION AND RESTORATION SERVICES. ON JUNE 12, 2024, THE INSURED SIGNED A SERVICE AGREEMENT WITH ECO RESTORE, WHICH INCLUDED PROVISIONS FOR ROOF REPAIRS CONTINGENT ON INSURANCE APPROVAL. AS PART OF THEIR EMERGENCY RESPONSE, ECO RESTORE INSPECTED THE PROPERTY, IDENTIFIED TWO AREAS OF CONCERN, AND APPLIED A TEMPORARY SEAL TARP TO PREVENT FURTHER DAMAGE. THE TOTAL INVOICED AMOUNT FOR THESE SERVICES WAS $1,000.00, WITH NO PAYMENTS RECORDED AS OF OCTOBER 21, 2024. CIVIL REMEDY NOTICE (CRN) ALLEGATIONS AND STATUTORY VIOLATIONS IN FLORIDA, THE WORK OF ADJUSTING INSURANCE CLAIMS ENGAGES THE PUBLIC TRUST. AMERICAN STRATEGIC INSURANCE CORP. (ASI), UNDER PROGRESSIVE, HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR PROPER INVESTIGATION AND EVALUATION OF CLAIMS HANDLING. THE INSURER HAS ALSO FAILED TO PROPERLY TRAIN AND SUPERVISE ITS EMPLOYEES, RESULTING IN STATUTORY VIOLATIONS AND IMPROPER CLAIM DENIAL. THE INSURER HAS REFUSED TO CONDUCT A THOROUGH, ACCURATE, AND COMPLETE INVESTIGATION AND EVALUATION OF THE INSURED’S CLAIM AND DAMAGES, THUS BREACHING ITS STATUTORY DUTY. FLORIDA STATUTE §624.02 DEFINES “INSURANCE” AS A CONTRACT WHERE ONE UNDERTAKES TO INDEMNIFY ANOTHER OR PAY SPECIFIED AMOUNTS UPON DETERMINABLE CONTINGENCIES. THE TIMELY AND PROMPT PAYMENT OF CLAIMS IS ESSENTIAL TO ALLOW INSUREDS TO MITIGATE THEIR DAMAGES AND RESTORE THEIR PROPERTIES TO PRE-LOSS CONDITION AS QUICKLY AS POSSIBLE. ASI HAS BREACHED THIS DUTY BY REFUSING TO INDEMNIFY THE INSURED, LEAVING HER WITH OUT-OF-POCKET EXPENSES FOR REPAIRS AND LEGAL REPRESENTATION. DESPITE TIMELY NOTICE AND COMPLIANCE WITH ALL POST-LOSS OBLIGATIONS, THE INSURER HAS DELAYED AND OBSTRUCTED THE CLAIM PROCESS. THE INSURER HAS NOT ACTED PROMPTLY UPON COMMUNICATION WITH THE INSURED AND HAS FAILED TO SETTLE THE CLAIM WHEN ITS OBLIGATION TO DO SO WAS REASONABLY CLEAR. THE INSURER’S REFUSAL TO TENDER ALL INSURANCE PROCEEDS CONSTITUTES WRONGFUL CONDUCT AND SUGGESTS FINANCIAL BENEFIT TO THE INSURER AND ITS REPRESENTATIVES THROUGH WRONGFUL CLAIM DENIALS. THE INSURER’S CONDUCT INCLUDES MATERIAL MISREPRESENTATIONS REGARDING THE NATURE, EXTENT, AND VALUATION OF DAMAGES. BY GROSSLY UNDERVALUING THE DAMAGES AT $6,250.00 WHILE THE INSURED'S INDEPENDENT ESTIMATE STANDS AT $59,628.00, ASI HAS ACTED IN BAD FAITH AND DEPRIVED THE INSURED OF RIGHTFUL INDEMNIFICATION UNDER THE POLICY. AMERICAN STRATEGIC INSURANCE CORP. (ASI) HAS VIOLATED NUMEROUS FLORIDA STATUTES, DEMONSTRATING A PATTERN OF BAD FAITH IN HANDLING MS. WILLIAMS' CLAIM. THESE VIOLATIONS INCLUDE, BUT ARE NOT LIMITED TO: VIOLATION OF § 626.951 - ASI ENGAGED IN UNFAIR TRADE PRACTICES BY MISREPRESENTING POLICY BENEFITS AND EXCLUSIONS TO JUSTIFY AN INADEQUATE PAYOUT. THE INSURER PROVIDED MISLEADING INFORMATION REGARDING COVERAGE LIMITS, FALSELY INDICATING THAT THE CLAIM DID NOT QUALIFY FOR FULL INDEMNIFICATION. VIOLATION OF § 624.155(1)(B)(1) - ASI FAILED TO ACT IN GOOD FAITH BY OFFERING A GROSSLY INSUFFICIENT CLAIM VALUATION, DESPITE CLEAR EVIDENCE SUPPORTING A SIGNIFICANTLY