Civil Remedy Notice of Insurer Violations
Login

Filing Number:     813262
Filing Accepted:  3/26/2025
         Print Filing
Complainant
Last/Business Name *  
ESCOBAR   First Name   MELISSA
Street Address * 101 S ATLAS DR.
City, State Zip * APOPKA, FL 32703
Email Address * ESCOBARMEL8118@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ESCOBAR   First Name   MELISSA
Policy # * P002096986 Claim #* 258899
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*   SECURITY FIRST INSURANCE COMPANY
NAIC Company Code 10117
 
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 September 26, 2024, Melissa Escobar and Christian Ramos ("Insured"), sustained a covered direct physical loss to Insured's property due to a storm. Insured reported the loss thereafter to Security First Insurance Company ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # P002096986 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 # 258899. 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 28, 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 $32,518.00 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
mhall@securityfirstflorida.com 04-24-2025 04/24/2025 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 Email: Joy Sandon 2300 Maitland Center Pkwy, Suit 106 JSandon@serranocagan.com Re: CIVIL REMEDY NOTICE OF INSURER VIOLATION Filing No.:813262 Insured: Melissa Escobar Insurer: Security First Insurance Company Claim No.: 258899 Policy No.: P002096986 Date of Loss: 09/26/2024 Dear Sir or Madam: This correspondence is in response to the Civil Remedy Notice of Insurer Violations (hereinafter referred to as the “CRN”) was filed by Grant Krapf on behalf of his client, Robert Godau (hereinafter referred to as “Insured”). Please be advised that the undersigned represents the interests of Security First Insurance Company (hereinafter referred to as “Security First”) with respect to the above-referenced matter. The Florida Department of Financial Services (hereinafter referred to as “Department”) assigned this CRN an acceptance date of 03/26/2025 and DFS File No.: 813262. This matter concerns a property damage claim made by the Insured pursuant to a homeowners’ insurance policy provided by Security First Policy No. P002096986 and assigned Claim No. 259899. As the basis for filing the CRN against Security First, Joy Sandon representing Melissa Escobar ****Please Note: Melissa Escobar has no insurable interest in property located at 101 S Atlas Dr. Apopka Fl, 32703)*****asserts in the “Reasons for Notice” section violations such as 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, along with the following statutory violations: 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). Security First welcomes this opportunity to respond to the CRN and denies each allegation contained therein. The allegations made in the CRN are premature, as the insured has failed to perfect the claim for bad faith and the CRN does not meet the specificity requirement of Section 624.155, Florida Statutes. This CRN does not sufficiently support the allegations stated above. As is standard procedure, upon the first notice of the claim, the subject property was dutifully inspected by an SFIC representative which was documented through photographs. I. Perfecting a Claim for Bad Faith SFIC specifically denies all allegations set forth in the Notice. SFIC contends that the Notice should be rejected and returned by the Department of Financial Services as it is premature. Pursuant to statute, there is no potential violation until a breach of contract is established. § 624.1551, Florida Statutes. Accordingly, any Notice filed prior to a finding that SFIC has breached the terms of the policy, is not ripe and is premature and thus fails to perfect Robert Godau rights to pursue civil remedies under Florida Statutes. II. Specificity Requirement The Insured’s CRN violates multiple requirements set forth in the Florida courts’ jurisprudence for Civil Remedy Notices. In addition, it fails to meet even the most basic requirements of the Statute. Pursuant to the terms of the statute, (3)(a) As a condition precedent to bringing an action under this section, thedepartment and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the email address designated by the insurer under s. 624.422. a. 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 (emphasis added): b.(3)(a) As a condition precedent to bringing an action under this section, thedepartment and the authorized insurer must have been given 60 days’ written notice of the violations. Notice to the authorized insurer must be provided by the department to the email address designated by the insurer under s. 624.422. i. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. ii. The facts and circumstances giving rise to the violation. iii. The name of any individual involved in the violation. iv. 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 acopy of the policy to the thirdparty claimant pursuant to written request. v. A statement that the notice is given in order to perfect the right topursue the civil remedy authorized by this section. In interpreting this statute, courts have emphasized the importance of filing specificcivil remedy notices. The civil remedy notice is “crucial to the procedural integrity of an action” under the Statute. Allstate Ins. Co. v. Clohessy, 32 F.Supp.2d 1328, 1333 (M.D.Fla. 1998). “It is, without a doubt, a condition that must be satisfied in order for one to perfect the right to sue under the statute.” Id. “In creating this statutory remedy for bad-faith actions, the Legislature provided this sixty-day window as a last opportunity for insurersto comply with their claim-handling obligations when a good-faith decision by theinsurer would indicate that contractual benefits are owed.” Talat Enterprises, Inc. v. AetnaCas. & Sur. Co., 753 So. 2d 1284 (Fla. 2000). Thus, the Notice cannot be “vague and ‘shotgun’ in nature,” rather than “the type of specific notice required by the statute that would allow [the insurer] an opportunity to cure.” Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299 (S.D. Fla. 2008). Because it is in derogation of the common law, Section 624.155(1)(b), Florida Statutes must be strictly construed. Talat, 753 So. 2d at 1283 (citing Baxter v. Royal Indem. Co., 285 So. 2d 652 (Fla. 1st DCA 1973). To perfect the right to sue under the statute, the insured must specifically notify the insured of any and all alleged violations claimed. Talat Enterprises, Inc. v. Aetna Casualty & Surety Co., 952 F.Supp. 773, 776 (M.D. Fla. 1996) (“Talat I”) See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017) (sufficiency means specificity). In Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875, 879 (Fla. 4th DCA 2021), the Honorable Court stated: The Middle District of Florida was confronted with a civil remedy notice that was similarly broad in scope and concluded that listing nearly all policy provisions on the notice did not satisfy the statute. Fox v. Starr Indem. & Liab. Co., No. 8:16- CV-3254-T-23MAP, 2017 WL 1541294, at *2 (M.D. Fla. Apr. 28, 2017). The court explained that “[i]f the statute contained no specificity requirement, [then] the [insureds’] casual ‘reference’ to the entire insurance policy undoubtedly would suffice.” Id. But, the court continued, “the Legislature included ‘specific’ or a variant not once but twice in the statute.” Id. As a result, the insureds’ listing of whole sections of the insurance policy “appear[ed] to lack specificity.” Id. In Valenti, the District Court for the Middle District of Florida considered the practical consequences of an insured’s non-specific civil remedy notice. Valenti v. UnumLife Ins. Co. of America, 2006 WL 1627276 (M.D. Fla. 2006). The plaintiff’s civil remedy notice included allegations that the defendant conducted an inadequate investigation. The plaintiff, however, failed to identify with the requisite specificity the defendant’s actions that were inadequate. The Middle District held that the plaintiff’s civil remedy notice was insufficient, and stated the following: [T]he civil remedy notice must be specific enough to provide insurers notice ofthe wrongdoing so the insurer can cure the same within sixtydays. … Plaintiffs’ counsel, during the hearing in this matter, argued a civilremedy notice that states “you denied my claim” should be sufficient to place the insurer on notice of what was needed to be cured. Plaintiffs’ counsel further argued that it was up to the insurer, as the insurance expert,to decipher what actions needed to be cured. This argument, in this Court'sestimation, is illogical and is counter to the purpose of the civil remedy notice. If a simple “you denied my claim” was sufficient to put insurers on notice, the sixty-day cure period would be little more than a guessing gamewith the insurer attempting to correctly guess what errors the insured claimed it made in the claims handling process, or risk defending a bad faithaction. This surely is not what the legislature had in mind when it created the civilremedy notice. Accordingly, thisCourt finds that Plaintiffs allegation that Defendant failed to conduct an adequate investigation is insufficient toprovide Defendant an opportunity to cure. Id. at *2. The guidance for an insured could not be more clear. “The purpose of the civil remedy notice is to give the insurer one last chance to settle a claim with its insured andavoid unnecessary bad faith litigation.” Lane v. Westfield Insurance Co., 862 So. 2d 774,779 (Fla. 5th DCA 2004). Its purpose is not “to give the insured a right of action to proceedagainst the insurer even after the insured’s claim has been paid or resolved.” Id. Ultimately, conclusory allegations without facts fail to perfect a statutory bad faith claim. Merely alleging the bare minimum allegations is insufficient pursuant to Florida courts’ interpretations of Section 624.155, Florida Statutes. III. Conclusion At all times, Security First has acted in good faith in its handling of the claim and it has acted fairly, honestly, and with due regard for the Insured’s interest and in determining obligations to Insured. Specifically, Security First has complied with its obligations under the applicable Florida Statutes and the applicable Security First Insurance policy. Security First specifically denies any claim for bad faith and argues that the insured’s claim for bad faith is premature. Security First continues to reserve all its rights under the policy, at law and in equity. Regardless, Insured’s conclusory allegations fail to place Security First on notice of any purported violations. Furthermore, the Civil Remedy Notice fails to identify how to cure the allegations set forth. The allegations are without basis. It is clear Security First properly handled and adequately investigated the claim. We hope that this response has answered any concerns regarding this matter. If the Department has any question concerning this matter, please do not hesitate to contact me. Sincerely, _______________________ Melissa Hall E024555 Security First Insurance Company P.O. Box 105649 Atlanta, GA 30348-5649 Catclaims@securityfirstflorida.com Telephone Number: 877-333-9992
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