Civil Remedy Notice of Insurer Violations
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Filing Number:     812545
Filing Accepted:  3/24/2025
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Complainant
Last/Business Name *  
RICHARDE   First Name   WILLIAM
Street Address * 12854 FORESTEDGE CIRCLE
City, State Zip * ORLANDO, FL 32828
Email Address * SERVICE@PROPERTYPEOPLELAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   RICHARDE   First Name   WILLIAM
Policy # * 79-CX-M865-6 Claim #* 59-75R7-72W
Attorney
Attorney is Applicable
Last Name* ILANI First Name * DANIEL Initial
Street Address* 80 SW 8TH STREET, SUITE 2590
City, State Zip* MIAMI , FLORIDA 33130
Email Address * SERVICE@PROPERTYPEOPLELAW.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):* ALL ADJUSTERS, SUPERVISORS, MANAGERS, ATTORNEYS, AND INDIVIDUALS ASSOCIATED WITH AND/OR RETAINED BY STATE FARM FLORIDA INSURANCE COMPANY CONCERNING THE CLAIM AT ISSUES; STATE FARM FLORIDA INSURANCE COMPANY’S DESK ADJUSTER(S); STATE FARM FLORIDA INSUR
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
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)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made.
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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing 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.
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.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

STATE FARM FLORIDA INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, STATE FARM FLORIDA INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

STATE FARM FLORIDA INSURANCE COMPANY (hereinafter the “Insurance Company”) issued a homeowners insurance policy to its insured, WILLIAM RICHARDE & GLORIA BERGES-RICHARDE (the “Insured”), for the insured property located at 12854 Forestedge Circle, Orlando, FL 32828. The subject Policy afforded various types of coverages including coverage for damage to dwelling, other structures, personal property, and for loss of use. On or about October 9, 2024, while the subject Policy was in full force and effect, the Insured’s home was damaged as a result of a covered loss. The Insured subsequently notified the Insurance Company of this loss. Thereafter, the Insurance Company acknowledged the loss and assigned claim number 59-75R7-72W to the loss. The Insured complied with all policy conditions and cooperated with the Insurance Company’s investigation efforts. The Insurance Company performed a cursory inspection and failed to retain the unbiased experts necessary to adequately inspect the property to restore the property to its pre-loss condition. Shortly after, the insurance company denied this loss based upon an unqualified evaluation of the damages. Notably, the Insurance Company failed to retain an expert to inspect the property to fully evaluate this claim, relying solely on an inadequate inspection concerning a subject matter and claim their representative is ill-equipped and unqualified to properly evaluate. The Insured and Insured’s representative provided the Insurance Company with all claim-related documents including an estimate to repair covered damages in the amount of $45,720.20 and other supporting documentation and/or information. Nonetheless, the Insurance Company continues to disregard and ignore the Insured’s claim and request for adequate payment. The Insurance Company has failed to issue proper payment for the claim and has failed to issue sufficient payment to compensate the Insured for damages and repairs covered by the policy and held to be contractually covered by Florida law. The Insured provided the Insurance Company with documentation evaluating the loss, and rather than issuing the proper payment or attempting to reach an agreement with its Insured, the Insurance Company is delaying and denying the claim. Upon information and belief, the Insurance Company performs the subject actions as a business practice, including delaying the claim and/or issuing insufficient payments in an attempt to dissuade its insured from pursuing the claim to the detriment of its insured to increase financial profits. Based upon self-serving conclusions regarding the cause of loss, the Insurance Company’s conclusions are disconcerting because they are demonstrably incorrect. Further, they directly conflict with the only first-hand accounts of the loss. To be clear, the Insured had personal knowledge of the condition of the property prior to the date of the loss and the amounts owed to make the necessary repairs. That said, the Insurance Company’s refusal to properly investigate, adjust, and fully compensate the Insured for their claim evidences the Insurance Company’s violation of Section 626.9541(1)(i)(3)(a), Florida Statutes, which requires the Insurance Company to “adopt and implement standards for the proper investigation of claims.” All available information leads to one