Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 810723

Filing Accepted: 3/12/2025

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Complainant

Last/Business Name *

2505 MANATEE AVE W LLC (GEORGE KEYZER)

First Name

Street Address *

2505 MANATEE AVENUE WEST

City, State Zip *

BRADENTON, FL 34205

Email Address *

GEORGE.KEYZER@GMAIL.COM

Complainant Type: *

Insured

Last/Business Name*		2505 MANATEE AVE W LLC (GEORGE KEYZER)		First Name
Policy # *		N9BP882385		Claim #*		N9BP882385-001-001-001

Attorney

Attorney is Applicable

Last Name*	KRAPF First Name * GRANT Initial W
Street Address*		2790 SUNSET POINT RD
City, State Zip*		CLEARWATER , FL 33759
Email Address *		GRANT@KRAPFLEGAL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		BERKSHIRE HATHAWAY DIRECT INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 10391

Name of individual responsible for violation (if any):* NATE HARWOOD, BEATRICE CHERRY, MIKE KARWOSKI, AND ANY OTHER INDIVIDUAL FROM, OR AGENT OF, BERKSHIRE HATHAWAY DIRECT INSURANCE COMPANY WHO WAS INVOLVED IN THE CLAIM.
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Delay
	Unfair Trade Practice
	Other : Misrepresenting the terms of the insurance policy
	Other : Not treating the Insured with good faith claims conduct
	Other : Looking for ways to deny full recovery to the Insured
	Other : Looking for ways to delay full recovery to the Insured
	Other : Failing to properly investigate the Insured's loss
	Other : Failing to provide the Insured with the full benefits awarded under the contract of insurance in a t
	Other : Not training, supervising, or managing adjusters properly so that prompt and full payments are made
	Other : Not adjusting claims and evaluating loss properly
	Other : Shifting the burden of insuring the loss to the Insured
	Other : Intentionally misstating the terms, conditions, and benefits of the insurance policy to the insured
	Other : Failing to implement proper standards for the adjustment and investigation of claims

* 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.
	626.9541(1)(i)(3)(a)		Failing to adopt and implement standards for the proper investigation of claims.
	626.9541(1)(i)(3)(c)		Failing to acknowledge and act promptly upon communications with respect to claims.
	626.9541(1)(i)(3)(h)		Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

627.70131 (1)(a) - Upon an insurer's receiving a communication with respect to a claim, the insurer shall, within 7 calendar days, review and acknowledge receipt of such communication unless payment is made within that period of time or unless the failure to acknowledge is caused by factors beyond the control of the insurer. If the acknowledgment is not in writing, a notification indicating acknowledgment shall be made in the insurer's claim file and dated. A communication made to or by a representative of an insurer with respect to a claim shall constitute communication to or by the insurer. 627.70131 (3)(a) Unless otherwise provided by the policy of insurance or by law, within 7 days after an insurer receives proof-of-loss statements, the insurer shall begin such investigation as is reasonably necessary unless the failure to begin such investigation is caused by factors beyond the control of the insurer. 627.70131 (3)(b) If such investigation involves a physical inspection of the property, the licensed adjuster assigned by the insurer must provide the policyholder with a printed or electronic document containing his or her name and state adjuster license number. An insurer must conduct any such physical inspection within 30 days after its receipt of the proof-of-loss statements. 627.70131 (3)(e) The insurer must send the policyholder a copy of any detailed estimate of the amount of the loss within 7 days after the estimate is generated by an insurer's adjuster. This paragraph does not require that an insurer create a detailed estimate of the amount of the loss if such estimate is not reasonably necessary as part of the claim investigation. 627.70131(7)(a)Within 60 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer. The insurer shall provide a reasonable explanation in writing to the policyholder of the basis in the insurance policy, in relation to the facts or applicable law, for the payment, denial, or partial denial of a claim. If the insurer's claim payment is less than specified in any insurer's detailed estimate of the amount of the loss, the insurer must provide a reasonable explanation in writing of the difference to the policyholder. Any payment of an initial or supplemental claim or portion of such claim made 60 days after the insurer receives notice of the claim, or made after the expiration of any additional timeframe provided to pay or deny a claim or a portion of a claim made pursuant to an order of the office finding factors beyond the control of the insurer, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured must select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. Reference to specific policy language: The violations alleged are statutorily based and do not rely on any specific policy language. "It is an accepted principle of law that when parties contract upon a matter which is the subject of statutory regulation, the parties are presumed to have entered into their agreement with reference to such statute, which becomes a part of the contract, unless the contract discloses a contrary intention." Westside EKG Assocs. v. Found. Health, 932 So. 2d 214, 216 (Fla. 4th DCA 2005), aff'd, 944 So. 2d 188 (Fla. 2006).

