Civil Remedy Notice of Insurer Violations
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Filing Number:     814294
Filing Accepted:  4/2/2025
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Complainant
Last/Business Name *  
LOMBARDO   First Name   JOHN
Street Address * 15192 BROLIO WAY
City, State Zip * NAPLES, FL 34110
Email Address * GPODOLAK@SDVLAW.COM, KOFCARCIK@SDVLAW.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   ROYAL CUSTOM HOMES LLC   First Name  
Policy # * P101.514.832.2 Claim #* 100.245.043A
Attorney
Attorney is Applicable
Last Name* PODOLAK First Name * GREGORY Initial
Street Address* 999 VANDERBILT BEACH ROAD, SUITE 603
City, State Zip* NAPLE , FL 34108
Email Address * GPODOLAK@SDVLAW.COM, KOFCARCIK@SDVLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   HISCOX INSURANCE COMPANY INC.
NAIC Company Code 10200
 
Name of individual responsible for violation (if any):* CHRISTOPHER LAMONDE RILEY
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unfair Trade Practice
Other : Refusal to provide copy of policy, recission notice and other insurance information related to 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.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Despite a request of Hiscox Inc. pursuant to Fla. Stat. s. 627.4137, Hiscox Inc. has refused to provide a copy of the policy to Mr. Lombardo within 30 days of Mr. Lombardo’s request.
 
* 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 around October of 2022, John Lombardo retained Royal Custom Homes LLC (“Royal Custom Homes”) to rebuild the second-floor flat roof/patio of his home located at 15192 Brolio Way, Naples, Florida 34110 (the “Subject Residence”), to address leaks from that flat roof/patio into his outdoor living room. This work was completed on or around November of 2022 and Mr. Lombardo was charged $18,596 for this work. However, Royal Custom Homes’ work was faulty in nature, resulting in leaks that were worse than those that predated Royal Custom Homes’ work. Further, additional repairs performed by Royal Custom Homes—and for which Mr. Lombardo paid in excess of $22,000—failed to address these leaks. As a result of Royal Custom Homes’ failure to address the problems caused by its faulty work, Mr. Lombardo retained Epic Home to perform an initial inspection of the flat roof/patio installed by Royal Custom Home as well as Royal Custom Homes’ failed remedial efforts. Epic Home discovered numerous issues with the work performed by Royal Custom Homes as well as further damage caused to the Lombardo residence by Royal Custom Homes’ work. The cost of Epic Home’s investigative work was $6,480.00, and Mr. Lombardo received an estimate of $78,460.00 from Epic Home to rebuild the balcony and stucco ceiling, to perform necessary electrical work, and to build a new wood frame for the arch; and an estimate from Crate Fireplace and Outdoor Living, LLC for $3,405.61 to address significant corrosion to the fireplace caused water damage from the faulty roof. Because Royal Custom Homes’ work had failed to address the leaks and even exacerbated them, resulting in significant additional expenses to Mr. Lombardo, Mr. Lombardo reached out to Royal Custom Homes to obtain its liability insurance information in order to submit a claim to its insurer to address Mr. Lombardo’s losses. However, Royal Custom Homes refused to provide any information concerning its liability insurance. Accordingly, Mr. Lombardo conducted his own investigation, identifying Royal Custom Homes’ insurer as Hiscox Inc., the Hiscox Inc. liability insurance policy number, and a mailing address for Hiscox Inc. Armed with this information, on or around November 12, 2024, Mr. Lombardo by way of counsel sent a letter to Hiscox Inc. detailing the above events concerning Royal Custom Homes’ faulty work and the damages incurred by Mr. Lombardo as a result. Further, pursuant to Fla. Stat. s. 627.4137, Mr. Lombardo requested the following to be provided within 30 days with respect to each known policy of insurance: 1. The name of the insurer; 2. The name of each insured; 3. The limits of any liability coverage; 4. A statement of any policy or coverage defense which such insured reasonably believes is available to such insured at the time of the statement; and 5. A copy of any policy, including all endorsements. On November 27, 2024, Christopher LaMonde Riley of Hiscox Inc. sent an email to Mr. Lombardo and his counsel, identifying himself as the assigned adjuster for Mr. Lombardo’s third-party liability claim. At that time, Mr. Riley stated that he was commencing an investigation of