conclusion—the Insured’s property was damaged by a covered cause of loss for which the Insured is entitled to full and complete compensation. The Insurance Company’s obligation to promptly settle the Insured’s claim is undeniable, and therefore, the Insurance Company has also violated sections 624.155(1)(b)(1), Florida Statutes. The Insurance Company’s conduct is egregious because the Insurance Company purposely ignored relevant facts, even facts from its own experts, that would have confirmed coverage for the Insured’s loss to avoid having to compensate the Insured for damages. To make matters even worse, the Insurance Company has failed to timely respond to the Insured and issue payment for the damages to the property to allow necessary repairs. The actions taken by the Insurance Company in the handling and adjustment of the Insured’s claim are willful, wanton, and in disregard for the rights of the Insured, and have occurred with such frequency as to indicate a general business practice in violation of the law. The practice includes the Insurance Company’s ongoing inaction of ignoring relevant and accessible information that supports coverage in order to avoid compensating its Insured for covered losses. To be clear, the recent ruling in Fortune v. First Protective Insurance Company d/b/a Frontline Insurance, out of Florida’s 2nd District Court of Appeal, clears up what this carrier must do the cure this CRN. Similar to here, In Fortune, the Insureds timely filed a claim with their homeowners insurance policy upon suffering damage to their property. The Insurer investigated the claim and denied, contending that the amount of damage did not exceed the Insureds’ deductible. Upon presenting the public adjuster’s estimate and all other materials to the insurance company, the Insurer invoked the appraisal process under the policy.Thereafter, the Insureds filed a Civil Remedy Notice alleging that the insurer made a lowball offer and “flagrantly breached” its duty to attempt in good faith to settle claims, under applicable Florida statutes. Additionally, the Insureds alleged that the Insurer refused to reassess its payment of benefits and the basis for payment and that the Insurer “turn[ed] a blindeye and refuse[d] to properly adjust and settle the claim.” Noteworthy in Fortune is that although the Homeowners' CRN did not state a specific cure amount, it did state that they had provided their public adjustor's estimate to the Insurer which covered "the full scope of necessary repairs to the direct and ensuing damages." Thus, the Insured had the public adjuster's estimate and knew the amount the Homeowners sought. Neither the statute nor this court's precedent requires the CRN to contain a specific amount sought to cure the alleged bad faith. See § 624.155(3)(b); see Hunt v. State Farm Fla. Ins. Co., 112 So. 3d 547, 549 (Fla. 2d DCA 2013) (recognizing that an appraisal award satisfies the condition precedent of "a determination of liability and extent of damages owed"). In addition to the above statutory violations, the Insurance Company’s adjuster violated the following ethical requirements of Florida Administrative Code 69B-220.201. (3) Code of Ethics…An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: (b) An adjuster shall treat all claimants equally. 2. An adjuster shall adjust all claims strictly in accordance with the insurance contract. (c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. (d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. (e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. (f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. (o) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. In Florida, the work of adjusting insurance claims engages the public trust. During the adjustment of the Insured’s claim, the Insurance Company breached this duty by failing to adhere to and comply with the above referenced obligations. To cure the defects outlined above, the Insurance Company must: 1. Immediately pay the Insured a cure of $45,720.20for losses suffered as a result of the claim; 2. Immediately issue payments for statutory interest for the late payments and owed profit/overhead; 3. Act fairly and honestly towards the Insured and with due regard for their interests; 4. Hire a fair and unbiassed adjuster and experts to properly assess the Insured’s damages; 5. Tender any additional insurance proceeds due and owing to the Insured that would reasonably place the Insured back into a pre-loss condition; 6. Timely adjust the claim with the insured and avoid/limit any additional delay, costs, and prejudice that the Insurance Company’s conduct above has caused and continues to cause the Insured; and 7. Compensate the Insured for the attorneys’ fees and costs accrued as a result of the Insurance Company’s bad faith conduct. Failure to cure all defects during the 60-day safe harbor period may result in additional extra-contractual damages.
