Civil Remedy Notice of Insurer Violations
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Filing Number:     809567
Filing Accepted:  3/5/2025
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Complainant
Last/Business Name *  
GREGORY   First Name   JAMES
Street Address * 26300 EASY STREET
City, State Zip * WESLEY CHAPEL, FL 33544
Email Address * UNKNOWN
Complainant Type: * Insured
Insured
Last/Business Name*   GREGORY   First Name   JAMES
Policy # * 000988643817 Claim #* 0772241824
Attorney
Attorney is Applicable
Last Name* SMITH First Name * JOSHUA Initial S
Street Address* 4043 HENDERSON BLVD
City, State Zip* TAMPA , FL 33629
Email Address * JHOFFMAN@JSPALAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   CASTLE KEY INDEMNITY COMPANY
NAIC Company Code 10835
 
Name of individual responsible for violation (if any):* CLAIM REPRESENTATIVE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Other : Failure to Conduct a Reasonable Investigation
Other : Failure to Act on Claim
Other : Failure to Pay the Full Amount of Covered Damages
Other : Misrepresentation of Insurance Policy Provisions
* Statutory provision(s) which the insurer allegedly violated.
 
626.9541(1)(i)(1) Attempting to settle claims on the basis of an application, when serving as a binder or intended to become a part of the policy, or any other material document which was altered without notice to, or knowledge or consent of, the insured.
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)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

626.9541(1)(i) – Unfair claim settlement practices. COVERAGE A PROVISION, THE DECLARATIONS PAGE, LOSS PAYMENT OR SETTLEMENT PROVISION, DUTIES IN EVENT OF LOSS POLICY PROVISION, ALL TERMS AND CONDITIONS OF SECTION I OF THE INSURANCE POLICY, THE INSURANCE POLICY DEFINITIONS SECTION, THE INSURANCE POLICY‘S EXCLUSION OF COVERAGE PROVISIONS
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

CASTLE KEY INDEMNITY COMPANY (“CASTLE KEY”) HAS COMMITTED THE FOLLOWING VIOLATIONS IN HANDLING THE INSURED, JAMES GREGORY’S, CLAIM: (1) CLAIM DELAY; (2) FAILURE TO CONDUCT A REASONABLE INVESTIGATION; (3) FAILURE TO ACT ON CLAIM; (4) FAILURE TO PAY THE FULL AMOUNT OF COVERED DAMAGES; AND (5) MISREPRESENTATION OF INSURANCE POLICY PROVISIONS. IN FLORIDA, THE WORK OF ADJUSTING INSURANCE CLAIMS ENGAGES THE PUBLIC TRUST. CASTLE KEY HAS BREACHED THIS DUTY THROUGH ITS HANDLING OF THE INSURED’S CLAIM. CASTLE KEY HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR THE PROPER INVESTIGATION, EVALUATION, AND HANDLING OF CLAIMS, LEADING TO SIGNIFICANT VIOLATIONS AS OUTLINED HEREIN. THE INSURED, SUFFERED A SIGNIFICANT LOSS TO HIS HOME ON OCTOBER 9, 2024, AS A RESULT OF A WINDSTORM AND HAIL EVENT. THE INSURED PROMPTLY REPORTED THE LOSS TO CASTLE KEY AND FULLY COOPERATED WITH THE CLAIM PROCESS, PROVIDING ALL REQUESTED DOCUMENTATION AND ACCESS TO THE PROPERTY. DESPITE THIS, CASTLE KEY HAS FAILED TO TIMELY AND PROPERLY INVESTIGATE THE CLAIM, LEADING TO AN UNJUSTIFIED DELAY IN PAYMENT. ON OCTOBER 23, 2024, CASTLE KEY CONDUCTED AN INSPECTION OF THE PROPERTY AND SUBSEQUENTLY ISSUED AN ESTIMATE ON OCTOBER 27, 2024. CASTLE