Civil Remedy Notice of Insurer Violations
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Filing Number:     813013
Filing Accepted:  3/25/2025
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Complainant
Last/Business Name *  
HUSSEY   First Name   JOAN
Street Address * 203 EAST BLUE WATER EDGE DR.
City, State Zip * EUSTIS, FL 32736
Email Address * JHUSSEYAJK@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   HUSSEY   First Name   JOAN
Policy # * 80R874850 Claim #* 59-P987-0H5
Attorney
Attorney is Applicable
Last Name* SANDON First Name * JOY Initial
Street Address* 2300 MAITLAND CENTER PKWY., SUITE 106
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * JSANDON@SERRANOCAGAN.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):* DESK ADJUSTER, FIELD ADJUSTER
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)(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.
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)(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.

SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section).
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about October 10, 2024, Joan Hussey and Leslie Hussey ("Insured"), sustained a covered direct physical loss to Insured's property due to a storm. Insured reported the loss thereafter to State Farm Florida Insurance Company ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # 80R874850 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # 59-P987-0H5. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $0.00 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about February 3, 2025, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated 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 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)(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): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $55,886.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.
Comments
User Id Date Added Comment
jsandon@serranocagan.com 12-04-2025 The Complainant hereby withdraws this Civil Remedy Notice, DFS #813013.
rpero@simonreedlaw.com 05-08-2025 Via Email to: JSANDON@SERRANOCAGAN.COM Joy Sandon, Esq. 2300 Maitland Center Pkwy., Suite 106 Maitland, FL 32751 Re: Complainant: Joan Hussey Insureds: Joan Hussey & Leslie Hussey Date of Loss: October 10,2024 Policy No.: 80R874850 Claim No.: 59-P987-0H5 Property Address: 203 East Blue Water Edge Dr., Eustis, FL 32736 Filing No.: 813013 Notice Accepted: March 25, 2025 Dear Ms. Sandon: Please be advised this office represents State Farm Florida Insurance Company (“State Farm®”) with regard to the above-referenced matter. Please accept this letter as State Farm’s response to the Civil Remedy Notice of Insurer violation dated March 25, 2025 (the “CRN”) filed by you on behalf of Joan Hussey (the “Complainant”). State Farm has also posted this response on the Department of Financial Services online site. The CRN sets forth insufficient facts and factually incorrect information to support that a violation has occurred. The Civil Remedy Statute requires that a civil remedy notice provide the insurer with notice of the circumstances giving rise to the violation so that the insurer has an opportunity to cure any deficiencies during the 60-day cure period. Talat Enterprises Inc. v. Aetna Casualty & Surety Co., 753 So. 2d 1278 (Fla. 2000). However, the Complainant’s CRN contains only general unspecific and unsupported allegations of violations and deliberately misstates and omits the facts of this claim of which the Complainant and her counsel are aware and as a result, the notice does not comply with the specificity requirement under the statute. Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla.4th DCA 2021). For instance, Florida Statute §624.155(3)(b) requires that a Civil Remedy Notice “state with specificity” the statutory provisions allegedly violated, the facts and circumstances giving rise to the violation, the name of any individual involved in the violation, and the specific policy language relevant to the violation. Rather than include the specifics required by Statute, when asked to identify the specific policy language relevant to the alleged violations, the Notice refers generally to Section I of the policy. The CRN does not provide an explanation as to how State Farm failed to comply with any specific language in the policy pertaining to the alleged incident. Simply listing a general section of a policy without providing any further analysis or discussion of how the policy was violated is in direct contradiction to Florida Statute §624.155(3)(b) and renders the CRN defective. See Julien v. United Property & Casualty Insurance Company, 2021 WL 824438 (Fla. 4th DCA 2021). The CRN states that State Farm can cure the alleged violations by “immediately tender[ing] payment in the amount of $55,886.00 less any applicable deductible and prior payment to the [Complainant] to complete the repairs for the Insured property.” As outlined above, the CRN leaves out pertinent information and makes a variety of vague and general allegations without any supporting facts and is therefore noncompliant with Florida Statute §624.155. State Farm denies the allegations contained in the CRN filed in this matter and finds them to be without merit. State Farm has acted and continues at all times to act in good faith. Without waiving objections to the deficiencies of the instant CRN, State Farm provides herein a brief summary in response to the CRN setting forth facts which specifically contradict the allegations contained in the CRN and show that a CRN is unwarranted. On October 10, 2024, Hurricane Milton caused damage to the Complainant’s property. On October 23, 2024, the damage was reported to State Farm. On October 31, 2024, and November 13, 2024, State Farm inspected Complainant’s property and estimated the cost to repair the covered damage. On November 21, 2024, State Farm notified the Complainant that State Farm’s estimated cost to repair the covered damage did not exceed the Complainant’s hurricane deductible. On March 18, 2025, Complainant served a Notice of Intent to Initiate Litigation (“NOIL”) with an estimate for $70,580.00. State Farm reviewed the estimate and responded to the NOIL with a settlement offer. On March 25, 2025, the Complainant filed the Civil Remedy Notice of Insurer Violation. The Complainant’s CRN cites a variety of statutes alleging they have been violated without any supporting facts. Each statute is addressed more specifically below: • 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. Contrary to this assertion, State Farm inspected, estimated and explained the scope of covered damage. State Farm made a settlement offer in response to Complainant’s NOIL. The CRN is thus devoid of ultimate facts to support the allegation that State Farm failed to act in good faith. State Farm denies any violation has occurred. • 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. The CRN is devoid of any fact supporting this allegation. State Farm investigated the claim, inspected the reported damage, estimated the cost to repair covered damage and explained its coverage decision in a letter to the Complainant. State Farm denies any violation has occurred. • 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. As stated above, State Farm inspected, estimated, evaluated, and communicated its evaluation of the damages and coverage decision to Complainant and her representatives. The cost to repair covered damage did not exceed the Complainant’s deductible, therefore no payment was issued. State Farm denies that any violation occurred. • 626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. Complainant makes this sweeping and conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. State Farm denies any violation occurred. • 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. As stated above, State Farm inspected, estimated and communicated its evaluation of the damages to Complainant and her representatives. The cost to repair covered damage did not exceed the Complainant’s deductible, therefore no payment was issued. State Farm denies any violation occurred. • 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. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. As stated above, State Farm inspected, estimated and communicated its evaluation of the damages to Complainant. The cost to repair covered damage did not exceed the Complainant’s deductible, therefore no payment was issued. State Farm denies that any violation occurred. • 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. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. As stated above, State Farm inspected, estimated and communicated its evaluation of the damages, in writing, to Complainant. The cost to repair covered damage did not exceed the Complainant’s deductible, therefore no payment was issued. State Farm denies that any violation occurred. • 626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. State Farm denies that any violation occurred. • 626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. Complainant makes this conclusory allegation without providing any facts supporting same and no explanation or proposed cure for this allegation if it were true, thus rendering this CRN inadequate and vague. State Farm denies that any violation occurred. • 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). This section does not apply to the subject claim and policy, demonstrating that the allegations of the CRN are boilerplate and are not supported by facts. Nothing herein constitutes nor should be construed as a waiver of any of the rights or defenses of State Farm under its policy of insurance nor is it the purpose of this letter to waive any of the policy terms and/or conditions which are specifically reserved. If you have any questions or concerns, please do not hesitate to contact the undersigned. Very truly yours, SIMON, REED & SALAZAR, P.A. Robin Pero
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