Civil Remedy Notice of Insurer Violations
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Filing Number:     817516
Filing Accepted:  4/24/2025
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Complainant
Last/Business Name *  
LADY LAKE BB, LLC   First Name  
Street Address * 415 US HIGHWAY 441
City, State Zip * LADY LAKE, FL 32159
Email Address * TCLARK@ORIONMIAMI.COM
Complainant Type: * Insured
Insured
Last/Business Name*   LADY LAKE BB, LLC   First Name  
Policy # * CPS7557468 Claim #* 02176745
Attorney
Attorney is Applicable
Last Name* SANDON First Name * JOY Initial
Street Address* 2300 MAITLAND CENTER PKWY, SUITE 106
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * JSANDON@SERRANOCAGAN.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   SCOTTSDALE INSURANCE COMPANY
NAIC Company Code 41297
 
Name of individual responsible for violation (if any):* DESK ADJUSTER, FIELD ADJUSTER
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section).
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On or about September 28, 2022, Lady Lake BB, LLC ("Insured"), sustained a covered direct physical loss to Insured's property due to a windstorm. Insured reported the loss thereafter to Scottsdale Insurance Company ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy #CPS7557468 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # 02176745. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $0.00 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about October 3, 2024, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 624.155(1)(b)(1): Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests; 624.155(1)(b)(3): Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims; 626.9541(1)(i)(3)(e): Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed; 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement. 626.9541(1)(i)(3)(g): Failing to promptly notify the insured of any additional information necessary for the processing of a claim. 626.9541(1)(i)(3)(h): Failing to clearly explain the nature of the requested information and the reasons why such information is necessary. 626.9541(1)(i)(3)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $315,314.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2300 Maitland Center Parkway, Suite 106, Maitland, Florida 32751.
Comments
User Id Date Added Comment
roeunc1@nationwide.com 06-06-2025 Un-Cured Response: Nationwide has responded to the Civil Remedy Notice on June 2, 2025.
bsmith@kaufmandolowich.com 06-02-2025 June 2, 2025 Via Electronic Mail, and DFS Portal Lady Lake BB, LLC c/o Joy Sandon, Esq. Serrano Cagan & Cagan 2300 Maitland Center Pkwy., Suite 106 Maitland, FL 32751 jsandon@serranocagan.com CRN Filing No.: 817516 CRN Filing Date: April 24, 2025 Insurer: Scottsdale Insurance Company (“Scottsdale”) Policy: CPS7557468 (“Policy”) Effective Dates: 04/08/2022-04/08/2023 Named Insured: Lady Lake BB LLC (“Insured”) Claim No: 02176745 Dear Ms. Sandon: This firm represents Scottsdale Insurance Company. Please accept this as Scottsdale’s response to the above-referenced Civil Remedy Notice of Insurer Violation (“CRN”). As explained in further detail below, the CRN is deficient on its face and does not comply with the requirements of Florida Statute § 624.155. I. BACKGROUND The property at issue is a commercial building resembling a former bank location in Lady Lake, Florida. Currently, the property is occupied by a marijuana dispensary. Notably, Lady Lake is located in central Florida, well inland of where Ian made landfall. Winds in the Lady Lake area maxed out at around 40-50 mph, well below the over 125+ mph wind rating for a typical tile roof. Nevertheless, the Insured claims the roof was damaged by high winds resulting in interior water infiltration. The Insured’s civil remedy notice fails to contain any facts and ignores that the Insured did not report the claim to Scottsdale until nearly two years after Hurricane Ian on August 2, 2024. On August 10, 2024, field adjuster Chris D’Antoni inspected the property. Mr. D’Antoni found numerous areas of prior repairs. He indicates that the areas of concern appeared to be age and wear related and that the roof was beyond its useful life. Inside the building, Mr. D’Antoni found water damage to ceiling tiles in the waiting room, two offices, two conference rooms, the men’s bathroom and the register area. A contractor with Central Homes (Chris Woodall) indicated that the insured claims the roof started leaking after Ian and that multiple repairs have been made to the interior over the two years. On April 18, 2024, Scottsdale sent engineer Randy Ciarlone of EFI Global to inspect the property further. Mr. Ciarlone found that the roof did not sustain damage from Hurricane Ian. Rather, he indicates that the leaks are the result of age-related deterioration as the roof is at the end of its useful life. On September 3, 2024, Scottsdale issued a coverage denial letter citing the fact that Scottsdale’s Policy does not cover pre-existing damage, wear and tear, and age-related deterioration. The letter further notes Plaintiff’s untimely notice and how the notice prejudiced Scottsdale’s ability to properly investigate the claim. II. THE CRN DOES NOT COMPLY WITH THE REQUIREMENTS OF FLORIDA STATUTE §624.155 In relevant part, Florida Statute §624.155 provides: (3)(a) As a condition precedent to bringing an action under this section, the department and the authorized insurer must have been given 60 days’ written notice of the violation. (b) The notice shall be on a form provided by the department and shall state with specificity the following information, and such other information as the department may require: 1. The statutory provision, including the specific language of the statute, which the authorized insurer allegedly violated. 2. The facts and circumstances giving rise to the violation. . . . 