Civil Remedy Notice of Insurer Violations
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Filing Number:     810000
Filing Accepted:  3/6/2025
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Complainant
Last/Business Name *  
WATERMAN KELLER   First Name   GINA
Street Address * 9198 BAY HILL BOULEVARD
City, State Zip * ORLANDO, FL 32819
Email Address * INTAKE2@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   WATERMAN KELLER   First Name   GINA
Policy # * 80-CS-L215-6 Claim #* 59-73D0-05Z
Attorney
Attorney is Applicable
Last Name* KADIR First Name * ALI Initial A.
Street Address* 986 DOUGLAS AVE, STE. 102
City, State Zip* ALTAMONTE SPRINGS , FL 32714
Email Address * INTAKE2@THEKRFIRM.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):* DONALD CAMERON, KELLY LYNNE HAYES, CRAIG M. MATHIEBE, ANDRIA PETERS, JALYN COOPER, INDIVIDUAL(S) WHO CONDUCTED AND/OR ATTENDED THE 11/10/2024 INSPECTION OF PLAINTIFF’S PROPERTY [NAME(S) UNKNOWN], AND ALL STATE FARM CLAIMS ADJUSTERS, EMPLOYEES, REPRES
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Misrepresentation
* 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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
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.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

“COVERAGE A – DWELLING We will pay for accidental direct physical loss to the property described in Coverage A, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. . . . COVERAGE B – PERSONAL PROPERTY We will pay for accidental direct physical loss to the property described in Coverage B caused by the following perils, unless the loss is excluded or limited in SECTION I – LOSSES NOT INSURED or otherwise excluded or limited in this policy. . . . . 2. Windstorm or hail.”
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Gina Waterman Keller (“Ms. Keller”) is a homeowner insured with a policy issued by State Farm Florida Insurance Company (“State Farm”). The insured property or home is located at 9198 Bay Hill Boulevard, Orlando, Florida 32819. In September of 2022, Hurricane Ian caused extensive damage to Ms. Keller’s home. Ms. Keller timely reported an insurance claim for this damage to State Farm and fully cooperated with all requests for inspections. She provided all requested documentation, if any, and complied with all post loss policy conditions. Three (3) tarp invoices and an estimate for repair of all damages were prepared on her behalf totaling $181,115.36 and were submitted to State Farm. After reporting the claim, State Farm retained an unqualified and biased field adjuster who has a financial relationship with State Farm. This field adjuster inspected Ms. Keller’s home in an apparent effort to minimize State Farm’s losses instead of adjusting the claim in good faith in due regard for Ms. Keller’s interests. Based on these findings, State Farm completely denied coverage for Ms. Keller’s claim. Due to such bad faith claim handling, Ms. Keller has been unable to permanently repair her home. Based on these facts, it is clear State Farm unreasonably denied coverage for Ms. Keller’s claim in bad faith. It denied coverage for the claim without conducting a reasonable investigation based upon the available information. It misrepresented pertinent policy provisions and facts and did not act fairly and honestly with Ms. Keller in due regard for her interests. State Farm also delayed the claim and failed to timely respond to communications. It further failed to adopt and implement standards for the proper investigation of this claim. This has become a common business practice of State Farm. Florida Statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. State Farm has breached this duty by refusing to properly and timely adjust the loss. As a result, Ms. Keller will have no choice but to retain the undersigned counsel to file a lawsuit against State Farm. State Farm has more than enough information and is still refusing to accept coverage for this claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. State Farm can avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Ms. Keller $156,380.36, which is the policy limit for coverage A less the 5% hurricane deductible.
