Civil Remedy Notice of Insurer Violations
Login

Filing Number:     813343
Filing Accepted:  3/26/2025
         Print Filing
Complainant
Last/Business Name *  
SCOTT   First Name   LISA
Street Address * 5722 NW 46TH DRIVE
City, State Zip * CORAL SPRINGS, FL 33067
Email Address * ALEX@WINDLAWGROUP.COM
Complainant Type: * Insured
Insured
Last/Business Name*   SCOTT   First Name   LISA
Policy # * 1501-1904-0676 Claim #* FL24-0107966
Attorney
Attorney is Applicable
Last Name* AVARELLO First Name * ALEXANDER Initial
Street Address* 8570 STIRLING RD, SUITE 102-406
City, State Zip* HOLLYWOOD , FLORIDA 33024
Email Address * ALEX@WINDLAWGROUP.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY
NAIC Company Code 10861
 
Name of individual responsible for violation (if any):* DAVID CHARLES, GRACE PEREZ, THE ASSIGNED DESK ADJUSTER, FIELD ADJUSTER, SUPERVISOR(S) AND/OR MANAGER(S); AND ANY OTHER INDIVIDUAL THAT HAS REVIEWED THIS CLAIM OR MADE DETERMINATIONS WITH RESPECT TO THIS CLAIM. BUT MOST IMPORTANTLY, DAVID CHARLES AND
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
Other : Intentionally ignoring insured's requests
Other : Intentionally ignoring insured's emails
Other : Pretending that the Carrier doesn't have documents previously provided by insured
Other : Desk Examiners giving up on adjusting the claim
* 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.
624.401(4)(b)(1) However, any person acting as an insurer without a valid certificate of authority who violates this section commits insurance fraud, punishable as provided in this paragraph. If the amount of any insurance premium collected with respect to any violation of this section is less than $20,000, the offender commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, and the offender shall be sentenced to a minimum term of imprisonment of 1 year.
624.401(4)(b)(2) However, any person acting as an insurer without a valid certificate of authority who violates this section commits insurance fraud, punishable as provided in this paragraph. If the amount of any insurance premium collected with respect to any violation of this section 2 is $20,000 or more, but less than $100,000, the offender commits a felony of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, and the offender shall be sentenced to a minimum term of imprisonment of 18 months.
624.401(4)(b)(3) However, any person acting as an insurer without a valid certificate of authority who violates this section commits insurance fraud, punishable as provided in this paragraph. If the amount of any insurance premium collected with respect to any violation of this section 3 is $100,000 or more, the offender commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, and the offender shall be sentenced to a minimum term of imprisonment of 2 years.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections, all endorsements and changes to the subject policy are relevant to the insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered. We will initially pay at least the actual cash value of the insured loss, less any applicable deductible. We will then pay any remaining amounts necessary to perform such repairs as work is performed and expenses are incurred, subject to 2.a. and 2.b. above. If a total loss of a building or structure insured under this policy occurs, the provisions of 2.d. above do not apply and we will pay the replacement cost coverage without reservation or holdback of any depreciation in value, subject to policy limits. This does not prohibit us from exercising our right to repair the damaged property in compliance with this policy and pursuant to Florida Statutes
 
* 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 April 3, 2024, while the insurance policy (Policy Number: 1501-1904-0676) was in full force and effect, the subject property located at 5722 NORTHWEST 46TH DRIVE CORAL SPRINGS, FL 33067 sustained a covered loss as a result of water damage from the refrigerator ice maker water line. The insured filed a claim (Claim Number: FL24-0107966) per the terms of the insurance policy with UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY (the “carrier”). UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY received timely notice of the claim but failed to perform a thorough and prompt investigation so the subject property could be restored to its pre-loss condition. The carrier’s adjuster did not properly adjust the loss to include obviously related damages resulting from the water damage from the refrigerator ice maker water line. After the carrier’s inspection, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY opened coverage for the loss and offered a miniscule payment of $4,253.10 to repair all the damages. This amount is a gross under-valuation of the claim and is not close to what is needed to restore the subject property to its pre-loss condition, even when accounting for the deductible and depreciation. The insured retained a representative, who performed a comprehensive investigation of the subject property that identified the damage that the carrier knew existed but failed to address. The insured’s representative determined there were damages and repairs necessary to restore the property to its pre-loss condition and submitted claim-related documentation to UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, including a detailed estimate for repairs for $141,981.58. After offering its initial payment, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY made it clear that it had no intention of dealing fairly with the insured and properly addressing the gross