4. Reference to the specific policy language that is relevant to the violation, if any… In its CRN, the Insured alleges that Scottsdale violated the following statutory provisions: §624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests. §624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage §626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. §626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. §626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information. §626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed §626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement. §626.9541(1)(i)(3)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). The Insured’s CRN fails to meet the above-referenced statutory requirements. First, the Statute requires that the Complainant set forth the “specific policy language that is relevant to the violation, if any.” Here, no policy language is even included in the CRN complaint. Additionally, at no point does the Insured/Complainant describe the specific policy language requiring payment or how Scottsdale has failed to comply with the policy requirements beyond simply stating that Scottsdale refuses to pay exactly what the Insured demands. The CRN posits a one-sided narrative which fails to accurately present any facts, much less relevant facts. Pursuant to section 624.155(3)(b)(2), Florida Statutes, the Notice must state the facts and circumstances giving rise to the alleged violations. The Notice contains only conclusory allegations and does not provide the specificity required under the statute or facts and circumstances giving rise to the alleged violation. In terms of §624.155(1)(b)(1) and (3), the Insured has provided no facts that Scottsdale has ever been provided with an opportunity to settle pending claims short of paying 100% of what the Insured demands. The only facts alleged by the Complainant is that Scottsdale refused to pay $315,314 – a number not supported by the facts and which fails to even factor in the Policy’s wind deductible. Notably, the only contractor estimate provided to Scottsdale by the Plaintiff totals $205,802.68, over $100,000 less than the Complainant’s demand. In terms of §626.9541(1)(i)(3)(a), the CRN relates to a single claim and the Insured has provided no facts whatsoever as evidence that Scottsdale failed to adopt and implement standards for the proper investigation of claims. To the contrary, Scottsdale fully investigated the claim and issued a coverage determination letter clearly citing the reasons no payment would be made. With respect to §626.9541(1)(i)(3)(c), failing to acknowledge and act promptly upon communications with respect to claims, the CRN again contains no evidence or even basic details to substantiate the claim. In fact, this claim completely ignores the continuous communication between the Insured and Scottsdale and further ignores Plaintiff’s untimely notice and failure to cooperate and participate in Scottsdale’s investigation of the claim. In terms of §626.9541(1)(i)(3)(d), the Insured has provided no facts that Scottsdale failed to conduct a reasonable investigation. Scottsdale inspected the property with both a field adjuster and engineer and reached a coverage determination within 41 days after receiving notice of the claim. With respect to §626.9541(1)(i)(3)(e), the Complainant’s allegations are not supported by the facts. Scottsdale issued a timely coverage determination letter on September 12, 2024 after being placed on notice of the claim on August 2, 2024. Importantly, this notice was not provided to Scottsdale until nearly two years after the alleged loss date. Similarly, the contentions in the CRN related to §626.9541(1)(i)(3)(f) are unfounded. Scottsdale issued a timely coverage determination letter only 41 days after being placed on notice of the claim. No proof of loss was provided in this matter. Lastly, §626.9541(1)(i)(3)(i) relates to claims for personal injury protection (PIP). The instant matter is not a PIP claim. III. SCOTTSDALE HAS ACTED IN “GOOD FAITH” THROUGHOUT THE CLAIM PROCESS At all times, Scottsdale acted in good faith in their investigation and adjustment of the claim. Scottsdale promptly acknowledged the claim, assigned an adjuster, coordinated an inspection with a field adjuster just days after receiving notice of the claim, further assigned an engineer to inspect the property and provide an opinion, communicated with the Insured and their representatives and timely provided a coverage determination all within 41 days of receiving notice of the claim. Fla. Stat. § 624.155(5)(b)(1) establishes a two-way street of good faith when it states that: The insured, claimant, and representative of the insured or claimant have a duty to act in good faith in furnishing information regarding the claim, in making demands of the insurer, in setting deadlines, and in attempting to settle the claim. The Insured failed to promptly report the claim to Scottsdale, waiting nearly two years to report and highly prejudicing Scottsdale’s investigation of the claim. Scottsdale further assigned both a field adjuster and engineer to inspect the property, both finding no evidence of storm related damage. This communication is not intended to be and should not be construed as an exhaustive listing of all policy terms and conditions that may apply to this matter. Nothing contained herein shall be deemed a waiver of Scottsdale’s rights to assert additional grounds for disclaiming coverage, whether now known or discovered in the future. Scottsdale specifically reserves its rights to rely upon any additional terms, conditions, limitations, exclusions, or provisions of the Policies or under applicable law to support its coverage determination, whether stated herein or otherwise. Should you wish to discuss this further, please feel free to contact us. Very truly yours, /s/ Brett A. Smith, Esq. Brett A. Smith, Esq.
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