Comments
User Id Date Added Comment
NJProsser@MDWCG.com 04-30-2025 We have been retained by State Farm Florida Insurance Company (“State Farm”) to response to the above-referenced Civil Remedy Notice of Insurer Violations (“CRN”) filed by you on behalf of William Richarde (“Richarde”). While State Farm welcomes the opportunity to respond to the CRN and specifically denies each and every allegation contained in the CRN filed in relation to this claim, State Farm requests the CRN be rejected as it fails to comply with the requirements as set forth in Florida Statute § 624.155 and Florida case law. THE CRN ALLEGATIONS The CRN asserts the following reasons for the notice: • Claim Denial • Claim Delay • Unsatisfactory Settlement Offer • Unfair Trade Practice Further, the CRN alleges State Farm violated the following Florida statutes: 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)(2) Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. 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 misrepesentation 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. 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the property 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)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed. 626.9541(1)(i)(3)(f) Failing 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. 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. 626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). Finally, the CRN alleges State Farm violated the following Florida Administrative Code Sections: 69B-220.201(3)(b) Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: (b) An adjuster shall treat all claimants equally. 69B-220.201(3)(b)(2) An adjuster shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(c) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(d) An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(e) An adjuster shall handle every adjustment and settlement with honesty and integrity, and allow a fair adjustment or settlement to all parties without any remuneration to himself except that to which he is legally entitled. 69B-220.201(3)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(o) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise. DISCUSSION A proper CRN requires the complainant “to enable the insurer to investigate and resolve your claim, describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time.” As can be seen, the CRN fails to provide any specific facts or circumstances giving rise to each specifically alleged violation. Further, the CRN itself only provides unsupported allegations with no basis in fact or circumstance. Notwithstanding these deficiencies, State Farm denies it committed the alleged acts or violated the statutes cited and asserts this is another reason why the CRN should be rejected. Florida Statute §624.155(3)(b) requires a Civil Remedy Notice to “state with specificity” (1) the statutory provisions allegedly violated, (2) the facts and circumstances giving rise to the violation, (3) the name of any individual with knowledge of or responsible for the violation, and (4) the specific policy language relevant to the violation. As discussed, the Complainants are required, pursuant to § 624.155(3)(b)4., to include “[r]eference to specific policy language that is relevant to the violation, if any”. However, despite claiming State Farm has failed to promptly settle the claim “under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage”, allegedly failed to “provide a reasonable explanation…of the basis in the insurance policy,…for denial of a claim…”, and allegedly made material misrepresentations of insurance policy provisions, the CRN does not cite to any specific policy provisions or language whatsoever but rather just generally states “STATE FARM FLORIDA INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, STATE FARM FLORIDA INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections specifically cited herein, any endorsements or changes to said sections are relevant to the Insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.” As the CRN makes certain allegations against State Farm based on the insurance policy, the failure to cite any specific policy language or provide any discussion whatsoever as to the generally cited policy sections applicability with respect to the alleged violations impedes State Farm’s ability to investigate or properly respond in this matter, in addition to failing to satisfy the requirement of section 624.155(3)(b)4. or Florida law. See, Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 878 (Fla. 4th DCA 2021). Also, despite the statutory requirement to identify all individuals with knowledge or or responsibility for the alleged violations, pursuant to § 624.155(3)(b)3., the Complainant fails to name any specific individuals. Rather, Complainant simply states “ALL ADJUSTERS, SUPERVISORS, MANAGERS, ATTORNEYS, AND INDIVIDUALS ASSOCIATED AND/OR RETAINED BY STATE FARM FLORIDA INSURANCE COMPANY CONCERNING THE CLAIM AT ISSUES; STATE FARM FLORIDA INSURANCE COMPANY’S