the claim and requested certain documents from Mr. Lombardo as a part of that investigation. However, Mr. Riley neither provided the requested information pursuant to Mr. Lombardo’s November 12, 2024 letter and Fla. Stat. s. 627.4137, nor acknowledged Hiscox’s statutorily required responsibility to do so. On December 27, 2024, Mr. Lombardo’s son, Anthony Lombardo, on behalf of his father, provided by way of email to Mr. Riley a package of information related to his father’s claim. However, on that same day, less than 90 minutes later, Mr. Riley informed Mr. Lombardo that Hiscox Inc. “had decided to rescind the issued policy to Royal Custom Homes. As a result, there is no longer a policy in place for this entity.” No further explanation was provided regarding why the policy was rescinded, nor was any of the information provided by Hiscox Inc. pursuant to Mr. Lombardo’s statutory request in the November 12, 2024 letter, despite it being more than 30 days since Mr. Lombardo requested that information pursuant to Fla. Stat. s. 627.4137. In response, Mr. Lombardo’s legal counsel immediately requested a copy of any rescission correspondence that Hiscox Inc. had issued. However, on January 10, 2025, Mr. Riley responded that the rescission letter was “considered internal correspondence” and has only been issued to its former insured, Royal Custom Homes. Once again, Hiscox Inc. failed to provide any of the information requested pursuant to Mr. Lombardo’s November 12, 2024 letter. That same day, counsel for Mr. Lombardo sent an email with a follow-up formal request for a copy of the rescission notice, this time pursuant to Fla. Stat. s. 627.4137. However, that same day, Mr. Riley responded that Hiscox Inc. was not required to provide a copy of the recission notice pursuant to Fla. Stat. s. 627.4137, and this despite the fact that the statute expressly requires disclosure of the following: (1) Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer’s claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance: (. . .) (d) A statement of any policy or coverage defense which such insurer reasonably believes is available to such insurer at the time of filing such statement (emphasis added). Once again, on January 10, 2025, counsel for Mr. Lombardo emailed Mr. Riley to highlight the above statutory language which requires Hiscox Inc. to provide a copy of the rescission notice, while also reminding Mr. Riley that the November 12, 2024 letter sent to Hiscox Inc. included a request pursuant to Fla. Stat. s. 627.4137, which was 45 days prior to Hiscox Inc.’s purported rescission of the policy on December 27, 2025 (and therefore, well past the 30-day statutory deadline). However, neither Mr. Riley nor anyone at Hiscox Inc. responded to counsel for Mr. Lombardo’s January 10, 2025 email, nor provided any information pursuant to either the November 12, 2024 or January 10, 2025 request pursuant to Fla. Stat. s. 627.4137. In light of the above, it is clear that Hiscox Inc. has acted in bad faith in the adjustment of Mr. Lombardo’s claim. In violation of Fla. Stat. s. 627.4137, Hiscox Inc. failed to provide the information to which Mr. Lombardo is entitled both before and after Mr. Riley emailed Mr. Lombardo that Hiscox Inc. had “decided to” rescind the policy. Further, Hiscox Inc. informed Mr. Lombardo of its decision to rescind the policy only after receiving from Mr. Lombardo’s son the loss information related to his father’s claim, including documentation related to the significant expenses Mr. Lombardo had incurred, while also refusing to provide any basis for the rescission much less a copy of the rescission notice requested. In sum, Hiscox Inc. has unilaterally rescinded the policy without justification or explanation, concealing its motives behind the assertion that the rescission is “internal correspondence,” even though Hiscox Inc. provided a copy of the rescission notice to its former insured. To cure, Hiscox Inc. must immediately provide a copy of the rescission notice issued to Royal Custom Homes and all information pursuant to Mr. Lombardo’s two requests pursuant to Fla. Stat. s. 627.4137, including a full and complete copy of Policy # P101.514.832.2, and pursuant to that policy issue payment for Mr. Lombardo’s losses pursuant to the estimates provided by Epic Home ($6,480.00 (investigation) + $78,460.00 (rebuild)) and Crate Fireplace and Outdoor Living, LLC ($3,405.61) = $88,345.61. All communication can be made through Mr. Lombardo’s legal counsel, Gregory Podolak, 999 Vanderbilt Beach Road, Suite 603, Naples FL 34108, (239) 315-4215 gpodolak@sdvlaw.com.
