Civil Remedy Notice of Insurer Violations
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Filing Number:     811455
Filing Accepted:  3/17/2025
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Complainant
Last/Business Name *  
VAZQUEZ   First Name   MARIA
Street Address * 525 W HIGHWAY 50
City, State Zip * CLERMONT,, FL 34711-30
Email Address * LCDAVAZQUEZPABON@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   VAZQUEZ   First Name   MARIA
Policy # * 80C1H1385 Claim #* 59-73C1-12V
Attorney
Attorney is Applicable
Last Name* DIAZ First Name * JESSE Initial
Street Address* 1540 INTERNATIONAL PKWY. STE. 2000
City, State Zip* LAKE MARY , FLORIDA 32746
Email Address * JESSE@DIAZLITIGATION.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* ELLIOTT FRANCIS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Other : Bad Faith
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.
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)(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)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Policy Provisions: A certified copy of the policy is not in the possession of the Insureds, but has been requested from the insurance carrier. Based on information and belief, the following policy provisions are relevant to this civil remedy notice. Section 1 – Coverage A – Perils Insured Against Section 1- Conditions – Loss Settlement Section 1 – Conditions - Loss Payment By violating the following statutory provisions: 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 his 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)(d): Denying claims without conducting reasonable investigations based upon available information; 626.9541(1)(i)(4): Failing to pay undisputed amounts of partial or full benefits owed under first party property insurance policies within 90 days after an State Farm receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Insured(s) Name: Maria Vazquez Insured Address: 525 W Highway 50, Clermont, FL 34711-3033 Policy Number: 80C1H1385 Claim Number: 59-73C1-12V Email: DOL: 8/28/2024 On or about August 28, 2024, the Insured, Maria Vazquez, suffered damage to their home located at 525 W Highway 50, Clermont, FL 34711-3033 as a result of Wind damage. It is safe to say that the property was significantly impacted by the Wind damage. Prior to the loss, STATE FARM FLORIDA INSURANCE COMPANY (“State Farm”), had issued a policy of insurance (Policy No.: 80C1H1385) for the Insured’s property. Said policy was in full force and effect on date of loss and afforded coverage for damage caused by a Wind damage. State Farm was timely notified of the loss by the Insureds and assigned claim number 59-73C1 12V. During the course of State Farm’s investigation, the Insured made their property available for inspection, provided facts and information surrounding the loss, and complied with State Farm’s adjustment of the claim. Despite fully cooperating with State Farm’s investigation, State Farm capriciously denied coverage for the Insured’s insurance claim even though there was clear evidence of Wind damage to covered property. State Farm came to its coverage determination by ignoring relevant facts and information provided by the Insured and established the damages to the roof and interior of the residence were unquestionably the result of Wind damage. Specifically, the Insureds provided State Farm with a Consulting cause and origin report from The property damage authority. It is clear that State Farm has not acted honestly or fairly towards it’s Insured. State Farm and its representatives have failed to conduct a proper investigation of the loss, misrepresented the scope and cause of damages at the residence, and misapplied exclusions in the policy in order to deny coverage for the Insured’s claim. It has become a general business practice of State Farm to not implement proper claims handling procedures, As is the case here, it is a pattern and practice for State Farm to arbitrarily deny claims without conducting reasonable investigations based upon information and evidence available to it. State Farm continues to chronically ignore the Policy’s Ordinance and Law Coverage, to delay and later avoid tendering coverage pursuant to Florida’s Section 626.9744 matching statute, as well as the applicable Florida Building codes. State Farm has failed to render a timely coverage determination in violation of its statutory obligations under Fla. Stat. § 627.70131(5)(a), which requires insurers to make a coverage decision within 90 days after receiving notice of a property insurance claim. On September 20, 2024, State Farm acknowledged receipt of the claim and extended written correspondence to the insured, thanking them for discussing the loss. Subsequently, the PA inspected on October 2, 2024. Despite the insured’s cooperation, State Farm’s representative, Elliott Francis, has exhibited disregard and gross negligence in the handling of the claim. Mr. Francis has consistently failed to respond to Mr. Basic’s multiple good-faith attempts at communication, not responding and avoiding to return calls and emails. His negligence has materially delayed the claims process, depriving the insured of their right to a prompt and proper investigation as mandated by Fla. Stat. § 626.9541(1)(i)(3)(c), which prohibits failing to acknowledge and act promptly upon communications with respect to claims. This inaction constitutes a breach of the implied agreement of good faith and fair dealing, as State Farm has neither conducted a thorough investigation nor provided satisfactory