Civil Remedy Notice of Insurer Violations
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Filing Number:     810871
Filing Accepted:  3/12/2025
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Complainant
Last/Business Name *  
ARCHIBALD   First Name   CONNIE
Street Address * 16935 SE 63 LANE
City, State Zip * OCKLAWAHA, FL 32179
Email Address * ESERVICE@SFLG-PA.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ARCHIBALD   First Name   CONNIE
Policy # * PFL196167-10 Claim #* CFL24607322
Attorney
Attorney is Applicable
Last Name* LOW First Name * MONIQUE Initial A
Street Address* 515 EAST LAS OLAS BOULEVARD, SUITE 1301
City, State Zip* FORT LAUDERDALE , FLORIDA 33301
Email Address * MONIQUE@SFLG-PA.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):* RANDALL MCGUIRE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
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)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
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.

Exceptions to c. (7) Unless the loss is otherwise excluded, we cover loss to property covered under Coverage A and B caused by or resulting from an accidental discharge or overflow of water .... from within a: ii. Plumbing
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of Connie Archibald (the "Insured"). The Insured purchased a homeowner's policy of insurance from PEOPLE'S TRUST INSURANCE COMPANY (PTI"), Policy No.PFL196167-10, effective August 5, 2024 through August 5, 2025 (the "Policy"), which insured the property located at 16935 SE 63rd Lane, Ocklawaha, Florida 32179 (the "Property"). The Insured paid all premiums on said Policy, and the Policy was in full force and effect at all relevant times herein. In consideration of the payment of the premiums, the Policy provides coverage for sudden and accidental direct physical loss to covered property unless the loss is otherwise excluded or limited. On or about October 16, 2024, the subject property sustained water damage as the result of toilet leak, a covered peril, as defined under the Policy. On or about October 30, 2024, the Insured reported the claim to PTI. On December 27, 2024, Randall McGuire issued a letter informing the Insured that PTI was denying her claim because the loss was not covered under the Policy. PTI intentionally and deliberately has sought to avoid providing the Insured all of her due and owing benefits under her Policy, even though it reasonably knew or should have known that insurance proceeds were due and owing to the Insured. Further, this evidences PTI has failed in exercising its duty of good faith and fair dealing to the Insured. The Insured has complied with all requests made by PTI and provided all the information available to the Insured with respect to the loss, including access to the Property. The concept of insurance is that insurance is the insurer's granting of timely and prompt indemnity or security against a contingent loss. Florida Statute Section 624.02 defines "insurance" as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that the Insured may mitigate damages and is placed back into the position the Insured was in prior to the loss, and as quickly as possible. PTI has breached this duty. As PTI must admit, implied within every insurance policy is a duty of good faith and fair dealing. In an insurance contract, each party is prevented from interfering with the other's right to benefit from the contract. The obligations of good faith and fair dealing encompass qualities of decency and humanity inherent in its responsibilities as a fiduciary. PTI is bound to conduct itself with the utmost good faith for the benefit of the Insured. However, PTI has failed to properly comply with the obligations in connection with this claim. Instead, PTI has looked for ways to deny coverage on this claim. These actions have been to the detriment of the Insured. Due to PTI's failure to properly adjust the claim, the Insured was forced to retain the professional services of the undersigned attorney to aid the Insured in obtaining contractual benefits due and owing under the Policy, and to further protect the rights of the Insured. The Insured provided PTI with all necessary documentation in support of her claim. While no specific "cure amount" is required for this Civil remedy Notice to be valid, the Insured will consider the allegations contained herein "cured" if PTI, without any requirement for a release, immediately completes the following in full: (1) tenders Coverage A policy limits; (2) tenders Coverage C policy limits; (3) pays all outstanding statutory interest on the past due amount, pursuant to Florida Statute Section 627.70131(7)(a), as more than 90 days have elapsed since the claim was reported; and (4) tenders payment to the Insured for the reasonable attorney's fees and costs incurred as a result of the actions or inaction perpetrated by PTI. The payment shall be tendered to the Insured's attorneys, South Florida Litigation Group, P.A., at 515 East Las Olas Boulevard, Suite 1301, Fort Lauderdale, Florida 33301. If PTI disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, PTI should cure to the extent it believes it must under the Policy and governing laws to correct the allegations of bad faith contained herein. This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statute, including any and all bad faith/extra contractual damages should PTI fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. The Insured has been and continues to remain cooperative in order to assist PTI with tendering all amounts due and owing under the Policy, and to avoid additional delay, costs and expenses. PTI must act fairly and honestly in its response to the Insured for a prompt, fair and reasonable resolution of the claim.