DESK ADJUSTER(S); STATE FARM FLORIDA INSUR”. Without specifically naming the allegedly relevant individuals and providing further discussion in this regard, the CRN fails to comply with the requirements of § 624.155(3)(b)3. as it fails to put State Farm on proper notice of the specific individuals allegedly involved with the purported violations thereby preventing State Farm from addressing any issues regarding these individuals and is one of the reasons why the CRN does not comply with § 624.155 or Florida law. See, Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 878 (Fla. 4th DCA 2021). Additionally, Florida Statutes also required the Complainant, pursuant to § 624.155(3)(b)1., to include “[t]he statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated”. The CRN filed in this matter cites as plethora of statutory provisions regardless to their applicability to the instant claim. It appears the Complainant is taking a “kitchen sink” approach to his allegations against State Farm in that the statutes cited in the CRN appear wholly irrelevant or inapplicable to the cited reasons for the CRN. For example, the CRN states that State Farm has allegedly violated Florida Statute § 626.9541(1)(i)(3)(a) by “[f]ailing to adopt and implement standards for the proper investigation of claims”; however, the allegations in the CRN fail to provide any facts whatsoever to support this alleged violation. No actual facts are provided as to how State Farm’s standards, guidelines, or investigations are allegedly improper. Additionally, despite alleging that State Farm violated Florida Statute § 626.9541(1)(i)(3)(c) by “failing to acknowledge and act promptly upon communications with respect to claims” the CRN again fails to indicate what allegedly unacknowledged communications were sent, or when they were sent, or by whom. Further, the CRN alleges State Farm violated Florida Statute §§ 624.9541(1)(i)(2) and 624.9541(1)(i)(3)(b) by making material misrepresentations regarding the claim and policy; however, again, the Complainant fails to provide any specific facts whatsoever as to any alleged misrepresentation whether material or not. Finally, the most egregious example of the Complainant’s meritless assertions of violations is that, despite the claim at issue being a property insurance claim, the Complainant has alleged State Farm somehow violated Florida Statute § 626.9541(1)(i)(3)(i) by “failing to pay personal injury protection insurance benefits”. Because the CRN fails to properly identify relevant applicable statutes, State Farm is unable to properly respond and it does not comply with F.S. § 624.155 or Florida law. See, Julien v. United Prop. & Cas. Ins. Co., 311 So. 3d 875, 878 (Fla. 4th DCA 2021). Further, contrary to the statutory requirement “to state with specificity… the facts and circumstances giving rise to the violation” as set forth in § 624.155(3)(b)(2), the purpose of which is “to enable the insurer to investigate and resolve [the] claim”, the CRN only provides boilerplate, broad, conclusory, unsupported and incorrect allegations with no basis in fact or circumstances. For example, the CRN alleges that State Farm’s investigation practices are improper and unreasonable but the CRN does not provide any facts to support this. Additional examples include, but are not limited to, the CRN alleging: (1) State Farm failed to acknowledge or act upon communications but failing to set forth any facts to support this; and, (2) State Farm denied the claim without conducting a reasonable investigation based on available information but, yet again, the CRN failed to include any specific facts as to how State Farm’s investigation in this matter was somehow unreasonable. Finally, the instant CRN impermissibly requires State Farm to pay extra-contractual damages, including attorney’s fees and costs, to cure the alleged violations. In a first-party insurance claim, however, the amount due under a CRN is a contractual amount due to the insured. See, Talat Enterprises Inc., vs. Aetna Cas. & Sur. Co., 753 So. 2d 1278 (Fla. 2000) (holding that “for there to be a ‘cure’ [under Fla. Stat. §624.155], what had to be ‘cured’ is the non-payment of the contractual amount due the insured . . . [the statute] cannot reasonably be construed to require payment of extra-contractual damages to avoid bad faith litigation.”). Accordingly, this is another reason why the Complainant’s CRN is invalid. For the aforementioned reasons, it is State Farm’s position that the CRN is deficient and invalid as a matter of law. Nonetheless, and without waiving any of the above deficiencies, the following shall provide you with the facts and circumstances regarding this matter which shall demonstrate that State Farm has not violated any statutory provisions. Setting forth the factual background, State Farm issued insurance policy number 79-CX-M865-6, with effective dates of October 29, 2023 through October 29, 2024 (the “Policy”) to William Richarde and Gloria Berges-Richarde (“Insureds”), for property located at 12854 Forestedge