updates regarding the status of the claim. The failure to properly investigate and communicate demonstrates a willful disregard for the insured’s interests and represents bad faith claims handling in transgression of Fla. Stat. § 624.155(1)(b)(1). The insured has fulfilled all post-loss obligations, yet State Farm’s continued delay and lack of substantive communication reflect an unreasonable failure to settle the claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insured. Additionally, on March 4, 2025, the insurer received a phone call from a State Farm Insurance Agent, to “randomly” inform the Insured that her policy may be cancellation due to an active claim. The Agent asserted that the client would be responsible for replacing the roof. The State Farm Agent then went on to say that she needed to go out-of-pocket to replace her roof. When confronted with the intent of the phone call, the Agent became defensive and rude. Ms. Vazquez told her that she did not appreciate being intimidated and that the Agent’s call was unsolicited and not necessary since the claim is not closed and the subject policy is not due for renewal until 2026. This situation raises concerns regarding potential intimidation and retaliatory actions by the insurance company towards the insured, Maria Vazquez. As a result, State Farm and through their insurance agent have violated Fla. Stat. 626.9541(1); 626.9541(1)(i)(2); and 626.9541(1)(i)(3)(b) in order induce and effect claims settlement. In order to cure this civil remedy notice, State Farm must immediately acknowledge in writing that the Insureds’ roof was damaged, and that replacement of the roof is covered by the policy. State Farm shall promptly tender $102,741.75 in coverage, plus 627.6131 interest made payable to “The Law Office of Jesse Diaz, PLLC f/b/o Maria Vazquez, and The Property Damage Authority”. Additionally written acknowledgement should be provided to the Insured’s counsel, attorney Jesse Diaz, of The Law Office of Jesse Diaz, PLLC at 1540 International Pkwy, Suite 2000, Lake Mary, FL 32746.
Comments
User Id Date Added Comment
tanderson@kirwanspellacy.com 05-16-2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance c/o: Civil Remedy Section Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0322 VIA E-MAIL AT JESSE@DIAZLITIGATION.COM Jesse Joseph Diaz The Law Office of Jesse Diaz. PLLC 1540 International Pkwy Suite 2000 Lake Mary, FL 32746 RE: CIVIL REMEDY NOTICE OF INSURANCE VIOLATION Complainant(s): MARIA VAZQUEZ Alleged Date of Loss: August 28, 2024 Claim No.: 5973C112V Policy No: 80-C1-H138-5 DFS Filing No.: 811455 Dear Sir or Madam: We represent STATE FARM FLORIDA INSURANCE COMPANY (hereinafter referred to as “STATE FARM”) regarding the claim presented by Maria Vazquez (hereinafter the “insured” or “Complainant”), for alleged damages sustained to the property located at 3939 Port Sea Pl, Kissimmee, FL 34746-1810 as a result of a roof leak that allegedly occurred on August 28, 2024. On March 17, 2025, the DFS accepted the filing of a Civil Remedy Notice of Insurer Violation (hereinafter “CRN”) number 811455. This will serve as STATE FARM’s response to said CRN. STATE FARM welcomes the opportunity to respond to this Civil Remedy Notice and specifically denies each and every allegation contained in the CRN. The Civil Remedy Notice fails to comply with the specific notice and information requirements as set forth in Florida Statute §624.155 and Florida case law. Julien v. United Prop. & Cas. Ins. Co, 311 So.3d 875 (Fla. 4th DCA 2021). As a preliminary matter, STATE FARM notes that the proper purpose for submitting a valid CRN to the Florida Department of Financial Services, as set forth in Fla. Stat. § 624.155, is to provide detailed notice of specific, factually supported statutory bad faith violations along with an opportunity to cure any such violations. The proper purpose is not to dispute coverage decisions or estimates of covered damages. The instant CRN provided no specificity of any purported bad faith allegations and is deficient on its face. The CRN alleges that STATE FARM violated Florida Statute Section § 624.155(1)(b)(1), 624.155(1)(b)(3), 626.9541(1)(i)(2), 626.9541(1)(i)(3)(a), 626.9541(1)(i)(3)(b), 626.9541(1)(i)(3)(c), 626.9541(1)(i)(3)(d), and 626.9541(1)(i)(4) as the basis for filing the instant notice. STATE FARM explicitly denies violation of any applicable Florida statute in the evaluation and adjustment of the referenced claim. STATE FARM maintains that it has acted promptly, fairly and honestly with its’ Insured at all times in the handling of this claim. Further, many of the sections the Complainant cites to are wholly inapplicable to this matter on their face. Specifically, STATE FARM explicitly denies violation of any applicable Florida Statute in the evaluation and adjustment of the referenced claim. STATE FARM denies that it did not, in good faith, attempt to settle the claim and asserts that it acted fairly and honestly toward its insureds with due regard for their interests. STATE FARM denies that it failed 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 settlement under other portions of the insurance policy coverage. STATE FARM denies that it made 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. STATE FARM denies that it failed to adopt and implement standards for the proper investigation of claims. STATE FARM denies that it misrepresented pertinent facts or insurance policy provisions relating to coverages at issue. STATE FARM denies that it failed to acknowledge and failed to act promptly upon communications with respect to the claim. STATE FARM denies that it denied the claim without conducting a reasonable investigation based on the information available. Lastly, STATE FARM denies that it failed to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). The CRN fails to comply with the very statute the Complainant is seeking to invoke. Contrary to the specific requirements of Section 624.155(3)(b), the CRN fails to identify the specific policy language that is relevant to the purported violation(s), despite STATE FARM previously providing a copy of the subject policy to the insured. Section 624.155(3)(b) includes five specific requirements for Civil Remedy Notices states, in pertinent part, as follows: . . . b. The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. 