Civil Remedy Notice of Insurer Violations
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Filing Number:     809732
Filing Accepted:  3/5/2025
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Complainant
Last/Business Name *  
ERICA TOMALTY AND JORDAN S. TOMALTY   First Name  
Street Address * 9089 PINTURA WAY
City, State Zip * BOCA RATON, FL 33496
Email Address * JT@NORTHSTARDENTALPARTNERS.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ERICA TOMALTY AND JORDAN S. TOMALTY   First Name  
Policy # * OIC30094710-02 Claim #* 24FLHOV0014847
Attorney
Attorney is Applicable
Last Name* BLACKMAN First Name * MAX Initial
Street Address* 925 FEDERAL HWY
City, State Zip* BOCA RATON , FL 33432
Email Address * MBLACKMAN@KPATTORNEY.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   OLYMPUS INSURANCE COMPANY
NAIC Company Code 12954
 
Name of individual responsible for violation (if any):* DARIUS NORFLEET
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
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)(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.

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.

The carrier was put on notice of the insureds’ property damage sustained due to water infiltrating the premises. The carrier initially attempted to low-ball the claim. Subsequently, the insureds prepared a loss package in the amount of $260,715.53 needed to restore the property back to its pre-loss condition. Whereas, the carrier furnished a wrongful estimate and, having withheld the deductible, offered a deficient payment in the amount of $14,489.84 only, leaving a remainder in the amount of $246,225.69 to be paid in order to cure the breach, less any applicable policy deductible. Additionally, the carrier did not appropriately address the damage, allegedly relying on the wrongful findings of a representative who it is believed was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of water damage to the property, for the purpose of wrongfully low-balling the claim as a whole. The insureds have complied with all of the carrier’s requests to date and the carrier has still failed to treat this claim with good faith. This intentional delay with the claim has led to direct prejudice of the insured. About three hundred and fifteen days have passed since the original date of loss. The carrier has still refused to pay the fully covered amount owed under the policy. The carrier is aware of damage sustained by the insureds’ property and has not taken any meaningful ensuing action. It is clear that the carrier is not treating the insureds with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insureds; failing to implement proper standards for the adjustment and investigation of claims by its adjusters and placing the company’s interests before the insureds’ interests; refusing to pay the full amount owed to the insureds despite the fact that the carrier has been on notice of the damages and looking for ways to delay full recovery or any recovery to the insureds, when a reasonable carrier in a similar position would have tendered a full payment in accordance with both the policy language and statutory requirements. The carrier’s actions are in violation of Florida Statutes §§ 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(3)(a); 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c) and 626.9541(1)(i)(3)(f), as well as Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. 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 in the amount of $260,715.53, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been sent to the carrier. Please do not hesitate to contact the undersigned or Chabeli Montas at (561)-892-9826 if you have any questions or concerns. Sincerely, Max Blackman Attorney at Law
Comments
User Id Date Added Comment
bbaker@bressler.com 05-02-2025 Bressler, Amery & Ross, P.C. 515 E. Las Olas Blvd., Suite 800 Fort Lauderdale, FL 33301 May 2, 2025 Via U.S. Mail, Certified Mail and E-mail: MBLACKMAN@KPATTORNEY.COM Max Blackman, Esq. Kanner & Pintaluga, P.A. 925 Federal Highway Boca Raton, FL 33432 Complainant(s): Erica Tomalty and Jordan S. Tomalty Policy #: OIC30094710-02 Claim #: 24FLHOV0014847 DFS Filing #: 809732 Dear Mr. Blackman: Please accept this response on behalf of Olympus Insurance Company (hereinafter “Olympus”) to the Civil Remedy Notice of Insurer Violations (hereinafter “CRN”) No. 809732, filed on behalf of Erica Tomalty and Jordan S. Tomalty (hereinafter, the “Complainants” or the “Insureds”), and accepted by the Florida Department of Financial Services on March 5, 2025. The CRN alleges that Olympus violated the following statutes: • 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)(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. Please accept this as Olympus’s response to the above-referenced CRN filed with the Department of Financial Services by the Complainants, Erica Tomalty and Jordan S. Tomalty. To summarize the below, Olympus hereby denies any allegation of not attempting to settle claims in good faith when it could and should have done so; failing to promptly settle claims when the obligation to settle a claim has become reasonably clear; failing to adopt and implement standards for the proper investigation of claims; misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; failing to acknowledge and act promptly upon communications with respect to claims; and failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy for denial of a claim or for the offer of a compromise settlement, and states that it has at all times handled and adjusted the Complainants’ claim with utmost good faith. Simply put, Olympus denies any acts or omission that could be construed or found to be deemed bad faith and/or a violation of Florida Statutes § 624.155 and § 626.9541, whether expressly stated in the Civil Remedy Notice or implied. Any and all allegations of bad faith are hereby denied and rejected in their entirety by Olympus. Olympus denies and rejects the instant CRN as it fails to comply with the requirements of Florida Statute § 624.155. The CRN is therefore deficient and fails to preserve any and all claims for statutory bad faith under Florida Law. Florida Statute § 624.155 requires a complainant to file with the Department of Financial Services a Civil Remedy Notice which shall be “on a form provided by the [Department] and shall state with specificity…such other