Civil Remedy Notice of Insurer Violations
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Filing Number:     810550
Filing Accepted:  3/11/2025
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Complainant
Last/Business Name *  
VASSER   First Name   DOUGLAS
Street Address * 602 STANLEY AVE
City, State Zip * WILDWOOD, FL 34785
Email Address * MKAHLEY@THEPAYNELAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   VASSER   First Name   DOUGLAS
Policy # * PFL391357-05 Claim #* CFL24603295
Attorney
Attorney is Applicable
Last Name* KAHLEY First Name * MARK Initial
Street Address* 126 E. JEFFERSON STREET
City, State Zip* ORLANDO , FLORIDA 32081
Email Address * MARK@THEPAYNELAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   PEOPLE'S TRUST INSURANCE COMPANY
NAIC Company Code 13125
 
Name of individual responsible for violation (if any):* PATRICK HOBBS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section)
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about August 27, 2024, Douglas Vasser reported a loss to insured property as a result of wind to his Insurer, People’s Trust Insurance Company (“Insurer”). Insurer violated Florida Statute Section 624.155(1)(b)(1) as follows: Mr. Vasser suffered direct physical loss to his home during the policy period of July 16, 2024 to July 16, 2025. Insurer has the burden to prove that the cause of all of the direct physical loss to the insureds’ home which occurred on or about July 16, 2024 as a result of wind and hail is excluded under the terms of the insurance policy. See, Citizens Prop. Ins. Corp. v. Munoz, 158 So. 3d 671, 674 (Fla. 2nd DCA 2014), Universal Prop. & Cas. Ins. Co. v. Secu Godiciu, 159 So. 3d 389 (Fla. 4th DCA 2015), Sawgrass Mut. Ins. Co. v. Moné, 199 So.3d 284 (Fla. 5th DCA 2016) and Tower Hill Prime Ins. Co. v. Newell, 183 So. 3d 1247 (Fla. 5th DCA 2016). Insurer cannot prove that the loss is due to a cause excluded under the policy. Although the Insureds are not required to prove the cause of the loss, the Insureds have provided Insurer with reports and estimates. Despite Insurer’s possession of all of the Insured’s evidence showing that the cause of the loss and scope of the damages are a direct result of wind resulting in significant exterior damages that are covered as detailed by the Insurer’s Policy, Insurer continues to withhold the Insured’s remaining owed Coverage A benefits and continues to offer inadequate claims decisions. As such, Insurer has not attempted in good faith to settle this claim when, under all the circumstances it could and should have done so, had it acted fairly and honestly toward its Insureds and with due regard for their interests. Insurer violated Florida Statute Section 626.9541 (1)(i)(2), 626.9541 (1)(i)(3)(a), 626.9541 (1)(i)(3)(b),626.9541 (1)(i)(3)(c), 626.9541 (1)(i)(3)(d) by the conduct detailed in the Claims correspondences and any and all claims estimate(s) prepared by Insurer’s agent(s). These claim documents clearly demonstrate that the insurer has not accurately investigated or evaluated all of its Insureds’ damages despite the Insureds providing ample supporting documentation of the necessary repairs for the damages suffered that resulted from wind. Instead, Insurer has forced Mr. Vasser to incur additional out of pocket costs to obtain additional inspections and estimates that corroborate the initial repair estimate that Insurer has been in possession of for more and refused to consider or pay. Insurer’s improper evaluation of the Insured’s claim forced them to retain counsel and file litigation against Insurer. Bad faith discovery will likely reveal that it is a business practice of Insurer to treat Insureds who are unrepresented disparately from those who are represented by legal counsel. Bad faith discovery will also likely reveal Insurer’s pattern and general business practice of initially abdicating its duty to adjust claims with its insureds and render a fair and competent claim decision, forcing its insureds to bear the burden of proof by incurring the expense of otherwise unnecessary experts to refute Insurer’s bad faith evaluation and negligent investigation of the claim. Bad faith discovery will also likely reveal Insurer’s business practice of failing to implement standards to properly investigate the claim from the beginning. “[T]he purpose of the CRN is to facilitate and encourage good-faith efforts to timely settle claims before [bad faith] litigation, not to vindicate continuing efforts to delay.” Landers v. State Farm Florida Insurance Company, 234 So.3d 856 (Fla. 5th DCA August 11, 2017)(citing Vest v. Travelers Insurance Co., 753 So.2d1270 (Fla. 2000). And to “give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation….” Lane v. Westfield Ins. Co., 862 So2d 774, 779 (Fla. 5th DCA 2003). Insurer can cure its bad faith conduct by accepting the insured’s claim in full as compensable, and agreeing to pay the claim in accordance with the above-referenced Loss Settlement provision prior to the expiration of the cure period; or (2) reach an amicable settlement of the pending claim prior to the expiration of the cure period. By doing either of these two things, the insurer will cure its bad faith in this case, and extinguish any and all of its liability for all bad faith damages which could be sought pursuant to this Civil Remedy Notice.
