Civil Remedy Notice of Insurer Violations
Login

Filing Number:     811512
Filing Accepted:  3/17/2025
         Print Filing
Complainant
Last/Business Name *  
TRANSFORMATIONS BY THE GULF, LLC   First Name  
Street Address * 8700 BLIND PASS ROAD
City, State Zip * ST. PETE BEACH, FL 33706
Email Address * TAMMY@TRANSFORMATIONSBYTHEGULF.COM
Complainant Type: * Insured
Insured
Last/Business Name*   TRANSFORMATIONS BY THE GULF, LLC   First Name   VANESSA
Policy # * VAVE0001425 Claim #* 79309 WB
Attorney
Attorney is Applicable
Last Name* ROSS First Name * VANESSA Initial R
Street Address* 2501 S. TAMIAMI TRL
City, State Zip* SARASOTA , FLORIDA 34239
Email Address * ESERVICE@ROSSLEGALFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* WILLIAM BOYLAN
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Unsatisfactory Settlement Offer
Claim Denial
Claim Delay
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)(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)(d) Denying claims without conducting reasonable investigations based upon available information.
* 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 We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss. Covered Property Covered Property, as used in this Coverage Part, means the type of property described in this section, A.1., and limited in A.2. Property Not Covered, if a Limit Of Insurance is shown in the Declarations for that type of property. a. Building, meaning the building or structure described in the Declarations, including: (1) Completed additions; (2) Fixtures, including outdoor fixtures; (3) Permanently installed: (a) Machinery; and (b) Equipment; (4) Personal property owned by you that is used to maintain or service the building or structure or its premises, including: (a) Fire-extinguishing equipment; (b) Outdoor furniture; (c) Floor coverings; and (d) Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering; (5) If not covered by other insurance: (a) Additions under construction, alterations and repairs to the building or structure; (b) Materials, equipment, supplies and temporary structures, on or within 100 feet of the described premises, used for making additions, alterations or repairs to the building or structure. b. Your Business Personal Property consists of the following property located in or on the building or structure described in the Declarations or in the open (or in a vehicle) within 100 feet of the building or structure or within 100 feet of the premises described in the Declarations, whichever distance is greater: (1) Furniture and fixtures; (2) Machinery and equipment; (3) "Stock"; (4) All other personal property owned by you and used in your business; (5) Labor, materials or services furnished or arranged by you on personal property of others; (6) Your use interest as tenant in improvements and betterments. Improvements and betterments are fixtures, alterations, installations or additions: (a) Made a part of the building or structure you occupy but do not own; and (b) You acquired or made at your expense but cannot legally remove; (7) Leased personal property for which you have a contractual responsibility to insure, unless otherwise provided for under Personal Property Of Others. c. Personal Property Of Others that is: (1) In your care, custody or control; and (2) Located in or on the building or structure described in the Declarations or in the open (or in a vehicle) within 100 feet of the building or structure or within 100 feet of the premises described in the Declarations, whichever distance is greater. However, our payment for loss of or damage to personal property of others will only be for the account of the owner of the property. Loss Payment a. In the event of loss or damage covered by this Coverage Form, at our option, we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property, subject to b. below; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality, subject to b. below. We will determine the value of lost or damaged property, or the cost of its repair or replacement, in accordance with the applicable terms of the Valuation Condition in this Coverage Form or any applicable provision which amends or supersedes the Valuation Condition. b. The cost to repair, rebuild or replace does not include the increased cost attributable to enforcement of or compliance with any ordinance or law regulating the construction, use or repair of any property. c. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. d. We will not pay you more than your financial interest in the Covered Property. e. