Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 808696

Filing Accepted: 2/27/2025

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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*		VARON		First Name
Policy # *		HCPC-HO3-270963-12		Claim #*		930803

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*		HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 12944

Name of individual responsible for violation (if any):* KYLENA LEE (CLAIM EXAMINER) ; JOSEPH JEFFERSON (CLAIMS TECHNICAL LEAD)
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Claim Denial
	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.

* 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

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

This claim arises from HCPCI’s failure and outright refusal to properly investigate, adjust, and pay for covered water damage to the insured property located at 3408 45th Street West, Bradenton, FL 34209. Despite the insureds’ full compliance with all post-loss obligations and extensive efforts to facilitate the claim adjustment process, HCPCI has deliberately delayed, underpaid, and misrepresented coverage in bad faith to avoid its contractual responsibilities. On February 27, 2023, the insured property suffered a covered water loss due to a pipe leak. The insureds promptly reported the claim to HCPCI on March 9, 2023, only 10 days after the loss, fulfilling their duty under the policy. Instead of properly investigating the loss and issuing payment for the full scope of covered damages, HCPCI engaged in an egregious pattern of bad faith conduct designed to suppress claim payments and force the insureds into an unfair settlement. HCPCI initially estimated the total damage at a grossly inadequate $1,346.13, despite overwhelming evidence that the actual damages far exceeded this amount. Florida Claim Advisors, acting on behalf of the insureds, estimated the damages at amounts ranging from $45,464.69 to $68,570.97. HCPCI ignored these findings and rejected the insureds’ Sworn Proof of Loss (SPOL) on August 28, 2023, without any legitimate explanation, further compounding its bad faith conduct. On March 8, 2024—365 days after the first notice of loss—HCPCI issued a partial denial letter, offering a mere $10,000.00 under the Mold Coverage limit, while refusing to pay for the full extent of the water damage, including necessary repairs to return the property to its pre-loss condition. HCPCI wrongfully denied coverage for necessary plumbing repairs, citing policy exclusions for wear and tear and deterioration, despite clear evidence that the loss was sudden and accidental—a covered peril under the policy. HCPCI then attempted to lowball the insureds with a settlement offer of only $3,846.13 on August 9, 2023, a fraction of the actual loss. When this was rightfully rejected, the insurer continued to delay resolution of the claim, forcing the insureds to file a Notice of Intent to Initiate Litigation (NOI) on September 4, 2024. In response, HCPCI made an insulting statutory settlement offer of $20,000 on September 12, 2024, far below the documented damages. The insurer conditioned this payment on a full release, demonstrating its intent to strong-arm the insureds into accepting a bad faith settlement. Bad Faith Conduct by HCPCI Failure to Properly Investigate & Adjust the Claim – HCPCI failed to send an adjuster to properly evaluate the full scope of damages and refused to accept the insureds’ expert findings, instead relying on a grossly deficient estimate to justify underpayment. Refusal to Honor the Appraisal Clause – The insureds rightfully requested appraisal per the policy terms, yet HCPCI arbitrarily denied the request on August 28, 2023, depriving the insureds of a fair means to resolve the dispute. Misrepresentation of Policy Benefits – HCPCI intentionally misrepresented the coverage available under the policy, misleading the insureds into believing their claim was worth far less than its actual value. Unjustified Delays in Payment – HCPCI delayed resolution of this claim for over a year, violating its duty to adjust and pay valid claims promptly. Attempting to Force the Insureds into an Unfair Settlement – HCPCI engaged in tactics designed to pressure the insureds into accepting an unreasonable settlement, while using delay as a weapon to leverage an unfair resolution. Cure Demand To remedy the bad faith violations described herein, HCPCI must: Immediately tender $68,570.97—the full amount of the insureds’ estimate—to compensate for all covered damages. Reimburse the insureds for all costs incurred, including public adjuster fees and attorneys’ fees. Cease all deceptive and misleading claims handling practices, including the use of biased adjusters and outcome-oriented consultants. Issue a formal written apology to the insureds for its delay and mishandling of their claim. Implement corrective measures to ensure fair claims handling, including proper training and oversight of adjusters. Comply with Florida Statutes governing good faith claims handling and cease all violations of §624.155 and §626.9541. If HCPCI fails to cure the violations set forth in this Civil Remedy Notice within sixty (60) days, the insureds will pursue all available legal remedies, including a claim for bad faith damages under Florida law. Conclusion HCPCI’s handling of this claim has been willfully and deliberately unfair, deceptive, and unlawful. Instead of fulfilling its contractual obligations, the insurer has acted in bad faith at every stage of the claim process, resulting in delays, underpayments, and unjustified denials. Florida law requires insurers to treat policyholders with good faith, honesty, and fairness—HCPCI has failed to meet this duty. Unless immediate action is taken to rectify these violations, HCPCI should prepare to be held fully accountable for its misconduct, including statutory and extra-contractual damages. Detailed Explanation of HCPCI’s Violations of Florida Insurance Laws 1. Violation of § 626.951 – Engaging in Unfair Trade Practices Homeowners Choice Property & Casualty Insurance Company, Inc. (“HCPCI”) engaged in unfair trade practices by misrepresenting the benefits, endorsements, and exclusions within the insureds’ policy. HCPCI led the insureds to believe that their policy would provide full indemnification for a sudden and accidental water loss, yet when the insureds submitted their claim, HCPCI selectively applied exclusions to justify underpayment and partial denial of benefits. Specifically, HCPCI claimed the plumbing system repairs were not covered, despite the policy providing coverage for sudden and accidental discharge of water. HCPCI further engaged in deceptive trade practices by initially offering a grossly inadequate settlement of $3,846.13, which did not reflect the true scope of damages, thereby violating Florida’s prohibition against unfair and deceptive insurance practices. 