Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 811271

Filing Accepted: 3/14/2025

Print Filing

Complainant

Last/Business Name *

BUDRIS

First Name

REGINA & MARK

Street Address *

45 OSTER COURT

City, State Zip *

CAPTIVA, FL 33924

Email Address *

RS@WEKLAW.COM

Complainant Type: *

Insured

Last/Business Name*		BUDRIS		First Name		REGINA & MARK
Policy # *		HCPC-HO3-332667-11		Claim #*		9210022

Attorney

Attorney is Applicable

Last Name*	SUGATHAPALA First Name * RUWAN Initial
Street Address*		800 EAST BROWARD BLVD., SUITE 500
City, State Zip*		FORT LAUDERDALE , FLORIDA 33301
Email Address *		RS@WEKLAW.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		HOMEOWNERS CHOICE PROPERTY & CASUALTY INSURANCE COMPANY, INC.
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 12944

Name of individual responsible for violation (if any):* BASIL RILEY,
Type of Insurance * Residential Property & Casualty

Reason for Notice *

	Claim Denial
	Claim Delay
	Unsatisfactory Settlement Offer

* 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)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.

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

COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property. 5. Fungi," Wet Or Dry Rot, Yeast Or Bacteria. a. We will pay up to $10,000 for: (1) The total of all loss payable under Section I – Property Coverages caused by "fungi," wet or dry rot, yeast or bacteria; 10. Loss Payment. We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment.