KEY INITIALLY ASSESSED THE TOTAL DAMAGES AT $40,570.55 BUT DEDUCTED $11,731.00 IN DEPRECIATION, RESULTING IN A NET PAYMENT OF ONLY $17,377.55. THIS UNDERVALUATION FAILED TO ACCOUNT FOR THE FULL SCOPE OF DAMAGES REQUIRED TO RESTORE THE PROPERTY TO ITS PRE-LOSS CONDITION, FORCING THE INSURED TO SHOULDER AN UNFAIR AND UNJUSTIFIED FINANCIAL BURDEN. ON DECEMBER 11, 2024, THE INSURED OBTAINED A FINAL INVOICE FROM ROOFING BY PINNACLE, LLC, CONFIRMING THAT THE TOTAL COST OF NECESSARY REPAIRS WAS $40,570.55, THE SAME AMOUNT ORIGINALLY ESTIMATED BY CASTLE KEY. THE INSURED ALSO COMPLETED ALL NECESSARY REPAIRS AND PROVIDED A CERTIFICATE OF COMPLETION TO CASTLE KEY ON DECEMBER 11, 2024, THEREBY SATISFYING ALL POLICY REQUIREMENTS. DESPITE THE INSURED’S FULL COMPLIANCE AND EVIDENCE SUPPORTING THE DAMAGES, CASTLE KEY HAS FAILED TO PAY THE REMAINING BALANCE OF $23,193.00, WHICH IS NECESSARY TO FULLY INDEMNIFY THE INSURED UNDER THE TERMS OF THE POLICY. RATHER THAN ACTING IN GOOD FAITH AND ISSUING PAYMENT FOR A VALID CLAIM, CASTLE KEY HAS ENGAGED IN A PATTERN OF DELAY AND UNDERVALUATION DESIGNED TO REDUCE ITS FINANCIAL LIABILITY AT THE EXPENSE OF ITS INSURED. CASTLE KEY’S REFUSAL TO TENDER FULL PAYMENT, DESPITE ACKNOWLEDGING THE DAMAGES, CONSTITUTES A FAILURE TO COMPLY WITH FLORIDA INSURANCE LAWS AND INDUSTRY CLAIMS-HANDLING STANDARDS. CASTLE KEY HAS FAILED TO CREATE AND IMPLEMENT ADEQUATE GUIDELINES FOR THE PROPER INVESTIGATION AND EVALUATION OF CLAIMS, RESULTING IN AN UNJUSTIFIED FAILURE TO ISSUE FULL PAYMENT. THIS BAD FAITH CONDUCT HAS CAUSED UNNECESSARY FINANCIAL BURDENS ON THE INSURED, WHO HAS HONORED ALL POLICY CONDITIONS. HAD CASTLE KEY PROPERLY INVESTIGATED AND PROCESSED THE CLAIM IN GOOD FAITH, IT WOULD HAVE ISSUED FULL PAYMENT FOR ALL COVERED DAMAGES. INSTEAD, CASTLE KEY HAS PLACED ITS FINANCIAL INTERESTS ABOVE ITS OBLIGATIONS TO THE INSURED, IN VIOLATION OF FLORIDA STATUTES §§ 624.155 AND 626.9541. CASTLE KEY HAS KNOWINGLY AND WILLFULLY ENGAGED IN UNFAIR CLAIMS HANDLING PRACTICES TO THE DETRIMENT OF THE INSURED. ITS FAILURE TO ISSUE FULL PAYMENT DESPITE CLEAR EVIDENCE OF COVERED DAMAGES DEMONSTRATES A DISREGARD FOR ITS CONTRACTUAL AND STATUTORY OBLIGATIONS, IN VIOLATION OF FLORIDA LAW. AS A RESULT, THE INSURED HAS BEEN LEFT WITHOUT THE FUNDS NECESSARY TO REPAIR HIS PROPERTY, CAUSING UNDUE FINANCIAL AND EMOTIONAL STRESS. CASTLE KEY’S ACTIONS WERE NOT ONLY IMPROPER BUT OCCUR WITH SUCH FREQUENCY AS TO INDICATE A GENERAL BUSINESS PRACTICE. THIS BAD FAITH CONDUCT IS A DIRECT VIOLATION OF FLORIDA STATUTES §§ 624.155 AND 626.9541 AND WARRANTS IMMEDIATE CORRECTIVE ACTION. CASTLE KEY’S ACTIONS AMOUNT TO BUT ARE NOT LIMITED TO THE FOLLOWING: 1. CLAIM DELAY 2. FAILURE TO CONDUCT A REASONABLE INVESTIGATION 3. FAILURE TO ACT ON CLAIM 4. FAILURE TO PAY THE FULL AMOUNT OF COVERED DAMAGES 5. MISREPRESENTATION OF INSURANCE POLICY PROVISIONS THEREFORE, TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, TOWER HILL MUST: (1). ADMIT FULL COVERAGE FOR THE INSUREDS’ LOSS. (2). TENDER ALL INSURANCE MONIES DUE AND OWING TO THE INSURED FOR THEIR LOSS IN AN AMOUNT EQUAL TO ALL DAMAGES UNDER THE SUBJECT POLICY. (3). PAY STATUTORY INTEREST ON THE AMOUNT OF UNPAID CONTRACT DAMAGES FROM THE DATE OF THE LOSS TO THE PRESENT TIME PURSUANT TO FLORIDA STATUTE § 627.70131 AND PAY REASONABLE ATTORNEY FEES AND COSTS INCURRED.
