Civil Remedy Notice of Insurer Violations
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Filing Number:     808933
Filing Accepted:  2/28/2025
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Complainant
Last/Business Name *  
SOUTHERN DUNES MASTER COMMUNITY ASSOCIATION INC.,   First Name  
Street Address * 2437-2518 ST.AUGUSTINE BLVD
City, State Zip * HAINES CITY, FL 33844
Email Address * FIRM@FLORIDAINSLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SOUTHERN DUNES MASTER COMMUNITY ASSOCIATION INC.,   First Name  
Policy # * AMR-75074-01 Claim #* 4208554
Attorney
Attorney is Applicable
Last Name* MICHAEL First Name * CIOCCHETTI Initial
Street Address* 125 NORTH RIDGEWOOD AVENUE, SUITE 100
City, State Zip* DAYTONA BEACH , FLORIDA 32114
Email Address * FIRM@FLORIDAINSLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* MATT MALOLEY
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
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.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
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.

The Building Coverage and Business Interruption Coverage portions of the multiple Policies are relevant to the Claims.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of the insured, SOUTHERN DUNES MASTER COMMUNITY ASSOCIATION INC. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155. In consideration of the premium paid to it, the carrier, CERTAIN UNDERWRITERS AT LLOYDS, LONDON, NATIONAL FIRE & MARINE INSURANCE COMPANY, INDIAN HARBOR INSURANCE COMPANY, GEOVERA SPECIALTY INSURANCE COMPANY, HDI GLOBAL SPECIALTY SE, LEXINGTON INSURANCE COMPANY, QBE SPECIALTY INSURANCE COMPANY, OLD REPUBLIC UNION INSURANCE COMPANY, SPINNAKER SPECIALTY INSURANCE COMPANY, TRANSVERSE INSURANCE COMPANY, UNITED SPECIALTY INSURANCE COMPANY, (“Carriers”), issued a policy, Policy Nos. AMR75074, (LLOYDS), 72AMR302208-00 – (NF&MINC), AMP7540683-01 (Indian Harbor), GVS-14315-01 (GEO), HAN-26928-01 (HDI), LEX-064851214-01 (LEXINGTON) MSP-33581-01 (QBE), ORAMPR0I 1577-01 (OLD REPUBLIC), SPI-11702-00 (SPINNAKER), TSAMPR0003789-01 (TRANSVERSE), USI-29376-01 (UNITED) to SOUTHERN DUNES MASTER COMMUNITY ASSOCIATION INC., (“Insured”) where the policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 2437-2518 St. Augustine Blvd Haines City, Fl 33844 (“Insured Property”). The policy was in full force and effect at the time the damage occurred from a hail and wind storm, and the ensuing damages as a direct result thereof, to the Insured Property, on or about April 19, 2023. Thereafter, the Carriers were timely notified of the Loss. In particular, the Carriers were put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policy. Claim number 4208554 (“Claim”) was assigned to the Loss. The Carrier sent an adjuster to the Insured Property to perform an inspection. The Carrier performed a cursory inspection of the Insured Property and failed to retain unbiased experts necessary to scope the entirety of the Loss and covered repairs necessary to restore the Insured Property to its pre-loss condition. This was done deliberately by the Carrier to undervalue portions of the claim. The Carrier knows its aforementioned investigation is insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition. This inspection placed The Carrier on notice of the severity of the Loss. Thereafter, the insured sought the assistance of a public adjuster who ensured the proper estimating of the loss and compliance with all Policy conditions. The public adjuster submitted a comprehensive estimate to the Carrier for the full scope of damages to the Insured Property. In addition, a Sworn Statement and Proof of Loss (“SPOL”) was provided, on or about January 2, 2024. The Carrier disregarded this comprehensive estimate and SPOL and, instead, underpaid the Claim. The Carrier has refused to reassess its payment of benefits and the basis of the payment and has refused to properly adjust and settle the Claim. The Carrier violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insured with a due regard for their interest. When the Carrier was confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier chose to underpay the Insured’s valid Claim for extensive damages that exceed the amount paid. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insured that Policy coverage was unavailable for the Insured’ Claim and Loss to the Insured Property. This misrepresentation was made in an attempt to underpay the Insured Claim and escape without paying for the full extent of substantial damage. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier apparently had no system or standards prepared or implemented which would allow it to evaluate the Claim as submitted by its Insured. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or insurance policy provisions relating to the coverage at issue. This has been discussed fully hereinabove. The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.
