Civil Remedy Notice of Insurer Violations
Login

Filing Number:     808736
Filing Accepted:  2/27/2025
         Print Filing
Complainant
Last/Business Name *  
WELLS   First Name   ANASTASIA
Street Address * 2648 GRASSMOOR LOOP
City, State Zip * APOPKA, FL 32712
Email Address * STASIE120@AOL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WELLS   First Name   ANASTASIA
Policy # * 80BAE8020 Claim #* 5963W446P
Attorney
Attorney is Applicable
Last Name* ALTMAN First Name * ALEXIS Initial
Street Address* 925 SOUTH FEDERAL HIGHWAY, 7TH FLOOR
City, State Zip* BOCA RATON , FL - FLORIDA 33432
Email Address * AALTMAN@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* TIA SPARKS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Unfair Trade Practice
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.
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.
* 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 settlement provision
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

State Farm Florida Insurance Company (“Carrier”) has not attempted in good faith to settle the insured’s 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 their interests. In fact, the carrier has intentionally undervalued the insured’s claim in an attempt maximize its profits, thereby preventing the insured from being able to restore his home to its pre-loss conditions. The carrier has engaged in these actions, despite the clear and unequivocal burden discussed in Allstate Indemnity Co. v. Ruiz, 899 So. 2d 1121 (Fla. 2005), wherein the Florida Supreme Court held, “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 insureds.” This claim arises from a hail and windstorm. Anastasia Wells (“insureds”) put the carrier on notice of the damages. The carrier sent out a field adjuster who inspected the home. Thereafter, an estimate was provided in the amount of $2,645.88. Reviewing the estimate of the carrier, it was clear that the estimate was extremely deficient and improperly scoped. The insured knew that this amount was insufficient to put the home back to its pre-loss condition. The insured retained a public adjuster who went to the home and provided a true evaluation of the damages. An estimate in the amount of $82,697.06 was provided to the carrier. Underpaying and denying claims has become a tactic of State Farm to deny all claims since Florida law on fee statutes has changed. It is known that State Farm uses its money for marketing to retain and pay celebrities millions of dollars rather to collect premiums and get more insured and then wrongfully denies their insureds claims. It is truly criminal at this point. Pursuant to Florida Statute §624.155(1)(b)(1), Carrier has failed to settle the claim in good faith when it could and should have done so. The Insured reported the Loss and the Property was presented for inspection. The damage to the Insured’s property was clearly caused by a covered peril under the Policy, but the carrier has not shown a good faith intention to pay what was owed under the policy and has wrongfully undervalued the claim. Florida law mandates that insurers and adjusters do not mislead the Insured. Florida Insurance companies that fail to follow these Florida laws and regulations, designed to protect consumers, do not only breach their duties under the policy of insurance but do so in bad faith. In violation of Florida Statute §626.9541(1)(i)(3)(b), the carrier intentionally misrepresented the available coverage under the policy by not providing full coverage under the policy of insurance. Pursuant to Florida Statute 626.9541(1)(i)(3)(a) the carrier has Failed to adopt and implement standards for the proper investigation of claims as both the field adjuster sent out and the desk adjuster have failed to provide the insured with full coverage. Further, in violation of Florida Statute §626.9541(1)(i)(3)(d), State Farm improperly denied replacement of the roof without conducting a reasonable investigation based upon available information. State Farm should have requested an ITEL report to determine if a matching shingle was available. Instead, State Farm places the obligation on policyholders to perform the investigation and provide the documentation after claims have been denied, delayed, and/or underpaid. In Florida, the work of adjusting insurance claims engages the public trust. State Farm has breached this trust in the improper adjustment of the Insured’s claim. Though the Insured sustained a loss that, pursuant to the terms of his policy, should be covered by the policy of insurance, State Farm refused to properly indemnify the Insured for his loss in direct contradiction of the terms of the Policy and Florida Statutes. From the very start, State Farm did not act in good faith during its adjustment of the Claim as evidenced by the violations noted above. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the indemnity portion in the amount of $82,697.06 minus any applicable deductibles or prior payments; 2.) Pay all emergency services retained by the insureds; 3.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. Please do not hesitate to contact the undersigned (561)-892-9988 if you have any questions or concerns.