Circle, Orlando, Florida 32828 (the “Property”). The Policy provided coverage for the Property pursuant to the terms, conditions, limitations and exclusions of the Policy. On October 9, 2024, the Insureds’ property reportedly sustained damage from Hurricane Milton. On October 18, 2024, the Insureds purportedly signed a public adjuster contract with Five Star Claims Adjusting (“Five Star”). On October 21, 2024, Five Star first reported the claim to State Farm advising there was roof and patio enclosure screen damage from Hurricane Milton. By letter dated October 22, 2024, State Farm acknowledged receipt of the claim. By correspondence dated October 22, 2024, Five Star submitted its signed contract with the Insureds. By letters dated October 23, 2024, State Farm notified the Insureds of the Homeowner Claims Bill of Rights and certain policy provisions concerning assignments of benefits and temporary repairs. On October 30, 2024, State Farm inspected the property with Five Star. At the inspection, State Farm observed and documented wind damage to 2 roof shingles and approximately 68 sq. feet of patio enclosure screens. The Five Star representative at the inspection confirmed there was no interior damage and declined an interior inspection. Following his inspection, State Farm prepared an estimate for repair of the 2 wind damaged shingles and 68 sq. ft. of patio screens totaling $1,106.89. By letter dated October 30, 2024, State Farm rendered its claim determination extending coverage for the 2 roof shingles and patio screens but advising no payment would be made as its repair estimate was below the policy’s $2,000 deductible with a copy of its estimate. By correspondence dated October 31, 2024, Five Star submitted its initial estimate along with 78 photographs. By letters dated November 1, 2024, State Farm notified the Insureds of the DFS Mediation Program and reissued its Homeowner Claims Bill of Rights and AOB/Temporary Repair letters. By correspondence dated November 4, 2024, Five Star requested a certified copy of the policy. By correspondence dated November 19, 2024, Five Star notified State Farm that the Insureds were disputing its claim determination and providing certain documentation including, but not limited to, a revised estimate. By correspondence dated November 25, 2024, State Farm acknowledged receipt of the PA documents and advised it was review and respond. By correspondence dated November 27, 2024, Five Star submitted an NTS Shingle Analysis report. By correspondence dated December 3, 2024, State Farm invited Five Star to provide a sample of the shingle for further analysis but informing that at this time its coverage position remains unchanged. By correspondence dated December 4, 2024, Five Star reiterated its position regarding a roof replacement. By correspondence dated December 7, 2024, State Farm informed Five Star its coverage position remains unchanged at this time. By correspondence dated January 2, 2025, State Farm requested Five Star provide a copy of its estimate and information concerning the shingle make/model and color for DFS Mediation. By correspondence dated January 6, 2025, Five Star provided a copy of its revised estimate and photographs as well as the NTS Shingle Analysis Report. On February 12, 2025, DFS Mediation was conducted and resulted in an impasse. By correspondence dated February 12, 2025, State Farm requested Five Star provide copies of certain documents shared at mediation. By correspondence dated February 12, 2025, Five Star provided State Farm with the requested documents. By correspondence dated February 19, 2025, Five Star provided a second, revised estimate with 69 photographs to State Farm and inquired regarding a possible reinspection. By correspondence dated February 20, 2025, Five Star inquired regarding a reinspection of the property. By correspondence dated February 25, 2025, Five Star advised it had found a roofer to meet State Farm at the property for a reinspection. By correspondence dated February 28, 2025, State Farm declined a reinspection. By correspondence dated March 24, 2025, an attorney, The Property People FL, PA, submitted their Letter of Representation on the Insureds’ behalf. By letter dated March 24, 2025, State Farm acknowledged the attorney’s representation. On March 24, 2025, the Insureds filed Civil Remedy Notice #812545 and Notice of Intent to Initiate Litigation #236813. By letter dated April 1, 2025, State Farm responded to the Notice of Intent to Initiate Litigation. By correspondences dated April 3, 2025, State Farm provided the Insureds’ attorney with a copy of the certified policy, its damage estimate and three previously issued letters in the claim. On or about April 4, 2025, the Insureds’ filed a lawsuit against State Farm. On April 8, 2025, State Farm was served with the Insureds’ lawsuit. State Farm performed a full investigation of Richarde’s claim which resulted in coverage for the identified damage, i.e. 2 roof shingles and 68 sq. ft. of patio enclosure screens, but no payment was issued as State Farm’s