Comments
User Id Date Added Comment
SARAH.WOLFER@ALLSTATE.COM 04-28-2025 Please allow this correspondence to serve as Castle Key Indemnity Company’s (hereinafter referred to as “Castle Key”) response to your Civil Remedy Notice of Insurer Violations filing number 809567. This response was uploaded to the DFS CRN website today’s date. Castle Key specifically denies the allegations set forth in the Civil Remedy Notice of Insurer Violations. At all time, Castle Key has acted in good faith. Castle Key wholly denies all allegations of wrongdoing; claim delay, failure to conduct a reasonable investigation, failure to act on a claim, failure to pay the full amount of covered damages and misrepresentation of insurance policy provisions on the above claim. Castle Key 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 insured’s right to pursue civil remedies. The potential statutory violations and information submitted are nothing more than unsupported, baseless allegations. The CRN does not name or identify the specific person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in this notice as required. Castle Key notes the CRN fails to reference the specific policy language relevant to the alleged violations or set forth facts in support of each of the alleged violations. This information is required to be included and be correct on the statutory Civil Remedy Notice form. Castle Key was notified of the Oct. 9, 2024, loss on October 11, 2024 by the named Insured. Castle Key investigated this loss and coverage was extended. Castle Key inspected the residence on Oct. 23, 2024 and wrote an estimate for a replacement cost value of $40,570.55 . The insured provided an invoice for repair that totaled $26,256 and was advised that Castle Key would not release depreciation, as the named Insured was able to have the repairs completed at a lower cost. Castle Key later received revised estimates from the Insured, but he was unable to provide supports to regarding the additional repairs completed and the contractor refused to speak with a Castle Key representative. The policyholder retained counsel. In response to your CRN and dispute over the covered damages, Castle Key has requested an itemized estimate, supports of the Insured’s payment for the services and photos of the damages being claimed prior to the repair. At this time, Castle Key has not received the requested documentation. A Florida Mediation letter was also sent to the insured. At all times, Castle Key has acted in good faith in investigating and handling the claim. Castle Key has not breached any duty owed to you. Castle Key is responding to the filed CRN within sixty days as required by Florida CRN statutes. If you have any questions or if you wish to discuss this matter in further detail, please do not hesitate to contact our office. Sarah Wolfer Claims Service Representative 585-613-0401 Sarah.wolfer@allstate.com
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