discrepancy between its offer and the insured’s estimate. Once the insureds retained counsel, the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, revised its estimate, and increased the total valuation of damages to $74,813.47. This alone amounts to bad faith, as the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, improperly adjusted the claim until the insureds retained counsel, and then finally changed their position prior to litigation. However, the insurance company still failed to fully adjust the claim based on the damages. On August 30, 2024, the signed contractor’s estimate was provided to the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, in response to the insurance company’s request for the signed contractor’s estimate. Then, the insureds commenced the repairs. The insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, paid the insureds ALE damages while the insureds were out of their house for the damages to be repaired and replaced. On January 6, 2025, the handling adjuster, Grace Perez, gave up on the subject claim, and stated that she was no longer going to be handling the claim. To make matters worse, Grace Perez, and the insurance company failed to immediately assign a new handling claims adjuster, and instead, Grace Perez said to “contact Customer Services at 800-470-1200 to request the new Desk Examiner information assigned to your claim.” Grace Perez, on behalf of insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, has done everything in their power to delay the subject claim and improperly handle and adjust the claim. On January 7, 2025, since the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, had zero intention of providing the new Desk Examiner information based on Grace Perez’s pathetic email giving up on the claim, the undersigned counsel called insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, to obtain the new Desk Examiner contact information. Again, to make matters worse, the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, assigned another adjuster/Desk Examiner who does not care about their job or projecting the Carrier’s insureds, and only cares about putting the insurance company first to the detriment of their insureds. The insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, assigned David Charles to the subject claim. David Charles apparently suffers from a condition called “I don’t respond to emails” condition, similar to the condition that most of the carrier’s employees suffer from. It appears that the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, instructs their employees to ignore, delay, and intentionally not respond to their insureds and their representatives, which amounts to bad faith. On January 8, 2025, David Charles confirmed that the pending ALE documents were “under review.” The undersigned counsel had to remind David Charles that the documents were under review for over a month. Without constant follow-ups, David Charles and insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, would take no action whatsoever. On January 17, 2025, the undersigned counsel once again followed up with the Desk Examiner, David Charles, regarding the status of the pending ALE payments that have been under review for nearly two months. To no surprise, David Charles ignored the email correspondence and did not respond. On February 3, 2025, the undersigned counsel followed up with David Charles, yet again, as to the status of the Loss of Use check. More importantly, since the insureds completed the repairs, the undersigned counsel provided David Charles with copies of the payments and checks to the contractor for the repairs that were completed, reflecting a total out of pocket expenses in the amount of $142,750.00. Specifically, on February 3, 2025, the insurance company, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY, was in possession of the proof of repairs and payments, and failed to issue the payment for the recoverable depreciation in the amount of $10,347.75. Further, the undersigned counsel demanded payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). To no surprise, David Charles ignored the email correspondence and did not respond. Since David Charles failed to respond, on February 11, 2025, the undersigned counsel sent an additional correspondence to David Charles following up regarding the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). Shockingly, on February 11, 2025, David Charles actually responded to an email, BUT, David Charles ignored a majority of the pending concerns, and only stated that the pending ALE check would be reissued soon since the insurance company made a mistake and included the mortgage company on the ALE check. The insurance company intentionally delayed this claim by including the mortgage company on the insured’s ALE (loss of use – coverage D) check, to prevent the insureds from recovering their ALE out of pocket expenses. On February 11, 2025, David Charles intentionally, and in bad faith, chose to ignore the demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). Since David Charles failed to respond, on February 13, 2025, the undersigned counsel sent an additional correspondence to David Charles following up regarding the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). To no surprise, David Charles provided a useless response on February 13, 2025, completely ignoring the correspondence and pending demands for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53), and only addressed the pending reissued draft for the ALE to remove the mortgage company from the ALE check. It is