Civil Remedy Notice of Insurer Violations
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Filing Number:     810053
Filing Accepted:  3/7/2025
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Complainant
Last/Business Name *  
TUTSCH   First Name   MATTHEW
Street Address * 4931 KLOSTERMAN OAKS BLVD.
City, State Zip * PALM HARBOR, FL 34683
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   TUTSCH   First Name   MATTHEW
Policy # * HOH160332 Claim #* H010018315
Attorney
Attorney is Applicable
Last Name* BURKE First Name * RYAN Initial S
Street Address* 575 SECOND AVENUE SOUTH, SUITE 201
City, State Zip* SAINT PETERSBURG , FLORIDA 33701
Email Address * PLEADINGS@DICUSBURKELAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 14407
 
Name of individual responsible for violation (if any):* AMOYA POWELL
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Unreasonable investigation
Other : Making material misrepresentations to the insured
Other : Misrepresenting insurance policy provisions to the insured
Other : Misconduct toward insured
* 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)(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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property… SECTION I – CONDITIONS 3. Loss Settlement. Covered property losses are settled as follows: a. Property of the following types: (1) Personal property; (2) Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; and (3) Structures that are not buildings; at actual cash value at the time of loss but not more than the amount required to repair or replace. 10.Loss Payment. We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable 60 days after we receive your proof of loss and: a. Reach an agreement with you; b. There is an entry of a final judgment; or c. There is a filing of an appraisal award with us. SPECIAL PROVISIONS FOR FLORIDA FOR USE WITH HPC HO 00 03 ADDITIONAL COVERAGES 2. Reasonable repairs is deleted and replaced by the following: 2. Reasonable Emergency Measures a. We will pay up to the greater of $3,000 or 1% of your Coverage A limit of liability for the reasonable costs incurred by you for necessary measures taken solely to protect covered property from further damage, when the damage or loss is caused by a Peril Insured Against. b. As it pertains to protecting and/or covering the roof: (1) We will reimburse you to install a temporary protective roof covering in an emergency circumstance, up to 2% of the Coverage A limit of liability; (2) We will reimburse you for the cost to remove and reset the roof covering in (1) to allow for our initial inspection if the claim is reported within 7 days of the first documented installation of the roof covering; (3) We will not reimburse you for the cost to remove and reset a temporary protective roof covering to allow you or your consultants to inspect, however, in the event the tarp is blown off or damaged by weather, we will reimburse you for the cost to remove and reset a roof covering, up to the limits set forth in (1); and (4) We will not pay more than the limit set forth in (1) for any type of roof covering, including but not limited to shrink wrap, installed to protect the roof after a loss. (5) This 2% temporary emergency roof covering limit is additional insurance, separate and apart from the $3,000 or 1% limit in a. above. c. We will not pay more than the amount in a. above, unless we provide you approval within 48hours of your request to us to exceed the limit in a. above. In such circumstance, we will pay only up to the additional amount for the measures we authorize. d. If we fail to respond to you within 48 hours of your request to us and the damage or loss is caused by a Peril Insured Against, you may exceed the amount in a. above only up to the cost incurred by you for the reasonable emergency measures necessary to protect the covered property from further damage. e. If however, form HO 03 51 or HO 0352 is part of your Policy and a covered loss occurs during a “Hurricane” as described in HO 03 51 or HO 03 52, the amount we will pay under this additional coverage is not limited to the amount in a.above. f. A reasonable measure under this Additional Coverage 2. may include a permanent repair when necessary to protect the covered property from further damage or to prevent unwanted entry to the property. To the degree reasonably possible, the damaged property must be retained for us to inspect. g. This coverage does not: (1) Increase the limit of liability that applies to the covered property; (2) Relieve you of your duties, in case of a loss to covered property, as set forth in SECTION I – CONDITION 2., Your Duties After Loss; or (3) Pay for property not covered, or for repairs resulting from a peril not covered, or for loss excluded in this policy. Paragraph 10. Loss Payment is deleted and replaced by the following: 10. Loss Payment. We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. In the event that any repair services were performed under the Our Option provision, we will pay the retained contractor directly for those services or part or portion of any services the retained contractor