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Berkshire Hathaway Direct Insurance Company (the "Insurer") has committed the following in handling the Insured's claim: 1) failure to act in due diligence and good faith to resolve claims; 2) placing the financial interest of Insurer before that of the policyholder and the Insured; 3) looking for ways to deny benefit payments and otherwise "low ball" or "stone wall" claims; 4) not adjusting the claims promptly and fairly; 5) not attempting in good faith to settle claims; 6) conducting inadequate investigations; 7) failing to employ policies and procedures to conduct adequate investigations; 8) failing to provide an estimate that complies with the Florida Building Codes; 9) shifting the burden of investigating the loss onto the Insured; 10) failing to render a claims determination within sixty (60) days; 11) requesting a re-inspection despite no changes to the above-referenced insured property; 12) failing to acknowledge and act promptly upon communications with respect to claims; 13) failing to clearly explain the nature of the requested information and the reasons why such information is necessary; 14) failing to begin its investigation of the Insured's supplemental claim within 7 days of receiving a proof of loss statement; 15) failing to conduct a physical inspection of the property within 30 days of receiving a proof of loss statement; and 16) failing to provide a copy of the field adjuster's estimate within 7 days of its creation. On or about October 9, 2024, while the subject policy was in full force and effect, the Insured's property was severely damaged by Hurricane Milton. The areas impacted include but are not limited to the roofing system, two interior rooms, exterior as well as damages related to loss of business income. The Insured timely submitted a claim to the Insurer for hurricane damage and the ensuing damage therefrom. Thereafter, the Insurer assigned claim number N9BP882385-001-001-001 to the loss and sent a field adjuster to inspect the property on October 13, 2024. Thereafter, the field adjuster prepared an estimate which he completed on October 24, 2024. The Insurer violated Fla. Stat. 627.70131 (3)(e) by failing to provide a copy of this estimate to the Insured within 7 days. Then the Insurer sent a letter dated November 11, 2024, which acknowledged the Insured's notice of loss submitted a month prior. The Insurer also requested the Insured send a "breakdown of the repair estimate regarding the windows, roof, and drywall." The Insurer violated Fla. Stat. 626.9541(1)(i)(3)(h) by failing to clearly explain the nature of the requested information and the reasons why such information was necessary. The Insurer repeated its request on December 13, 2024, and January 15, 2025,--both times again failing to explain why this information was required or necessary for the Insurer to investigate the claim, especially after it had already inspected the property. Furthermore, the Insurer was improperly shifting the burden to investigate the claim onto the Insured by trying to require the Insurer to get a contractor to amend his invoice something not in the Insured's control. Finally, in a letter dated January 15, 2025, the Insurer notified the Insured that it was extending coverage for the loss. However, the Insurer wrongfully determined that it would only require $10,002.09 to restore the insured property to its pre-loss condition. The Insurer's lowball estimate is that of a classic under scope and under value of the claim. Given the vastly underestimated cost of repairs, the Insured's disagreement with the coverage decision, and the scope and nature of the damage resulting from Hurricane Milton, the Insured retained a public adjuster. On January 25, 2025, the public adjuster sent the Insurer a repair estimate, photographic evidence of the damage, and a sworn proof of loss. The public adjuster also sent his own version of an itemized invoice for the contractor's invoice which the Insurer had requested. The public adjuster calculated the replacement cost value of the loss at $45,196.08. On January 28, 2025, the public adjuster requested an update on the claim and a plan of action moving forward. On January 30, 2025, the Insurer responded that a local field adjuster may need to perform a reinspection. On February 12, 2025, the public adjuster sent an email advising that he had not received a response to his request for an update on the claim. The Insurer had violated Fla. Stat. 627.70131 (1)(a) by failing to respond to the public adjuster's communication within 7 days. Furthermore, the Insurer violated Fla. Stat. 627.70131 (3)(a). This statute required the Insurer to being such investigation as was reasonably necessary within 7 days of receiving the sworn proof of loss. By February 12, 2025, the Insurer had not assigned a field adjuster to reinspect the property or even attempt to schedule the same. It was also unclear whether a reinspection was even required. To date, the Insurer has not reinspected the property with a field adjuster or an engineer, as it requested, in violation of Fla. Stat. 627.70131 (3)(b). This statute requires the Insurer to conduct any such physical inspection within 30 days after its receipt of the poof of loss statement. Upon receiving notice of the loss, the Insurer had the duty to provide the full benefits under the policy. This includes providing the Insured with a proper investigation and the funds necessary to return the home to its pre-loss condition. However, when the Insurer conducted its inspection of the insured property, the Insurer's adjuster failed to conduct a thorough and adequate investigation, or the adjuster intentionally ignored the damage observed and failed to make truthful and unbiased reports of the facts after investigating. As a