Civil Remedy Notice of Insurer Violations
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Filing Number:     809647
Filing Accepted:  3/5/2025
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Complainant
Last/Business Name *  
THOMPSON   First Name   LINDA
Street Address * 146 WEST VIRGIL STREET
City, State Zip * APOPKA, FL 32712
Email Address * WITHELD
Complainant Type: * Insured
Insured
Last/Business Name*   THOMPSON   First Name   LINDA AND JAMES
Policy # * ATM203521 Claim #* AM151093
Attorney
Attorney is Applicable
Last Name* GUTIERREZ First Name * DANIEL Initial
Street Address* 924 DELANEY AVENUE
City, State Zip* ORLANDO , FLORIDA 32806
Email Address * SERVICE@DGPALAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN TRADITIONS INSURANCE COMPANY
NAIC Company Code 12359
 
Name of individual responsible for violation (if any):* VICTORIA BOSTWICK
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)(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.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
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.
* 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 coverage decision correspondence incorrectly asserts the Duties After Loss Conditions of the policy which state as follows: 2. Duties After Loss. Even if a claim is assigned, all provisions of this policy apply. In case of a loss to covered property, we have no duty to provide coverage under this Policy if the failure to comply with following duties is prejudicial to us. a. “Your” Duties After Loss. In case of a loss to covered property, you must see that the following are done. These duties must be performed either by you, an “insured” seeking coverage, or a representative of either: … (6) As often as we reasonably require: … (c) Provide us with records and documents we request … (12) Cooperate with us in the investigation of a claim. … The duties above apply regardless of whether you an “insured” seeking coverage, or a representative of either, retains or is assisted by a party who provides legal advice, insurance advice, expert claim advice, regarding an insurance claim under this policy. Additionally, they reference that the policy excludes earth movement and settlement, despite having report stating that structural damage to the mobile home may be the result of sinkhole activity. Finally, they have failed to properly adjust and pay the claim pursuant to the Section I – Conditions, Loss Settlement provision and the Section I – Conditions, 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.

On or about January 2, 2024, Linda and James Thompson (hereinafter referred to the “Insureds”) reported a claim for cracking damages to their mobile home, possibly from sinkhole, to homeowners’ insurance company, American Traditions Insurance Company (hereinafter referred to as “Insurer”). The Insurer responded to the claim assigned June 15, 2023 as the date of loss and inspected the damages. The Insurer retained Forcon Engineering to determine if there is structural damage to the dwelling which may be the result of sinkhole activity. Forcon Engineering concluded structural damage to their mobile home which may be the result of sinkhole activity. The insurer advised that in order to determine if is sinkhole related, additional testing of the land is needed. Specifically, the report states that in order to meet the criteria for Structural damage, according to Florida Statue 627.706, the property must meet at least one of the criteria “a-e” listed in the Statute. Based on the site observations, testing, measurements, and analysis by CFTL and subsequent engineering evaluation by Forcon, it was the professional opinion of Forcon Engineer Dara Thomas that ALL FIVE criteria “a-e” for Structural Damage have been met and that it is their opinion that the criteria for SUBSTANTIAL structural damage has been met. In correspondence dated February 6, 2024, the Insurer advised Forcon Engineering concluded that there was structural damage to the Insureds’ mobile home which may be the result of sinkhole activity. They stated that in order to determine if it is sinkhole related, additional testing of the land would be needed. However, American Traditions advised that it was unable to proceed under Fla. Stat. § 627.707 to conduct subsurface testing as described in Fla. Stat. § 627.702 as the land the mobile home resides on is owned by the mobile home park. American Tradition Insurance Company’s requested that the Insureds contact the mobile home park to be placed on notice of potential sinkhole activity on the land which they own. Then they stated that “any and all testing to determine the cause of loss within a reasonable professional probability should be conducted by and through the mobile home park”. This is a misrepresentation of the policy. American Traditions has no ability to instruct the mobile home park to conduct testing. Additionally, the Insureds cannot force the mobile home park to conduct testing nor is there any policy obligation that requires the Insureds to make the mobile home park perform testing. The Insureds have cooperated and did contact and notify the mobile home park of potential sinkhole activity. The mobile home park hired GPRS to conduct testing. They provided the insurer with a report that stated that they scanned roughly 400 square feet for underground voids and no voids were detected. However, the surface present throughout the scope was grass and max depth GPR was between 5-6 feet and the report stated that voids are commonly not found in grassy or dirt areas due to voids being filled by collapsing ground above. Following the receipt of this report, the Insurer’s correspondence dated June 2, 2024 advised that the policy excludes earth movement and settlement. And although they were not extending coverage, they were offering to resolve the claim for payment of $10,271.30 