Comments
User Id Date Added Comment
dwall@kpsds.com 04-10-2025 VIA E-Mail Only Ali A. Kadir, Esquire Kuhn Raslavich, P.A. 986 Douglas Avenue, Ste. 102 Altamonte Springs, FL 32714 Intake2@thekrfirm.com Re: Insured: Gina Waterman Keller Claim No.: 59-73D0-05Z DFS Filing No.: 810000 Dear Mr. Kadir: As you know, we represent State Farm Florida Insurance Company (“State Farm”) regarding the above-referenced matter. We are in receipt of the Civil Remedy Notice (“CRN”) you filed on behalf of your client, Gina Waterman Keller (the “Insured”), against State Farm on March 6, 2025, with a DFS Filing Number 810000. Please allow this correspondence to serve as State Farm’s response to the CRN. The stated reasons for the CRN are listed as: claim denial; claim delay; unsatisfactory settlement offer; unfair trade practice; and misrepresentation. The CRN claims State Farm violated 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); 626.9541(1)(i)(3)(d); 626.9541(1)(i)(3)(e); 626.9541(1)(i)(3)(f); 626.9541(1)(i)(3)(g); and 626.9541(1)(i)(3)(h). As a preliminary matter, State Farm denies it violated the statutes cited in the CRN. We also note that although we did receive a response from you, you provided no new information regarding these allegations since the time of State Farm’s initial response to the CRN and request for information dated March 19, 2025. Specifically, we had requested that you provide us with any facts to support the allegations in the CRN. We indicated that we would be happy to review any details you may have supporting these allegations. However, we have not received any new information to date. As an initial matter, the CRN is deficient and fails to comply with the requirements of Florida law. The purpose of a Civil Remedy Notice is to provide an insurer with a chance to settle the claim and avoid unnecessary litigation. See Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000); see also, The Heritage Corporation of South Florida v. National Union Fire Insurance Company of Pittsburgh, P.A., 580 F.Supp. 2d 1294 (S.D. Fla. 2008). In furtherance of this purpose, 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. The CRN is deficient as it fails to specifically state any policy language from the Insured’s policy of insurance. Rather than include the specific policy language relevant to the alleged statutory violations cited in the CRN as required by § 624.155(3)(b), Florida Statutes, the CRN merely states “Coverage A - Dwelling” and “Coverage B – Personal Property.” Florida courts have held that a Civil Remedy Notice that merely identifies section headings of provisions of the subject policy, rather than identifying the specific policy language at issue, renders the Civil Remedy Notice deficient under § 624.155(3)(b), Florida Statutes. See Junior Julien v. United Property and Casualty Insurance Company, No. 4D19-2763 (Fla. 4th DCA September 23, 2020); Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). The CRN is void of any policy language, breach of policy, or details explaining statutory violations. Further, the CRN fails to provide any explanation as to how State Farm failed to comply with the terms of the policy and/or any specific language in the policy pertaining to the alleged incident. Also, the CRN does not provide an explanation as to how State Farm failed to comply with the terms of the policy or any specific policy language therein by referencing the specific language in the policy pertaining to the alleged statutory violations. In addition, the “facts and circumstances” section of the CRN is not in compliance with Florida law. Contrary to the requirements of Florida Statutes, the CRN makes false, boilerplate accusations, and does not contain any specific facts supporting the violations alleged. For example, the CRN fails to provide any factual support for various allegations regarding State Farm’s alleged claim denial; claim delay; unsatisfactory settlement offer; unfair trade practice; and misrepresentation, or its alleged violations of those statutory provisions noted above and in the CRN. As more fully discussed below, the allegations contained within the CRN are false, and the CRN contains no facts to support them. Although the CRN alleges that State Farm “unreasonably denied coverage for Ms. Keller’s claim in bad faith”, the following summary demonstrates that State Farm has acted responsibly and in good faith during the investigation and handling of this claim. The failure to provide any factual support for the alleged violations of Florida statutes and administrative law renders the CRN deficient and in violation of Florida Statute § 624.155(3)(b). It appears on August 30, 2024, a Hurricane Ian claim was reported for alleged damage sustained to the roof and interior of the insured property located at 9198 Bay Hill Blvd, Orlando, Florida 32819 (the “Property”). A date of loss September 29, 2022 was provided at the time of reporting by the Insured’s Public Adjuster, Lifeline Public Adjusters. While the