Civil Remedy Notice of Insurer Violations
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Filing Number:     810663
Filing Accepted:  3/12/2025
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Complainant
Last/Business Name *  
BLANTON   First Name   JARRED
Street Address * 5361 MYAKKA VALLEY TRL.
City, State Zip * SARASOTA, FL 34241
Email Address * SERVICE@PROPERTYPEOPLELAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BLANTON   First Name   JARRED
Policy # * FLE013281 Claim #* N010035935
Attorney
Attorney is Applicable
Last Name* ILANI First Name * DANIEL Initial
Street Address* 80 SW 8TH STREET, SUITE 2590
City, State Zip* MIAMI , FLORIDA 33130
Email Address * SERVICE@PROPERTYPEOPLELAW.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):* ALL ADJUSTERS, SUPERVISORS, MANAGERS, ATTORNEYS, AND INDIVIDUALS ASSOCIATED WITH AND/OR RETAINED BY HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY CONCERNING THE CLAIM AT ISSUES; HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY’S DESK ADJUSTER(S); HERI
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)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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)(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.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY (hereinafter the “Insurance Company”) issued a homeowners insurance policy to its insured, JARRED BLANTON & SUZAN WATSON (the “Insured”), for the insured property located at 5361 Myakka Valley Trl., Sarasota, FL 34241. The subject Policy afforded various types of coverages including coverage for damage to dwelling, other structures, personal property, and for loss of use. On or about October 9, 2024, while the subject Policy was in full force and effect, the Insured’s home was damaged as a result of a covered loss. The Insured subsequently notified the Insurance Company of this loss. Thereafter, the Insurance Company acknowledged the loss and assigned claim number N010035935 to the loss. The Insured complied with all policy conditions and cooperated with the Insurance Company’s investigation efforts. The Insurance Company performed a cursory inspection and failed to retain the unbiased experts necessary to adequately inspect the property to restore the property to its pre-loss condition. Shortly after, the insurance company denied this loss based upon an unqualified evaluation of the damages. Notably, the Insurance Company failed to retain an expert to inspect the property to fully evaluate this claim, relying solely on an inadequate inspection concerning a subject matter and claim their representative is ill-equipped and unqualified to properly evaluate. The Insured and Insured’s representative provided the Insurance Company with all claim-related documents including an estimate to repair covered damages in the amount of $135,885.13 and other supporting documentation and/or information. Nonetheless, the Insurance Company continues to disregard and ignore the Insured’s claim and request for adequate payment. The Insurance Company has failed to issue proper payment for the claim and has failed to issue sufficient payment to compensate the Insured for damages and repairs covered by the policy and held to be contractually covered by Florida law. The Insured provided the Insurance Company with documentation evaluating the loss, and rather than issuing the proper payment or attempting to reach an agreement with its Insured, the Insurance Company is delaying and denying the claim. Upon information and belief, the Insurance Company performs the subject actions as a business practice, including delaying the claim and/or issuing insufficient payments in an attempt to dissuade its insured from pursuing the claim to the detriment of its insured to increase financial profits. Based upon self-serving conclusions regarding the cause of loss, the Insurance Company’s conclusions are disconcerting because they are demonstrably incorrect. Further, they directly conflict with the only first-hand accounts of the loss. To be clear, the Insured had personal knowledge of the condition of the property prior to the date of the loss and the amounts owed to make the necessary repairs. That said, the Insurance Company’s refusal to properly investigate, adjust, and fully compensate the Insured for their claim evidences the Insurance Company’s violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, which requires the Insurance Company to “adopt and implement standards for the proper investigation of claims.” All available information leads to one conclusion—the Insured’s property was damaged by a covered cause of loss for which the Insured is entitled to full and complete compensation. The Insurance Company’s obligation to promptly settle the Insured’s claim is undeniable, and therefore, the Insurance Company has also violated sections 624.155(1)(b)(1), Florida Statutes. The Insurance Company’s conduct is egregious because the Insurance Company purposely ignored relevant facts, even facts from its own experts, that would have confirmed coverage for the Insured’s loss to avoid having to compensate the Insured for damages. To make matters even worse, the Insurance Company has failed to timely respond to the Insured and issue payment for the damages to the property to allow necessary repairs. The actions taken by the Insurance Company in the handling and adjustment of the Insured’s claim are willful, wanton, and in disregard for the rights of the Insured, and have occurred with such frequency as to indicate a general business practice in violation of the law. The practice includes the Insurance Company’s ongoing inaction of ignoring relevant and accessible information that supports coverage in order to avoid compensating its Insured for covered losses. To be clear, the recent ruling in Fortune v. First Protective Insurance Company d/b/a Frontline Insurance, out of Florida’s 2nd District Court of Appeal, clears up what this carrier must do the cure this CRN. Similar to here, In Fortune, the Insureds timely filed a claim with their homeowners insurance policy upon suffering damage to their property. The Insurer investigated the claim