information as the Department may require.” The Department created a CRN form, Form DFS-10-363, which lays out 15 requirements, including in part, the complainant’s e-mail address, complainant type, claim number, attorney’s name, attorney’s address, attorney’s e-mail address, type of insurer, the person with knowledge of the facts giving rise to the allegations, and the reason for notice. According to § 624.155, these mandates are required by the Department, and they must be stated with specificity. The instant CRN fails to provide the specificity required by § 624.155 and fails to comply with the form requirements as a whole. Therefore, the instant CRN is facially deficient. See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Specifically, the instant CRN filing lists the “person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in this notice,” as “[Darius Norfleet.]” Mr. Norfleet is one of several Claims Adjusters who provided limited correspondences to the Complainants but is neither the adjuster nor manager assigned to the claim and is not a person who is most responsible for/knowledgeable of the facts giving rise to the allegations in this notice. Since the claim was opened on April 30, 2024, five (5) adjusters have been assigned on the claim from Olympus, and none of them have been Mr. Norfleet. Moreover, Mr. Norfleet has not had any involvement in the handling of the instant claim since July of 2024. Whether the Complainants misread the Department’s prompt or simply dismissed what the Department had requested and inserted the first name that they saw, the Complainants’ failure to comply with the requisite baseline form requirements is insufficient under Florida law to support any action for bad faith against Olympus without speculation on its part. Due to this intentional withholding of mandated information, the CRN is facially deficient as it fails to comply with the form requirements set forth in Florida Statute § 624.155, and specifically § 624.155(3)(b)(3). See Bay v. United Servs. Auto. Ass’n, No. 4D19-3332, 2020 WL 6154256 (Fla. 4th DCA Oct. 21, 2020). Furthermore, the CRN’s attempt to identify the specific policy language relevant to the violation is woefully deficient. “Courts have found that listing whole sections of the insurance policy constitutes insufficient specificity.” See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294 at *2 and Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020).” When prompted to reference the policy language that is relevant to the alleged violation, the Complainants make absolutely no effort to provide relevant policy language. Instead, the Complainants provided only one policy provision heading of the only section which is relevant to any and every claim for insurance benefits. The Complainants entirely failed respond to the Department’s prompt, again dismissing the mandated information needed to submit a valid CRN against an insurer. The Complainants actually failed to provide any specific policy language at all, and instead lists the name of one section contained within the policy, citing “Loss settlement provision,” as “[r]eference to specific policy language that is relevant to the violation…” Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith that is required as a condition precedent to any civil claim for bad faith pursuant to Florida Statute § 624.155. Julien v. United Property & Casualty Insurance Company No. 4D19-2763 (Fla. 4th DCA 2020). Failure to provide specific reference to any relevant policy language is direct and clear noncompliance with the requirements of Florida Statute § 624.155, and therefore renders the CRN deficient on its face as to form and substance. For these reasons alone, the CRN fails at its inception. Additionally, the CRN fails to provide a complete description relating to the facts and/or circumstances which give rise to the alleged statutory violations, thus, prejudicing Olympus from providing any meaningful or complete response. In summary, the CRN is hardly more than a recitation of a number of Florida statutory provisions, with minimal factual allegations in support of the conclusory statutory recitations. A Civil Remedy Notice must state the facts and circumstances that give rise to an alleged violation with specificity sufficient to allow an insurer to cure the alleged violation within the sixty-day statutory period. Lane v. Westfield Insurance Company, 862 So.2d 774 (Fla. 5th DCA 2003). The instant CRN therefore fails to comply with the requirements of Florida Statute § 624.155(3), which requires that a CRN of insurer violation “state with specificity,” inter alia, the facts and circumstances giving rise to the violation and the “specific” language of the subject insurance policy that is relevant to the violation. The CRN fails to specify what was lacking in Olympus’s investigation and fails to specify facts which support that its investigation was unfair or merits additional steps. To Olympus’s knowledge, the instant claim for insurance benefits has been adjusted and/or repaired properly. The CRN further lacks any specificity, facts, or rationale which indicate that Olympus’s coverage determination should have been different. Generally, the CRN lacks the requisite facts and/or specificity, as ruled on numerous times and cited to throughout this response, to put Olympus on notice as to the allegations against it. Moreover, the few facts that are stated in the CRN are contrary to the facts of the underlying claim or are at best misleading. The CRN states that “…[Olympus] did not appropriately address the damage, allegedly relying on the wrongful findings of a representative who it is believe was instructed to look for any signs of damage that could be attributed to any causes of loss excluded under the policy and to disregard any evidence of water damage to the property, for the purpose of wrongfully low-balling the claim as a whole.” However, each of these claims are immediately false and inappropriate. Also, the CRN claims that, “[Olympus] is aware of damage sustained by the insureds’ property and has not taken any meaningful action.” Again, this statement is untrue and unfounded, and undermines Olympus’s investigation and claims handling process. Rather, Olympus received notice of the claim on April 30, 2024, and inspected the subject property through an independent leak detection company, Sleuth Incorporated. Then, on