estimate of damage did not exceed the applicable deductible. State Farm has at all times investigated Richarde’s claim in good faith. Therefore, as reflected above, there is simply no basis for the claims made by Richarde in the CRN, namely and singularly that State Farm failed to tender the full amount owed to Richarde. State Farm inspected Richarde’s property, reviewed reviewed available documentation, and promptly and properly made a coverage determination, fully explaining said determination. As discussed above, it is State Farm’s position that the CRN filed by Richarde in this matter is deficient and invalid as a matter of law and should therefore be rejected. Nevertheless, in light of the true facts as set forth above, State Farm responds to each and every alleged statutory allegation as follow: As to the allegations of claim settlement practices (alleged violations 624.155(1)(b)(1) and 624.155(1)(b)(3) above), State Farm states that it has at all times promptly and properly investigated the Complainant’s claim and acted in good faith, fairly and honestly toward the Complainant and its Insureds and with due regard for their interests in this claim. As discussed in detail above, State Farm conducted a prompt and proper investigation of this claim including through a physical inspection of the property and issuance of a timely claim determination by letter dated October 30, 2024. The Complainant fails to set forth any specific facts evidencing State Farm failed to act in good faith, fairly and honestly and with due regard for the Insureds’ interests. Additionally, the Complainant failed to set forth any facts evidencing State Farm allegedly failed to settle the claim under one portion of coverage in order to influence a settlement under another policy coverage. As such, there are no violations of Florida law including, but not limited to, Fla. Stat. 624.155(1)(b)(1) or Fla. Stat. 624.155(1)(b)(3). With respect to the allegations of making claim payments not accompanied by statements setting forth the coverage(s) under which said payment is made (alleged violation Fla. Stat. 624.155(1)(b)(2) above), the Complainant fails to present any facts supporting this alleged violation. As an initial matter, State Farm did not make a claim payment in this claim. However, State Farm, as it detailed in its claim determination letter, did extend coverage for the claim and through its estimate provided to the Insureds detailed what damages it was extending coverage for and the amount of State Farm’s estimate for same. As such, there are no violations of Policy provisions or Florida law including, but not limited to, Fla. Stat. 624.155(1)(b)(2). Concerning the allegations of material misrepresentations with the intention and purposes to effect settlement (alleged violation Fla. Stat. 626.9541(1)(i)(2) above) and misrepresenting pertinent facts or policy provisions (alleged violation Fla. Stat. 626.9541(1)(i)(3)(b) above), the Complainant again has failed to set forth any specific facts or policy provisions upon which the Complainant contends State Farm misrepresented in this matter, or that sets forth that State Farm made material misrepresentations with the intent and purpose to effectuate settlement on less favorable terms. To the contrary, State Farm has at all times adjusted this matter pursuant to the true facts of the claim and policy provisions as contained in the Policy. There has been no misrepresentations, material or otherwise, of any facts or Policy provisions, or in an attempt to effectuate settlement on less favorable terms than provided for in the policy. Accordingly, there are no violations of any policy provision or Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(2) and Fla. Stat. 626.9541(1)(i)(3)(b). Regarding the allegations of failing to adopt and implement standards for the proper investigation of claims and denying claims without conducting reasonable investigations (alleged violations Fla. Stat. 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(d) above), the Complainant has failed to set forth any specific facts supporting these alleged violations or showing that State Farm’s investigation in this claim was improper and/or unreasonable. To the contrary, as discussed, State Farm conducted a prompt, proper and reasonable investigation into its Insureds’ claim and rendered a timely claim determination by letter dated October 30, 2024. Therefore, there are no violations of any policy provision or Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(a) and 626.9541(1)(i)(3)(d). With respect to the allegation of failing to acknowledge and act promptly upon communications (alleged violation Fla. Stat. 626.9541(1)(i)(3)(c) above), the Complainant has failed to set forth any specific facts supporting this alleged violation including, but not limited to, the date, time, method, sender and recipient of such communications that State Farm allegedly failed to acknowledge or act promptly upon. State Farm at all times promptly acknowledged and acted upon communications by the Complainant, Insureds and/or their representatives in this claim. Accordingly, there are no violations of any policy provision or Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(c). To address the allegation of failing to affirm or deny full or partial coverage upon an insured’s written request within 30 days after proof-of-loss statements have been completed (alleged violation Fla. State. 