Civil Remedy Notice of Insurer Violations
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Filing Number:     810202
Filing Accepted:  3/7/2025
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Complainant
Last/Business Name *  
REGAN   First Name   SUSAN
Street Address * 13313 STARFISH DR
City, State Zip * HUDSON, FL 34667
Email Address * MYBEACH1213@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   REGAN   First Name   SUSAN
Policy # * 1501-1507-0028 Claim #* FL24-0124512-K324
Attorney
Attorney is Applicable
Last Name* BOGGS First Name * AMY Initial
Street Address* 4554 CENTRAL AVE, SUITE L
City, State Zip* ST, PETERSBURG , FLORIDA 33711
Email Address * BOGGS-PLEADINGS@BOGGSLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* N/A
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unfair Trade Practice
Unsatisfactory Settlement Offer
Other : Undervalued Claim
Other : Failure to Settle
* 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.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

A. Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises". Coverage C – Personal Property 1. Covered Property We cover personal property owned or used by an "insured" while it is anywhere in the world. Coverage D – Loss Of Use The limit of liability for Coverage D is the total limit for the coverages in 1. Additional Living Expense, 2. Fair Rental Value and 3. Civil Authority Prohibits Use below. 1. Additional Living Expense If a loss covered under Section I makes that part of the "residence premises" where you reside not fit to live in, we cover the Additional Living Expense, meaning any necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

The Insured owns real property located at: 13313 Starfish Dr, Hudson, FL, 34667 (the “Property”). On or about September 27, 2024, the Property suffered extensive damage due to Hurricane Helene. The storm compromised the Property’s roof and windows, and, due to this damage, subsequent water intrusion occurred throughout the interior of the Property. The Property was insured through Universal Property & Casualty Insurance Company (“Universal”) under Policy No. 1501-1507-0028 (the “Policy”) at the time of the loss. The Insured had ample coverage under the Policy to cover the loss. The Insured made a claim with Universal, who assigned claim No. FL24-0124512-K324 and investigated the loss. Universal accepted coverage for the loss but has failed and refused to pay the full amount due for the Insured’s covered loss. To date, Universal has only paid the Insured $9,708.01 under Coverage A for this covered loss. The Insured retained licensed Public Adjuster Mark Wicks, of Public Adjusters of Florida, to investigate the loss and provide an estimate of the damages the Property sustained. Mr. Wicks estimated the total cost to restore the Property back to its pre-loss condition at $124,110.12 ACV $125,236.25 RCV for the dwelling. Additionally, the Insured has incurred $401.97 in expenses for Coverage C contents damages. Also, due to the Property’s damaged state, the Insured was forced to relocate and has incurred $8,355.47 worth of additional living expenses, which falls under Coverage D of the Policy. This ALE total will continue to accrue as the Property is still uninhabitable. After accounting for the Policy’s deductible and prior payments made to the Insured, the total amount due under the Policy is $117,724.55 ACV. The disparity between the Insured’s estimate and Universal’s payment to the Insured constitutes a bad faith effort by Universal to avoid payment for the Insured’s covered loss. Universal hopes that the Insured will settle her claim for far less than the full benefits she is owed under the Policy. In sum, Universal has vastly underpaid benefits that the Insured is due for this covered loss under the Policy. In failing to make full payment of benefits due, Universal has also failed to investigate and settle the claim in good faith and misrepresented pertinent facts pertaining to the Policy’s coverage. On information and belief, Universal has engaged in the following behaviors with such frequency that the conduct is a pattern and practice of Universal: delay, improper adjustment of claims, under-valuation of claims, and failure to communicate with insureds. Universal and the Insured are parties to a valid and binding contract of insurance. This contract of insurance requires Universal to provide benefits to the Insured in the case of a covered loss to the Property. The Insured suffered a covered loss under the Policy and has otherwise suffered damage that is not excluded under the Policy. All conditions precedent to obtaining coverage for the loss have been complied with, met, or waived. Universal has simply failed and refused to pay the full benefits due for the covered loss the Property sustained. The Insured has been damaged by Universal’s breach of contract. This notice is given to perfect the right to pursue the civil remedy authorized by Florida Statute, including all bad faith/extra-contractual and punitive damages, should Universal fail to cure the violations set forth in this notice within the given cure period. To cure the defects outlined in this civil remedy notice Universal must: (1) Provide full payment of benefits for the Insured’s claim; and (2) Tender interest for benefits due at the statutory rate dating back to reporting of the loss per Fla. Stat. §627.70131.