Comments
User Id Date Added Comment
lalfano@alfanokingsford.com 04-24-2025 Dear Ms. Wells: This letter has been directed to you through your attorney as State Farm Florida Insurance Company’s (“State Farm”) formal response to the allegations set forth in the purported Civil Remedy Notice (“Notice”) of insurer violation dated February 27, 2025. This Notice was filed on your behalf by Attorney Alexis Altman Esq. of Kanner & Pintaluga, P.A. and purports to comply with Florida Statute §624.155. (A copy of the Notice is attached as Exhibit A). In your purported Notice, there is an indication that State Farm did not handle this claim in good faith because State Farm delayed your claim, it committed some form of unidentified unfair trade practice, and it did not issue payment of benefits you believe are owed to you, along with many other unfounded claims. State Farm denies each of the allegations in your Notice, and as the facts below will demonstrate, this claim was properly investigated, and State Farm did not treat you unfairly in its adjustment of the claim. On February 28, 2024, you submitted the subject hail and water damage claim to State Farm with a reported date of loss of February 4, 2024. The same day, a State Farm representative attempted to contact you and did not receive a response. On March 4, 2024, State Farm sent correspondence advising you of your Duties After Loss and the Homeowner Claims Bill of Rights. (Please see attached Exhibit B and Exhibit C). On March 5, 2024, State Farm Representative Tia Sparks spoke with you, at which time you advised of hail and wind damage to your roof, as well as interior water damage to the garage ceiling. On March 14, 2024, Ms. Sparks inspected your property with you and a contractor with Hi Low Roofing LLC present. On March 21, 2024, Ms. Sparks spoke with you and advised you of the inspection findings. On March 27, 2024, State Farm sent you its coverage determination, dated March 22, 2024, explaining that its investigation revealed two (2) wind damaged shingles, two (2) hail damaged window screens, one (1) hail damaged downspout, and hail damage to the pool enclosure, however, the cost of repairs for the covered damage does not exceed the policy deductible, and therefore no payment could be issued. State Farm further advised that it also found wear, tear, and deterioration to the roof and elevations, which are not covered damage under the subject policy. State Farm enclosed a copy of its estimate totaling $2,681.30 for the covered repairs. (Please see attached Exhibit D). The same day, State Farm sent correspondence to you advising of your right to participate in the Florida Department of Financial Services mediation program. (Please see attached Exhibit E). On April 4, 2024, State Farm received email correspondence from Ask An Adjuster, LLC attaching a Public Adjuster Contract executed you and public adjuster, Jeremy Dragon, on April 4, 2024. (Please see attached Exhibit F). The same day, State Farm sent correspondence to Ask An Adjuster acknowledging receipt of the Public Adjuster Contract, and that a copy of the subject policy had been ordered from underwriting and would be forwarded upon receipt. This correspondence also attached copies of previous claims correspondence sent to you, as well as a copy of State Farm’s estimate. (Please see attached Exhibit G). On April 8, 2024, State Farm received email correspondence from Ask An Adjuster requesting any policies, estimates, photographs, or other documentation used to adjust the loss. (Please see attached Exhibit H). The same day, State Farm sent email correspondence to Ask An Adjuster attaching its April 4, 2024 correspondence previously responding to the public adjuster’s request. (Please see attached Exhibit I). On April 16, 2024, State Farm sent email correspondence to Ask An Adjuster attaching a copy of the subject policy. (Please see attached Exhibit J). On April 17, 2024, State Farm received email correspondence from Ask An Adjuster requesting the declarations pages of the policy. (Please see attached Exhibit K). On April 20, 2024, State Farm sent email correspondence to Ask An Adjuster attaching the declarations to the policy. (Please see attached Exhibit L). On April 30, 2024, State Farm received email correspondence from Ask An Adjuster attaching its estimate totaling $76,828.72, along with photographs of the subject property. (Please see attached Exhibit M). On May 17, 2024, State Farm received email correspondence from Ask An Adjuster attaching its revised estimate totaling $82,697.06. (Please see attached Exhibit N). On June 11, 2024, State Farm sent correspondence to Ask An Adjuster acknowledging receipt of the documentation. (Please see attached Exhibit O). On June 29, 2024, State Farm sent correspondence to you and Ask An Adjuster advising that it had received the public adjuster’s estimate and requesting photographs. (Please see attached Exhibit P). On July 29, 2024, State Farm received email correspondence from Ask An Adjuster attaching a Sworn Proof of Loss (“SPOL”) in the amount of $82,697.06, executed by you on June 4, 2024, and includes the estimate prepared by Ask An Adjuster in support. (Please see attached Exhibit Q). On August 2, 2024, State Farm received email correspondence from Ask An Adjuster attaching the public adjuster’s photos dated April 26, 2024. (Please see attached Exhibit R). On August 22, 2024, State Farm received email correspondence from Ask An Adjuster attaching the public adjuster’s updated photos dated August 22, 2024. (Please see attached Exhibit S). On September 6, 2024, State Farm Representative Nathan Hunter spoke with the public adjuster, Jeremy Dragon, and advised that he would review the updated photos. On October 30, 2024, State Farm sent correspondence to Ask An Adjuster acknowledging receipt of the SPOL and advising that it cannot accept the proof of loss as it was not received within sixty days of the date of loss. (Please