Comments
User Id Date Added Comment
paydon.broeder@csklegal.com 04-07-2025 March 31, 2025 PEOPLE’S TRUST INSURANCE COMPANY’S RESPONSE TO CIVIL REMEDY NOTICE #810550 VIA EMAIL Mark Kahley, Esq. Payne Law, PLLC 126 E. Jefferson Street Orlando, FL 32081 mark@thepaynelaw.com Re: Case Name: Douglas Vasser v. People's Trust Insurance Company Case Number: 2025CC000037 Our File No. : 0741.1546-00 Dear Mr. Kahley: The undersigned attorneys represent People’s Trust Insurance Company (hereinafter “PTI”) with respect to the above-referenced Civil Remedy Notice of Insurer Violations (hereinafter referred to as “CRN”). This response is provided on behalf of PTI and all of its employees, agents, officers, and affiliates. The Department of Financial Services accepted the CRN on March 11, 2025. Therefore, this response has been timely filed within the statutory deadline. At all times during the investigation and adjustment of the insured’s, Douglas Vasser, claim, PTI has acted in good faith. PTI has also acted fairly and honestly towards the claim and has acted with due regard for the insured’s interests. Moreover, PTI has acted in conformity with all other requirements set forth in §624.155, Florida Statutes. Further, PTI has investigated and adjusted the claim pursuant to the appropriate standards governing the investigation of claims. I. Specificity Requirement Douglas Vasser’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for civil remedy notices, and it fails to meet the requirements of the Statute. Respectfully, PTI requests the Department return the CRN and instruct that Douglas Vasser provide the facts required for civil remedy notices. See Section 624.155(3)(c), Florida Statutes. These requirements arise from the provisions of Section 624.155: (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days' written notice of the violation. If the department returns a notice for lack of specificity, the 60-day time period shall not begin until a proper notice is filed. (b) The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require (emphasis added): 1. The statutory provision, including the specific language of the statute, 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. If the person bringing the civil action is a third-party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specific civil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D. Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad-faith actions, the Legislature provided this sixty day window as a last opportunity for insurers to comply with their claim-handling obligations when a good-faith decision by the insurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1284 (Fla. 2000). Thus, the CRN cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So.2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So.2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”). In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. … Plaintiff’s counsel, during the hearing in this matter, argued a civil remedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiff’s counsel further argued that it was up to the insurer, as the insurance expert, to decipher what actions needed to be cured. This argument, in this Court's estimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing game with the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faith action. This surely is not what the legislature had in mind when it created the civil remedy notice. Accordingly, this Court finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient to provide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be clearer. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So.2d 774, 779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceed against the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. II. The Elements of a Valid Civil Remedy Notice There are at least eight requirements for a valid civil remedy notice. Pursuant to Section 624.155(3)(c)’s requirement that a civil remedy notice must set forth the “facts and circumstances giving rise to the violation,” a valid civil remedy notice must contain the following: 1. “explain how the [insurer] violated [the statutes],” Heritage Corp., 580 F.Supp. 2d at 1299; 2. “explain the amounts of damage at issue caused by the [insurer’s] alleged statutory violations,” rather than caused by the loss itself, Id.; 3. provide the facts showing “knowledge and/or delay on the insurance company’s part,” 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1192 (N.D. Fla. 2008). 4. provide the facts supporting the specific contractual damages allegedly owed rather than merely the policy limits, Id. at 1193; 5. if an inadequate investigation is alleged, the civil remedy notice must be specific enough to allow the insurer to conduct an additional investigation, Nowak v. Lexington Ins. Co., 464 F.Supp.2d 1248, 1252 (S.D. Fla. 2006). Additionally, subsections (3)(a)1., 3., and 4. require: 6. “the statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated;” 7. “the name of any individual involved in the violation;” and 8. “reference to specific policy language that is relevant to the violation.” As noted, the first five requirements mandate the insured to provide specific facts and circumstances of the alleged violations. This would necessarily include specific facts regarding the method of the investigation; the reasons the investigation was improper or otherwise inadequate; the reasons why this alleged inadequacy is due to the failure to adopt and implement standards for the proper investigation of claims, and the facts supporting these conclusions. To allege an inadequate investigation, the Notice must include specific facts regarding the method, rather than merely the results. Valenti, 2006 WL 1627276, at *1. Florida law does not allow an insured, without providing any facts, to allege that the insurer’s only option to avoid bad faith is paying whatever the insured demands. 