performs or provides. For all other claims payments, we will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be paid upon the earliest of the following: a. 20 days after we receive your written proof of loss and reach a written, executed agreement of settlement with you according to the terms of the written agreement; or b. Within 60 days after we receive your proof of loss; and: (1) There is an entry of a final judgment or, in the case of an appeal from such judgment, within 60 days from and after the affirmance of the same by the appellate court; or (2) There is a written executed mediation settlement with us according to the terms of the written mediation settlement; or (3) There is a filing of an appraisal award with us; or c. Within 60 days after we receive notice of an initial claim, “reopened claim” or “supplemental claim” from you, we will pay or deny such claim or portion of the claim unless the failure to pay such claim or portion of claim is caused by factors beyond our control which reasonably prevent such payment. Our failure to comply with this paragraph shall not form the sole basis for an action against us for breach of contract under this policy or for benefits under this policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

PURSUANT TO SECTION 624.155, F.S. please indicate all statutory provisions alleged to have been 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)(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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 69O-220.201(4)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition thereof. *********************************************************************************************************************************************************************************************************************************** FACTS OF THE CASE: Heritage Property & Casualty Insurance Company (“Heritage”) committed the following in the handling of the Insured’s claim: 1) failing to pay benefits owed; 2) failure to act in due diligence and good faith to resolve claims; 3) placing the financial interest of the insurer before that of the policy holder; 4) failure to properly train, evaluate, and manage adjusters retained to represent the policies and procedures of Heritage; 5) looking for ways to delay the proper handling of the insured’s claim; 6) looking for ways to deny the Insured’s claim; 7) looking for ways to reduce recovery to the Insured; 8) performing an inadequate investigation; 9) Failing to promptly pay the full benefit owed to the Insureds; 10) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; and 11) making a material misrepresentation 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. The reasons for this may be attributed to improper training, supervision, and/or motivation of outside adjusters and claims supervisors to promptly and fairly adjust and pay full benefits available to the Insured. The Insurer may have failed to adopt proper standards of investigation and adjustment of losses or is otherwise not implementing those standards because a proper investigation and full and prompt payment for the loss is not occurring. Despite the Insured’s notification to Heritage of their insurance claim, Heritage failed in tendering to the Insured all proceeds due and owing under the subject policy of insurance. Despite the Insured’s pleas otherwise, Heritage has failed to acknowledge its obligations under the subject policy of insurance and tender the coverage the Insureds are contractually owed. Mr. Matthew Tutsch (the “Insured”) insured their home located at 4931 Klosterman Oaks Blvd., Palm Harbor, Florida 34683 with Heritage Property & Casualty Insurance Company with coverages beginning and or renewing on or around October 11, 2023. It was during this policy period, on or around April 3, 2024, that Mr. Tutsch suffered a covered loss to the property. On this date, a powerful windstorm impacted the Tutsch’s home causing significant, open and obvious damage to the roofing system. Following the reporting of the claim to Heritage, Heritage conducted a lackluster claim investigation that failed to take into consideration basic adjusting guidelines, the age or condition of the roof, repairability of the roof, the mandates of the Florida Building Code – Existing Structures. On April 29, 2024, Heritage sends a coverage determination letter authored by Amoya Powell where in they state that unfortunately since the damage to the shingles is “not from a windstorm or hailstorm, we are unable to cover the claim”. The letter continues that” based upon our investigation, there is no evidence of wind and hail damage to the roof or any exterior elevation”. On August 27, 2024, the Insured had a forensic engineer inspect the property and issue a report. In this report a Professional Engineer opines that “A review of historic weather data supports the opinion that the severe weather event that occurred on/or about the date of reported loss was the probable storm event that caused the reported roof covering and interior finish moisture damage to the subject property. The report also states “The following