HIGHER AMOUNT. THE INSURER REFUSED TO NEGOTIATE IN GOOD FAITH, COMPELLING THE INSURED TO RETAIN LEGAL COUNSEL TO RECEIVE FAIR COMPENSATION. VIOLATION OF § 624.155(1)(B)(3) - ASI DELIBERATELY DELAYED CLAIM RESOLUTION, IGNORING CLEAR EVIDENCE OF COVERED DAMAGES. BY UNDERVALUING THE CLAIM AND REFUSING TO PROMPTLY SETTLE, ASI EXERTED UNDUE PRESSURE ON THE INSURED TO ACCEPT AN UNJUST SETTLEMENT. VIOLATION OF § 626.9541(1)(I)(2) - ASI MADE MATERIAL MISREPRESENTATIONS REGARDING THE DAMAGE ASSESSMENT, ASSERTING THAT THE ROOF DAMAGE WAS MINOR WHEN IN REALITY, IT NECESSITATED FULL REPLACEMENT. THIS MISREPRESENTATION LED TO AN UNDERVALUATION OF THE CLAIM. VIOLATION OF § 626.9541(1)(I)(3)(A) - ASI FAILED TO ESTABLISH AND ENFORCE APPROPRIATE INVESTIGATIVE PROTOCOLS, RESULTING IN A SUBSTANDARD CLAIMS REVIEW PROCESS. THE ADJUSTER OVERLOOKED CRITICAL DAMAGE INDICATORS, CONTRIBUTING TO THE WRONGFUL DENIAL OF ADEQUATE COVERAGE. VIOLATION OF § 626.9541(1)(I)(3)(B) - ASI MISREPRESENTED POLICY PROVISIONS, MISLEADING THE INSURED REGARDING COVERAGE LIMITATIONS AND EXCLUSIONS TO JUSTIFY AN INSUFFICIENT PAYOUT. VIOLATION OF § 626.9541(1)(I)(3)(C) - ASI FAILED TO RESPOND TO COMMUNICATIONS PROMPTLY, CREATING UNNECESSARY DELAYS AND FAILING TO KEEP THE INSURED INFORMED ON CLAIM STATUS. VIOLATION OF § 626.9541(1)(I)(3)(D) - ASI DENIED THE CLAIM WITHOUT A REASONABLE INVESTIGATION. THE ADJUSTER RELIED ON AN INCOMPLETE INSPECTION AND DISREGARDED EVIDENCE SUPPORTING A HIGHER PAYOUT. VIOLATION OF § 626.9541(1)(I)(3)(E) - ASI FAILED TO AFFIRM OR DENY COVERAGE IN A TIMELY MANNER, LEAVING THE INSURED WITHOUT CLEAR GUIDANCE ON THE STATUS OF HER CLAIM. VIOLATION OF § 626.9541(1)(I)(3)(F) - ASI DID NOT PROVIDE A REASONABLE WRITTEN EXPLANATION FOR THE CLAIM DENIAL OR THE BASIS FOR THE SIGNIFICANTLY LOWER SETTLEMENT OFFER. VIOLATION OF § 626.9541(1)(I)(3)(G) - ASI FAILED TO REQUEST NECESSARY ADDITIONAL INFORMATION IN A TIMELY MANNER, STALLING CLAIM RESOLUTION. VIOLATION OF § 626.9541(1)(I)(3)(H) - ASI PROVIDED VAGUE REQUESTS FOR DOCUMENTATION WITHOUT EXPLAINING WHY THE INFORMATION WAS REQUIRED, FURTHER DELAYING SETTLEMENT. VIOLATION OF § 69-220.201(A) - THE INSURER’S ADJUSTERS FAILED TO DISCLOSE FINANCIAL INTERESTS IN CLAIM OUTCOMES, RAISING CONCERNS OF BIAS IN CLAIM EVALUATION. VIOLATION OF § 69-220.201(B) - ASI ENGAGED IN DISCRIMINATORY CLAIMS HANDLING BY APPLYING UNJUSTIFIABLY STRICT ASSESSMENTS ON MS. WILLIAMS' CLAIM COMPARED TO SIMILAR CASES. VIOLATION OF § 69-220.201(C) - ASI APPROACHED THE CLAIM INVESTIGATION WITH BIAS, FAILING TO CONSIDER ALL RELEVANT FACTS IMPARTIALLY. VIOLATION OF § 69-220.201(E) - ASI FAILED TO HANDLE THE CLAIM WITH INTEGRITY, INSTEAD PRIORITIZING COST-SAVING MEASURES OVER FAIR INDEMNIFICATION. VIOLATION OF § 69-220.201(F) - ASI FAILED TO RESOLVE THE CLAIM EXPEDITIOUSLY, CREATING UNNECESSARY HARDSHIP FOR THE INSURED. VIOLATION OF § 69-220.201(M) - ASI FAILED TO FULLY INFORM THE INSURED OF HER POLICY RIGHTS AND OPTIONS, DEPRIVING HER OF THE ABILITY TO MAKE