Civil Remedy Notice of Insurer Violations
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Filing Number:     813702
Filing Accepted:  3/28/2025
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Complainant
Last/Business Name *  
STANOPRUD   First Name   ROXANNE
Street Address * 412 E. MADISON ST. STE 1206
City, State Zip * TAMPA, FL 33602
Email Address * ROXSTANO@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   STANOPRUD   First Name   ROXANNE
Policy # * EDH5476426-01 Claim #* EDI967698
Attorney
Attorney is Applicable
Last Name* CONSTANTINOS First Name * JEFFREY Initial
Street Address* 412 E. MADISON ST SUITE 1206
City, State Zip* TAMPA , FLORIDA 33602
Email Address * SPATEL@APEXFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   EDISON INSURANCE COMPANY
NAIC Company Code 12482
 
Name of individual responsible for violation (if any):* LUKE LAMBERTH AND ANY EMPLOYEES OR CONTRACTORS INVOLVED IN CLAIM NUMBER EDI967698
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.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
* 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 – PERILS INSURED AGAINST A. Coverage A - Dwelling And Coverage B - Other Structures 1. We insure for sudden and accidental direct loss to property described in Coverage A and B. In addition to the above listed statutory provisions, see also the following statutes and rules that were violated: FLORIDA STATUTES VIOLATED 626.877 - Every adjuster shall adjust or investigate every claim, damage, or loss made or occurring under an insurance contract, in accordance with the terms and conditions of the contract and of the applicable laws of this state. 626.878 - An adjuster shall subscribe to the code of ethics specified in the rules of the department. The rules shall implement the provisions of this part and specify the terms and conditions of contracts, including a right to cancel, and require practices necessary to ensure fair dealing, prohibit conflicts of interest, and ensure preservation of the rights of the claimant to participate in the adjustment of claims. 627.70131 (5)(a) Within 90 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer which reasonably prevent such payment. Any payment of an initial or supplemental claim or portion of such claim made 90 days after the insurer receives notice of the claim, or made more than 15 days after there are no longer factors beyond the control of the insurer which reasonably prevented such payment, whichever is later, bears interest at the rate set forth in s. 55.03. Interest begins to accrue from the date the insurer receives notice of the claim. The provisions of this subsection may not be waived, voided, or nullified by the terms of the insurance policy. If there is a right to prejudgment interest, the insured shall select whether to receive prejudgment interest or interest under this subsection. Interest is payable when the claim or portion of the claim is paid. Failure to comply with this subsection constitutes a violation of this code. However, failure to comply with this subsection does not form the sole basis for a private cause of action. FLORIDA ADMINISTRATIVE CODE SECTIONS VIOLATED 69B-220.201(3) – Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall constitute a code of ethics that shall be binding on all adjusters: 69B-220.201(3)(c) - An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured. 69B-220.201(3)(d) - An adjuster shall make truthful and unbiased reports of the facts after making a complete investigation. 69B-220.201(3)(j) - An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim options in accordance with the terms and conditions of the insurance contract. 69B-220.201(3)(k) - An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Roxanne Stanoprud paid premiums to Edison Insurance Company and in exchange, Edison issued a policy of insurance number EDH5476426-01 to Ms. Stanoprud. This policy was in full force and effect on or about December 20,2024, when Ms. Stanoprud suffered direct physical loss to the property. Ms. Stanoprud reported the loss within a reasonable time and requested that Edison investigate the loss and promptly issue payment in order to bring the property back to its pre-loss condition and prevent further damage to the property. While Edison is an expert in identifying loss, damage and coverage, Ms. Stanoprud has no such experience. Edison knew the importance of identifying all loss and damage. Edison employs a team of experts and professionals that were available to determine the extent of loss, damage and coverage. In spite of these resources, Edison conducted an inadequate investigation of the damage. Edisons handling and adjustment of the claim of loss reveals that it has failed to adopt or implement standards for the proper investigation of claims. Edison sent an under-qualified adjuster who did not investigate all the damage. The lack of diligence and care in investigating the damage reveals a lack of experience in the type of work that needed to be done and the adjuster’s incentive to adjust the claim dramatically in favor of his employer, Edison’s. Subsequently, Edison has refused to settle the claim in good faith. Edison unfairly underpaid the claim without conducting any additional investigation. In explaining the partial denial to Ms. Stanoprud, Edison misrepresented the terms of the policy and misapplied policy provisions. Since that time, Edison has refused to