absurd that the Carrier allows its employees to continue to act in bad faith on behalf of the Carrier. Again, on February 13, 2025, the undersigned counsel replied to David Charles and inquired about the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). Finally, on February 13, 2025, David Charles decided to read his email and respond to the request for the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). David Charles stated that “in regards to the recoverable depreciation we still do not have any completion documents in file. Please upload all completion document and certificate of completion to recover the full recoverable depreciation.” Importantly, using David Charles own words from David Charles’ email dated February 13, 2025, the Carrier stated that it needed the completion documents for the full recoverable depreciation payment to be issued. As explained below, David Charles lied and committed bad faith because the requested documents were provided, and the recoverable depreciation payment has yet to be issued as of the date of this Civil Remedy Notice. Daivd Charles is acting in bad faith on behalf of the Carrier. On February 18, 2025, the undersigned counsel provided clarification to David Charles that the Carrier is in possession of the documents showing that the insureds made payment to the contractor for the work performed as provided to the Carrier in August 2024. To no surprise, David Charles ignored the email dated February 18, 2025, and refused to respond in bad faith. On March 4, 2025, since David Charles’ aforementioned condition was in full force, the undersigned counsel was forced to follow up with David Charles, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 4, 2025, additional photographs of the completed repairs were sent to David Charles (but David Charles probably didn’t look at the photographs since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 4, 2025, and refused to respond in bad faith. On March 5, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 5, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 5, 2025, and refused to respond in bad faith. On March 6, 2025 (at 10:11 am), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 6, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 6, 2025, and refused to respond in bad faith. On March 6, 2025 (at 5:09 pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 6, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 6, 2025, and refused to respond in bad faith. On March 7, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 7, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 7, 2025, and refused to respond in bad faith. On March 10, 2025 (at 8:18 am), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 10, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 10, 2025, and refused to respond in bad faith. On March 10, 2025 (at 6:12 pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 10, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 10, 2025, and refused to respond in bad faith. On March 11, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 11, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 11, 2025, and refused to respond in bad faith. On March 12, 2025 (at 7:52 am), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 12, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 12, 2025, and refused to respond in bad faith. On March 12, 2025 (at 6:37 pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 12, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). ON MARCH 13, 2025, DAVID CHARLES FINALLY RESPONDED, ONLY TO SHOW HOW CLUELESS DAVID CHARLES ACTUALLY IS… Specifically, on March 13, 2025, David Charles responded as follows: “In regards to the above claim, the recoverable depreciation documents were never uploaded into the claim file to be reviewed. You stated the insured incurred $142,750.00 for the replacement cost however we have no estimate in file for this amount. Please provide us with a rebuild estimate / Paid invoice’s totaling $142,750.00 to be reviewed.” David Charles’ response on March 13, 2025, is an absolute joke and embarrassment for the Carrier, which is clearly amounting to bad faith. How does David Charles in good faith state that he does not have the documents for review for the demand for recoverable depreciation and supplemental replacement cost value expenses? If David Charles opened his eyes and read the emails that have been sent to him, David Charles would know that he has been in possession of the documents he is requesting. However, this does not come as a surprise since the Carrier employes many individuals with similar intelligence levels and skillsets similar to David Charles, and continues to act in bad faith on many claims, including this claim. On March 13, 2025, the undersigned counsel called David Charles after reading the nonsensical response provided by David Charles. It was apparent that David Charles did not understand how to properly and adequately adjust a claim while on the telephone with David Charles, as David Charles pretended like he did not have any documents related to the this matter, specifically, the contractor’s estimate provided to the Carrier on August 30, 2024. After the telephone conference with David Charles, on March 13, 2025, the undersigned counsel emailed David Charles a copy of the email chain and corresponding signed contractor’s estimate previously provided to Grace Perez on August 30, 2024. Between Grace Perez and David Charles, the Carrier has two bad actors who have continued to act in bad faith on behalf of the Carrier. To no