and denied, contending that the amount of damage did not exceed the Insureds’ deductible. Upon presenting the public adjuster’s estimate and all other materials to the insurance company, the Insurer invoked the appraisal process under the policy.Thereafter, the Insureds filed a Civil Remedy Notice alleging that the insurer made a lowball offer and “flagrantly breached” its duty to attempt in good faith to settle claims, under applicable Florida statutes. Additionally, the Insureds alleged that the Insurer refused to reassess its payment of benefits and the basis for payment and that the Insurer “turn[ed] a blindeye and refuse[d] to properly adjust and settle the claim.” Noteworthy in Fortune is that although the Homeowners' CRN did not state a specific cure amount, it did state that they had provided their public adjustor's estimate to the Insurer which covered "the full scope of necessary repairs to the direct and ensuing damages." Thus, the Insured had the public adjuster's estimate and knew the amount the Homeowners sought. Neither the statute nor this court's precedent requires the CRN to contain a specific amount sought to cure the alleged bad faith. See § 624.155(3)(b); see Hunt v. State Farm Fla. Ins. Co., 112 So. 3d 547, 549 (Fla. 2d DCA 2013) (recognizing that an appraisal award satisfies the condition precedent of "a determination of liability and extent of damages owed"). In addition to the above statutory violations, the Insurance Company’s adjuster violated the following ethical requirements of Florida Administrative Code 69B-220.201. (3) Code of Ethics…An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: (b) An adjuster shall treat all claimants equally. 2. An adjuster shall adjust all claims strictly in accordance with the insurance contract. (c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. (d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. (f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. (o) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. In Florida, the work of adjusting insurance claims engages the public trust. During the adjustment of the Insured’s claim, the Insurance Company breached this duty by failing to adhere to and comply with the above referenced obligations. To cure the defects outlined above, the Insurance Company must: 1. Immediately pay the Insured a cure of $135,885.13for losses suffered as a result of the claim; 2. Immediately issue payments for statutory interest for the late payments and owed profit/overhead; 3. Act fairly and honestly towards the Insured and with due regard for their interests; 4. Hire a fair and unbiassed adjuster and experts to properly assess the Insured’s damages; 5. Tender any additional insurance proceeds due and owing to the Insured that would reasonably place the Insured back into a pre-loss condition; 6. Timely adjust the claim with the insured and avoid/limit any additional delay, costs, and prejudice that the Insurance Company’s conduct above has caused and continues to cause the Insured; and 7. Compensate the Insured for the attorneys’ fees and costs accrued as a result of the Insurance Company’s bad faith conduct. Failure to cure all defects during the 60-day safe harbor period may result in additional extra-contractual damages.
Comments
User Id Date Added Comment
ncarlisle@heritagepci.com 04-30-2025 April 30, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainant: Jarred Blanton Insured: Jarred Blanton Insurer: Heritage Property & Casualty Insurance Company DFS File No.: 810663 Claim No: N010035935 Policy No.: FLE013281 Address: 5361 Myakka Valley Trl., Sarasota, FL 34241 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 810663, filed on behalf of Jarred Blanton (“Complainant”). The Department accepted the Notice on March 12, 2025. As a preliminary matter, Heritage cannot confirm that the Notice pertains to the claim or insurance policy indemnified by Heritage because the Notice alleges material facts, including the name of an insured, the claim number, or a policy number on record associated with a claim filed with Heritage. Heritage has no record of an insurance contract with Jarred Blanton. Heritage has no record of claim number N010035935. Heritage has no record of Policy number FLE013281. As a result, Heritage is unable to respond to the Complainant’s allegations adequately or even confirm the Notice’s validity. The Notice mistakenly refers to a loss reported to Heritage under a policy issued by Heritage, but in fact, the policy that is the subject of the Notice was issued by Narragansett Bay Insurance Company (hereafter, "NBIC”). Moreover, the policy number FLE013281 is an NBIC policy number, and the claim number N010035935 is an NBIC claim number. Therefore, the Notice is deficient as a matter of law and should be returned by the Department. Although Heritage and NBIC are both insurance companies and share the same parent company, they are two separate and distinct legal entities. NBIC is a wholly owned subsidiary of Heritage Insurance Holdings, Inc., which is a different entity from Heritage. They each issue their own policies. To the extent this Notice was intended to be given under a claim filed and adjusted by NBIC, then this Notice should be withdrawn and refiled against the intended insurer, NBIC. Additionally, it should be noted that if the Complainant is filing this Notice as a condition precedent to a civil action pursuant to Fla. Stat. 624.155, the Notice is inapplicable considering that the NBIC policy contains a forum selection clause whereby suits arising under the policy fall within the exclusive jurisdiction of Rhode Island, and any litigation must be filed in Rhode Island, subject to Rhode Island law. Notwithstanding the deficiencies, through research, Heritage informs that the claim underlying this Notice was settled between NBIC and the Complainant’s representatives on or about March 21, 2025. The release was executed, and payment was issued based on the terms of the settlement. As a condition of the settlement, the Complainant was to withdraw CRN 810663. Notwithstanding the settlement, Heritage 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. Further, the Notice failed to identify the “persons representing” from the Claims department, which supervisor, management, agents, and adjuster, including following representative and adjusters, and vendors who are most responsible for knowledgeable of the facts giving rise to the allegation in the Notice, as explicitly required. First, 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 NBIC’s adjustment of this claim. 