2. The facts and circumstances giving rise to the violation. 3. The name of any individual involved in the violation. 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request. 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. § 624.155(3)(b) Fla. Stat. (2024) [emphasis added]. STATE FARM also objects to the CRN, as it lacks sufficient specificity, as required by §624.155, Fla. Stat., in addition to other defects. As filed, the CRN fails to accurately and specifically describe the facts and circumstances of STATE FARM’s alleged statutory violation. Instead, the insured’s recitation of “facts” presents mere conclusory statements and offers no support as to the acts and/or omissions purportedly taken by STATE FARM which substantiate the insured’ allegations. The Insured’s assertions are vague, baseless, and contrary to Florida law. Section 624.155(2)(d) “requires that the civil remedy notice state with specificity the facts and circumstances giving rise to the violation.” Lane v. Westfield Ins. Co., 862 So.2d 774, 778 (5th DCA 2003). The purpose of a civil remedy notice is to give the insurer one last chance to settle a claim with the Insured, and not to give the Insured a right of action to proceed against the Insurer. Lane, 862 So.2d at 779; see also Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773 (M.D. Fla. 1997) (holding that a claimant must give the Florida Department of Insurance and the insurer sixty days written notice of a violation so that the insurer may cure any violation) and Julien v. United Prop. & Cas. Ins. Co., 46 Fla. L. Weekly D486 (Fla. 4th DCA March 3, 2021). Without such notice, STATE FARM is unable to cure any alleged defect, if warranted. Instead of citing actual facts and policy language, where the CRN form requires the Complainant to do so, the Complainant provides a vague, inaccurate, and misleading recitation of the facts of this claim, omitting pertinent facts, and misstating others. This approach in completing a CRN is not only non-conforming to the requirements of Florida law, but it also fails to place STATE FARM on notice as to what the Complainant contends STATE FARM has or has not done to the insured’s satisfaction. Stripped of its purpose to give STATE FARM notice of potentially applicable cures, the CRN is entirely deficient with respect to the explicit requirements of Section 624.155, and should be rejected as being non-compliant with the statute. Due to the lack of specificity and other defects, the CRN is invalid and cannot serve as a condition precedent to any action for alleged bad faith under §624.155, Fla. Stat., or otherwise under Florida law. With more specific reference to the statutory requirements, the subject CRN is insufficient as follows: The facts and circumstances giving rise to the violation – The CRN is replete with general recitations of alleged wrongdoing without any specific application to the claim at issue. The Complainant has only provided template, unsupported, and incorrect allegations with no basis in fact or circumstances. The Complainant’s generic statements are patently false, vague, confusing, and do not provide any specific facts or circumstances to support any allegation that there have been statutory violations. The aforementioned statements could not possibly be sufficient to comply with the strict requirements of Florida’s bad faith statute. “This ‘kitchen sink’ approach does not satisfy the specificity requirements of section 624.155.” Demase v. State Farm Florida Ins. Co., 351 So.3d 136, 141 (Fla. 5th DCA 2022). The allegations contained in the subject CRN also mischaracterize the facts. On or about August 29, 2024, a claim was reported to STATE FARM for damages allegedly sustained to the home due to a roof leak from a heavy storm resulting in interior water leaks in multiple rooms, which occurred on August 28, 2024. After various attempts, on September 20, 2024, STATE FARM was able to speak with the insured who advised that a wind storm caused roof damage and allowed water to damage 2 bedrooms, the garage, the kitchen, the formal living room and family room. Addtionally, she advised that the garage also has a crack and was bulging in the ceiling. On October 2, 2024, STATE FARM was allowed to inspect the exterior of the property and no wind, hail or storm damage was found on the roof surface or elevations. As such, on October 22, 2024, STATE FARM issued their initial coverage determination regarding the roof advising that there was no wind or hail damage to the roof surface or exterior elevations and instead the roof inspection revealed age-related wear, tear, and deterioration consistent with the roof's age. These conditions are excluded under the policy; therefore, no coverage for roof damage would be extended. After various attempts and as requested