in exchange for a release. This offer is based on an estimate from their adjuster for repairs totaling $12,110.51 after application of non-recoverable depreciation and deductible. The Insureds hired an attorney to assist them with the claim. After a notice of representation was sent to the Insurer, the Insurer responded by reiterating the June 2, 2024 correspondence and offer and asking whether the mobile home park had proceeded with further testing. The Insurer’s representative hired a contractor to prepare an estimate of all necessary repairs to the dwelling from the sinkhole damages. The contractor’s estimate totaled $88,507.34 RCV and $87,422.43 ACV. The contractors’ estimate was submitted to the Insurer on December 30, 2024 and on January 27, 2024 the Insurer and advised no further testing had been conducted. The Insurer continues to offer to resolve the claim for payment of $10,271.30 in exchange for a release; however, no claim payment has been made. The Insurer has been misrepresenting the policy language and their obligations under the policy to avoid making a payment clearly owed. Their own engineers concluded that there was structural damage which may be the result of sinkhole activity, yet they are withholding payment of the claim stating that the policy excludes coverage for earth movement and settlement. They have not provided any expert opinions or information to support a position that the damages were caused by earth movement or settlement. Rather the Insurer is using this policy language with the intent of effecting a settlement of the claim for an amount less favorable then what is actually owed. In addition to their baseless reliance on the policy exclusions mentioned, the American Traditions has also attempted to make the Insureds feel as if they haven’t complied with their post loss obligations, when they clearly have. The duties after loss state that the duties must be performed by you, an “insured” seeking coverage, or a representative of either: provide us with records and documents we request and cooperate with us in the investigation of the claim. The Insureds have complied. They allowed inspections, provided documents, and even asked their mobile home park to allow inspection and testing or to conduct their own. The mobile home park chose to conduct their own. The Insured cannot control the actions of the mobile home park and more importantly they are not obligated under the policy to do so. Any assertion by the Insurer that the Insureds have not complied with their duties after loss are a misrepresentation of the policy and done with the intent to induce the insured into a settlement under terms less favorable then what is owed to them pursuant to the policy. It is clear that the carrier is not treating the Insureds with good faith claims conduct by failing to pay a claim clearly owed, not adjusting the claim and evaluating the loss properly, failing to promptly and fairly provide full and prompt indemnity to the Insureds, failing to provide a reasonable explanation in writing of the basis in the insurance policy in relation to the facts for the denial of the claim as there is no information to support application of earth movement and settlement exclusions, and failing to implement proper standards for the adjustment and investigation of claims by its adjusters. This Insurer is placing the company’s interests before the Insureds’ interests when a reasonable carrier in a similar position would have provided full coverage. In particular, it is a business practice of the Insurer to assert there is no coverage or minimal coverage for claims to settle on less favorable terms than those provided by the policy. 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 complete covered loss pursuant to the estimate (after application of the deductible) and 2.) Pay the statutory interest on the amount of unpaid damages from the date the loss was reported to the date payment is finally made. A copy of this form has been submitted to the FDFS and has been printed out and mailed to the following parties providing them notice of the filing of the Civil Remedy Notice: American Traditions Insurance Company 7785 66th Street Pinellas Park, Florida 33781 Certified Return Receipt #9589 0710 5270 1009 7574 97
Comments
User Id Date Added Comment
hfleming@tlsslaw.com 05-04-2025 This will respond to the Civil Remedy Notice of Insurer Violations (“Notice”) filed against American Traditions Insurance Company (“ATIC”). The Notice alleges Claim Denial,” “Claim Delay,” “Unfair Trade Practice,” and “Unsatisfactory Settlement Offer” as well as violations of Florida Statute § 624.155(1)(b)(1), and (3); as well as § 626.9541(1)(i)(2), (3)(a),(b),(d), and (f). The allegations contained in the Notice are wholly without merit, and lack sufficient legal and factual support. Accordingly, ATIC denies each and every alleged violation of Florida statutory and administrative law as alleged in the Notice. The Notice lists the “Complainant’s email address as being “withheld” yet the Insured communicated with ATIC via email throughout the claim As an initial matter, the Notice is deficient and fails to comply with the requirements of the Florida Statutes. Florida Statute § 624.155(3)(b) requires that a Civil Remedy Notice “state with specificity” the statutory provisions allegedly violated, the facts and circumstances giving rise to the violation, the name of any individual involved in the violation, and the specific policy language relevant to the violation. Rather than include the specifics required by Statute regarding the facts and circumstances giving rise to the statutory provisions allegedly violated, the Notice makes general, boilerplate conclusions. Additionally, the Notice does not provide an explanation as to how ATIC failed to comply with the terms of the policy with specific factual support pertaining