CRN alleges that “Ms. Keller timely reported an insurance claim for this damage to State Farm…”, the loss was reported seven hundred one (701) days, or one (1) year, eleven (11) months, and one (1) day after it is alleged to have occurred. The Insured’s contract for insurance requires that the Insured “give immediate notice” to State Farm of the loss. Specifically, the policy states: SECTION I – CONDITIONS 2. Your Duties After Loss. After a loss to which this insurance may apply, you must cooperate with us in the investigation of the claim and also see that the following duties are performed: a. give immediate notice to us or our agent… (Emphasis added.) The Insured’s reporting of the claim was untimely and prejudicial to State Farm’s inspection and investigation. On September 3, 2024, State Farm attempted to contact the Insured to discuss the alleged loss, but the Insured was at work and could not talk. On September 25, 2024, State Farm received the Public Adjuster’s letter of representation and left a voicemail to discuss the alleged loss with the Public Adjuster. On October 8, 2024, State Farm left a voicemail for the Insured to discuss the alleged loss and sent a contact letter. On October 15, 2024, State Farm sent a copy of the Insured’s policy to the Public Adjuster and left a voicemail for the Public Adjuster to discuss the alleged loss. On October 17, October 18, October 21, October 22, and October 23, State Farm called and/or emailed the Public Adjuster, leaving messages, requesting contact back to discuss the alleged loss. Finally, on October 25, 2024, almost two (2) months after the claim was reported by the Public Adjuster, State Farm was able to speak with someone on the Insured’s behalf regarding the alleged loss. Unfortunately, the Public Adjuster had minimal information, could not provide the age of the roof, and only stated that hurricane wind caused damaged to the rook and leaking in the garage. On November 7, 2024, State Farm emailed the Public Adjuster requesting interior photographs that depict the alleged damage. Due to the Insured’s delay in reporting the alleged loss, and the Insured’s and/or her representatives delay in speaking with State Farm regarding the alleged loss, State Farm was unable to inspect the Property until November 10, 2024. During the inspection, State Farm observed no damage from a covered loss to roof or exterior of the Property. On November 18, 2024, State Farm emailed the Public Adjuster again asking for photographs of the alleged interior damage. On November 19, 2024, State Farm emailed the Insured, informing her that we had not received the photographs requested from the Public Adjuster and that State Farm cannot complete its investigation without that. State Farm further requested information regarding the alleged interior damage. State Farm then emailed the Public Adjuster again seeking the photographs. On November 20, 2024, State Farm finally received the interior photographs it had been requesting, however, State Farm did not receive the written explanation and answers to its questions regarding the same. On December 10, 2024, State Farm emailed the Insured and Public Adjuster stating it cannot complete the investigation without the outstanding information. State Farm sent the same email to the Insured and Public Adjuster again on December 16, 2204. On December 17, 2024, the Public Adjuster sent the photographs again, but no answer to its questions. On December 18, 2024, State Farm spoke to the Public Adjuster and advised that it needed to know specifically when the damages were noticed. The Public Adjuster originally stated, very vaguely, “after Hurricane Ian.” State Farm stated they needed to know exactly when the damages were noticed and the Public Adjuster stated that the Insured noticed the damages in eely to mid October 2022. Ultimately, State Farm determined that the claim was not covered and issued its determination for the Insured’s claim, on or about December 23, 2024. The coverage letter explained the reasons for the coverage determination, based on the inspection and investigation conducted by State Farm, as well as the Insured’s or her representatives’ statements to State Farm, along with the applicable policy exclusions to the Insured. The letter outlined the basis for the denial of the claim was due to wear, tear, deterioration, deferred maintenance, mechanical damage, and weathering overtime observed, which are specifically excluded under the policy. There was no accidental direct physical loss to the roof or exterior of the Property from Hurricane Ian On March 6, 2025, a Notice of Intent to Initiate Litigation was filed by your office on behalf of the Insured. On or about March 19, 2025, State Farm responded to the Notice of Intent to Initiate Litigation standing by its denial. On March 21, 2025, a lawsuit alleging a breach of contract and declaratory relief was filed by your office on behalf of the Insured. On March 27, 2025 the lawsuit was served upon State