316, Inc., 625 F.Supp.2d at 1194. Requirements two and four regarding the alleged damages must also be specifically provided in the civil remedy notices. Importantly, the Talat court held that payment of undisputed damages within the cure period is sufficient to preclude a statutory bad faith action. In that circumstance, the insurer has “timely paid ‘the damages’ and has corrected ‘the circumstances giving rise to the violation’ within the meaning of [Section 624.155(2)(d), Florida Statutes].” Id. at 1281. The insurer is not required to pay any compensatory damages that flow from any alleged delay in settling the claim. Importantly, only the contractual benefits are owed during the 60-day cure period. To provide an insurer with the notice of the contractual and extra-contractual damages, Florida law clearly requires facts supporting the amount. Merely requesting policy limits without any basis renders the civil remedy notice invalid. If the civil remedy notice does not satisfy each of the eight elements, it cannot be considered valid pursuant to the Florida case authority cited above. Douglas Vasser’s CRN is deficient for a number of reasons. For starters, the CRN fails to include necessary facts that provide context to their statutory allegations. The aggregate of the CRN’s deficiencies causes the CRN to fall woefully short of providing notice to PTI of any alleged wrongdoing, and these glaring deficiencies deny PTI the ability to cure the alleged wrongdoing within sixty (60) days. III. Factual Background On August 27, 2024, Plaintiff’s claim was reported to PTI by a representative of the insured as wind and hail damage to the roof along with missing and loose shingles and dented gutters, which allegedly occurred on July 16, 2024. Following the reporting of the claim, PTI retained a field adjuster to inspect the subject property on September 16, 2024. During the inspection, the field adjuster observed no wind or hail damages to the roof system. The insured advised the field adjuster that there were no interior damages associated with the claim, and the field adjuster did not observe any damages to the interior. Thereafter on September 19, 2024, PTI issued a coverage determination letter to the Plaintiff, denying the claim in full based on its findings of no physical damage to the roof, exterior, or interior. On November 10, 2024, Plaintiff’s attorney filed a Notice of Intent to Initiate Litigation, including an estimate of damages of $25,257. In response, PTI retained Keystone Experts & Engineers to conduct a reinspection of the property. The engineer conducted the reinspection on December 20, 2024. The engineer found that the roof was not damaged by wind or hail, and any damage to the roof was related to age and deterioration. On the interior, the engineer found moisture stains related to long-term and repeated water infiltration through areas of deteriorated sealant around the chimney and vent pipe, unrelated to any wind damage or storm-created opening. Following the reinspection, on January 15, 2025, PTI issued a stand on denial letter, based in part on the findings of the Keystone Engineer inspection which confirmed the initial coverage decision. IV. The Statutory Allegations Are Without Merit The CRN alleges several statutory violations without adequate facts to support the same. Rather than stating the required specific underlying facts, the CRN simply alleges that any and all actions taken by PTI were wrongful. The factual analysis above, however, implicitly addresses many of the unsupported statutory allegations set forth in the CRN, making it clear that PTI acted fairly in evaluating and thoroughly investigating the claim. Consequently, allegations of claim denial, claim delay, unsatisfactory settlement offer, unfair trade practice, as well as the following statutory allegations are unsupported and entirely without merit. 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. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 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. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has implemented standards for the proper investigation of claims, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim and its communications, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. 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. Douglas Vasser failed to allege facts that support this statutory allegation. PTI has been honest and fair in the evaluation of the claim and its correspondences, and therefore demands that Douglas Vasser provide facts or documentation to support this statutory allegation. Sincerely, /s/ Paydon R. Broeder Paydon R. Broeder Robert J. DeLuca PRB/rjd
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