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

This Civil Remedy Notice of Insurer Violation (hereinafter “CRN”) is being submitted on behalf of Regina Budris and Mark Budris as against their insurance company, Homeowner’s Choice Property & Casualty Insurance Company, Inc. As of the submission of this CRN, and as shall be demonstrated in further detail below, the insurance company has violated multiple bad-faith statutes by not attempting, in good faith, to settle the insured’s claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly towards the insured and with due regard for their interests. The commission of these violations has been known to Homeowner’s Choice dating back to at least December 2022 and likely earlier and even now, with the information known to Homeowner’s Choice, instead of immediately seeking to cure these violations, instead continues to draw out litigation and take unnecessary discovery in a drawn-out legal battle to the detriment of its insureds. The specific facts are as follows: Regina Budris and Mark Budris (the "Insureds") purchased an insurance policy ("Policy") from Homeowner’s Choice Property & Casualty Insurance Company, Inc. ("Homeowner’s Choice"), with effective coverage on the date of the loss, on or about September 28, 2022, and policy number HCPC-HO3-332667-11 to insure their home located at 45 Oster Court, Captiva, FL 33924 (the "Property"). On or about September 28, 2022, the aforementioned Property suffered severe damage as the result of the devastating Hurricane Ian, which caused damages to the Property, including but not limited to the exterior of the property. The Insured promptly reported their claim to Homeowner’s Choice. Homeowner’s Choice acknowledged receipt of the claim by generating claim number 9210022. As required, Homeowner’s Choice went to inspect the property and generated an evaluation of the damage. Homeowner’s Choice advised the Insureds to make any reasonable and necessary repairs. Homeowner’s Choice initial valuation of damage was estimated to be merely $9,278.78 as per an estimate dated from November 2022, immediately following the storm’s aftermath. Nearly a year later, Homeowner’s Choice supplemented the Insureds’ loss with an estimate of approximately $37,600 per an estimate dated approximately September 2023. The initial value of loss by the insurance company was deemed to be less than the deductible, despite a finding that roof damage was caused by the hurricane. The adjusters who made the determinations as to the extent and scope of damage did so without a full investigation and based on haphazard, cut-short inspections with no regard for the complexity of damage and repair process of damage sustained by the storm. Throughout the process of navigating the devastating loss and complex insurance claim, the Insureds attempted on countless occasions to seek guidance, response, and information from the insurance company which included submission of contractor evaluations of their damage. Upon information and belief, Homeowner’s Choice failed to process the submission of claim-related documentation supporting the extent of damage. Homeowner’s Choice appears to have also during the claim investigation erroneously closed the Insureds’ claim which was later discovered. Upon information and belief, Homeowner’s Choice was woefully understaffed and under equipped to handle the processing of claims such as that of the Insureds following Hurricane Ian. The facts as alleged herein are known to have occurred on a wide-scale basis to many Homeowner’s Choice insureds in and around the West Coast of Florida. The Property sustained damage that is attributed to the insurance company’s lacking investigation, low-ball evaluation of damage, and delay in timely processing the claim, including moisture and mold damage that pose a threat to the health and safety of the Insureds. The Insureds in fact asked about what repairs were needed to be done based on the complex and complicated insurance estimate(s) prepared using industry-accepted Xactimate software. In fact, the Insureds asked the insurance company about specific line-item breakdowns to properly determine what steps should be taken only to be told this is confidential information. In some instances, the Insureds supplied information to the insurance company concerning the inability to effectuate repairs due to the materials or supplies that was ignored or otherwise unaccounted for by Homeowner’s Choice. The Insureds supplied construction bids or proposals for work to advise the insurance company that the estimates it had prepared for the damage were insufficient to address and remedy and properly indemnify for the losses sustained – including from StrikeForce, Chimney Cricket, Tangent Technologies, LLC, John Grey Painting, and Mold Experts of SWFL among others. By March of 2024, the Insureds supplied Homeowner’s Choice with a breakdown and detailed explanation of exactly what was in dispute and where they believed the insurance company undervalued the claim or failed to consider costs, labor, and logistics of servicing the area where the Property is located. Ultimately, the Insureds representing themselves, were forced to retain the services of a public adjuster to assist in pursuing the rightful outcome of the claim and retained OceanPoint Claims Company. The Insureds and their public adjuster proceeded to a pre-suit mediation that proved unsuccessful. Homeowner’s Choice’s blatantly insufficient coverage decision has resulted in further damages to the Insured by preventing them from returning their Property to its pre-loss condition, rather than participating in the settlement process in good faith. As a direct consequence of Homeowner’s Choice’s failure to adjust this loss in good faith and pay what it owed under the policy, the Insureds are continuing to sustain considerable hardship. Homeowner’s Choice continues to this day to engage in bad faith and is aware of the fact that their own agent admits to there being covered damage that Homeowner Choice is unwilling to pay for. Homeowner’s Choice has violated Florida Statute § 624.155(1)(b)(1) by continuously not attempting in good faith to settle this claim when it should have done so if it had acted fairly and honestly towards its Insured. Homeowner’s Choice has also violated Florida Statute § 624.155(1)(b)(3) by failing to promptly settle this obviously covered claim to influence settlement in its favor. Despite being presented all of the indisputable evidence of the amount of damage sustained by this Property, it is a disgrace that the Insured have been treated in this manner by their insurance company after sustaining an obviously covered loss, submitting to every demand of Homeowner’s Choice, and making a good faith effort to resolve in an attempt to amicably come to a fair resolution. Homeowner’s Choice violated Florida Statutes § 626.9541(1)(i)(2) and § 626.9541(1)(i)(3)(b) by making material misrepresentations to the Insured for the purpose and with the intent to settle the claim on less favorable terms than those provided and contemplated by the policy. While Homeowner’s Choice was made aware, and even admits to knowing, of this information for the purpose of obtaining the money contractually owed to the Insured, Homeowner’s Choice wantonly disregards these facts, knowing all too well the additional damage and hardship that is being placed on the Insured by its actions. Homeowner’s Choice violated § 626.9541(1)(i)(3)(a) when it failed to adopt and implement standards for the proper investigations of claims. Under no circumstances is there an excuse for the lack of care and utter disregard for the investigations in this case. Homeowner’s Choice and their representatives are willfully blind and grossly underqualified to handle a loss such as the one sustained by the Insured. In addition, after being placed on notice as to the blatant underpayment of the Insured’ claim, Homeowner’s Choice has yet to rectify their actions and do right by the Insured by paying the money they are contractually owed. There still has yet to be significant action taken by Homeowner’s Choice to this date, despite Homeowner’s Choice being presented with the incongruencies in their farcical rationale for underpaying the Insureds. As demonstrated above, Homeowner’s Choice has known of covered damage it did not pay or properly adjust, resolving to pay only a fraction of covered loss. Homeowner’s Choice violated § 626.9541(1)(i)(3)(g) by failing to promptly notify the Insured of any additional information necessary for processing the claim. The Insured have more than complied with each and every request and there has still been no action by Homeowner’s Choice. In the event Homeowner’s Choice is in need of additional information, they have failed to promptly notify the Insured in a timely manner. This pattern of behavior is perpetuated by Homeowner’s Choice and their representatives undeterred by the Ethical Requirements that are imposed by law on all Adjusters. Fla. Admin. Code Ann. R. (3) explicitly states the adjustment of insurance claims engage the trust of the public, and therefore, an adjuster has a duty of fair and honest treatment of the Insured throughout the insurance claim process. Several duties and responsibilities to the Insured were violated in the handling of this claim, which are specifically listed responsibilities of an Adjuster in the Florida Administrative Code. These breached duties and responsibilities include adjusters from Homeowner’s Choice approaching the investigation and settlement in a manner prejudicial to the Insured, failing to allow a fair settlement with the Insured, and acting with due diligence in achieving a proper disposition of the claim. In contrast to the legislative intent motivating the enumeration of an Adjuster’s responsibilities outlined in the Administrative Code, the Insured were not afforded the professional duties entrusted on Homeowner’s Choice by the public. To date, Homeowner’s Choice has failed to adequately compensate the Insured for the damage that occurred on September 28, 2022. As a direct result of Homeowner’s Choice’s delay, the Insured were forced to seek the help of legal counsel to assist them. Due to the amount of time that has passed since the date of loss, this acknowledgement is evidence that Homeowner’s Choice knowingly and intentionally are delaying the claims process in order to further disadvantage the Insured. The financial detriment caused to the Insured is a direct result of Homeowner’s Choice’s reckless delay of the claim process. The Insured are dutiful customers who made it a priority to pay their insurance premiums to ensure that in such an event as this devastating incident, their home would be covered. The Insured timely filed their claim and fulfilled all of their post-loss obligations. All requested information and documentation has been turned over to Homeowner’s Choice and their representatives promptly by the Insured. However, Homeowner’s Choice failed at every step of the process to adequately establish or identify the basis of its gross mismanagement of the claim, failed to inform the Insured how they may remedy any deficiencies in their claim, and failed to provide them with qualified representatives to ensure the claim was initially adjusted, evaluated, and estimated properly. To deny the Insured the benefit of their bargain after they satisfied all of their obligations is morally and ethically reprehensible. Upon belief, the aforementioned actions complained of, among others, were made by Homeowner’s Choice so often as to constitute a general business practice, evidencing a motive to enhance Homeowner’s Choice’s profits, and designed to cause a detrimental effect to its policy holders. Homeowner’s Choice was aware that the Insured’ damages were covered and took advantage of its Insured in an attempt to force them into an irreparably disadvantaged position, which they hope will force the Insured to settle for less coverage than they are contractually entitled to under the policy. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Homeowner’s Choice fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. Therefore, to cure the defects outlined in this Civil Remedy Notice, Homeowner’s Choice must: (1) Immediately tender the Coverage “A” Dwelling indemnity of $200,000.00 as well as Coverage “D” Loss of Use limit of $61,970.00 which represent the insurance proceeds due and owing to the Insured that are fairly owed to the Insured under the insurance policy that would reasonably place the Insured back to a pre-loss condition as identified in the estimate submitted by the Insured during the initial claim adjustment (and referenced previously above); (2) Agree to reimburse the Insured’ reasonable attorneys’ fees and costs for having to become involved to resolve the claim; (3) Although the Insured have made a demand herein and have previously provided Homeowner’s Choice with all the necessary estimates, invoices, receipts, etc. in support thereof, the Insured are still willing to consider and to potentially accept any reasonable counter-offer made by Homeowner’s Choice. Therefore, if Homeowner’s Choice is not in agreement with the Insured’ reasonable demand for payment of their rightfully-owed insurance benefits being submitted at this time, the Insured hereby request that Homeowner’s Choice now make a reasonable counter-offer before the expiration of the cure period.