2. Violation of § 624.155(1)(b)(1) – Failing to Act in Good Faith HCPCI failed to act in good faith by refusing to issue timely and adequate payments, despite having clear evidence of the extent of damages and its obligation to settle the claim. The insurer’s own field adjuster inspected the loss and issued an unreasonably low estimate of $1,346.13, failing to account for extensive property damage. Even after the insureds submitted multiple professional estimates totaling between $45,464.69 and $68,570.97, HCPCI continued to delay resolution and failed to provide a reasonable settlement offer. The insurer’s intentional underestimation of damages and failure to tender sufficient insurance proceeds forced the insureds to expend significant resources in legal fees and a public adjuster to compel HCPCI to meet its obligations. 3. Violation of § 624.155(1)(b)(3) – Failing to Promptly Settle Claims to Influence Settlements on Other Coverage HCPCI deliberately delayed payment and underpaid portions of the insureds’ claim to gain leverage over the insureds and pressure them into an inadequate settlement. HCPCI initially ignored the insureds’ Sworn Proof of Loss submission and later rejected it without justification. By taking nearly one year to issue a partial denial and payment under the Mold Coverage limit, HCPCI used this delay as a tactic to force the insureds into settling for far less than what they were owed. Additionally, when the insureds filed a Notice of Intent to Litigate (NOI), HCPCI suddenly increased its offer to $20,000, demonstrating that the insurer had the ability to settle the claim earlier but chose to withhold payments to exert financial pressure on the insureds. 4. Violation of § 626.9541(1)(i)(2) – Material Misrepresentation for Underpayment HCPCI knowingly misrepresented material facts to the insureds to effectuate an unfair settlement. The insurer falsely claimed that the damage fell under policy exclusions, despite clear evidence that the damage resulted from a covered peril. Furthermore, HCPCI misrepresented the valuation of damages by issuing an initial settlement offer of $3,846.13, which was significantly lower than all independent damage assessments. HCPCI’s refusal to acknowledge the full extent of damages and failure to provide an accurate assessment was designed to settle the claim on less favorable terms than those provided under the policy. 5. Violation of § 626.9541(1)(i)(3)(a) – Failing to Implement Proper Investigation Standards HCPCI failed to implement proper standards for claim investigations, leading to significant errors and omissions in the adjustment process. The insurer conducted a deficient investigation, relying on an outcome-oriented adjuster’s estimate that significantly undervalued the damages. HCPCI further refused to engage in an appraisal process, which would have provided a fair valuation of the loss. The lack of a thorough, unbiased investigation demonstrates HCPCI’s failure to train and supervise its claims personnel adequately. 6. Violation of § 626.9541(1)(i)(3)(b) – Misrepresenting Policy Provisions HCPCI misrepresented pertinent policy facts by denying coverage based on improper exclusions and misleading statements regarding coverage limitations. The policy expressly provides coverage for water damage resulting from accidental discharge, yet HCPCI denied coverage for necessary plumbing system repairs by wrongly categorizing them as "wear and tear" issues. HCPCI also misrepresented the availability of the appraisal process, falsely asserting that it was not an available option, despite the policy permitting such a resolution method. 7. Violation of § 626.9541(1)(i)(3)(c) – Failing to Acknowledge and Act Promptly on Communications HCPCI failed to promptly respond to the insureds’ communications, including multiple requests for claim updates and an explanation of the denial decision. The insureds submitted their Sworn Proof of Loss on July 14, 2023, and HCPCI ignored it for over a month before issuing a rejection on August 28, 2023. Furthermore, HCPCI did not issue a coverage determination until March 8, 2024—365 days after the First Notice of Loss (FNOL). This excessive delay in communication prevented the insureds from receiving timely relief and demonstrated HCPCI’s bad faith tactics. 8. Violation of § 626.9541(1)(i)(3)(d) – Denying Claims Without Conducting a Reasonable Investigation HCPCI denied coverage for key portions of the claim without conducting a reasonable investigation. The insurer relied on an inadequate estimate that grossly undervalued damages and failed to address all affected areas. HCPCI also ignored independent damage assessments provided by the insureds, which included expert evaluations and a public adjuster’s findings. By failing to consider critical evidence, HCPCI denied coverage without a legitimate basis. 9. Violation of § 626.9541(1)(i)(3)(e) – Failing to Affirm or Deny Coverage or Provide a Written Statement HCPCI failed to affirm or deny full or partial coverage in a timely manner. Despite receiving the insureds’ Sworn Proof of Loss on July 14, 2023, HCPCI failed to issue a timely response and instead waited until August 28, 2023, to reject the proof of loss without a reasonable explanation. Moreover, the insurer did not issue a formal coverage decision until March 8, 2024, over a year after the insureds’ first notice of loss. 10. Violation of § 626.9541(1)(i)(3)(f) – Failing to Provide a Reasonable Explanation for Denial HCPCI failed to provide a reasonable written explanation for its denial and underpayment of the claim. The insurer’s March 8, 2024, coverage letter did not clearly outline the policy provisions that supported its partial denial. Instead, HCPCI issued vague and misleading statements regarding exclusions without explaining why the full extent of repairs and replacements were not covered. 11. Violation of § 626.9541(1)(i)(3)(g) – Failing to Notify the Insured of Necessary Information HCPCI failed to inform the insureds of any additional information needed to process the claim in a timely manner. The insurer delayed responding to inquiries and requests for clarification, leaving the insureds without guidance on how to move forward with their claim. The lack of transparency further contributed to delays in resolving the claim and forced the insureds to seek legal counsel. 12. Violation of § 626.9541(1)(i)(3)(h) – Failing to Clearly Explain Requested Information HCPCI failed to clearly explain what additional documentation or information was necessary to evaluate the claim. The insureds made multiple attempts to clarify their claim’s status, yet HCPCI provided vague, unhelpful responses that did not specify what was needed to move forward. This failure obstructed the insureds’ ability to comply with the claims process and unnecessarily prolonged the dispute.