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the Covered Property. f. We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. g. We will pay for covered loss or damage within 30 days after we receive the sworn proof of loss, if you have complied with all of the terms of this Coverage Part, and: (1) We have reached agreement with you on the amount of loss; or (2) An appraisal award has been made. h. A party wall is a wall that separates and is common to adjoining buildings that are owned by different parties. In settling covered losses involving a party wall, we will pay a proportion of the loss to the party wall based on your interest in the wall in proportion to the interest of the owner of the adjoining building. However, if you elect to repair or replace your building and the owner of the adjoining building elects not to repair or replace that building, we will pay you the full value of the loss to the party wall, subject to all applicable policy provisions including Limits of Insurance, the Valuation and Coinsurance Conditions and all other provisions of this Loss Payment Condition. Our payment under the provisions of this paragraph does not alter any right of subrogation we may have against any entity, including the owner or insurer of the adjoining building, and does not alter the terms of the Transfer Of Rights Of Recovery Against Others To Us Condition in this policy.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In Florida, the work of adjusting insurance claims engages the public trust. Underwriters at Lloyd's, London (“INSURER”) has breached the public’s trust by its adjustment of Transformations by the Gulf, LLC (“INSURED”) claim of loss. Underwriters at Lloyd's, London’s mailing address is One Lime Street, London EC3M 7HA, United Kingdom. INSURER has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervision of employees resulting in statutory violations as set forth above. INSURER has failed and/or refused to thoroughly, accurately, and completely investigate and evaluate the INSURED’S insurance claim for damages. INSURER has failed to promptly settle the INSURED’S insurance claim when the obligation to settle the insurance claim had become reasonably clear. To date, notwithstanding the INSURED’S pleas otherwise, INSURER has continued to refuse to acknowledge its obligation to conduct a proper investigation, and to tender the full amount of insurance monies due and owing its INSURED under the policy. This claim involves the INSURED’S property located at 8700 Blind Pass Road, St. Pete Beach, FL 33706 which sustained significant damage from Windstorm on or about October 9, 2024. The INSURED immediately reported the loss to INSURER and allowed for inspection. The INSURED suffered damage to the roof, exterior, and interior of the property. INSURER inspected the property and accepted coverage for the claim, however they estimated the loss to total just $57,324.17. The INSURED’S hurricane deductible is $37,207.40, recoverable depreciation applied was $2,986.45 and code upgrade coverage for $2,426.28. There are also invoices for the install, removal and reinstall of a roof tarp totaling $3,000.00. Payment was issued for $20,116.77. The INSURED retained Storm One Claims LLC. to assist with determining the amount of damage sustained to the property. Storm One prepared an estimate in the amount of $164,382.05. The INSURED are owed additional insurance benefits in order to return the property to pre-loss condition. Therefore, demand is hereby made as follows: Estimate $167,382.05 Less Prior Payments $20,116.77 Less Deductible $37,207.40 TOTAL $135,162.37 The concept of insurance is that the insurer will investigate and grant timely and prompt indemnity or security against a contingent loss. Florida Statute §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 in that definition is the fact that payment must be made timely and promptly so that the INSURED may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. INSURER has breached this duty. The INSURED was, and still is, forced to expend out of pocket monies to submit her insurance claim, e.g., retaining an attorney and other experts to force INSURER to honor its obligations under the insurance policy and to pay all the insurance proceeds due and owing to them. INSURER has refused and/or failed to tender all the insurance proceeds due and owing to the INSURED. INSURER’s refusal and/or failure to settle the insurance claim when under all circumstances it could have and should have done so had it acted fairly and honestly towards the INSURED is wrongful conduct. Furthermore, the INSURED contends that INSURER’s adjusters and/or representatives financially benefit from such wrongful conduct. This notice is given in order to perfect the right to pursue the civil remedy authorized by Fla. Stat. §624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, INSURER must: (1) Create and implement adequate guidelines for the proper investigation and evaluation of claims and for the training and supervision of employees, which will avoid future statutory violations as set forth above, and prevent this from occurring in the future; (2) INSURER must create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees with regard to these claims to ensure that the claims handling procedure with regard to these types of losses are adequate to prevent other Insureds from being treated unfairly and wrongfully; (3) INSURER must tender to the INSURED $135,162.37 as set forth above; and, (4) INSURER must act fairly and honestly towards its INSURED and with due regard for her interests in attempting to settle its INSURED’S claim.