626.9541(1)(i)(3)(e) above), the Complainant has failed to set forth any specific facts or circumstances supporting the allegation in this matter. The Complainant does not even allege that he ever submitted a proof-of-loss form to State Farm. Nevertheless, State Farm at all times has provided prompt and proper claim determinations in this matter as set forth above. As such, there are no violations of Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(e). As to the allegation of failing to promptly provide a reasonable explanation in writing of the basis for denial of a claim or the offer of a compromise settlement (alleged violation Fla. Stat. 626.9541(1)(i)(3)(f) above), the Complainant has failed to set forth any specific facts or circumstances supporting their allegation in this matter. To the contrary, as discussed above, following its prompt and reasonable investigation of the claim, State Farm timely rendered its claim determination in writing by letter dated October 30, 2024, which set forth the reasonable bases for its determination in the claim. As such, there are no violations of any policy provision or Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(f). Regarding the allegations of failing notifying the insured of additional necessary information and failing to explain the nature and reasons for such information (alleged violations Fla. Stat. 626.9541(1)(i)(3)(g) & (h) above), the Complainant again has failed to set forth any specific facts or circumstances supporting these alleged violations. As the facts of the claim above evidence, State Farm conducted a prompt and reasonable investigation of the claim including through a physical inspection of the property and review of available documentation which culminated in prompt and proper claim determination by letter dated October 30, 2024. Accordingly, there are no violations of any policy provision or Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(g) and 626.9541(1)(i)(3)(h). Concerning the alleged violation of failing to pay personal injury protection benefits (alleged violation 626.9541(1)(i)(3)(i), this is wholly inapplicable as the claim at issue in this matter is not a personal injury protection claim. Thus, there are no violations of Florida law including, but not limited to Fla. Stat. 626.9541(1)(i)(3)(i). Finally, as to Complainant’s allegations of violations of the Florida Administrative Code 69B-220.201, again, the Complaint has failed to set forth any specific facts or evidence supporting these alleged violations. At all times, State Farm has adjusted and investigated the Complainant and Insureds’ claim in this regard in good faith and in compliance with contractual, statutory and administrative code provisions as discussed in greater detail above. Therefore, there are no violations of any policy provision or Florida law including, but not limited to Florida Administrative Code 69B-220.201. In closing, State Farm first requests the CRN be rejected due to its failure to comply with Florida Statute § 624.155 and Florida case law, and regardless of the rejection, as demonstrated above, State Farm has at all times acted in good faith, with due diligence, and in accordance with the terms of its insurance policy, Florida Statutes and Florida Administrative Code with respect to the handling of Richarde’s claim. An insurer is not required to pay whatever an insured demands. While an insurance carrier is required to settle claims that should be settled, it is not required to settle claims that are legitimately contested or disputed. State Farm maintains that its coverage decision was appropriate and that the claim was adjusted properly in accordance with the terms and conditions of the Policy and Florida law. State Farm expressly denies all allegations contained in the CRN. While this response is meant to be comprehensive, State Farm’s response above is based upon the limited information provided in the CRN and the information we have to date. If the Complainant feels that we are 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 Florida Statute § 624.155. Also, this letter, or any act or failure to act on the part of State Farm, or any agent or representative of State Farm, should not be construed as a waiver of any rights or defenses, including but not limited to proper notice and service by Complainant, or any other rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust this response addresses the allegations of violations alleged in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very truly yours, /s/ Noah J. Prosser Noah J. Prosser, Esquire Marshall Dennehey, P.C.
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