listed observations of damages described below are not to be construed as a condition survey of the roof covering or other building components for the subject property. • Shingles with granular loss due to wind-borne debris impacts were observed on the right facing and front facing roof slopes. • Lifted shingle tabs with linear granular loss were observed on multiple roof slopes. The majority of damage was documented on the front and right facing roof slopes of the subject property. • Bending of unsealed shingles resulted in audible mat fracturing and loss of granular adhesion at less than 45 degrees of flexural rotation. • Areas of reported associated interior finish moisture damage were documented down-gradient from the documented asphalt shingle roof covering damage. • Damage to the asphalt shingles was inspected for weathering indicators such as frayed edges and oxidized bitumen. These observations indicated that pre-loss damaged shingles existed on the roof covering for a small percentage of the total damage.” Mr. Tutsch had a tarp installed to mitigate his damages. Mr. Tutsch was responsible for removing and replacing the tarp for each inspection conducted by Heritage throughout this heinous claim investigation. He is now responsible for the cost of the original tarp and each instance of removal and replacement due to Heritage’s negligence. On October 4, 2024, Heritage, through Amoya Powell, sends additional correspondence to Mr. Tutsch again denying his claim and stating” Thank you for the opportunity to help you during this difficult time. Heritage Insurance Companies has concluded, to the extent possible, its investigation of the above-referenced claim. The claim was reported with a date of loss of April 03, 2024, and was reported on April 17, 2024. The claim was reported 14 days after the reported date of loss. You submitted this claim under policy number HOH160332 effective October 11, 2023, to October 11, 2024. During your reporting of the claim, you advised that roof damages and interior moisture stains were present, which you attributed to a recent storm event. No coverage was found for the interior damages as the moisture stains were not caused by a storm-created opening, and the roof damages were attributed to wear and tear and deterioration, not related to the claimed date of loss. Please see below for a detailed explanation of our coverage decision. Upon receipt of notice of the claim, Heritage assigned a field adjuster to inspect your property. The field adjuster conducted an inspection on April 22, 2024. You advised that the damage occurred during a storm on April 3, 2024. The inspection included the roof, where 43 creased shingle tabs were observed, with 18 creased tabs on the front slopes and 25 on the rear slopes. No exterior damages were found at the time of inspection.” The letter continues” However, the damages reported are not covered due to the incorrect date of loss and the nature of the damages being attributed to wear and tear and deterioration, which are specifically excluded under your policy.” Heritage states that creased shingles and tabs were observed, but that this does not constitute exterior damages and that the nature of said damages is solely wear and tear. The use of such language with the knowledge and information that has been provided to Heritage is merely a tactic to have their Insured abandon their claim and walk away. In addition, language used in this letter which suggestive that the Insured reported the loss in less than a timely manner, is inappropriate considering the loss was reported timely. Heritage, not surprisingly, was not timely in the releasing a coverage determination. As a result of the bad faith handling of their valid insurance claim, Mr. Tutsch was forced to retain my firm in order to bring a full and fair resolution to their claim and they are now obligated to my firm for their contractual fees and costs. Fla. Stat. s. 624.02 defines insurance as a contract whereby one undertakes to indemnify another or allow specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the insured may mitigate its damages and put the structure and business operation back to the condition it was in prior to the loss as quickly as possible; Heritage clearly breached this duty. Heritage failed to adhere to basic adjusting guidelines and acted in its own self-interest rather than in the interests of its Insureds. Heritage’s behavior throughout the claims process is characterized by bad faith and dishonest trade practices. The actions taken by Heritage in the mishandling of this claim were willful, wanton, and in complete disregard of the rights of its Insureds and occurred with such a frequency in this case as to indicate a general business practice and are in violation of Fla. Stat. §§ 624.155 and 626.9541. Heritage’s actions include but are not limited to the following: 1. CLAIM DELAY 2. UNSATISFACTORY SETTLEMENT OFFER 3. FAILING TO CONDUCT A PROPER INVESTIGATION 4. NOT TREATING THE POLICYHOLDER WITH GOOD FAITH CLAIMS CONDUCT 5. LOOKING FOR WAYS TO REDUCE RECOVERY TO THE INSURED 6. LOOKING FOR WAYS TO DELAY FULL RECOVERY TO THE INSURED 7. NOT ADJUSTING CLAIMS AND EVALUATING LOSS PROPERLY, PROMPTLY AND FAIRLY TO PROVIDE FULL AND PROMPT INDEMNITY TO THE INSURED 8. FAILING TO IMPLEMENT PROPER STANDARDS FOR THE ADJUSTMENT AND INVESTIGATION OF CLAIMS 9. NOT TRAINING, SUPERVISING OR MANAGING ADJUSTERS PROPERLY SO THAT PROMPT AND FULL PAYMENTS ARE MADE, BUT RATHER PLACING THE COMPANY’S INTERESTS BEFORE THE POLICYHOLDERS’ INTERESTS 10. ESTABLISHING SEVERITY CONTROL INITIATIVES AND OTHERWISE ESTABLISHING A CULTURE OF NOT FULLY AND PROMPTLY PAYING CLAIMS FOLLOWING LOSSES 11. MATERIALLY MISREPRESENTING FACTS AND THE INSURANCE POLICY PROVISIONS 12. FAILING TO ACKNOWLEDGE AND/OR COMMUNICATE REGARDING CLAIMS COMMUNICATIONS 14. FORCING AN INSURED TO ADJUST HER OWN LOSS. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: TENDER $64,565.81 LESS THE APPLIABLE POLICY DEDUCTIBLE. A copy of this form submitted to the FDFS has been transmitted to the following parties providing them notice of the filing of this Civil Remedy Notice: Certified Mail: 7022 3330 0000 8444 3304 Heritage Property & Casualty Insurance Company 2600 McCormick Dr., Suite 300 Clearwater, FL 33759 cc: claims@heritagepci.com
Comments
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ncarlisle@heritagepci.com 04-29-2025 April 29, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: MATTHEW TUTSCH Insured: MATTHEW TUTSCH Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 810053 Claim No: H010018315 Policy No.: HOH160332 Dear Madam and/or Sir: Please allow this correspondence to serve as Heritage Property & Casualty Insurance Company’s (“Heritage”) official response to the Civil Remedy Notice of Insurer Violation (“Notice”), Filing Number 810053, filed on behalf of Heritage’s insured MATTHEW TUTSCH (“Complainant”). The Notice was accepted by the Department on March 7, 2025. While Heritage welcomes the opportunity to respond to the Notice filed concerning this claim, it responds to it specifically denying each and every allegation contained in the Notice. Heritage believes that the Notice should be rejected and returned by the Department of Financial Services as it fails to comply with the specific information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions as promulgated in Florida Statute §624.155 and Florida Case law. The Notice fails to inform Heritage whether it had been given to perfect the right to pursue the civil remedy authorized by Florida Statute §624.155 and Florida Case law. History of Claim For clarification, Heritage provides a brief history of the claim: Subject to its terms, endorsements, limitations, exclusions, and conditions, the Complainant was issued Policy HOH160332 (“Policy”) for the property at 4931 KLOSTERMAN OAKS BLVD, PALM HARBOR, FL 34683 (“Property”). The Policy of Insurance applies to direct physical loss of or damage to covered property at the premises described in the Declarations of the Policy or resulting from any Covered Cause of Loss as described in the Policy. Upon receiving the Complainant’s first notice of loss on April 17, 2024, claiming damages from a windstorm that allegedly occurred on April 3, 2024, Heritage promptly assigned claim number H010018315. On the same day the loss was reported, Heritage issued its acknowledgment letter and Bill of Rights to the Complainant. Moving forward, Heritage’s representative coordinated an inspection of the damage to the Property caused by the alleged windstorm. Complainant requested the inspection to occur on April 22, 2024, and the on-site inspection documented the interior and exterior conditions of the property. During the inspection the licensed Field Adjuster took photographs and measurements, as well as scoped the damage. After conducting a reasonable investigation based upon available information, on April 29, 2024, Heritage advised Complainant that it could not extend coverage under the policy because the damage observed was precluded from coverage by the subject policy. Heritage promptly provided 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 the claim. In accordance with its obligations under §627.70131, Fla. Stat., a letter including a written explanation of the coverage decision was sent to Complainant on April 29, 2024, which included pertinent facts or insurance policy provisions relating to coverages at issue. Due to a dispute in coverage, Heritage requested an engineer inspection. On October 4, 2024, after review of all of the claim, Heritage reaffirmed the previous denial. On March 7, 2025, the Complainant filed this Notice, to which Heritage now submits its response. A Notice of Intent to Initiate Litigation was also submitted on March 7, 2025, to which Heritage promptly responded. Heritage is pleased to inform that the parties amicably resolved the claim on April 24, 2025. As previously stated, Heritage has adjusted the subject claim at all times in accordance with the insurance policy and Florida Statute. To date, Heritage has not received any information that would alter its understanding of the loss or coverage. Alleged Reasons for the Notice In accordance with Fla. Stat. §624.155, the Civil Remedy Notice requires the