result, the Insurer breached the policy by failing to fully indemnify the Insured for the covered loss. Additionally, although there was interior water damage the adjuster did not use a moisture meter. A moisture meter can be purchased online from Amazon for around $40 before tax. The Insurer could purchase a moisture meter and assess thousands of properties with one meter. Instead, the Insurer would rather place its financial interests over those of the Insured by failing to provide the adjuster with the necessary tools to correctly inspect the loss. As a result of the inadequate investigation and surrounding circumstances it is apparent that Insurer significantly underestimated the scope of the loss to the Insured's property. Insurer and its adjuster have colluded to misrepresent the true scope of damages to the insured property and the true replacement costs of the damages. This is an underhanded attempt to place the financial interest of Insurer over those of the Insured, to delay the Insured's claim, and to delay the Insured in restoring his property to its pre-loss condition. Rather than the Insurer pay for a roof replacement consistent with all laws and ordinances, the Insurer contends the roof is repairable which is not true. All repairs to the roofing system must be done in accordance with applicable Florida Building Codes which require all repairs be done consistent with the manufacturer's specifications and warranties which this Insurer clearly did not account for. The Insurer has placed obstacles to its Insured's ability to have the claim adjusted promptly to begin restoring the home by waiting more than sixty (60) days after receiving notice of the Insured's claim to make a claims determination. The Insured first reported the loss in October 2024. The Insurer rendered its claims determination on January 15, 2025. Under Fla. Stat. 627.70131(7)(a), "[w]ithin 60 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer." There were no factors outside of the Insurer's control. As such, in addition to the below requirements to cure this CRN, any payment made to the Insured must contain interest for the damage as a result of the loss from the date the Insurer received first notice of the loss. There may be further wrongful conduct which has not been made known to the Insured at this moment. Certain conduct or actions may be discovered throughout discovery or cannot be verified without a review of the Insurer's claim file and standards and procedures for the adjustment and investigation of claims. In short, the Insurer is not acting with due regard for the Insured's interests or safety. In Florida the work of adjusting insurance claims engages the public trust. The Insurer has breached this trust and its duty to the Insured. The Insurer and its agents conducted cursory and inadequate investigations and wrongfully determined that it would only require $10,002.09 to restore the insured property to its pre-loss condition. Moreover, the Insurer has engaged in bad faith practices designed to delay claims and prevent the Insured from recovering what is rightfully owed under the subject policy of insurance. The Insurer's actions and inactions have continued to frustrate and delay the resolution of the Insured claim. The Insurer's actions amount to but are not limited to the following: 1. Claim delay 2. Not treating the Insured with good faith claims conduct 3. Looking for way to reduce recovery to the Insured 4. Looking for ways to deny recovery to the Insured 5. Not adjusting claims and evaluating loss properly, promptly and fairly to provide full and prompt indemnity to the Insured 6. Not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company's interests before the Insured's interests 7. Placing the financial interest of the Insurer over that of the health and safety of the Insured 8. Failing to provide an estimate that complies with the Florida Building Codes 9. Shifting the burden of investigating onto the Insured 10. Conducting inadequate investigations 11. Failing to render a written claims determination to the Insured within 60 days 12. Failing to acknowledge and act promptly upon communications with respect to claims 13. Failing to clearly explain the nature of the requested information and the reasons why such information is necessary 14. Failing to begin its investigation of the Insured's supplemental claim within 7 days of receiving a proof of loss statement 15. Failing to conduct a physical inspection of the property within 30 days of receiving a proof of loss statement 16. Failing to provide a copy of the field adjuster's estimate within 7 days of its creation. Therefore, to cure the defects outlined in this civil remedy notice, the Insurer must: (1). Admit full coverage for the Insured's loss. (2). Tender full benefits owed to the Insured under the insurance contract. A copy of this form submitted to the FDFS has been sent via e-mail to the following parties providing them notice of the filing of the civil remedy notice. Please e-mail any response to this civil remedy notice to badfaith@krapflegal.com. Via E-mail: Berkshire Hathaway Direct Insurance Company P.O. Box 3300 Wilkes-Barre, PA 18773 claims@biberk.com

Comments

User Id		Date Added		Comment
grant@krapflegal.com		08-26-2026		The details herein have been amicably resolved between the parties; therefore, we withdraw this Civil Remedy Notice. This Civil Remedy Notice is hereby withdrawn.
phernandez@hinshawlaw.com		05-09-2025		Hinshaw & Culbertson LLP, on behalf of Berkshire Hathaway Direct Insurance Company, responded to the Civil Remedy Notice in correspondence dated May 9, 2025, to 2505 Manatee Ave W LLC c/o Grant W. Krapf, Esq. denying it acted in bad faith.

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. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008