Comments
User Id Date Added Comment
eservice@rosslegalfl.com 08-13-2026 The Insured, Transformations by the Gulf, LLC, hereby provide notice to the Department of Financial Services and Underwriters at Lloyd's, London, that the issues outlined in Civil Remedy Notice #811512 have been resolved between the parties and Underwriters at Lloyd's, London has cured all allegations listed therein. Accordingly, Transformations by the Gulf, LLC, hereby withdrawals Civil Remedy Notice #811512 filed on 03/17/2025.
dania@sselegal.com 05-09-2025 Re: Response to Civil Remedy Notice of Insurer Violations D.F.S. File No.: 811512 Insurer: Certain Underwriters of Lloyd’s London Insured: Transformations by the Gulf, LLC Underwriters Claim No. 79309 WB Underwriters Policy No. VAVE0001425 Date of Loss: October 9, 2024 Please be advised that our firm represents and is acting on behalf of Certain Underwriters at Lloyds, London Subscribing to Policy No. VAVE0001425 (hereinafter “Underwriters”). Underwriters issued an insurance policy to the insured with effective dates of January 4, 2024 – January 4, 2025. This will acknowledge receipt of the Civil Remedy Notice of Insurer Violations (“CRN”) No. 811512 served by Vanessa R. Ross. The CRN was filed on behalf of the insured. The claim arises from damage allegedly caused by a windstorm. Underwriters first request that the CRN be rejected as it fails to comply with the requirements set forth in Section 624.155, Florida Statutes, and Florida case law. The CRN generally alleges that Underwriters: failed to attempt in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly towards its insured in violation of §§624.155(1)(b)(1) and 624.155(1)(b)(3). The CRN further alleges that Underwriters (a) failed to adopt and implement standards for the proper investigation of claims; (b) misrepresented pertinent facts; (c) failed to acknowledge and act promptly with respect to the claim; and (d) failed 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 and has violated various provisions of Florida Statute §626.9541(1)(i). Underwriters vehemently denies any violation to §626.9541(1)(i). Underwriters contend that the CRN as filed is deficient as a matter of law as it fails to comply with Section 624.155. 316 Inc. v. Maryland Casualty Insurance Company, 526 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Insurance Corp., 2010 WL 7367059, (S.D. Fla. 2010); Heritage Corporation of South Florida v. National Union Fire Insurance Company of Pittsburgh, PA, 580 F. Supp. 2d 1294 (S.D. Fla. 2008). Pursuant to Section 624.155(3)(b), the notice "shall state with specificity" the following information: 1. The statutory provision, including the specific language, 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; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by the section. First and foremost, the CRN fails to allege any facts to notify Underwriters of any of the specific statutory violations at issue. Therefore, the CRN is insufficient as a matter of law. As such, the CRN lacks the requisite specificity required by Section 624.155(3)(b)(3). Finally, the CRN also fails to satisfy Section 624.155(3)(b)(4) in that it fails to reference any policy language. The CRN does not cite any provision of the policy. The failure to cite any policy language allowing Underwriters to investigate the allegations renders the CRN insufficient pursuant to Florida law. As such, the CRN does not satisfy the specificity required by Section 624.155(3)(b)(4). Also, the CRN fails to specify the policy language and provisions that are relevant or applicable to the alleged facts contained in the CRN. Because the CRN fails to identify any specific statutes that actually apply to the allegations, Underwriters is unable to properly respond, and the CRN should be rejected and returned. Additionally, the CRN fails to set forth any specific policy language alleged to have been violated in accordance with Florida Statutes Section 624.155(3)(b)(4). The failure to identify any specific policy provision that is allegedly relevant to the alleged violations prevents Underwriters from addressing any issues regarding the policy and, as a result, the CRN should be rejected. The CRN sets forth various "cures" for the alleged defects. There are also multiple "cures" in the CRN that are improper pursuant to Florida case law, specifically the case of Talat Enterprises, Inc. v. Etna Casualty & Surety Company, 753 So. 2d 1278 (Fla. 2000). The Talat case provides that the scope of what can be "cured" is limited to the alleged non-payment of the contractual amount due to the insured. Talat also commented that "it naturally follows that for there to be a 'cure,' what had to be 'cured' is the non-payment of the contractual amount due the insured. In the context of a first-party insurance claim, the contractual amount due the insured 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 the payment are fulfilled...." As a result, the "cures" in the CRN not relating to payment are improper remedies and contrary to Florida law. The CRN also requires the Complainant to "describe the facts and circumstances giving rise to the insurer's violation as you understand them at this time," the purpose of which is "to enable the insurer to investigate and resolve the claim." Instead of providing facts and circumstances, the CRN contains