to the alleged incident or how ATIC failed to comply with the statutory provisions allegedly violated. Making general conclusions, without providing further analysis, or discussion of how ATIC violated the policy and/or statutory provisions, is in direct contradiction to Florida Statute § 624.155(3)(b) and renders the Notice defective. See Julien v. United Property & Casualty Insurance Company, 2020 WL 5652364 (Fla. 4th DCA 2020). As stated by the Florida Supreme Court, the purpose of a Notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). The purpose of Fla. Stat. § 624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003). Further, a Notice must be sufficiently specific to provide the insurer with an opportunity to cure the alleged violations. This would include i) identifying the specific policy provision(s) at issue, ii) citing specific language of the statutory provision(s) the insurer allegedly violated, and iii) specifically identifying what actions the insurer must take to remedy the alleged violations. Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. Aug. 13, 2010); Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299-1300 (S.D. Fla. 2008). Your Notice does not comply with the requirements of Florida law. Additionally, the “facts and circumstances” section of the Notice does not comply with Florida law. Contrary to the requirements of Florida Statutes, the Notice makes false, boilerplate accusations. For example, the Notice alleges that ATIC violated Florida Statute § 626.9541(1)(i)(3)(a)—failing to adopt and implement standards for the proper investigation of claims. However, the body of the Notice fails to describe how ATIC failed to adopt and implement standards to investigate the Insured’s claims. Similarly, the Notice does not provide factual support for various allegations listed above, including but not limited to how ATIC’s investigation was conducted in bad faith, or how ATIC has engaged in unfair trade practices. Contrary to the allegations in the Notice, ATIC acted promptly, responsibly, and in good faith at every opportunity in connection with this claim. The failure to provide any factual support for the alleged violations of Florida statutory and administrative law and otherwise comply with the requirements of Florida Statute § 624.155, renders the Notice deficient and in violation of Florida Statute § 624.155. The Notice does not have the correct facts. The true facts regarding the investigation and handling of this claim are as follows: The insureds reported a claim for sinkhole damage and ATIC investigated the claim to the extend they were able. The claim remains open and pending with the delay being the result of the mobile home park’s failure to permit testing of the property upon which the Insureds’ mobile home sits. The Insureds do not own the land but rather the mobile home park owns the land. ATIC cannot conduct statutorily compliant testing without the permission of the mobile home park “Park.” The Park elected to conduct its own testing by having a company conduct insufficient ground penetrating radar over a 4oo sq. foot area. The testing revealed there were no voids identified BUT then goes on to say that voids are not found in grassy or dirt areas when the entire area tested is a grass and dirt area. The testing was basically worthless. ATIC is willing to complete the sinkhole testing if allowed by the Park. ATIC and the Insureds have emailed and talked to the Park but to date no additional testing has been permitted. The Notice alleges that the claim was denied and that ATIC advised that there was no coverage for earth movement. ATIC did advise that there was no coverage for earth movement but there was not that basis of a coverage determination it was merely putting the Insureds on notice that should that be the ultimate finding, then there would be no coverage. This is supported for the additional months of correspondence with ATIC, the Insureds and even the Park regarding the need for testing. Both Florida law and the policy require that there be an actual finding of sinkhole activity and here the Park is preventing that aspect of the claim investigation. A “Sinkhole Loss” is defined as: “Sinkhole Loss” means “structural damage” to the “principal building” including the foundation: a. Arising out of; or b. Caused by; “sinkhole activity”. Contents coverage and additional living expenses apply only if there is structural damage to the “principal building” caused by “sinkhole activity”. Here, there is no dispute that the home has experienced structural damage but it is the cause of the structural damage that is unknown. Additionally, Florida law put additional obligations on the professional engineers or geologists in order to be able to diagnose sinkhole activity and ensure a statutorily compliant investigation and at this point in the claim there has been no statutorily compliant investigation under Florida Statute §627.7072. There has also not been a report issued in compliance with Florida Statute §627.7073. The claim investigation has not been completed as testing required under Florida law has not yet been performed. Not even the Notice asserts that the testing requirements and reporting requirements have been met. The Notice simply alleges that ATIC should have issued payment on an incomplete claim investigation. Without waiving its rights to contest the validity of the subject defective and improper Civil Remedy Notice, as the facts clearly demonstrate, ATIC has, and continues to comply with both Florida law and the applicable Policy throughout the entire handling of this claim. With regard to the investigation and handling of this claim, ATIC’s actions were prompt, thorough, and conducted in good faith. Therefore, ATIC specifically denies each and every violation alleged in the Notice.
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