Complainant, “to indicate all statutory provisions alleged to have been violated.” The Notice alleges the reasons for the Notice are the following: Claim Denial The Notice fails to state instances of “claim denial" practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Claim Delay The Notice fails to state instances of “claim delay" practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Unfair Trade Practice The Notice fails to state instances of “unfair trade" practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Unsatisfactory Settlement Offer The Notice fails to state who, how and when an unsatisfactory settlement offer was made therefore it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Misrepresenting insurance policy provisions to the insured The Notice fails to state who, how and when misrepresentation of the provisions of the insurance policy occurred therefore it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Unreasonable investigation The Notice fails to state instances of unreasonable investigating of the Insured's loss practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Making material misrepresentations to the insured The Notice fails to state instances of material misrepresentations to the insured practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Misconduct toward insured The Notice fails to state instances of misconduct toward the Insured practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put Heritage on the requisite notice. Alleged Violations of Statutory Provisions Further, the Notice filed in this matter alleges Heritage violated the following statutory provisions: • §624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all circumstances, it could and should have done so, had it acted fairly and honestly toward its Complainant and with due regard for his or her interests. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a fully covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. Regardless, Heritage denies the allegations contained herein. • §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. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Nowhere in the notice does it state when Heritage paid under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage, nor does it state who did it. Accordingly, and as indicated by the facts stated above, Heritage has at all times promptly settled claims. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. Regardless, Heritage denies the allegations contained herein. • 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 Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Nowhere in the notice does it state what the material misrepresentation was, or who made the material misrepresentation. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly in its representations 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. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainant’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • §626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Nowhere in the notice does it state what the alleged standards for proper investigations are that Heritage failed to adopt or implement, and/or who failed to adopt and implement the standards. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly, upholding and implementing standards for the proper investigation of claims. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Nowhere in the notice does it state what the pertinent facts or policy provisions which were allegedly misrepresented, and who made the misrepresentations. Furthermore, Florida courts have found that listing nearly all policy provisions on the notice did not satisfy the statute. Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 U.S. Dist. LEXIS 65123, 2017 WL 1541294, at *2 (M.D.Fla. Apr. 28, 2017). Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly in its representation of pertinent facts and insurance policy provisions relating to coverages at issue. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received and obtained do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • §626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has always promptly acknowledged communications and acted promptly with respect to the claim. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received and obtained do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • §626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Response: The Insureds fail to state who, how and when a claim denial was made without conducting a reasonable investigation based on available information. Therefore, it lacks a factual basis to support this allegation and lacks the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly, and conducted a reasonable investigation based on available information. Furthermore, Heritage made a proper coverage determination in reference to Complainant’s claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • §626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Therefore, it lacks a factual basis to support this allegation and lacks the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly, promptly notifying the insured of any additional information necessary for the processing of a claim. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. • 69O-220.201(4)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition thereof. Response: The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Therefore, it lacks a factual basis to support this allegation and lacks the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Regardless, Heritage denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, Heritage has at all times acted fairly and honestly, promptly notifying the insured of any additional information necessary for the processing of a claim. Further, Heritage has conducted a reasonable investigation based on available information and made a coverage determination in reference to Complainants’ claim based upon the information and documentation obtained and/or received by Heritage during its investigation of the claim and the subject policy. The documentation and information received do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. Request to Reject Notice Florida Statute §624.155(3)(b)(2) requires the Complainant to “describe the facts and circumstances giving rise to the insurer’s violation” to enable the insurer to investigate and resolve the claim. Contrary to the requirement set forth in the statute, this Notice contains overbroad and incorrect allegations, which stem only from the Complainant’s opinions regarding the value of their own claim and, therefore, the Complainant’s opinions regarding Heritage’s adjustment of this claim. Florida Statute §624.155(3)(b)(4) requires the Complainant to refer to specific policy language that is relevant to the alleged violation, if any. Moreover, the Notice contains a list of violations that Heritage has allegedly committed but fails to provide an adequate basis in support of those allegations and, on that basis alone, fails to satisfy the basic requirements of an otherwise proper Notice. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021); Fla. Stat. §§ 624.155 and 626.9541. Strict construction of §624.155 demands a specificity level of compliance with the requisite provision of information to the Department and the insurer. See id; See also Marques v. Heritage Property & Cas. Ins. Co., No. 56 2020 CA 000805, 2021 WL 3473940, at 2 (Fla. Cir. Ct. Aug. 02, 2021). As such, the Notice does not comply with Florida law and is legally insufficient. Furthermore, the Complainant’s Notice seeks cures for the alleged defects. However, the “cures” sought are improper pursuant to Florida Case law. Specifically, the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000), provides that the scope of what can be “cured” is limited to the alleged non-payment of the contractual amount due the Complainant. Talat also commented that “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the Complainant. In the context of a first-party insurance claim, the contractual amount due to the Complainant is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As a result, only the demanded “cures” relating to the payment for covered damages are proper and legal. The purpose of the Civil Remedy Notice is to provide the insurer notice of the issue its Complainants have with the claim and what it is seeking to remedy that issue. However, it is important to note that Insurers are not required to pay any amount demanded by their Complainants to avoid a bad-faith claim. Rousso v. Liberty Surplus Ins. Corp., 2010 U.S. Dist. LEXIS 82328, at *14-15 (S.D. Fla. Aug. 13, 2010). Similarly to Rousso, the Notice reflects a “shotgun-blast effort to hit a lot of targets with a single salvo. This approach is contrary to the purpose of the statute.” The Notice must reflect a good-faith effort to inform Heritage of how it has fallen short of its obligations under the policy and what it can do to fix its shortcomings. Thus, the Notice is insufficient as a matter of law. Under §624.155, Heritage is entitled not only to a clear proposed solution, but also more and accurate details about how Heritage fell short of its obligations to provide coverage pursuant to the terms of the insurance agreement. As such, the Notice is deficient, and the Complainant has failed to comply with several conditions precedent to bringing a claim under §624.155. In closing, Heritage Property & Casualty Insurance Company believes that the Notice should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Moreover, regardless of the rejection, Heritage denies all allegations contained in the Notice and submits there are no violations. While this response is meant to be comprehensive, Heritage Property & Casualty Insurance Company’s response above is based upon the limited information provided in the Notice and the information we have to date. If the Complainant feels that Heritage does not have all the facts, please inform Heritage immediately. Sincerely, /s/ Tamara Schweinsberg Tamara Schweinsberg, Esq. Senior Claims Counsel Heritage Property & Casualty Insurance Co. Civil Remedy Notice of Insurer Violation Response
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