pay Ms. Stanoprud the full amount of damages despite being provided with sufficient opportunity and documentation relating to the expenses. A review of Edisons actions leads to the inevitable conclusion that Edison has breached its duty of good faith and fair dealing. Edison failed to thoroughly, accurately, and promptly investigate and settle Ms. Stanoprud’s claim. Moreover, Edison claims handling procedure reflects that its employees and its contractors are encouraged and trained to act in the interest of the company at the expense of the interests of the insureds. Edison failed to properly investigate the claim, failed to promptly and thoroughly investigate the claim, failed to promptly and properly adjust the loss, failed to exercise diligence and candor in contact with Ms. Stanoprud and failed to act in good faith in attempting to settle the claim. These violations may be cured by the following: payment of the fair estimates and invoices that were submitted to Edison, payment of the damages that resulted from Edison’s refusal to fairly and timely adjust the claim including, but not limited to, fair market value of the loss of use of property, interest on payments not made, related costs and fees. Inevitably, additional damages will accrue from Edison’s failure to settle the claim and bring Ms. Stanoprud’s property back to its pre-loss condition. In addition, Edison must implement proper standards for the training, supervision and management of all claims handling personnel, including adjusters. These standards must include new requirements for the proper qualifications and training of its adjusters. In addition, Edison must revise the procedures by which its claims handling personnel are hired, retained and promoted in order to encourage its employees and contractors to handle claims in good faith, rather than incentivize them to act solely in the interests of the company.
Comments
User Id Date Added Comment
shannon@zinoberdiana.com 05-23-2025 While Edison welcomes the opportunity to respond to this CRN, Edison specifically denies each and every allegation contained in the CRN filed in relation to this claim. Further, Edison asserts that the CRN should be rejected and returned by DFS, as the CRN fails to comply with the specific information requirements as set forth within § 624.155, Florida Statutes, and Florida case law, and is therefore facially invalid and deficient. I. The CRN fails to satisfy the requirements of Florida law. Concerning the contents of the CRN, the law requires strict compliance with the specificity requirements in § 624.155, Florida Statutes, which the CRN fails to satisfy. Both § 624.155(3), Florida Statutes, and the Civil Remedy Notice form require the Complainant to specifically state, among other things, the statutory provisions, including the specific language of the statute, which the insurer 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 that is relevant to the violation. Additionally, § 624.155(3)(b) mandates that the Civil Remedy Notice must be “on a form provided by the [Department] and shall state with specificity … such other information as the department may require.” (emphasis added). Notably, in the section that requires the Complainant identify the person or persons representing the insurer who are most responsible for or knowledgeable of the facts giving rise to the allegations in this notice, in addition to one individual, the Complainant states “and any employees or contractors involved in claim number EDI967698.” This is clearly nonspecific, inaccurate, and fails to provide Edison with a proper ability to identify the proper individuals therefore rendering the CRN deficient. Additionally, in the section of the CRN for Complainant’s address, the CRN instead improperly provides the address for the Complainant’s attorney. Further, the purpose of the specificity requirement for a civil remedy notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to “cure” the alleged claim defects and otherwise avoid litigation. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278, 1283-4 (Fla. 2000); Rousso v. Liberty Surplus Ins. Corp., 2010 U.S. Dist. LEXIS 82328 (S.D. Fla. Aug. 13, 2010). Uninformative recitations that do not inform the insurer of the facts underlying the alleged violations or match up with the statutes that the complainant identifies as the statutes that were purportedly violated are insufficient to fulfill the requirements of § 624.155. Rousso, 2010 U.S. Dist. LEXIS 82328. The CRN fails to meet the specificity requirements of § 624.155, Florida Statutes, and therefore is invalid and deficient. Notably, in contravention of the statutory and form requirements that a complainant must state the specific statutory provisions allegedly violated and the facts and circumstances giving rise to the violation, the CRN identifies numerous statutory provisions and administrative codes, though they are not wholly relevant or applicable to the alleged facts or claimed violations contained in the CRN or fail to correlate with any specific facts or circumstances giving rise to the alleged violations. Likewise, the CRN identifies several “reason[s] for notice” without providing sufficient facts to support each. Additionally, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is to “enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported, incomplete, generic, conclusory, and insufficient allegations with no