Comments
User Id Date Added Comment
tsalehi@salehiboyer.com 04-23-2025 VIA ELECTRONIC SUBMISSION: civilremedy@myfloridacfo.com Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 RE: Complainant: John Lombardo Policyholder: Royal Custom Homes LLC Filer: Gregory Podolak Claim #: 100.245.043A Policy #: P101.514.832. (1&2) Date of Loss: November 2022 CRN Filing No.: 814294 CRN Filing Date: April 02, 2025 To Whom It May Concern at The Department of Financial Services: With this correspondence, Hiscox Insurance Company Inc. (“Hiscox”) responds to the Civil Remedy Notice of Insurer Violations (“CRN”) filed by Gregory Podolak. on behalf of John Lombardo (the “Complainant” or “Claimant”). After reviewing the CRN, Hiscox conducted a thorough review of its handling of the Complainant’s claim. Hiscox denies that it has violated any of the statutes referenced in the CRN. At all times, Hiscox has acted in good faith, fairly and honestly toward the Complainant and with due regard for their interests. Hiscox also argues that the CRN fails to sufficiently describe the alleged violations and fails to provide any information such as facts and circumstances which would allow Hiscox to correct the alleged violations. The Complainant alleges violations of the following statutory provisions: 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all the circumstances it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests. Hiscox denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Hiscox denies this allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(b): Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. Hiscox denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims. Hiscox denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Hiscox denies the allegation that it violated the above referenced statute. 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement. Hiscox denies the allegation that it violated the above referenced statute. Hiscox specifically denies each and every one of the Complainant’s allegations that it violated any of the above referenced statutes. In addition to the allegations specifically denied above, Hiscox generally denies all allegations presented in this CRN as Hiscox has not violated any statute or rule. CRN MUST BE DISMISSED The CRN must be dismissed first and foremost because the Complainant failed to allege sufficient, actual facts in support of any of their statutory allegations. The CRN first addresses Section 624.155(1)(b)(1), Florida Statutes, which addresses an insurer’s refusal to attempt to settle in good faith. The CRN, however, does not specify the details of the settlement proposal, the nature of the underlying claim(s), or the circumstances supporting the conclusion that the unspecified refusal to settle was not in good faith. To the extent the CRN suggests that Hiscox should tender payment due on the claim, the CRN fails to provide a sufficient description of the facts and circumstances supporting this contention. Instead, the entirety of Claimant’s assertion rests upon the allegation that Hiscox did not tender payment according to the first demand received within approximately 45 days of receipt of Claimant’s demand. Moreover, as to Section 624.155(1)(b)(3), Florida Statutes, the CRN is completely devoid of any facts to support that Hiscox failed to promptly settle a claim under one portion of the policy in order to influence settlement under other portions of the policy. Additionally, the statute clearly states that it does not apply to liability coverages. Upon information and belief, Claimant is seeking payment from Hiscox under liability coverage. Therefore, aside from the allegation being devoid of any facts or circumstances, the allegation is not appropriate as the statute is not applicable. Furthermore, 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, conclusory, and incorrect allegations with no basis in fact or circumstance. Aside from the fact that the allegations are devoid of adequate facts, the tenor and inferences of the allegations are wholly without merit and Hiscox denies each and every one. The allegations set forth in the CRN are denied as they are mere conclusory allegations unsupported by facts, devoid of logic and intended solely to tarnish Hiscox’s name and reputation. Hiscox, at all times, acted fairly, honestly and in good faith in its dealings with the Complainant. Hiscox at no time misrepresented any pertinent facts or insurance policy provisions. Hiscox conducted a reasonable and prudent investigation of the claim and acted upon all communications from the Complainant. Finally, Hiscox promptly and appropriately communicated with the Complainant and provided explanations for the actions and decisions that were made. As it relates to the facts of the claim, Hiscox received notice of the subject loss from the claimant on or about November 19, 