see attached Exhibit T). On October 31, 2024, State Farm sent its updated coverage decision to you and Ask An Adjuster explaining that there is no hail damage to the roof surface or exterior and further advised that the water damage to the garage ceiling was caused by reoccurring rainwater intrusion over a period of time from multiple historical weather events. State Farm also enclosed another copy of its estimate totaling $2,681.30. (Please see attached Exhibit U). The same day, State Farm sent another letter reminding you of your right to participate in the Florida Department of Financial Services mediation program. (Please see attached Exhibit V). On November 14, 2024, State Farm received notification that you had requested mediation through the Department of Financial Services. On December 17, 2024, the parties participated in mediation, which resulted in an impasse. On February 27, 2025, Alexis Altman, Esq. of Kanner & Pintaluga, P.A. filed a Notice of Intent to Initiate Litigation (“NOIL”) in the amount of $75,500.00 on your behalf. (Please see attached Exhibit W). The NOIL attaches the estimate prepared by Ask An Adjuster totaling $82,697.06. The same day, Ms. Altman filed the subject Notice on your behalf. On March 11, 2025, State Farm sent correspondence to Kanner & Pintaluga advising that it believes its estimate of the cost to repair the damage to be correct. Regardless, State Farm made a settlement offer of $500.00. (Please see attached Exhibit X). As the above-referenced facts demonstrate, there is no support for your allegations against State Farm, and State Farm has properly handled this claim and treated you fairly in its adjustment. Florida Statute §624.155 requires specificity in Civil Remedy Notices. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000); Julien v. United Prop. & Cas. Inc. Co., 2021 Fla. App. LEXIS 3131 (Fla. 4th DCA 2021). Your Notice lacks any information in support of its allegations. For example, your Notice alleges that State Farm “has not attempted in good faith to settle the insured’s 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 their interests. In fact, the carrier has intentionally undervalued the insured’s claim in an attempt maximize its profits, thereby preventing the insured from being able to restore his home to its pre-loss conditions.” Yet, you fail to provide any information to show that State Farm was ever obligated to settle this claim. State Farm completed a proper investigation of your claim and determined that the cost of repairs for the covered damage does not exceed the deductible. Your Notice fails to discuss how State Farm acted unfairly by not engaging in negotiations to pay for damages that do not exceed the deductible or are otherwise not covered by the policy. Moreover, your Notice does not demonstrate that State Farm’s estimate undervalues the amount of covered damage, or that State Farm somehow intentionally undervalued the loss. It is clear that these speculative allegations are based merely on your disagreement with State Farm’s evaluation of your loss, and not upon any factual support. As such, your Notice fails to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003); Julien, 2021 Fla. App. LEXIS 3131. State Farm denies these allegations and all others in your Notice. Your Notice alleges that State Farm’s estimate “was extremely deficient and improperly scoped. The insured knew that this amount was insufficient to put the home back to its pre-loss condition.” Your Notice continues by alleging “the insured retained a public adjuster who went to the home and provided a true evaluation of the damage. And Estimate in the amount of $82,697.06 was provided to the carrier.” As previously discussed, your Notice contains no information relevant to State Farm’s estimate to show that State Farm improperly scoped the value of covered damage. In fact, the public adjuster’s estimate you reference here simply calls for extensive repairs to your property and does nothing to demonstrate causation of damages as applied to the policy in favor of coverage. State Farm’s estimate provides for full repairs to the covered damage described in its coverage determination letter pursuant to the provisions of the subject policy. Despite this, your Notice insists that “underpaying and denying claims has become a tactic of State Farm to deny all claims since Florida law on fee statutes has changed.” This is simply a false statement, as State Farm certainly does not deny all claims. Amusingly, State Farm did not even deny coverage for your claim in this instance. These boilerplate allegations have no basis in relevant fact and have nothing to do with the subject claim. Accordingly, your Notice fails to meet its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. Your Notice further alleges that “the work of adjusting insurance claims engages the public trust. State Farm has breached this trust in the improper adjustment of the Insured’s claim. Though the Insured sustained a loss that, pursuant to the terms of his policy, should be covered by the policy of insurance, State Farm refused to properly indemnify the insured for his loss in direct contradiction of the terms of the Policy and Florida Statutes.” This is another clear example of boilerplate allegations that have no relevance to the facts of the subject claim. State Farm did not deny coverage for the loss, and has provided multiple copies of its estimate to you and your representatives. The amount of loss does not exceed your deductible, and thus, State Farm cannot refuse to indemnify you for insurance proceeds that were never due. State Farm prepared its estimate pursuant to the terms of the subject policy. You go on to allege that “All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insured’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida.” Yet you have provided no factual support to show that State Farm performed these behaviors during