conclusory, unsupported statements as to the claim. The tenor and inferences of the allegations are wholly without merit and Underwriters denies all of the insured’s allegations. The true facts are as follows: On November 7, 2024, Underwriters received notice of the loss that was reported by the insured’s public adjuster, Storm One Claims, as windstorm damage to the roof with interior water damage to one of the units as the result of Hurricane Milton. A third-party adjuster with Specialty Adjusting International, appointed by Underwriters, inspected the property on November 19, 2024, in the presence of the insured and the insured’s public adjuster, Joe Gonzalez with Storm One Claims. On December 3, 2024, Underwriters issued a letter to the insured requesting a copy of the insured’s mortgage statement. On December 10, 2024, the insured provided a copy of the mortgage statement. On December 19, 2024, Underwriters issued a payment letter to the insured enclosing settlement check, #13553, totaling $20,116.77 and a Sworn Statement in Proof of Loss which outlined the settlement of the claim. On January 2, 2025, Underwriters received a document package from Storm One Claims, LLC, including an estimate totaling $167,314.72 RCV/$164,382.05 ACV and an Executed Sworn Statement in Proof of Loss. On January 3, 2025, Underwriters issued a letter to the insured advising that due to the significant difference in scope between estimates, Underwriters retained an engineer to perform a reinspection of the property. On January 14, 2025, a reinspection was performed by Zinski Baggan, P.E., from J.S. Held, LLC. On January 17, 2025, Underwriters issued a Partial Denial/Reservation of Rights Letter advising that the field adjuster’s and Engineer’s investigation revealed flood cuts in the drywall in the garage of building 8702, which indicated that there was flooding at the property that impacted the exterior of the building. The policy excludes coverage for Flood damage. Thus, the portion of the claim regarding flood damage was denied and no payment was issued. Additionally, the insured submitted a Sworn Statement in Proof of Loss totaling $167,314.72. Underwriters rejected the Sworn Statement in Proof of Loss as it is an inaccurate representation of the actual damage that occurred. Furthermore, Underwriters requested an Examination Under Oath. On February 21, 2025, undersigned issued a letter to the insured on behalf of Underwriters scheduling the insured’s examination under oath for April 11, 2025, at 10:00 a.m. via Zoom. On March 7, 2025, Underwriters received a Letter of Representation and a request for documentation from Ross Legal Group, PA. On March 17, 2025, the insured filed the subject Civil Remedy Notice. Also on March 17, 2025, Underwriters received a Notice of Intent to Litigate pursuant to Florida Statute §627.70152. Attached to the Notice in support of the demand is an estimate prepared by Storm One Claims, LLC totaling $167,314.72 RCV/$164,382.05 ACV, a tarp installation invoice from BeeGreen Solar & Roofing totaling $1,500, and a tarp removal and reinstallation invoice from BeeGreen Solar & Roofing, totaling $1,500. On March 31, 2025, Underwriters responded to the Notice of Intent to Litigate filed by the insured advising that the Underwriters had yet to make a coverage determination and there was a pending Examination Under Oath. The Examination Under Oath is pending. After reviewing the CRN, Underwriters conducted a thorough review of its decision. Underwriters respectfully submits that it has investigated and adjusted the insured's loss in the utmost good faith. Underwriters further assert that it has fully complied with all statutory requirements with respect to this claim and has acted in good faith toward its insured during the investigation and resolution of this claim. While this response is meant to be comprehensive, Underwriters' response is based upon limited information provided in the CRN and the information Underwriters has to date. If the insured or his attorney feels that Underwriters is not in possession of all the facts, it requests that he inform us immediately. Please note that Underwriters' response is not necessarily exhaustive and does not preclude Underwriters from asserting any other valid reason for seeking rejection and return of the CRN. Furthermore, this response or any act or failure to act on the part of Underwriters or any agent or representative of Underwriters should not be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. Thus, the Civil Remedy Notice of Insurer Violation is without merit. Underwriters acted timely and appropriately to adjust the claim. In the event the insured can demonstrate any loss for which it has not been fairly and fully compensated, Underwriters stands ready to fully compensate the insured for such loss, within the terms of the Policy. With respect to the allegations of the CRN, Underwriters submits that it has at all times acted in the utmost good faith in the handling of the claim and, further, has made payment based upon the estimate and documentation presented subject to the Policy’s terms, conditions, exclusions and endorsements. Please contact us at your convenience in the event we can be of additional assistance to your examination of the Civil Remedy Notice.
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