surprise, David Charles ignored the email dated March 13, 2025, and refused to respond in bad faith. On March 17, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 17, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 17, 2025, and refused to respond in bad faith. On March 18, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 18, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 18, 2025, and refused to respond in bad faith. On March 19, 2025 (at 7:49 am), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 19, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 19, 2025, and refused to respond in bad faith. On March 20, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 20, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 20, 2025, and refused to respond in bad faith. On March 21, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 21, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 21, 2025, and refused to respond in bad faith. On March 24, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 24, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 24, 2025, and refused to respond in bad faith. On March 25, 2025 (at 1:51pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 25, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 25, 2025, and refused to respond in bad faith. On March 25, 2025 (at 6:46 pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 25, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 25, 2025, and refused to respond in bad faith. On March 25, 2025 (at 9:35 pm), since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 25, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). To no surprise, David Charles ignored the email dated March 25, 2025, and refused to respond in bad faith. On March 26, 2025, since David Charles’ intentionally ignored the prior email correspondence in furtherance of the Carrier’s bad faith handling of the subject claim, yet again, as to the status of the pending demand for the outstanding recoverable depreciation in the amount of $10,347.75 and payment of the replacement cost value of the damages ($142,750.00 - $74,813.47 = $67,936.53). On March 26, 2025, the notice of completion from the contractor was sent to David Charles (but David Charles probably didn’t look at the notice of completion since David Charles doesn’t know how to adequately adjust a claim and acts in bad faith on behalf of the Carrier). Once it became abundantly clear that UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY had no intention of acting in good faith, the insured was forced to file the instant Civil Remedy Notice. The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim the representatives on behalf of UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY have approached this investigation in a manner prejudicial to the insured. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY is using either untrained or improperly trained adjusters in connection with this claim. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY should have been fairly adjusting this claim, but instead, it was looking for ways not to pay the claim at all or not pay the claim in full. The above are all examples of UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY’S unfair trade practices, improper investigation and adjustment of the claim, and unfair claim settlement practices. These actions demonstrate the carrier is 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 the insured. The insured gives this notice to perfect the right to pursue the civil remedy authorized by Florida Statute § 624.155. Therefore, to cure the defects outlined in this Civil Remedy Notice, the carrier must: (1) Pay the complete covered loss in the amount of $141,981.58, less any prior payments and less any applicable policy deductible; (2) Pay the statutory interest on the amount of unpaid damages from the date of loss to the date payment is finally made; and (3) implement appropriate standards and procedures for claims investigations and resolution in regard to the outstanding amount of this claim.
Comments
User Id Date Added Comment
ry0419@universalproperty.com 05-15-2025 May 15, 2025 VIA ELECTRONIC FILING Florida Department of Financial Services Bureau of Consumer Assistance Civil Remedy Section 200 East Gaines Street Tallahassee, FL 32399-0322 Re: DFS File No.: 813058 Filing Date: 3/25/2025 Complainant(s): Lisa Scott Insured(s): Lisa Scott Policy No.: 1501-1904-0676 Claim No.: FL24-0107966 Re: DFS File No.: 813343 Filing Date: 3/26/2025 Complainant(s): Lisa Scott Insured(s): Lisa Scott Policy No.: 1501-1904-0676 Claim No.: FL24-0107966 Re: DFS File No.: 814395 Filing Date: 4/3/2025 Complainant(s): Lisa and Brett Scott Insured(s): Lisa and Brett Scott Policy No.: 1501-1904-0676 Claim No.: FL24-0107966 Re: DFS File No.: 815369 Filing Date: 4/9/2025 Complainant(s): Lisa and Brett Scott Insured(s): Lisa and Brett Scott Policy No.: 1501-1904-0676 Claim No.: FL24-0107966 Dear Sir/Madam: Please allow this to serve as Universal Property & Casualty Insurance Company’s (“Universal”) formal response to the above-referenced Civil Remedy Notices (“Notices”) filed by attorney, Alexander Avarello, on behalf of Complainants, Lisa Scott and Lisa and Brett Scott (also referenced as “Insureds.”) As a preliminary matter, the Complainants prematurely filed the Notices, and they are therefore legally deficient. Pursuant to Sec. 627.70131(7)(a) Fla. Stat., an insurer has sixty (60) days from the date it receives notice of a supplemental claim to make a coverage determination unless there are factors beyond its control that prevents