on December 5, 2024, STATE FARM inspected the interior of the property for re-evaluation. On February 12, 2025, STATE FARM issued its amended coverage determination which stated amongst other things, that hat there was no wind or hail damage to the roof surface or exterior elevations. The roof inspection revealed age-related wear, tear, and deterioration consistent with the roof's age. These conditions are excluded under the policy; therefore, no coverage for roof damage can be extended. The interior inspection observed water damage on the ceilings and walls in the garage, hallway, office, bedrooms, and pantry area. This damage was attributed to roof issues resulting from wear, tear, and deterioration caused by various weather events occurring over time, with multiple dates of loss. The result was interior water damage, mold, and peeling paint. Ceiling cracks also appeared to be related to long-term water intrusion or settlement cracking; therefore, no coverage for interior damage can be extended. Furthermore, the CRN alleges that the insured had provided STATE FARM with a “Consulting cause and origin report from The property damage authority.” It is unclear what “report” the Complainant is referring to as no such report was provided to STATE FARM during its investigation. Reference to specific policy language that is relevant to the violation, if any – The Complainant has failed to specifically identify the relevant policy language, instead the Notice states, “Section 1—Coverage A—Perils Insured Against,” “Section 1—Conditions—Loss Settlement,” “Section 1—Conditions—Loss Payment,” However, a bad faith lawsuit arises out of a claim under a property insurance contract. “If there is no insurance coverage, nor any loss or injury for which the insurer is contractually obligated to indemnify, the insurer cannot have acted in bad faith in refusing to settle the claim.” Maryland Cas. Co. v. Alicia Diagnostic, Inc., 961 So.2d 1091, 1092 (Fla. 5th DCA 2007). Additionally, Fla. Stat. 624.1551 states that “[a] claimant must establish that the property insurer breached the insurance contract to prevail in a claim for extracontractual damages under s.624.155(1)(b).” Accordingly, the policy language is required otherwise the insured could not establish the insurer breached the contract. Fla. Stat. § 624.155(1)(c) provides: “No action shall lie if, within 60 days after the insurer receives notice from the department in accordance with this subsection, the damages are paid or the circumstances giving rise to the violation are corrected. This purpose of this provision “is to give the insurer one last chance to settle a claim with its insured and avoid unnecessary bad faith litigation.” Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003). An insurer can “cure” a CRN and avoid a lawsuit by payment, within 60 days of the CRN, the contractual amount due the insured, which 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.” Talat, 753 So. 2d at 1282. The Notice fails to identify any provision of the insurance contract that would entitle Complainant to such payment. Lastly, because no specific facts or remedies are referenced, STATE FARM cannot be expected to investigate the Insured’s allegations and determine whether any corrective measures are warranted. As such, the CRN is defective and must be rejected. STATE FARM further objects to the CRN, and the CRN is defective, additionally because it neither provides a general description, nor references to the specific policy language at issue in the alleged violations, as required by Florida Statute §624.155(3)(b)4. Rather, the CRN merely uses boilerplate language as to STATE FARM’s actions, which fails to explain how STATE FARM was wrong in its assessment of coverage. The subject policy issued by STATE FARM is governed by the policy’s terms, conditions, and exclusions together with any endorsements. This CRN response does not waive any such provisions of the policy. To the extent the CRN could possibly be accepted as compliant, and without waiver of any of the arguments above, STATE FARM denies that it violated the statutes as alleged. STATE FARM has acted in good faith, fairly, and honestly toward its insureds and in compliance with its policy of insurance and Florida law. The assertions in the Civil Remedy Notice are patently false and not supported by the facts or documentation in this matter. STATE FARM respectfully denies each and every allegation contained in the CRN. STATE FARM has followed all proper procedures and is bound by the subject insurance policy contracted for by the insured. While this response is meant to be comprehensive, STATE FARM’s response above is based upon the limited information provided in the Civil Remedy Notice and the information we have to date. If the Complainant feels that STATE FARM is not in possession of all the facts, please inform us immediately. Please note that STATE FARM’s response is not necessarily exhaustive and does not preclude STATE FARM from asserting any other valid reason for the lack of compliance with Fla. Stat. § 624.155. Lastly, STATE FARM does not intend by this letter or any other aspect of its investigation of this claim to waive or relinquish any of its rights, claims, or defenses and specifically reserves any and all rights and defenses that may now exist or arise in the future. Please contact the undersigned if you would like to discuss this matter further or would like clarification of any of the above information. Sincerely, Lissette M. Alvarez LMA/lma
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