Farm. Throughout the handling of this claim, State Farm fully inspected, evaluated, and communicated the claim with the Insured or their representatives. Based upon the Insured’s statements regarding the alleged loss and Property as well as the investigation conducted by State Farm, the claim was denied based upon the condition of the Property and the exclusions within the Insured’s policy of insurance. Based upon our review of the facts of this matter, State Farm has fully and properly attempted to adjust the claim in accordance with the insurance policy and Florida law. State Farm has handled this claim in the appropriate manner and in good faith, doing everything it could reasonably do to timely and properly investigate the Insured’s claim and pay benefits where owed. The allegation that State Farm “denied coverage for the claim without conducting a reasonable investigation based upon the available information. It misrepresented pertinent policy provisions and facts and did not act fairly and honestly with Ms. Keller in due regard for her interests. State Farm also delayed the claim and failed to timely respond to communications. It further failed to adopt and implement standards for the proper investigation of this claim” is malicious and false. Additionally, State Farm has always acted fairly and honestly towards the Insured. Furthermore, the only delay that occurred in this matter was by the Insured and/or her representatives who reported the claim seven hundred one (701) days, or one (1) year, eleven (11) months, and one (1) day from the alleged date of loss. Specifically, the CRN alleges violation of: 1. FS 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. State Farm denies violation of section 625.155 (1)(b)(1) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Thus, this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 2. FS 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. State Farm denies violation of section FS 624.155(1)(b)(3) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 3. FS 626.9541(1)(i)(3)(a); Failing to adopt and implement standards for the proper investigation of claims. State Farm denies violation of section 626.9541(1)(i)(3)(a) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 4. FS 626.9541(1)(i)(3)(b); Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. State Farm denies violation of section 626.9541(1)(i)(3)(b) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 5. FS 626.9541(1)(i)(3)(c); Failing to acknowledge and act promptly upon communications with respect to claims. State Farm denies violation of section 626.9541(1)(i)(3)(b) because State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. State Farm also promptly responded and attempted to contact the Insured or her representatives to discuss the claim. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice. Thus, this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 6. FS 626.9541(1)(i)(3)(d); Denying claims without conducting reasonable investigations based upon available information. State Farm denies violation of section 626.9541(1)(i)(3)(d) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 7. FS 626.9541(1)(i)(3)(e); Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. State Farm denies violation of section 626.9541(1)(i)(3)(e) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 8. FS 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. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 9. FS 626.9541(1)(i)(3)(g); Failing to promptly notify the insured of any additional information necessary for the processing of a claim. State Farm denies violation of section 626.9541(1)(i)(3)(g) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. 10. FS 626.9541(1)(i)(3)(h); Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. State Farm denies violation of section 626.9541(1)(i)(3)(h) because it made a good faith effort to appropriately investigate and evaluate the Insured’s claim. State Farm has, at all times, acted in accordance with the terms, conditions, and coverages of the insurance policy. State Farm inspected the subject property, reviewed all the documents and information provided and advised of its evaluation and coverage determination in compliance with the policy. Absolutely no facts or circumstances supporting the Insured’s allegations have been set forth in the Notice, thus this allegation of a statutory violation is denied. The CRN fails to provide facts or information to support this alleged violation. For the reasons set forth above, State Farm denies the allegations contained in the CRN. However, we would welcome the opportunity to review any additional information you may have that you believe supports your client’s position. Should you have any documents or other information that State Farm has not had the opportunity to review, please provide those at your earliest convenience. Very truly yours, /s/ Danielle M. Wall Danielle M. Wall DMW cc: Client
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