Comments
User Id Date Added Comment
taylor@floridainslaw.com 09-11-2025 The Carrier has resolved the Civil Remedy Notice to the satisfaction of the Insured, and the Insured hereby withdraws the instant CRN.
acapote@goldbergsegalla.com 04-25-2025 To Whom It May Concern: We write on behalf of Certain Underwriters at Lloyd’s London, Indian Harbor Insurance Company, QBE Specialty Insurance Company, United Specialty Insurance Company, Lexington Insurance Company, HDI Global Specialty SE, Old Republic Union Insurance Company, GeoVera Specialty Insurance Company, Transverse Specialty Insurance Company, National Fire & Marine Insurance Company, and Spinnaker Specialty Insurance Company (collectively referred to as “Insurers”). The Insurers issued a policy of insurance to Southern Dunes Master Community Association, Inc. under account number 985784 for the period July 8, 2022 to July 8, 2023 (collectively, “the Policy”). Furthermore, we write in response to the Civil Remedy Notices of Insurer Violations (“the CRNs”) submitted to the Department of Financial Services, Bureau of Consumer Assistance (“the Department”) by Michael Ciocchetti, Esq. on behalf of Southern Dunes Master Community Association Inc. The CRNs all contain the same allegations against the Insurers and bear the filing numbers indicated above. The CRNs allege that the Insurers violated various sections of the Florida Statutes sections 624.155(1)(b)(1), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), and 626.9541(1)(i)(3)(b) with regard to a claim under the Policy for alleged damage to the premises at 2437-2518 St. Augustine Boulevard in Haines City, Florida. The CRNs are deficient on their face for various reasons. First, the CRNs assert, “The Building Coverage and Business Interruption Coverage portions of the multiple Policies are relevant to the Claims.” The Insured never made any claim for business interruption loss, so the Insurers reject any assertion that this could be the basis for a civil remedy notice. The CRNs also assert that the alleged date of loss was April 19, 2023, but various other documents claim the date of loss was April 26, 2023. The CRNs are also invalid in that any dispute related to the Policy must be arbitrated in New York and decided pursuant to New York law. Thus, any disputes outlined in the CRNs must be arbitrated. The CRNs are also invalid because they are vague and deficient in describing the facts and circumstances giving rise to the Insurers’ alleged statutory violations. Specifically, the CRNs list 4 different statutes that were allegedly violated but then fail to explain what Insurers allegedly did to violate any of the statutes. The CRNs are also invalid because they fail to properly state the specific policy language relevant to the alleged violation. Section 624.155(3)(b)(4), Florida Statutes requires that the Notices must state with specificity the policy language that is relevant to the alleged violation. See, e.g., Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Here, the Notices state only that “[t]he Building Coverage and Business Interruption Coverage portions of the multiple Policies are relevant to the Claims.” Accordingly, the CRNs do not satisfy the specificity requirements of section 624.155(3)(b)(4), Florida Statutes, and should be rejected by the Department. The CRNs are also deficient because they fail to state with specificity what the Insurers must do to “cure” the alleged violations as required by Florida law. They state that the Insurers must issue payment for the amounts contractually owed, but fail to provide any additional details. Regardless, even if making a demand for payment were enough to satisfy the Insured’s requirement of explaining how to cure alleged violations, which it is not, it is unclear what that amount is. In any event, none is owed because the amount of covered damages was below the policy deductible. Moreover, the Insurers categorically deny that they or any of their representatives engaged in any prohibited conduct or violated any of the statutes referenced in the CRNs with respect to this claim. Despite the deficiencies in the CRNs, the Insurers continue to act in good faith, without delay, and with due regard for the Insured’s interests at all times during the investigation, handling, and adjustment of the claim. A detailed response to the CRNs was sent via U.S. Mail and via e-mail to the Insured c/o Mr. Ciocchetti on April 25, 2025. This response is subject to and without prejudice to Insurers’ rights and defenses under the Policy, each of which are reserved. In addition, this response is not an exhaustive statement of the Insurers’ rights and defenses and is only intended to point out the various deficiencies in the CRNs. Respectfully submitted, /s/Ashlyn M. Capote Ashlyn M. Capote
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