basis in fact or circumstance, as well as omits specific facts to support its allegations of violations. The CRN includes minimal information, commentary on unsupported, conclusory accusations, unqualified opinion, legal conclusions, conjecture, and inaccurate statements of facts cast in the light most favorable to the Complainant and her representatives. In short, the facts alleged are simply inaccurate, fail to paint a complete picture of the handling of this claim, fail to apprise Edison of how its actions constituted a violation of said statutes, or were identified without any factual support. II. Despite the deficiencies, Edison denies all allegations contained in the CRN. Notwithstanding the deficiencies in the CRN and without waiving the objections above, Edison explicitly denies any violation of the Florida Statutes sections referenced in the CRN. Edison hereby denies each and every allegation contained in the CRN, either explicitly or implicitly, and denies any wrongdoing in the handling of this matter. Rather, Edison handled the claim both diligently and properly under the terms and conditions of the insurance policy, as well as in accord with Florida law. Edison denies each and every allegation contained in the CRN and responds to them individually as follows: The Complainant lists several purported reasons for submitting the CRN which are 1) Claim Denial; 2) Claim Delay; 3) Unsatisfactory Settlement Offer; and 4) Unfair Trade Practice. As indicated in detail below, the CRN fails to establish or set forth any specific facts that would support the allegations asserted in support of the perceived violations and Edison denies each and every allegation. Specifically, Edison responds as follows: Allegation of Claim Denial: This allegation is without basis in law or in fact and is therefore denied. Counsel for Complainant should immediately withdraw this allegation from the CRN as it cannot be established by any credible evidence. Edison handled the claim both diligently and properly under the terms and conditions of the insurance policy as well as in accord with Florida law, a good faith attempt to investigate this claim has and continues to be made, a determination of coverage was made based on a good faith investigation and the terms and conditions of the subject policy and coverage opened and the appropriate corresponding payment issued, and at all times material to this claim, Edison has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, as it does on every claim. Allegation of Claim Delay: This allegation is without basis and therefore denied. Complainant should immediately withdraw this allegation from the CRN as it cannot be established by any credible evidence. At all times material to this claim, Edison acted timely, diligently, and responsibly in its pursuit of coverage. First and foremost, the CRN identifies no facts whatsoever supporting the inclusion of “claim delay” as a purported violation. At all times material to this claim, Edison acted timely, promptly, diligently, and responsibly in its pursuit of coverage. Moreover, any perceived delays alleged in the CRN are not due to the actions of Edison, nor did Edison have control over any actions causing any perceived delays. Further, claim delay, in and of itself, is not a valid reason for filing a CRN. Allegation of Unsatisfactory Settlement Offer: This allegation is wholly without basis in law or in fact and is therefore denied. Complainant should immediately withdraw this allegation from the CRN as it cannot be established by any credible evidence. Edison handled the claim both diligently and properly under the terms and conditions of the insurance policy as well as in accord with Florida law, a good faith attempt to investigate this claim has and continues to be made, a determination of coverage was made based on a good faith investigation and the terms and conditions of the subject policy and coverage opened and the appropriate corresponding payment issued, and at all times material to this claim, Edison has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, as it does on every claim. Moreover, “unsatisfactory” settlement offer, in and of itself, is not a valid reason for filing a CRN. Allegation of Unfair Trade Practice: This allegation is without basis in law or in fact and is therefore denied. Counsel for Complainant should immediately withdraw this allegation from the CRN as it cannot be established by any credible evidence. Edison handled the claim both diligently and properly under the terms and conditions of the insurance policy as well as in accord with Florida law, a good faith attempt to investigate this claim has and continues to be made, a determination of coverage was made based on a good faith investigation and the terms and conditions of the subject policy and coverage opened and the appropriate corresponding payment issued, and at all times material to this claim, Edison has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, as it does on every claim. Moreover, the subject CRN cites several statutes Edison has allegedly violated. While Edison categorically and unequivocally denies violating any statutes, Edison will briefly address the specific statutes alleged to have been violated, in an abundance of caution. § 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. Edison denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination along with the Statement of Loss, estimate, and applicable policy language for transparency purposes as well as the corresponding appropriate and proper payment. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. At no time has Edison acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with Florida Statute § 624.155(1)(b)(1) and has in no way violated said statutory provisions. § 626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy. Edison denies this allegation. The CRN sets forth no actual facts to support this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison had a qualified adjuster inspect the insured property in the subject claim and conducted a reasonable investigation of the claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law, and issued a detailed and honest explanation to the Insured explaining its coverage determination thoroughly and honestly along with the Statement of Loss, estimate, and applicable policy language for transparency purposes as well as the corresponding appropriate and proper payment. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. Moreover, at no time has Edison acted dishonestly or unfairly toward the Insured and/or her representatives. Edison has not made misrepresentations to the Insured and/or her representatives. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with Florida Statute § 626.9541(1)(i)(2) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(a) Failing to adopt and implement standards for proper investigation of claims. Edison denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination along with the accompanying estimate. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. Edison has always implemented standards for investigating and adjusting claims commensurate with the requirements of Florida Statutes, and it will continue to do so. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with Florida Statute § 626.9541(1)(i)(3)(a) and has in no way violated said statutory provisions. § 626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. Edison denies this allegation. The CRN sets forth no actual facts to support this allegation, only opinions as to how the Complainant believes the claim should have been resolved. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim and conduct a reasonable investigation of the claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its good faith investigation and the terms and conditions of the subject policy and Florida law and issued a detailed explanation to the Insured regarding its coverage determination along with the Statement of Loss, estimate, and applicable policy language for transparency purposes as well as the corresponding appropriate and proper payment. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. Edison made the coverage determination after it conducted a reasonable investigation based upon available information. All actions have been performed in good faith for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with Florida Statute § 626.9541(1)(i)(3)(d) and has in no way violated said statutory provisions. § 626.877 While this section is not provided in the list of purported statutes and cannot form the basis for a CRN pursuant to § 624.155, it is included in the section of the CRN for providing applicable policy language and therefore Edison will respond in an abundance of caution. Edison denies this allegation. The CRN sets forth no facts whatsoever to support the application of these allegations of purported violations, only opinions as to how the Complainant believes the claim should have been resolved. Edison denies this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its reasonable and good faith investigation and the terms and conditions of the subject policy. In Edison’s communications, Edison provided reasonable explanations regarding its coverage determinations to the Insured and her representatives along with supporting documentation and explained what information was necessary for Edison to investigate the claim. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. At no time has Edison acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with the Adjuster’s Code of Ethics. Edison acted in accordance with Florida Statute § 626.877 and has in no way violated said statutory provision. § 626.878 While this section is not provided in the list of purported statutes and cannot form the basis for a CRN pursuant to § 624.155, it is included in the section of the CRN for providing applicable policy language and therefore Edison will respond in an abundance of caution. Edison denies this allegation. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its reasonable and good faith investigation and the terms and conditions of the subject policy. In Edison’s communications, Edison provided reasonable explanations regarding its coverage determinations to the Insured and her representatives along with supporting documentation and explained what information was necessary for Edison to investigate the claim. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. At no time has Edison acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with the Adjuster’s Code of Ethics. Edison acted in accordance with Florida Statute § 626.878 and has in no way violated said statutory provision. § 627.70131(5)(a) While this section is not provided in the list of purported statutes and cannot form the basis for a CRN pursuant to § 624.155, it is included in the section of the CRN for providing applicable policy language and therefore Edison will respond in an abundance of caution. Edison denies this allegation. The CRN sets forth no facts whatsoever to support the application of these allegations of purported violations, only opinions as to how the Complainant believes the claim should have been resolved. Notably, Edison did, in fact, issue its coverage determination and payment within 90 days after receiving notice of the claim in addition to interest. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with Florida Statute § 627.70131 and has in no way violated said statutory provision. ADJUSTER’S CODE OF ETHICS, 69B-220.201 In the section of the CRN for the relevant policy language, Complainant claims that Edison also violated Fla. Admin. Code Ann. R. 69B-220.201. Edison denies allegations regarding any violation of these or any other administrative codes. The CRN also sets forth several inaccuracies and incomplete information regarding the claim based solely on unsupported opinions. Edison retained a qualified independent adjuster to inspect the insured property in the subject claim. Additionally, Edison made a determination of coverage on this claim based on the totality of its reasonable and good faith investigation and the terms and conditions of the subject policy. In Edison’s communications, Edison provided reasonable explanations regarding its coverage determinations to the Insured and her representatives along with supporting documentation and explained what information was necessary for Edison to investigate the claim. While Edison has and continues to make a good faith attempt to investigate this claim and has and continues to act fairly and honestly towards the Insured and with due regard for the interests of the Insured, Edison is also not obligated to settle a claim in a matter beyond that which is covered under the terms, conditions and exclusions of the subject policy. The remainder of the CRN simply states disparaging and unsubstantiated opinions regarding Edison and its agents assisting in the investigation of the subject claim. At no time has Edison acted dishonestly or unfairly toward the Insured and/or her representatives. All actions have been performed in good faith and for the purpose of moving the claim towards a just and equitable resolution. Edison acted in accordance with the Adjuster’s Code of Ethics. Alleged Violations of Policy of Insurance The CRN requires the Complainant to reference the specific policy language that is relevant to the violation. Rather than complying with this requirement, the CRN solely includes “SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure for sudden and accidental direct loss to property described in Coverage A and B” which is clearly nonspecific, over generalized, and noncompliant with the CRN requirements. Additionally, to the extent the Complainant subsequently intends to rely on specific additional policy provisions, she is precluded from doing so as she failed to properly include those provisions in the CRN. Notwithstanding, Edison denies violating any provision or duty set forth in the policy. Alleged Factual and Circumstantial Support for the CRN A review of the facts and circumstances surrounding the investigation and claim decisions on the subject claim reveals Edison acted in good faith and diligently investigated, handled, and adjusted the claim at issue in this dispute. Edison acted fairly, honestly, and in good faith, acknowledged and acted promptly upon receipt of the claim, attempted in good faith to adjust the claim pursuant to the terms of the policy, took reasonable steps to investigate the claim, communicated reasonably and honestly with the Insured and the Insured’s representatives about the claim, and provided the Insured reasonable explanations for its actions. The subject claim involves alleged windstorm damage with a reported date of loss of October 9, 2024 (Hurricane Milton) to the property located at 1290 Bluffs Cir., Dunedin, FL 34698 (the “Property”) first reported to Edison on October 15, 2024. Edison promptly responded with acknowledgement of the claim and the Homeowner Claims Bill of Rights and initiated its investigation of the claim, which included an inspection of the Property by a qualified independent adjuster. Edison made a determination of coverage on this claim based on the totality of its diligent, reasonable, and good faith investigation and the terms and conditions of the subject policy and Florida law. Based on the investigation, Edison issued its coverage determination letter on December 20, 2024 providing a detailed explanation regarding the coverage determination and payment amounts being issued by Edison and providing the statement of loss, estimate, and applicable policy language for transparency purposes. In addition, Edison issued payments in the amount of $140.95 for Coverage A Dwelling and $3,657.83 for Matching of Undamaged Property after applying the deductible. In addition, on January 8, 2025, Edison issued correspondence explaining that it was issuing payments in the amounts of $65.51 and $2.52 for interest owed on the coverage payments. Edison has continued to promptly and fairly adjust the claim as information is made available to it. Edison promptly and honestly made all coverage determinations based on its reasonable investigation of the claim. Moreover, contrary