Civil Remedy Notice of Insurer Violations
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Filing Number:     813288
Filing Accepted:  3/26/2025
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Complainant
Last/Business Name *  
SANTOS   First Name   RAMON AND NELY MARTINEZ
Street Address * 5031 HARVEST DRIVE
City, State Zip * HAINE CITY, FL 33844
Email Address * VARGASRAMON45@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SANTOS   First Name   RAMON AND NELY MARTINEZ
Policy # * ATH1084458 Claim #* AH142904
Attorney
Attorney is Applicable
Last Name* FERNANDEZ First Name * NATALIE Initial
Street Address* 333 SE 2ND AVE, SUITE 2000
City, State Zip* MIAMI , FL 33131
Email Address * NFERNANDEZ@DKLAWFL.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   AMERICAN TRADITIONS INSURANCE COMPANY
NAIC Company Code 12359
 
Name of individual responsible for violation (if any):* CLAIMS DEPARTMENT AND/OR CHEVONNE COWARD
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
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.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

These actions from the carrier as set forth above violate 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; 626.9541(1)(i)(3)(a), Failing to adopt and implement standards for the proper investigation of claims. The Carrier’s actions set forth above also violated the following policy provisions: Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

March 26th, 2025 Sent Via U.S. Mail & Email American Traditions Insurance Company (Attn: Claims department and/or Chevonne Coward) P.O. Box 1877 Pinellas Park, FL 33780 866-270-8430 ATICclaims@westpointuw.com RE: Insured(s) : Ramon Santos and Nely Martinez (insured(s)”) Policy # : ATH1084458 Claim # : AH142904 Property Address : 5031 Harvest Drive Haine City FL 33844 Insured(s) Email : vargasramon45@gmail.com Dear American Traditions Insurance Company, (“carrier”): Please find enclosed the civil remedy notice filed for the above referenced claim. As discussed in greater detail in the notice, the carrier has not attempted in good faith to settle the insureds’ claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insureds and with due regard for their interests. The carrier is required to properly investigate and adjust claims and cannot place that burden upon the insureds. The carrier was put on notice of the insureds’ claim that occurred on 10/09/2024. After being put on such notice, the carrier initially sent a representative to inspect the property. It is believed the representative initially sent to the property was unqualified or lacked the necessary training to determine the cause of the damages observed during the inspection. It is also believed that the representative initially sent to the property was unqualified or lacked the necessary training to determine the amount of damages sustained as a result of the loss. It is upon information and belief that the carrier’s initial representative observed widespread hurricane damages to the property. The initial representative was unable to rule out hurricane as the cause of the damages observed during the inspection of the property. After the cursory inspection of the property, the carrier advised the insured there was coverage for the loss but the carrier drastically underestimated the amount/scope of damages sustained as a result of the loss. The carrier’s valuation of the damages is severely less than the damages actually sustained as a result of the loss. The carrier did not pay for all direct physical damages sustained as a result of the loss. The carrier failed to properly investigate the claim due to the fact it unvalued the amount/scope of damages sustained as a result of the loss. The carrier failed to provide the full amount of coverage for the physical damages sustained to the property as a result of the loss. The carrier engages in this practice of underpaying/undervaluing claims with such regularity and frequency as to indicate that it is a general business practice of this carrier, in reckless disregard for the rights of the insureds. The carrier consistently relies on under scoped and underpriced estimates to under pay or not pay for covered claims. The carrier’s value of the damages sustained and the amount needed to restore the property are well below the relevant market pricing. Rather than inspecting the property and evaluating the damage in a prudent manner or making any good-faith effort to investigate the claim, the carrier incorrectly undervalued the claim. The carrier’s actions have significantly delayed the resolution of this claim and the insured has been unable to restore the property to it’s pre-loss condition. The carrier has a pattern of drastically lowballing claims and then demanding appraisal when the insured disputes the coverage determination/valuation. These appraisal awards consistently come back drastically above the carrier’s evaluation and coverage of the loss. The insurance carrier undertakes this lowball scheme with such frequency as to be a regular business pattern. The scheme is undertaken as a textbook pattern and practice for underpaying paying claims in order to maximize the carrier’s profits. The carrier hopes the insureds do not have the funds/ability to pay the cost and participate in appraisal so that the carrier can drastically underpay claims. The carrier has failed to adjust the loss with the insured and has failed to pay for all sudden and accidental physical damage to the property. This investigation by the carrier was not done in good faith and is in direct violation of the statutory requirement for carriers to promptly and properly investigate all claims. These actions from the carrier as set forth above violate 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; 626.9541(1)(i)(3)(a), Failing to adopt and implement standards for the proper investigation of claims. The Carrier’s actions set forth above also violated the following policy provisions: Section I- Perils Insured Against, subsection 1, providing coverage for direct loss to