May 24, 2024, Olympus re-inspected the subject property through an independent home restoration company, Paul Davis Restoration of Palm Beach County, in an effort to thoroughly inspect the reported damages and to gather opinions from several experts. Olympus thereafter issued its coverage decision, which included a partial payment for what was determined to be covered damages, on June 19, 2024. Meanwhile, the Complainants have provided no facts or evidence to support their allegations in support of the instant CRN or in any other context throughout the entirety of their claim. The facts outlined above show that Olympus promptly and thoroughly investigated the subject claim and has acted in good faith based upon its understanding of the facts. It is the Complainants who are not complying with the policy’s terms and who are continuing to make unsupported allegations in an attempt to deceive Olympus to issue unwarranted payments and/or additional benefits. The subject CRN makes egregious and baseless allegations that “It is clear hat [Olympus] is not treating the insureds with good faith claims conduct,” and “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.” These are serious blanket allegations made without one scintilla of factual evidence in support of any of such claims. The facts of this very claim disprove each baseless allegation that the Complainants have raised: Olympus diligently investigated the subject loss within ten (10) days of it being reported, inspected the reported damages through both an independent leak detection company and an independent home restoration company, issued its coverage determination and payment to the insured Complainants for the covered damages, has actively engaged in open communication with the insured Complainants and their representative(s), and has acted accordingly based upon the facts and according to the terms of the insurance contract which provides rights to both the Complainants as well as the insurer for scenarios just like this one. Conversely, the Complainants have continued to act without communicating with Olympus nor notifying of its intentions. The Complainants’ cure demand is indiscernible and as such Olympus is not given a fair opportunity to cure the CRN. The CRN states: To cure the defects outlined in this [CRN], [Olympus] must: 1.) Pay the complete covered loss in the amount of $260,715.53, less any prior payments and less any applicable policy deductible; and 2.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. This is the functional equivalent of “Pay me everything I’ve asked for.” Rousso v. Liberty Surplis Ins. Co., 2010 WL 736059, *5 (S.D. Fla. 2010). “Insurers are not required to pay any amount demanded by their insureds to avoid a bad-faith claim.” Id. (citing 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1194 (N.D. Fla. 2008)). However, regardless of its legitimacy, the CRN itself contains a cure in the form of an admission of liability and Olympus cannot even begin to attempt to cure the instant CRN on such unclear terms. In addition to demanding “everything I’ve asked for,” by stating “[Olympus] must… pay the complete covered loss,” the cure is unclear as to what it’s asking for. Based upon Olympus’s evaluation of the claim, there is no complete covered loss and therefore Olympus has satisfied this condition of the Complainants’ cure demand. This was communicated by Olympus to the Complainants via written correspondence dated June 19, 2024. Rather, the cure provides no clear basis for Olympus to even attempt to calculate what it seeks when demanding some unclear payment to the insured Complainants, and then some unknown amount of interest purportedly owed on top of that indeterminate payment. Rather, the cure demand is merely an attempt to deceive Olympus into issuing some ambiguous payment rather than defending itself against a threat of bad faith when no bad faith is remotely existent anywhere throughout the instant claim. Given the cure, Olympus affirmatively asserts that the CRN is deficient. Since no other distinct basis for a cure has been set forth by the Civil Remedy Notice, Olympus was not provided with a reasonable opportunity to purge any alleged violations. See Kafie v. NorthWestern Mut. Life Ins. Co., 834 F. Supp. 2d 1354, 1359 (S.D. Fla. 2011) (“In order to demonstrate good faith, ‘[t]he insurer must investigate the facts, [and] give fair consideration to a settlement offer that is not unreasonable under the facts…’”). Based on the facts provided, it is impossible for Olympus to satisfy the Complainants without significantly prejudicing itself, and therefore the CRN fails to provide a true and feasible cure method. Accordingly, the CRN does not provide the contemplated and mandated notice of alleged bad faith that is required as a condition precedent to any civil claim for bad faith pursuant to Florida Statute § 624.155. Similarly, for these reasons, the CRN fails. As outlined above, contrary to the allegations made by the CRN, Olympus sufficiently and diligently investigated the loss. Olympus maintains that it has acted fairly and honestly toward the Complainants, and any other person having an interest in the subject policy or assisting the Complainants in connection with the instant claim. Olympus consistently and promptly communicated with the Complainant and/or their agents throughout all stages of the investigation and conducted a thorough investigation in good faith. To the extent that the instant CRN is intended to address any other facts or circumstances which purport to establish additional coverage for the reported losses, the CRN provides insufficient identification of any such facts or circumstances and therefore prevents Olympus from addressing any other aspect herein. Notwithstanding, Olympus believes that the above facts demonstrate beyond dispute that it has at all times acted in good faith with regard to its investigation of the subject claim, and further believes that the facts provided to date fail to establish that it has not adjusted the reported loss in accordance with the express terms, provisions, limitations and exclusions contained within the policy. If we can provide any additional information, or be of any further assistance, please do not hesitate to contact us at your earliest convenience. Very truly yours, /s/ Brett Baker, Esq. _ Brett Baker, Esq.
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