the adjustment of your claim, much less any other State Farm insured claim in a manner that would indicate an ongoing pattern and practice. Your failure to support these allegations with any factual information relevant to your claim demonstrates the boilerplate nature of your Notice and a lack of credibility for your allegations as a whole. Your Notice alleges that State Farm has violated several Florida Statutes without providing any factual support to demonstrate how State Farm engaged in such behaviors. For instance, your Notice alleges that “pursuant to Florida Statute §624.155(1)(b)(1), Carrier has failed to settle the claim in good faith when it could and should have done so . . . the damage to the Insured’s property was clearly caused by a covered peril under the Policy, but the carrier has not shown a good faith intention to pay what was owed under the policy and has wrongfully undervalued the claim.” Similarly, your Notice also alleges that State Farm violated Fla. Stat. § 624.155(1)(b)(3) by “failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear.” State Farm has prepared an estimate for the damage to your property caused by a covered loss. This estimate does not exceed the deductible, and no payment is owed under the subject policy. As previously discussed, you have not provided any information or documentation to State Farm, evidencing the existence of covered damage beyond that outlined in its estimate. There is no support for your assertion that State Farm could or should have settled this claim to pay for damages that do not exceed the deductible or are otherwise excluded from coverage. Even so, State Farm has offered to settle your claim in good faith in response to your NOIL. Your Notice alleges that “pursuant to Florida Statute 626.9541(1)(i)(3)(a) the carrier has Failed to adopt and implement standards for the proper investigation of claims as both the filed adjuster sent out and the desk adjuster have failed to provide the insured with full coverage.” Yet, you have failed to identify any conduct or standards exercised by State Farm during the investigation of your claim that would be considered improper. The facts above show that State Farm completed a prompt and proper investigation of your claim and accepted the appropriate amount of coverage for the loss. Your Notice alleges that “in violation of Florida Statute §626.9541(1)(i)(3)(b), the carrier intentionally misrepresented the available coverage under the policy by not providing full coverage under the policy of insurance.” Your Notice then fails to identify any specific provisions of the subject policy that had allegedly been misrepresented by State Farm’s determination of coverage. State Farm accepted coverage for the loss pursuant to the policy and issued a coverage determination letter that outlines the relevant policy provisions that State Farm based its decision upon. Your Notice alleges that “in violation of Florida Statute §626.9541(1)(i)(3)(d), State Farm improperly denied replacement of the roof without conducting a reasonable investigation based upon available information . . . Instead, State Farm places the obligation on policyholders to perform the investigation and provide the documentation after claims have been denied, delayed, and/or underpaid.” Notably, you fail to include § 626.9541 (1)(i)(3)(d) in the field of your Notice that requires you to indicate all statutory provisions alleged to have been violated. Nonetheless, your Notice fails to describe any details or information regarding State Farm’s investigation to suggest that it was unreasonable in any way. The above facts and exhibits demonstrate that State Farm conducted a complete and proper investigation while considering all available information. State Farm specifically acknowledged receipt of all documentation that you and your representatives submitted in support of your claim. Furthermore, there is no information in support of your assertion that State Farm obligated you to perform the investigation yourself. State Farm did advise that you may submit your own estimates and any other materials, which creates no such forced obligation. Your Notice fails to provide any evidence demonstrating that State Farm violated any of the referenced statutes aside from a mere recitation of the statutory language. State Farm denies that it violated any statutory provisions in its handling of the claim. As has already been a problem with the Notice, it continues to fail to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. You go on to allege that “All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insured’s rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida.” Yet you have provided no factual support to show that State Farm performed these behaviors during the adjustment of your claim, much less any other State Farm insured claim in a manner that would indicate an ongoing pattern and practice. In another bizarre attempt to make this point, you allege that “it is known that State Farm uses its money for marketing to retain and pay celebrities millions of dollars rather to collect premiums and get more insured and then wrongfully denies their insurance claims. It is truly criminal at this point.” This run-on rant about the manner in which State Farm conducts its marketing is in no way relevant to its adjustment of your claim. You offer no information regarding any claim submitted to State Farm that demonstrates any instance of wrongful conduct to substantiate these assertions. State Farm denies that this claim has been handled in bad faith, unfairly, or with delay. State Farm hereby denies each and every allegation against it as put forth in your Notice. State Farm has in the past, and continues at the present time, to make all efforts to promptly resolve this claim in a fair and reasonable fashion and in full accord with the insurance policy and Florida law.
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