a coverage determination. The Complainants submitted notice of a supplemental claim to Universal on or about March 12, 2025. The instant Notices were filed well within the 60-day period allowed an insurer to pay or deny a claim pursuant to Florida law. Thus, the Notices are legally deficient. The Notices allege violations of Sections 624.155, 626.9541, and 624.401 Florida Statutes. Universal denies the allegations contained in the Notices. Additionally, Universal denies that it violated these or any statutes, Florida law, or policy provisions regarding the claim adjustment of this matter. With that said, Universal asserts that the Notices fail to comply with the specific notice and information requirements as set forth in Civil Remedy Notice of Insurer Violation document provisions, Section 624.155, Florida Statutes and Florida law. The Notices are deficient as a matter of law as they fail to comply with Section 624.155, Florida Statutes. See 316, Inc. v. Maryland Cas. Ins. Co., 625 F. Supp. 2d 1187 (N.D. Fla. 2008); Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059, (S. D. Fla. 2010); Heritage Corp. of South Fla. v. Nat’l Union Fire Ins. Co. of Pittsburgh, P.A., 580 F. Supp. 2d 1294 (S.D. Fla. 2008); Talat Enterprises, Inc. v. Aetna Cas. & Surety Co., 753 So. 2d 1278 (Fla. 2000). Pursuant to Section 624.155(3)(b), Florida Statutes the Notices “shall state with specificity” the following information: 1. The statutory provision, including the specific language, which the authorized insurer allegedly violated; 2. the facts and circumstances giving rise to the violation; 3. the name of any individual involved in the violation; 4. reference to specific policy language that is relevant to the violation, if any...; 5. a statement that the Notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Moreover, the Department of Financial Services (“DFS”), created form DFS-10-363, which lays out 15 requirements that the Complainants must respond to with specificity. The Florida Supreme Court holds 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). Such an interpretation would mean that statutory bad faith cases cannot proceed unless the Complainants have specifically complied with all statutory requirements. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). To begin, the Notices fail to meet the requirement of Section 624.155, Florida Statutes, on several grounds. First, the Notices fail to sufficiently satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations. In order to comply with the requirements of Section 624.155, Florida Statutes, the Complainants must name the individual(s) involved with specificity as it relates to the purported violation(s) to allow Universal to investigate the allegations. The Notices lacks the requisite specificity as required by Section 624.155, Florida Statutes. Here, the Complainants include an attempted “catch-all” by stating, “THE ASSIGNED DESK ADJUSTER, FIELD ADJUSTER, SUPERVISOR(S) AND/OR MANAGER(S); AND ANY OTHER INDIVIDUAL THAT HAS REVIEWED THIS CLAIM OR MADE DETERMINATIONS WITH RESPECT TO THIS CLAIM.” The statement prejudices Universal, as it has not been properly notified by Complainants of the individual(s) that purportedly committed statutory violations or the specific statutory violations any individual purportedly committed. Specific identification of a person or persons with the most knowledge within Universal is of particular importance because the Complainants allege in Notices No. 813058, 814395 and 815369 that Universal has “[m]isrepresent[ed] pertinent facts or insurance policy provisions relating to coverages at issue.” The Notices fail to include sufficient specificity as to whom made any misrepresentations, what was misrepresented, and when any of these misrepresentations were made. Accordingly, Complainants’ Notices are insufficient as a matter of law. Second, the Notices fail to satisfy Section 624.155(3)(b)(4), Florida Statutes, in that it fails to reference any specific policy language relevant to any alleged violation(s). Instead, the Notices states the following: “UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY failed to adequately adjust and pay the claim covered under the subject insurance policy. Specifically, but not limited to, UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY failed to properly apply the Loss Settlement and Loss Payment provisions of the policy. In addition to the policy sections, all endorsements and changes to the subject policy are relevant to the insured’s claim for civil remedy. There may be additional policy language relevant to this violation that may be discovered.” The Complainants’ statement fails to identify any specific policy provisions and instead broadly references two policy sections and “all endorsements and changes” which provides no guidance or explanation, such that Universal is left to wonder what policy provisions Complainants believe were allegedly violated. The Complainants assertion “[t]here may be additional policy language relevant to this violation that may be discovered” is contrary to the obligations imposed on the Complainants under Section 624.155(3)(b)(4), Florida Statutes which requires Complainants to identify specific policy language relevant to any alleged violation(s). General, vague, and overbroad references to policy provisions and/or potential or possible policy language do not satisfy the specificity required by Section 624.155(3)(b)(4), Florida Statutes. As such, the Notices are deficient as a matter of law. See generally Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Third, with respect to the requirement to set forth with specificity the “facts and circumstances giving rise to the violation,” the Notices fail to allege any specific conduct on the part of Universal that would violate any policy provision or statute. The Notices assert allegations consisting of inaccuracies and conclusory statements. For example, the Notices allege Universal “failed to perform a thorough and prompt investigation so the subject property could be restored to its pre-loss condition.” The Complainants fail to specify facts to support these conclusory statements. The Notices also allege “the representatives on behalf of UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY have approached this investigation in a manner prejudicial to the insured. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY is using either untrained or improperly trained adjusters in connection with this claim. UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY should have been fairly adjusting this claim, but instead, it was looking for ways not to pay the claim at all or not pay the claim in full.” The Complainants fail to specify any facts or examples to support these conclusory statements. Moreover, the Complainants allege Universal violated Section 626.9541(1)(i)(3)(b), Florida Statutes, by “[m]isrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.” However, the Notices do not set forth sufficient facts regarding any misrepresentations made by Universal. It is clear the statements of facts falls short of the specificity required by Section 624.155, Florida Statutes. As a result, the Complainants fail to comply with the requirements provided in Section 624.155(3)(b)(2), Florida Statutes. In summary, as outlined above, the Complainants fail to respond to each of the fields set forth on the DFS Form with the requisite specificity, including but not limited to, the failure to identify all named policyholders in Notice Nos. 813058 and 813343, the failure to satisfy the requirement to identify the person or persons representing the insurer most responsible for or knowledgeable of the facts giving rise to the allegations, the failure to reference specific policy language relevant to the alleged violation and the failure to allege any specific conduct on the part of Universal that would violate any policy provision or statute. Therefore, the Notices are legally deficient and fails to satisfy the condition precedent to filing a bad faith action. Pin-Pon Corp. v. Landmark American Ins. Co., 500 F. Supp. 3d 1336 (S.D. Fla. 2020); Julien v. United Property & Casualty Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). For the aforementioned reasons, the Notices are deficient as a matter of law. Nonetheless, and without waiving the above-referenced deficiencies, the following shall provide you with Universal’s response to the Notices. On April 8, 2024, Universal was notified by the Insureds’ public adjuster, Dobbins Claims Consultants, that the insured location was damaged on April 3, 2024. Universal inspected the property and documented any visible damage. Universal also requested material documents and information from the Insureds. In accordance with the terms and conditions of the Policy, Universal issued payment in the full amount of its estimate, less recoverable depreciation and applicable deductible. Thereafter, the Insureds submitted a supplemental claim. Upon receipt of certain requested documentation, Universal issued payments to the Insureds for the full amount of the available policy limits for Mold and Coverage D – Loss of Use. In addition, Universal, in accordance with the terms and conditions of the Policy, issued payment in the full amount of its supplemental estimate, less recoverable depreciation and prior payment. On or about March 12, 2025, Universal received an additional supplemental claim from the Insureds. Universal requested additional material documents and information from the Insureds. On March 25, 2025, the Insureds filed Notice No. 813058 followed by Notice No. 813343 on March 26, 2025, and Notice Nos. 814395 and 815369 on April 3, 2025, and April 9, 2025, respectively. As indicated above, pursuant to Sec. 627.70131(7)(a) Fla. Stat., an insurer has sixty (60) days from the date it receives notice of a supplemental claim to make a coverage determination unless there are factors beyond its control that prevents a coverage determination. The Complainants filed the instant Notices well within the 60-day period allowed an insurer to pay or deny a claim pursuant to Florida law. Thus, the Notices are legally deficient. Universal continues to investigate the Insureds’ supplemental claim and awaits the Insureds compliance with policy conditions. Any supplemental payment, if owed, will be issued accordingly. At no time has Universal breached any duty to its Insureds. Universal remains committed to resolving any outstanding issues with its Insureds. As outlined above, the alleged statutory violations set forth in the Notices lack sufficient factual support and are therefore without merit. Therefore, the Notices are legally deficient and fail to satisfy the condition precedent to filing a bad faith action. Universal has complied with all policy provisions and applicable Florida law regarding the adjustment of this claim. We trust that the foregoing is sufficient to advise you of Universal’s position regarding this matter and fully responds to the Notices filed by the Complainants. Sincerely, /s/ Rose Y. Valentine Rose Y. Valentine, Esq. Senior Managing Associate General Counsel
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