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. Moreover, 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. The Notice is legally insufficient because it indicates that the specific policy provision includes “loss settlement and loss payment provisions of the policy,” without specifying which provisions were violated. Therefore, the Notice failed to provide sufficient notice to NBIC of which policy provision was violated. Additionally, the Notice states that the Complainant demands attorney fees and costs, which is an improper component of the cure. Further, the Notice failed to indicate the correct insurer and the insurer’s address, as required explicitly by Florida Law. As such, the Notice does not comply with Florida law and is legally insufficient. Notwithstanding the deficiencies and settlement, for clarification, NBIC provides a brief history of the claim: Subject to its terms, endorsements, limitations, exclusions, and conditions, the Complainant was issued Policy FLE013281 for property located at 5361 Myakka Valley Trl., Sarasota, FL 34241 by NBIC. 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 November 7, 2024, claiming damages from Hurricane Milton that occurred on October 9, 2024, NBCI promptly assigned claim number N010035935. On the same day, an acknowledgement letter was issued to Complainant. Moving forward, NBIC’s representative coordinated an inspection of the damage caused by the alleged hurricane. The Complainant requested the inspection to occur on November 13, 2024, and the on-site inspection documented the exterior conditions of the property. Due to Complainant’s refusal, the interior inspection did not occur. On December 16, 2024, NBIC received a letter of representation by Mubarak, Sherif & Oladipo, PLLC, on behalf of the Complainant. NBIC acknowledged the letter soon after. November 30, 2024, after conducting a reasonable investigation based on available information to NBIC, and in accordance with its obligations under §627.70131, Fla. Stat., NBIC issued a letter including a written explanation of the coverage decision to Complainant, which included pertinent facts and insurance policy provisions relating to coverages at issue. The letter explained that based on the field adjuster's estimate for repairs to the dwelling, and additional coverages assessed for the loss, a gross loss of $39,237.42 was evaluated for the loss. A net payment of $ 17,900.97 was later issued, considering other deductions. Following the letter, Complainant’s representative submitted documentation in support of the claim, such as an estimate, additional photographs, and a Sworn Statement in Proof of Loss. On March 12, 2025, on behalf of the Complainant, Property People Law submitted this Notice, which NBIC now submits in response. On March 21, 2025, the parties settled. In accordance with Fla. Stat. §624.155, the Civil Remedy Notice requires 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 who, how, and when a “claim denial” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put NBIC on the requisite notice. The claim was adjusted in a timely manner, following all statutory requirements. Claim Delay The Notice fails to state who, how, and when a “claim delay” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put NBIC on the requisite notice. The claim was adjusted in a timely manner, following all statutory requirements. Unsatisfactory Settlement Offer The Notice fails to state who, how, and when a “claim delay” practice occurred; therefore, it lacks the specificity required by Florida Statute 624.155 and thus does not put NBIC on the requisite notice. The claim was adjusted in a timely manner, following all statutory requirements. 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 NBIC on the requisite notice. Further, the Notice filed in this matter alleges NBIC violated the following statutory provisions: 1. 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: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. The documentation and information received and obtained by NBIC in its investigation of Complainant’s claim do not support a covered loss as demanded by Complainant. Nonetheless, the claim has been settled with Complainant’s representatives. Therefore, this is an unsupported, sweeping allegation and is without merit. 2. 624.155(1)(b)(2): Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. The documentation and information received and obtained by NBIC in its investigation of Complainant’s claim do not support a covered loss as demanded by Complainant. Therefore, this is an unsupported, sweeping allegation and is without merit. 3. 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: NBIC denies the allegations contained herein. The claim has been settled between the parties. Therefore, the above allegations are not applicable. Accordingly, and as indicated by the facts stated above, NBIC 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 during its investigation of the claim and the subject policy. Therefore, this is an unsupported, sweeping allegation and is without merit. 4. 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: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. The documentation and information received and obtained in its investigation of Complainant’s claim do not support a covered loss as demanded by Complainant. Further, the Notice fails to specifically identify the “material misrepresentation…” allegedly committed by NBIC. Therefore, this is an unsupported, sweeping allegation and is without merit. 5. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 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. Additionally, the Notice fails to specifically identify how NBIC failed “to adopt and implement standards for the proper investigation of claims.” Therefore, this is an unsupported, sweeping allegation and is without merit. 6. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. Further, the Notice fails to specifically identify the “misrepresenting facts or insurance policy provision” allegedly committed by NBIC. Therefore, this is an unsupported, sweeping allegation and is without merit. 7. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has always promptly acknowledged communications and acted promptly in furtherance of the resolutions of the claim. Further, the Notice fails to specifically identify instances where NBIC failed “to acknowledge and act promptly upon communications.” Therefore, this is an unsupported, sweeping allegation and is without merit. 8. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC 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 NBIC during its investigation of the claim and the subject policy. Further, the Notice fails to specifically identify instances where NBIC did not conduct “reasonable investigations based upon available information.” Therefore, this is an unsupported, sweeping allegation and is without merit. 9. 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. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has acted promptly in furtherance of the resolutions of the claim Further, the Notice failed to specifically identify instances where NBIC failed “to affirm or deny full or partial coverage of claims” or failed “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.” Therefore, this allegation is an unsupported, sweeping allegation, and without merit. 10. 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. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. The documentation and information received and obtained by Heritage in its investigation of Complainant’s claim do not support a covered loss as demanded by Complainant. Further, the Notice failed to specifically identify instances where NBIC failed “to promptly provide a reasonable explanation in writing to the insured [. . .].” Therefore, this allegation is an unsupported, sweeping allegation and without merit. 11. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has at all times acted fairly and honestly. Further, NBIC 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 during its investigation of the claim and the subject policy. The documentation and information received and obtained in its investigation of Complainant’s claim do not support a covered loss as demanded by Complainant. Further, the Notice failed to specifically identify instances where NBIC failed “to promptly notify the insured of any additional information necessary for the processing of a claim [. . .].” Therefore, this allegation is an unsupported, sweeping allegation and without merit. 12. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. Response: NBIC denies the allegations contained herein. Accordingly, and as indicated by the facts stated above, NBIC has always promptly communicated and provided a reasonable explanation for the nature of the requested information. Each and every document requested was intended to substantiate the claim and provide information as to whether coverage existed for the reported loss. Therefore, this is an unsupported, sweeping allegation and is without merit. 13. 626.9541(1)(i)(3)(i): Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). Response: The allegations do not apply to this claim. Therefore, this is an unsupported, sweeping allegation and is without merit. As detailed by the facts stated above, NBIC did not violate any of the statutes mentioned above sections. NBIC has diligently and thoroughly investigated the subject claim, followed up with Complainant for documents supporting their claim, provided a coverage determination, and settled the claim with the representatives. 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). The Florida Supreme Court has held that an insurer's appropriate response to a Civil Remedy Notice filed pursuant to Fla. Stat. 624.155 is “based upon the insurer's good-faith evaluation of what is owed on the insurance contract.” Vest v. Travelers Ins. Co., 753 So. 2d 1270, 1275 (Fla 2000). The Court further stated, “What is owed on the contract is . . . governed by whether all conditions precedent for payment contained within the policy have been met.” Id. For its part, an insurer “must evaluate a claim based upon proof of loss required by the policy and its expertise in advance of a determination by a court or arbitration.” Id. at 1275-76. See also Julien. NBIC’s position is that it has complied, in good faith, with these obligations. 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 Complainants. 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. In short, 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 NBIC 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, NBIC is entitled not only to a clear proposed solution, but also more and accurate details about how NBIC 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. NBIC 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, NBIC denies all allegations contained in the Notice and submits there are no violations. While this response is meant to be comprehensive, NBIC’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 NBIC does not have all the facts, please inform NBIC immediately. In closing, NBIC denies each and every assertion of bad faith in the Notice. And, notwithstanding the foregoing, nothing in this letter should be construed as a waiver or surrender of the policy terms, limitations, exclusions, conditions or agreements, nor should this letter be considered an exhaustive recitation of the deficiencies in the Notice. NBIC reserves the right to supplement its response at a later time. Should the Department have any questions, concerns, or require any additional information regarding this matter, please feel free to contact the undersigned at your convenience. Sincerely, /s/ Priscila Ferreira Priscila Ferreira, Esq. Claims Counsel Narragansett Bay Insurance Company
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