INFORMED DECISIONS. CURRENT STATUS AND DEMANDS TO CURE TO RECTIFY THESE VIOLATIONS, ASI MUST: IMMEDIATELY TENDER ALL UNDISPUTED PROCEEDS UNDER THE POLICY. ACT FAIRLY AND HONESTLY TOWARDS THE INSURED, WITH DUE REGARD FOR HER INTERESTS. TENDER ALL INSURANCE MONIES DUE AND OWING, ENSURING ADEQUATE FUNDS TO RESTORE THE PROPERTY TO PRE-LOSS CONDITION, MINUS THE DEDUCTIBLE. REIMBURSE ATTORNEY’S FEES AND COSTS INCURRED DUE TO THE INSURER’S REFUSAL TO FAIRLY SETTLE THE CLAIM. CEASE THE USE OF BIASED OUTCOME-DRIVEN ADJUSTERS AND ENGINEERS WHO SEEK TO DENY CLAIMS RATHER THAN FAIRLY ASSESS LOSSES. IMPLEMENT PROPER TRAINING AND SUPERVISION FOR ADJUSTERS TO PREVENT WRONGFUL CLAIM DENIALS IN THE FUTURE. FAILURE TO COMPLY WITH THESE DEMANDS WITHIN SIXTY (60) DAYS OF THIS CIVIL REMEDY NOTICE WILL RESULT IN FURTHER LEGAL ACTION, INCLUDING CLAIMS FOR BAD FAITH DAMAGES AND POLICY LIMITS IF THE PROPERTY SUFFERS FURTHER STRUCTURAL DETERIORATION DUE TO THE INSURER’S REFUSAL TO COMPLY WITH ITS CONTRACTUAL OBLIGATIONS.THE NOITL WAS ACCEPTED ON AUGUST 15, 2024, CONFIRMING THE INSURED’S INTENT TO PURSUE LITIGATION SHOULD A RESOLUTION NOT BE REACHED WITHIN THE STATUTORY TIMEFRAME. INSURER’S RESPONSE AND CONTINUING BAD FAITH CONDUCT THE INSURER RESPONDED WITH A NOITL RESPONSE STATUS LETTER AND AN UNDER DEDUCTIBLE STATUS LETTER, REAFFIRMING THEIR INITIAL COVERAGE DETERMINATION. THE INSURER MAINTAINED THAT THEIR VALUATION OF THE LOSS AT $6,250.00 WAS ACCURATE, AND SINCE IT FELL BELOW THE DEDUCTIBLE, NO PAYMENT WAS REQUIRED UNDER THE POLICY TERMS. THIS RESPONSE DISREGARDS THE INSURED’S EVIDENCE AND CONTINUES TO DEPRIVE THE INSURED OF RIGHTFUL COMPENSATION. GIVEN THIS RESPONSE, THE INSURED’S LEGAL COUNSEL HAS INDICATED AN INTENT TO PROCEED WITH LITIGATION AGAINST AMERICAN STRATEGIC INSURANCE CORP. IF A SETTLEMENT IS NOT REACHED IN GOOD FAITH. THE INSURED WILL ARGUE THAT THE INSURER UNDERVALUED THE DAMAGE AND FAILED TO PROPERLY ASSESS THE EXTENT OF THE WIND-RELATED LOSS. DEMANDS TO CURE THE BAD FAITH CONDUCT TO RECTIFY THE VIOLATIONS OUTLINED IN THIS CIVIL REMEDY NOTICE, ASI MUST: IMMEDIATELY TENDER ALL UNDISPUTED PROCEEDS UNDER THE POLICY. ACT FAIRLY AND HONESTLY TOWARDS THE INSURED, WITH DUE REGARD FOR HER INTERESTS. TENDER ALL INSURANCE MONIES DUE AND OWING, ENSURING ADEQUATE FUNDS TO RESTORE THE PROPERTY TO PRE-LOSS CONDITION, MINUS THE DEDUCTIBLE. REIMBURSE ATTORNEY’S FEES AND COSTS INCURRED DUE TO THE INSURER’S REFUSAL TO FAIRLY SETTLE THE CLAIM. CEASE THE USE OF BIASED OUTCOME-DRIVEN ADJUSTERS AND ENGINEERS WHO SEEK TO DENY CLAIMS RATHER THAN FAIRLY ASSESS LOSSES. IMPLEMENT PROPER TRAINING AND SUPERVISION FOR ADJUSTERS TO PREVENT WRONGFUL CLAIM DENIALS IN THE FUTURE. FAILURE TO COMPLY WITH THESE DEMANDS WITHIN SIXTY (60) DAYS OF THIS CIVIL REMEDY NOTICE WILL RESULT IN FURTHER LEGAL ACTION, INCLUDING CLAIMS FOR BAD FAITH DAMAGES AND POLICY LIMITS IF THE PROPERTY SUFFERS FURTHER STRUCTURAL DETERIORATION DUE TO THE INSURER’S REFUSAL TO COMPLY WITH ITS CONTRACTUAL OBLIGATIONS.