Comments

User Id		Date Added		Comment
Legal@hcpci.com		05-12-2025		This is Homeowners Choice Property & Casualty Insurance Company’s (“HCPCI”) response to the Civil Remedy Notice of Insurer Violations (“CRN”) filed on behalf of Regina & Mark Budris (“Insured”). HCPCI reviewed this CRN and conducted a thorough review of the subject claim (“claim”) and confirmed it handled the claim properly. Regarding an aspect of the claim, HCPCI issued payment for it on the information available to HCPCI and the circumstances at the time of such payment. HCPCI handled the claim in accordance with the policy and all statutory and regulatory requirements. HCPCI denies each allegation of bad faith and improper conduct in the CRN. At all times, HCPCI acted in good faith, fairly and honestly toward the Insured and with due regard for the Insured’s interests. Otherwise, the CRN is deficient. Generally, pursuant to Florida Statutes, Section 624.155, CRNs must identify and set forth statutory provisions insurers allegedly violated in handling insureds’ insurance claims along with specific, relevant insurance contract language and facts and circumstances. The foregoing provides insurers with notice of alleged statutory violations AND the opportunity to cure such alleged violations. Instead of complying with Florida Statutes, Section 624.155, the Insured’s attorney in the CRN contained an inaccurate recitation of the facts, failed to reference specific, relevant insurance policy language; cited irrelevant statutes; and relied on inaccurate and conclusory statements. The Insured’s laundry list of inapplicable statutes is insufficient. Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875 (Fla. 4th DCA 2021). Furthermore, the Insured’s attorney filed a lawsuit based on the claim prior to the filing of this CRN. Regardless of the fact there were no violations in this case, any action by HCPCI to cure violations alleged in the CRN could have been used against HCPCI in the lawsuit. The foregoing shows abuse by the Insured and the Insured’s attorney of the CRN and legal processes. Also and generally, the CRN constitutes an abuse of the CRN process, contravenes the purpose of CRNs, which is to promote resolution of issues in insurance claims. The CRN must be rejected, and it cannot serve as the basis of any action against HCPCI. Upon request by the Florida Department of Financial Services, HCPCI will provide to the DFS detailed correspondence HCPCI provided regarding the claim.

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