Comments

User Id		Date Added		Comment
Legal@hcpci.com		04-23-2025		This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Complainant Britt Degennaro. After reviewing the CRN, HCPCI conducted a thorough review of the subject claim (“claim”) and confirmed it has handled the claim properly. Overall, HCPCI has handled the claim in accordance with the subject insurance contract and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI has acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. However, the CRN is deficient. Generally, CRNs must set forth with specificity relevant insurance contract language, statutory provisions and facts and circumstances to provide insurers with a meaningful opportunity to cure statutory violations alleged in CRNs. Here, Instead of complying with Florida Statutes, Section 624.155, the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; failed to offer a valid cure, and relied on inaccurate and conclusory statements. The CRN’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The CRN cannot serve as the basis of a bad-faith action against HCPCI. Further, Britt Degennaro does not have standing to have filed the CRN as the named Complainant. For instance, HCPCI has never provided insurance to Britt Degennaro in relation to this claim and moreover, Britt Degennaro is an attorney and has no personal cause of action against HCPCI for extra-contractual damages or otherwise under Florida law. Additionally, prior to the filing the CRN— the Complainant’s law firm filed a lawsuit against HCPCI in relation to the claim. It is clear the filing of this CRN was intended to be nothing more than an attempt to harass and bully HCPCI in an active lawsuit. The foregoing shows abuses by the Complainant of the CRN and legal processes. Finally, upon request by the Department of Financial Services, HCPCI will provide to the Department of Financial Services detailed correspondence HCPCI provided to the Insured regarding HCPCI’s obligations for the claim under the insurance contract and the facts of the claim.

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