Comments
User Id Date Added Comment
jr0405@universalproperty.com 04-24-2025 April 24, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 810202 Filing Date: 3/7/2025 Complainant: Susan Regan Insured: Susan Regan Policy No.: 1501-1507-0028 Claim No.: FL24-0124512-K324 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notice (“Notice”) filed by attorney, Amy Boggs, on behalf of Complainant, Susan Regan (also referenced as “Insured”). The Notice alleges violations of Sections 624.155 and 626.9541, Florida Statutes. Universal specifically denies each allegation contained in the Notice. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notice fails to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Sec. 624.155, Fla. Stat. and Florida law. The Notice is deficient as a matter of law as it fails to comply with Sec. 624.155, Fla. Stat. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Sec. 624.155(3)(b), Fla. Stat., the Notice “shall state with specificity” the following information: 1. The statutory provision, including the specific language which the authorized insurer allegedly violated; 2. the facts and circumstances giving rise to the violation; 3. the name of any individual involved in the violation; 4. reference to specific policy language that is relevant to the violation, if any...; and 5. a statement that the Notice is given to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Florida Department of Financial Services (“DFS”) created form DFS-10-363, which sets out fifteen (15) requirements that the Complainant(s) must respond to with specificity. The Florida Supreme Court holds that Sec. 624.155, Fla. Stat. "must be strictly construed." Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainant(s) specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). The Notice fails to meet the requirements of Sec. 624.155, Fla. Stat., on several grounds. First, concerning the requirement to set forth with specificity the "facts and circumstances giving rise to the violation," the Notice fails to specify any facts that would put Universal on notice that it violated any policy provision or statute. The Complainant lists five (5) reasons for filing the Notice: “Claim Delay,” “Unfair Trade Practice,” “Unsatisfactory Settlement Offer,” “Undervalued Claim,” and “Failure to Settle.” However, the Complainant’s allegations regarding these “Reasons for Notice” have no factual support anywhere in the Notice. The Notice asserts general allegations of conclusory, boilerplate and/or inaccurate statements without the requisite specificity. For example, the Notice alleges “[o]n information and belief, Universal has engaged in the following behaviors with such frequency that the conduct is a pattern and practice of Universal: delay, improper adjustment of claims, under-valuation of claims, and failure to communicate with insureds.” The Notice does not specify any facts to support this speculative and conclusory statement. The Complainant is required to provide with specificity the facts and circumstances giving rise to the alleged violation strictly related to Complainant’s allegations, not conjecture or speculation of what may be the carrier’s “pattern and practice.” In addition, the Notice generally alleges that Universal “misrepresented pertinent facts pertaining to the Policy coverage.” However, the Notice fails to specify any facts regarding any misrepresentations made by Universal and does not identify any person or persons who made such misrepresentations nor to whom any alleged misrepresentations were made. Therefore, it is evident that the statement of facts falls short of the specificity required by Sec. 624.155, Fla. Stat. As a result, the Complainant fails to comply with Sec. 624.155(3)(b)(2), Fla. Stat. Second, the Notice fails to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of Fla. Stat. § 624.155, the Complainant must name the individual(s) involved with specificity as it relates to the purported violation to allow Universal to properly investigate the allegations. The Notice lacks the requisite specificity as required by Fla. Stat. § 624.155. Here, the Complainant does not identify the person or persons at Universal with the most knowledge of the facts regarding any alleged violation(s), but instead states “N/A.” The Notice does not have the requisite specificity as to whom the Complainant is asserting has knowledge as to each specific allegation contained in the Notice. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainant alleges Universal has “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to coverages at issue.” The Notice fails to include sufficient specificity as to whom made any misrepresentations, what was misrepresented, and when any of these misrepresentations were made. Accordingly, Complainant’s Notice is insufficient as a matter of law. Third, the Notice fails to satisfy Section 624.155(3)(b)(4), Florida Statutes, in that it fails to reference specific policy language relevant to the alleged violation. Instead, the Notice references various policy provisions but fails to specify any facts regarding how those provisions were violated. Therefore, it is unclear what if any policy language pertains to any allegation. General, vague, or overbroad references to policy provisions do not satisfy the specificity required by Section 624.155(3)(b)(4), Fla. Stat. As such, the Notice is deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). In summary, the Complainant failed to respond to each of the fields set forth on the DFS Form with the requisite specificity as stated herein including, but not limited to, failing to identify the person or persons representing the insurer who are most responsible for/knowledgeable of the facts giving rise to the allegations in the Notice, failing to sufficiently allege facts and circumstances giving rise to the violation, and failing to reference specific policy language relevant to any alleged violation. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. See Julien, 311 So. 3d 875 (Fla. 4th DCA 2021). Accordingly, the Notice is deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notice. On September 30, 2024, Universal was notified by Adrian Regan that the insured location was damaged on September 27, 2024. Universal inspected the property and documented any visible damage. Universal, in accordance with the terms and conditions of the Policy, issued payment in the full amount of its estimate for covered damages observed, less recoverable depreciation and applicable deductible. Universal also advised the Insured that certain claimed damages were not covered as they were due to flood and/or surface water. Under the terms of the Policy, Universal will initially pay at least the actual cash value of the insured loss, less any applicable deductible. It will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred. At no time has Universal breached any duty to its Insured. An Insurer is not required to pay whatever amount its insureds demand. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested. As outlined above, the alleged statutory violations set forth in the Notice lack factual support and are without merit. Therefore, the Notice is legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjustment of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the Notice filed by the Complainant. Sincerely, /s/ Jonathan Rodriguez Jonathan Rodriguez, Esq. Associate General Counsel
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