2024, alleged to have occurred on or about November of 2022. Specifically, it was alleged that Royal Custom Home LLC (“Insured”), incorrectly installed a flat roof/patio at John Lombardo's residence. Allegedly, this resulted in damage, which Royal Custom Home LLC failed to repair. An independent inspection determined Royal Custom Home LLC’s work was defective and caused damage to the Lombardo residence. The alleged cost of repairs totaled $78,460.003. Following receipt of the notice of loss, Hiscox’s investigation determined Royal Custom Homes LLC made misrepresentations on the application for insurance with Hiscox. Also, Hiscox determined Royal Custom Homes LLC was conducting business operations outside the scope of the intended purpose of their policy of insurance with Hiscox. Therefore, Hiscox rescinded the insurance policies issued to Royal Custom Homes LLC and returned the premium paid as a direct result of the material misrepresentation made by Royal Custom Homes LLC. As such, both policies issued by Hiscox bearing policy number P101.514.832 (1&2) were voided ab initio. Hiscox communicated this information to John Lombardo and Mr. Lombardo’s counsel on numerous instances. In the civil remedy notice, the complainant lists the date of loss as November 2022. The policy with Hiscox incepted February 9, 2023 and thus, was in force after the date of loss. Therefore, if the policies had not been voided ab initio, the loss would have been excluded by the policies of insurance due to the loss taking place prior to the inception of the Hiscox policies. In response to the CRN notice and to demonstrate good faith, Hiscox prepared a disclosure under Florida Statute 627.4137 for the complainant. Additionally, copies of the rescinded policies that were voided ab initio were provided along with the disclosure of insurance information. The above demonstrates quite clearly that Hiscox acted in good faith, acted fairly and honestly, acknowledged and acted promptly upon receipt of the claim, attempted to determine coverage for the claim pursuant to the terms of the policy, took reasonable steps to investigate the claim, communicated reasonably with the Complainant about the claim, and provided the Complainant a reasonable explanation for each of its actions. Additionally, the CRN contains “cures” for the alleged defects. As stated, Hiscox complied with Fla. Stat. s. 627.4137, by providing Mr. Lomabrdo’s legal counsel Gregory Podolak with full and complete copies of the Hiscox policies issued to Royal Custom Homes LLC. Additionally, Hiscox provided Attorney Podolak with copies of the rescission notices. However, the additional listed “cures” are improper pursuant to Florida case law, specifically the case of Talat Enterprises, Inc., v. Aetna Casualty and Surety Co., 753 So.2d 1278, 1281 (Fla. 2000). The Talat case provides that the scope of what can be "cured" is limited to the alleged non-payment of the contractual amount due to the insureds. Talat also commented that, “[i]t naturally follows that for there to be a ‘cure,’ what had to be ‘cured’ is the non-payment of the contractual amount due the insured. In the context of a first-party insurance claim, the contractual amount due the insured is the amount owed pursuant to the express terms and conditions of the policy after all of the conditions precedent of the insurance policy in respect to payment are fulfilled....” As noted, Mr. Lomabrdo and his legal counsel Gregory Podolak are third-party claimants. As a result, only a demanded “cure” relating to the specific amount needed to repair covered damages owed to a first-party is proper and legal – any remaining “cures” are improper remedies and contrary to Florida law. In closing, Hiscox first believes that the CRN should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute § 624.155 and Florida case law, and regardless of the rejection, Hiscox denies all allegations contained in the CRN and submits that there are no violations. While this response is meant to be comprehensive, Hiscox based the above-mentioned statements upon the limited information provided in the CRN and the information Hiscox has been provided to date. If the Complainant feels that Hiscox is not in possession of all the facts, please provide such additional information as soon as possible. Please note that Hiscox’s response is not necessarily exhaustive and does not preclude the assertion of other valid reasons for seeking rejection and return of the CRN. Also, nothing in this letter, or any act or failure to act on the part of Hiscox or any agent or representative of Hiscox should 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. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Sincerely, Christopher LaMonde Riley, AIC, AIM, AINS, CIA, CIU Complex Claims Specialist Hiscox USA P: 678-781-6057
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