property unless the damage was caused solely by an excluded or excepted cause of loss; and the loss payment provision under Section I- Conditions requiring payment of a claim within 90 days. The carrier has mishandled the claim in a classic textbook bad-faith claims handling practice by stonewalling, stalling, and failing to adjust and properly cover the claim by retaining outcome-oriented agents that did not evaluate the loss, coverage, or information objectively. Had the carrier taken the time to properly investigate this claim, reviewed the readily available guidelines, or sent qualified unbiased people out to the property to investigate, the insured would not be in this situation. It is clear that the carrier is not treating the insured with good faith claims conduct; failing to pay a claim clearly owed and acknowledged in writing; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the insured; failing to implement proper standards for the adjustment and investigation of claims; not training, supervising or managing adjusters properly so that prompt and full payments are made, but rather placing the company’s interests before the insured’s interests; refusing to cover the claim and pay the full amount owed to the insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the insured’s loss in a timely manner. The carrier engages in this practice of attempting to delay, low-ball, deny claims in order to maximize the carrier’s profit margins with such regularity and frequency as to indicate that it is a general business practice of this carrier, in reckless disregard for the rights of the insured. It is clear that the carrier is not treating the insured with good faith claims conduct. All the aforementioned are part of what appears to be an ongoing pattern and practice of behavior of the carrier that it demonstrates a wanton and reckless disregard for the insureds’ rights and a pattern and practice of bad faith claims practices to its insureds across the state of Florida. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: 1.) Pay the complete covered loss in the amount of $43,500.00; 2.) Pay the Insureds’ attorneys’ fees and costs as they have been forced to retain counsel; 3.) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made. A copy of this letter and filed form submitted to the FDFS has been printed out and mailed. Please do not hesitate to contact the undersigned if you have any questions or concerns. Sincerely, Natalie Fernandez, Esq. Attorneys at Law Enclosed: Civil Remedy Filing
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edwin@bcflalaw.com 05-23-2025 VIA EMAIL: Natalie Fernandez, Esq. Dennis Kessler Law 333 SE 2nd Ave, Suite 2000 Miami, FL 33131 nfernandez@dklawfl.com RE: Policyholder: Ramon and Nely Martinez Santos Claim Number: AH142904 Policy Number: ATH1084458 CRN Filing Number: 813288 Ms. Fernandez: This is the formal response of American Traditions Insurance Company (“American Tradition or ATIC”) to the purported Civil Remedy Notice of Insurer Violations (“Purported Notice”) that was filed on behalf of Ramon and Nely Martinez Santos. The Florida Department of Financial Services accepted the Purported Notice, in form only, on March 26, 2025. The Purported Notice was filed in connection with Ramon and Nely Martinez Santos’ insurance claim for property damage. The Purported Notice names ATIC and alleges claim delay, unsatisfactory settlement offer, and unfair trade practice in violation of Sections 624.155(1)(b)(1) and 626.9541(1)(i)(3)(a) Florida Statutes. The Purported Notice is a legal nullity for the reasons discussed below. American Traditions reserves all (and waives none) of its rights or defenses, including its right to assert additional deficiencies in the Purported Notice. Under Section 624.155(3), Florida Statutes, a claimant must file a notice with the Florida Department of Financial Services (“the Department”) at least 60 days before filing a Statutory “bad faith” lawsuit. This notice is commonly referred to as a “civil remedy notice” (“CRN”). Section 624.155(3), Florida Statutes sets out five pieces of information which must be included in a CRN: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated; 2. The facts and circumstances giving rise to the violation; 3. The name of any individual involved in the violation; 4. Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third party claimant pursuant to written request; and 5. A statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. The statute also provides that, in addition to these five requirements, the CRN shall be “on a form provided by the [Department] and shall state with specificity . . . such other information as the department may require.” (emphasis added); The Florida Supreme Court has held that Section 624.155, Florida Statutes “must be strictly construed.” Talat Enterprises, Inc. v. Aetna Cas. and Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). Strict construction is appropriate as “this statute is in derogation of the common law.” Id. When interpreting a statute in derogation of the common law, “[a] court will presume that such a statute was not intended to alter the common law other than as clearly and plainly specified in the statute.” Time Ins. Co., Inc. v. Burger, 712 So. 2d 389, 393 (Fla. 1998). Accordingly, such an interpretation would mean that statutory bad faith cases cannot proceed unless the claimant has specifically complied will all statutory requirements. After the promulgation of this statute, the Department created a CRN form: Form DFS-10-363. Form DFS-10-363 lays out 15 requirements: 1. Complainants Name; 2. Complainants Address; 3. Complainants E-mail address; 4. Complainant type (Insured or otherwise); 5. Insured’s Name; 6. Insurance Policy Number; 7. Insurance Claim Number; 8. Attorney’s Name; 9. Attorney’s Address; 10. Attorney’s E-mail Address; 11. Type of Insurer (authorized or otherwise); 12. Name of Insurer; 13. Address of Insurer; 14. Type of Insurance (Commercial Property & Casualty or otherwise); and 15. Reason for Notice. As these requirements are all information required by the Department, according to Section 624.155, Florida Statutes, they each must be stated with specificity. Deficiency #1 Section 624.155(3)(b)(2), Florida Statutes, requires that the CRN state with specificity the facts and circumstances giving rise to the violation. The Purported Notice appears to be a boilerplate document which lacks specific facts. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(2), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to claim delay, unsatisfactory settlement offer, and unfair trade practice in violation of Sections 624.155(1)(b)(1) and 626.9541(1)(i)(3)(a) Florida Statutes. Deficiency #2 Section 624.155(3)(b)(4), Florida Statutes, requires the CRN to reference specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a third-party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer has not provided a copy of the policy to the third-party claimant pursuant to written request. Your client is not a third-party claimant; therefore, the Purported Notice must include specific language from the subject policy that is relevant to the alleged violations. It does not. Rather, the Purported Notice lists vague headings from an unknown policy, making it impossible to identify the specific policy provisions at issue. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. Thus, the Purported Notice is invalid for noncompliance with Section 624.155(3)(b)(4), Florida Statutes. This deficiency applies to all allegations in the Purported Notice, including but not limited to claim delay, unsatisfactory settlement offer, and unfair trade practice in violation of Sections 624.155(1)(b)(1) and 626.9541(1)(i)(3)(a) Florida Statutes. On March 3, 2021, the Fourth District Court of Appeal issued a relevant opinion in Junior Julien v. United Property and Casualty Insurance Company, 311 So.3d 875 (Fla. 4th DCA 2021). In Julien, the insured appealed the circuit court’s dismissal of his lawsuit against his insurer, finding that the insured’s Civil Remedy Notice (“CRN”) failed to satisfy the statutory requirement that an insured “state with specificity” the policy language and the statutory provisions at issue. In his CRN, the insured cited numerous statutory provisions and listed nearly every provision in the insurance policy, as follows: Coverage A - Dwelling Coverage B - Other Structures Coverage C - Personal Property Coverage D - Loss of Use / Additional Living Expenses All Optional Coverage provisions All Additional Coverage provisions All Coverage(s) provided by Endorsement or Rider The Declarations Page Loss Payment or Settlement provision Duties in Event of Loss Policy provision The insurance policy's definition section The insurance policy's exclusion of coverage provisions All insurance policy provisions that provide coverage to the insured property All policy provisions. On appeal, the Fourth District affirmed the dismissal and agreed with the circuit court that the CRN failed to specify the statutory and policy provisions at issue. Like the CRN in Julien, the Purported Notice fails to “state with specificity” the policy language at issue. Deficiency #3 The Purported Notice improperly demands that ATIC pay purported extra-contractual damages in the form of attorneys’ fees. Not only is it improper to demand attorneys’ fees in a Civil Remedy Notice, but the subject Policy was incepted after the passage of SB2A. Therefore, there is no entitlement to attorneys’ fees in this action. In Talat, the Florida Supreme Court adopted the following analysis by United States Magistrate Judge Glazebrook: The Court rejects as unsupported Talat's contention that the insurer must not only pay the claim within the sixty-day window, but must also pay all compensatory damages that flow from any delay in settling the claim. Section 624.155 does not impose on an insurer the obligation to pay whatever the insured demands. The sixty-day window is designed to be a cure period that will encourage payment of the underlying claim, and avoid unnecessary bad faith litigation. Surely an insurer need not immediately pay 100% of the damages claimed to flow from bad faith conduct in order to avoid the chance that the insured will succeed on a bad faith cause of action. If the insurer may avoid a bad faith action only by paying in advance every penny of the damages that it faces if it loses at trial, the insurer would have no reason to pay. Furthermore, few insureds would restrict their demands to compensatory damages. There is no reason why insureds would not demand also the advance payment of punitive damages and attorney's fees. Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. § 624.155(2)(d). See Talat, 753 So. 2d 1278, at 1282 (emphasis added). As noted by Judge Glazebrook and the Florida Supreme Court, Section 624.155, Florida Statutes does not contemplate payment of extra-contractual damages in Civil Remedy Notices. Thus, the Purported Notice is invalid. This deficiency applies to all allegations in the Purported Notice, including but not limited to claim delay, unsatisfactory settlement offer, and unfair trade practice in violation of Sections 624.155(1)(b)(1) and 626.9541(1)(i)(3)(a) Florida Statutes. Notwithstanding the deficiencies in, and the invalidity of, the Purported Notice, ATIC denies any wrongdoing. It specifically denies that it violated the insurance policy or Florida Statutes, as alleged in the Purported Notice. Please be advised, by this letter, ATIC neither waives, nor is estopped, from asserting any and all rights it may have in law, or, under the terms of the policy. In fact, ATIC hereby again, expressly, and specifically, reserves all of its rights, without exception or limitation. If you have any questions or concerns with this response, or, regarding any other matter, please contact me in writing. Sincerely, /s/ Matthew J. Morin Matthew J. Morin BICKFORD & CHIDNESE, LLP 1860 N. Avenida Republica de Cuba Tampa, FL 33605 (813) 726-2030 matthew@bcflalaw.com
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