Comments

User Id		Date Added		Comment
bd@weklaw.com		03-28-2025		DFS: 808635 CLAIMANT REPLY TO ASI RESPONSE ASI’s response to the Civil Remedy Notice (CRN) is not only factually unsupported but constitutes a boilerplate denial that wholly disregards the specific and substantiated issues raised in the original filing. In its response, ASI relies exclusively on its initial determination that the covered damages amounted to $6,250—below the $7,080 policy deductible—and uses that single estimate to justify its refusal to issue any payment. However, this response ignores the fact that the insured, Vicki Williams, through legal counsel, submitted a comprehensive and detailed rebuttal to ASI’s valuation. This included an independent contractor estimate totaling $59,628—nearly ten times ASI’s valuation—prepared by a licensed Florida contractor, Eco Restore, LLC. The estimate was based on a full inspection and included documented roof damage, line-item pricing, and justifications for full roof replacement based on building code compliance and the condition of the property following the windstorm on May 15, 2024. Despite the submission of this additional, material evidence, ASI made no effort to reassess the loss or request reinspection. Its response letter does not address or even acknowledge the supplemental estimate or the mitigation work performed—work which included emergency tarping and temporary sealing to prevent further interior damage. Moreover, ASI received a Letter of Representation (LOR) on July 10, 2024, in which counsel for the insured not only requested a certified copy of the policy and all claim correspondence, but also asked for clarification of any further documentation needed to process the claim. ASI failed to provide a meaningful response to this request. Its so-called “under deductible” response was issued after these materials were submitted, and instead of grappling with the detailed factual allegations, ASI resorted to a generic, conclusory restatement of its original position without investigation or explanation. This approach is in direct violation of § 626.9541(1)(i)(3)(d), which prohibits insurers from denying claims without a reasonable investigation, and § 626.9541(1)(i)(3)(f), which requires insurers to provide a reasonable written explanation of claim decisions in relation to the facts and policy provisions. ASI’s response also fails under § 624.155(1)(b)(1), which imposes a duty on insurers to act in good faith when the obligation to settle is reasonably clear. The disparity between ASI’s $6,250 estimate and the insured’s $59,628 estimate—backed by professional assessment—made the insurer’s obligation to revisit and properly evaluate the claim reasonably clear. Instead, ASI doubled down on its original figure, choosing not to address the discrepancy at all. This selective ignorance demonstrates bad faith and is designed not to reach a fair resolution but to wear down the insured into abandoning her claim or accepting an inadequate settlement. Furthermore, the CRN provided detailed allegations of misconduct, including violations of Florida’s Unfair Insurance Trade Practices Act, and outlined ASI’s failure to communicate, misrepresentations of policy coverage, and delays that created unnecessary hardship for the insured. In response, ASI did not dispute the facts alleged or offer counter-evidence. It issued a canned response devoid of substantive engagement—offering no explanation of how its estimate was reached, no discussion of how or why it ignored the $59,628 estimate, and no legal basis for disregarding the insured’s extensive post-loss documentation. In sum, ASI’s response is a perfunctory and superficial dismissal that fails to address the facts, evidence, or legal obligations raised in the CRN. It reflects a pattern of claims handling designed to underpay and delay, rather than to fairly and promptly indemnify the insured. As such, ASI’s conduct constitutes a continuation of bad faith, and further supports the insured’s intent to pursue litigation for full policy benefits, attorney’s fees, and statutory bad faith damages.
lashawna_e_nesbitt@progressive.com		03-28-2025		While American Strategic Insurance Corp response believes that the Civil Remedy Notice fails to comply with the requirements of Florida Statute §624.155 and Florida Case law, it has responded to the notice in writing to WEK Law, on March 28, 2025.

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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

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