to the Complainant’s claims, Edison has and continues to promptly respond to all communications, communicate honestly with the Insured and her representatives, and conduct a fair and good faith ongoing investigation of the claim. There is no indication in the CRN nor anywhere within the record evidence to suggest that Edison handled the subject claim in bad faith or incongruent with the applicable Florida Statutes. Rather, the record evidence establishes the opposite, and shows that Edison properly handled and adjusted the subject claim and has continued to do so from the time it was first received through the present. Furthermore, under the circumstances, and upon information and belief, the filing of the CRN appears to be an effort to strong-arm Edison into payment for repairs and excessive benefits for which the Complainant is not entitled under the policy. The disagreement with the claim decision does not in any way constitute bad faith on the part of Edison. Under the circumstances presented, Edison cannot in good faith issue a payment for damages that are claimed and demanded by the Complainant as doing so would, in essence, breach Edison’s duty of good faith and fair dealing owed toward each and every one of its other policyholders. Accordingly, there is no evidence that Edison has acted in any way, whatsoever, contrary to the terms of the policy or in violation of the statutes listed in the CRN. III. Demands to Cure Defects. Moreover, the CRN does not specify a cure for the alleged violations that comports with the provisions of the subject Policy. Further, the CRN requests “cures” that are improper according to Florida law and Fla. Stat. §624.155. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278, 1281 (Fla. 2000). The Talat decision provides that a “cure” must be limited to contract damages. Additionally, Section 624.155, Florida Statutes, does not impose on an insurer the obligation to pay whatever its insured demands. Talat, 753 So. 2d at 1282. On the contrary, the Florida Supreme Court holds that the scope of what can be “cured” in responding to a Civil Remedy Notice, is limited to contractual amounts due to the insured. See Talat, 753 So. 2d at 1281. The subject Notice is deficient as it does not provide an opportunity to “cure” the alleged violations without imposing obligations on Edison not owed or contemplated by the Policy. To the extent the CRN requests anything other than contract proceeds, the CRN is defective and should be rejected. The offer to cure in the CRN, rather, is illusory and even a reading of the CRN in a light most favorable to the Complainant requires that it be invalidated and rejected. Notably, the CRN requests that in order to cure the alleged violations, Edison must: 1) issue payment based on the estimates and invoices submitted to Edison; 2) payment of alleged “damages that resulted from Edison’s refusal to fairly and timely adjust the claim including, but not limited to, fair market value of the loss of use of property, interest on payments not made, related costs, and fees”; 3) payment of undefined alleged “additional damages” which are clearly ambiguous; 4) implement proper standards for the training, supervision and management of all claims handling personnel; and 5) revise the procedures by which its claims handling personnel are hired, retained and promoted. First and foremost, the CRN’s failure to identify a specific cure or cure amount renders the CRN deficient. Additionally, the CRN’s alleged cures attempt to demand beyond what it available pursuant to Florida law and the Policy. Also, Edison has and continues to implement property and appropriate standards for the hiring, training, supervision, and management of all claims handling personnel. Moreover, based on its thorough investigation, the information received at this time, and the terms and conditions of the Policy, Edison issued the proper amounts owed under the Policy and in accordance with Florida law including interest payments, therefore, no amounts are due and owing pursuant to the Policy and Florida law. The cures demanded is clearly deficient and improper. IV. Conclusion. In closing, Edison first believes that the CRN does not comply with section 624.155, Florida Statutes, and should therefore be rejected and returned by DFS due to its failure to comply with § 624.155, Florida Statutes, and Florida case law. Regardless of the rejection and lack of compliance, Edison denies all allegations contained in the CRN and submits there are no violations. While this Response is meant to be comprehensive, Edison’s Response above is based upon the limited information provided in the CRN and the information we have to date. If the Complainant feels that we are not in possession of all the facts, please inform us immediately. Please note that Edison’s Response is not necessarily exhaustive and does not preclude us from asserting any other valid reason for the lack of compliance with Florida Statute § 624.155. Also, this letter or any act or failure to act on the part of Edison or any agent or representative of Edison should not be construed as a waiver of any rights or defenses available to it by contract or at law as all such rights and defenses are hereby specifically reserved. We trust that this Response addresses the allegations of insurer violation alleged in the CRN filed on March 28, 2025.
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