Comments
User Id Date Added Comment
bfrankel@gmail.com 05-06-2025 On behalf of People’s Trust Insurance Company (hereinafter “PTI”), I am responding to the Civil Remedy Notice filed on behalf of PTI’s insured, Connie Archibald. The Civil Remedy Notice of Insurer Violation submitted lacks specificity and merely tracks the language of the bad faith statutes, citing general allegations of misconduct without setting forth the facts and circumstances giving rise to the alleged violations. The Civil Remedy Notice filed on behalf of Connie Archibald alleges a laundry list of allegations without factual support, and without specificity or telling the insurer how it can “cure” the alleged violations. The carrier maintains that it has not been in violation of the law, and that the above-referenced Civil Remedy Notice filed by Connie Archibald is defective on its face and does not comply with the specificity requirements set forth in Florida Statute §624.155. A simple review of the facts reveals that there was no “bad faith” in the handling of this claim. The first notice of this loss was reported by the insured on October 30, 2024 as a plumbing loss that occurred on or about October 16, 2024. On the same day the claim was reported, PTI issued a Homeowner Bill of Rights letter to the insured, and sent a claim acknowledgment letter, outlining what the insured could expect during the claim process. On November 4, 2024, a licensed field adjuster inspected the property with the insured. At the inspection, the field adjuster observed water damage due to a broken toilet tank. Pursuant to the investigation, PTI took a recorded statement of the insured, in which she advised that the loss occurred while she was out of town between September 28, 2024 and October 29, 2024. On December 27, 2024, a formal coverage determination letter was sent to the insured, in which coverage was denied based on the constant and repeated seepage or leakage exclusion in the policy. Following the claims decision, PTI spoke to the insured, and was told she would forward documents or other evidence showing that someone had been at the property during the time period of September 28, 2024 through October 29, 2024. To date, nothing has been forthcoming. On March 12, 2025, People’s Trust Insurance Company received the Civil Remedy Notice of Insurer Violation filed on behalf of the insured, which generally asserts allegations of misconduct by the insurer in the handling of the claim. Since the time the Civil Remedy Notice was filed, PTI has reached out to the attorney’s office seeking any information that may cause PTI to reconsider its coverage determination. As of the time of this filing, PTI has not received a response. As the Department knows, a Civil Remedy Notice of Insurer Violation is a prerequisite to bringing a bad faith lawsuit against People’s Trust. The March 12, 2025 Civil Remedy Notice contains broad accusations and conclusions without any factual support and fails to meet the specificity requirement set forth in Florida Statute §624.155. Based on these broad allegations, People’s Trust is not aware of the facts surrounding the alleged statutory violations or what the insured believes People’s Trust must do in order to “cure” these allegations within the sixty day safe harbor period. The Civil Remedy Notice alleges that People’s Trust Insurance Company committed, inter alia, the following violations: • Not attempting in good faith to settle all claims when, under all the circumstances, it could and should have done so had it acted fairly and honestly toward the insured and with due regard for her or his interests. With regard this alleged violation, the Notice includes no specific facts as to how PTI has failed to negotiate and settle claims. • Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a clam 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. The notice contains no particularity as to what portions of the policy under which PTI is unreasonably withholding settlement in order to influence settlement under another. • 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 effectuating settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy. The notice contains no particularity as to what the material misrepresentation was, who engaged in the misrepresentation, when it occurred, by what method it occurred (written, spoken, etc.), and to whom the misrepresentation was made. • Failing to adopt and implement standards for the proper investigation of claims. PTI denies this alleged statutory violation and advises that Claimant has not provided any facts to sustain such an allegation. PTI advises that this allegation requires 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 v. Unum Life Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). • Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. The notice contains no particularity as to what facts or policy provisions were misrepresented, who engaged in the misrepresentation, when it occurred, by what method it occurred (written, spoken, etc.), and to whom the misrepresentation was made. • Failing to acknowledge and act promptly upon communications with respect to claims. The Notice fails to identify what communications (who sent, how sent, when, or to whom) to which PTI failed to respond. • Denying claims without conducting reasonable investigations based upon available information. The Notice contains no specificity as to this allegation other than the insured disagrees with the claims decision. • Failing to promptly notify the insured of any additional information necessary for the processing of the claim. The Notice does not contain any specificity as to how the carrier failed to notify the insured of additional information needed to process the claim. In January 2025, the carrier discussed the claims decision with the insured, and the insured advised she would forward evidence that her neighbor was in the house during the month she was out of town. To date, no information has been forthcoming. • Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. The Notice does not contain any specific information in this regard, and the recorded call of January 2025 suggests otherwise, if the insured wishes to refute the claim decision. The above recitations are nothing more than a laundry list of accusations and conclusions without any factual support. Florida Statute §624.155(3)2 requires that a Civil Remedy Notice state with specificity the facts and circumstances that give rise to the alleged violations. A Civil Remedy Notice is not intended to be a guessing game. If the insured maintains that People’s Trust committed the above-listed violations, she must provide specificity as to the facts and circumstances giving rise to these alleged violations. Based on these broad accusations People’s Trust does not know what is being alleged and/or how the insured believes People’s Trust can “cure” all of the alleged violations. Florida Statute §624.155 is not a notice statute. It is intended to advise the carrier of any alleged violations so that it can “cure” them within the statutory “cure period”. A Civil Remedy Notice must be made with sufficient specificity to allow the insurer to understand and to cure any purported violation. Longpoint Condominium Assn. v. Allstate Ins. Co., 2005 WL 1315810 (N.D. Fla.2005). The Civil Remedy Notice filed by Connie Archibald is factually insufficient because there is no specificity regarding the allegations against People’s Trust. Here, the allegations concerning the claim have no nexus with the bad faith statutes listed in the Civil Remedy Notice, thereby presenting a situation that precludes the insurer from understanding what the actual improper conduct in the claims handling may be, and precluding the insurer from adequately or timely responding. Nonetheless, the repairs are currently underway and lines of communication open between counsel for the parties. As shown, PTI has not acted in bad faith but has observed the terms and conditions of the Policy. As discussed above, People’s Trust Insurance Company maintains that it has not been In violation of the law and that the Civil Remedy Notice filed by Connie Archibald is defective on its face and does not comply with the specificity requirements set forth in Florida Statute §624.155. We trust the foregoing fully explains the facts and circumstances of the claim and addresses any concerns raised. If we can provide other information or clarification of information concerning the claim, please do not hesitate to contact the undersigned. Very truly yours, Arielle Molinet Peters Corporate Counsel, Claims/Legal People’s Trust Insurance Company Cc: Monique Low
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