Civil Remedy Notice of Insurer Violations
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Filing Number:     821491
Filing Accepted:  5/14/2025
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Complainant
Last/Business Name *  
GUAJARDO   First Name   GABRIELA
Street Address * 3410 MCBROOM ST.
City, State Zip * DALLAS, TX 75212
Email Address * GABBY1GUAJARDO@GMAIL.COM
Complainant Type: * Third Party
Insured
Last/Business Name*   49 COLLINS AVENUE RESTAURANT LLC D/B/A CARBONE   First Name  
Policy # * UNKNOWN – ZURICH FAILED TO PROVIDE Claim #* 9510180387
Attorney
Attorney is Applicable
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   ZURICH AMERICAN INSURANCE COMPANY
NAIC Company Code 16535
 
Name of individual responsible for violation (if any):* MARK BURTON, ROBERT PICKETT, CASONDRA ADAMS, DAMIAN SEPANIK, ZURICH CLAIMS DEPARTMENT
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
Other : UNKNOWN — Zurich has failed to provide a certified copy of the policy. Claimant invokes all relevant
* 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)(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)(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)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

UNKNOWN — Zurich has failed to provide a certified copy of the policy. Claimant invokes all relevant coverage provisions, including bodily injury, medical payments, and liability coverage for premises liability incidents under Commercial General Liability policy in effect on April 30, 2023.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

On April 30, 2023, Claimant suffered a slip-and-fall injury at Carbone restaurant (49 Collins Avenue, Miami Beach), a Zurich-insured premises. A preservation letter was issued May 2, 2023. Despite this, Zurich and its insured failed to produce surveillance video or incident documentation during discovery. On January 31, 2025, Zurich filed a privilege log withholding the video and incident report, claiming work product, with no sworn denial of their existence. This constitutes spoliation under Florida law. Claimant’s own counsel failed to compel the video, withdrew mid-case, and participated in improper mediation representation without consent or appearance notices. Defense counsel engaged in abusive deposition conduct and leveraged the absence of video to discredit the claim. No good faith effort to resolve the claim occurred, despite Zurich having full notice, medical treatment documentation, and an opportunity to settle. Zurich violated § 624.155(1)(b)(1), § 624.155(1)(b)(3), and multiple provisions of § 626.9541(1)(i), including failure to investigate, delay, misrepresentation, and failure to explain denials. These acts deprived Claimant of a fair claims process and demonstrate a pattern of bad-faith handling designed to suppress evidence and discourage settlement. The statutory 60-day cure period begins immediately.
Comments
User Id Date Added Comment
iolman@smsm.com 07-11-2025 Please be advised that this law firm represents Zurich American Insurance Company (“ZAIC”) (NAIC Code 16535) with respect to the Civil Remedy Notice of Insurer Violations number 821491 filed by pro se complainant, Gabriela Guajardo (“Complainant”) and accepted by the Department on May 14, 2025 (hereinafter “CRN”). This response is timely made. The CRN is in relation to ZAIC Claim Number 9510180387 under the ZAIC policy bearing policy number CPO 7986069 – 01 issued to MFG MIAMI FUND LLC, which includes 49 Collins Avenue Restaurant LLC as a scheduled Named Insured (hereinafter “Insured”) for the policy period of April 1, 2023 to April 2, 2024 (hereinafter “Policy”). ZAIC categorically denies any and all wrongdoing, including any violation of Fla. Stat. Sections 624.155 or 626.9541 and any subparts thereof. ZAIC responds that it has acted in good faith, fairly, and honestly in the handling of the subject claim. ZAIC provides this detailed response to clarify the factual inaccuracies, omissions, and deficiencies within the CRN. I. Allegations Contained in the CRN The Complainant alleges that ZAIC violated §§ 624.155 and 626.9541 due to the alleged failure to produce surveillance video footage or incident documentation during the course of litigation. Complainant further contends that ZAIC improperly withheld evidence by asserting work product privilege with “no sworn denial of their existence” and characterizing this as “spoliation under Florida law.” The Complainant additionally raises concerns unrelated to ZAIC, including accusations against her own prior counsel for allegedly failing to compel production of video, withdrawing mid-litigation, and participating in mediation without proper notice or authority. The CRN further includes vague and unsupported allegations of “abusive deposition conduct” by defense counsel and claims that ZAIC failed to act in good faith in evaluating or attempting to resolve the claim. Complainant generally asserts that ZAIC engaged in delay, misrepresentation, and a failure to properly explain denials, claiming these actions deprived her of a fair claims process and reflected a pattern of alleged bad faith. II. Background of the Claim and Litigation History On or about June 11, 2024, the Complainant, through her then-retained counsel, filed a Complaint against ZAIC’s insured, 49 Collins Avenue Restaurant LLC, d/b/a Carbone, in the Circuit Court of the Eleventh Judicial Circuit in and for Miami-Dade County, Florida, Case No. 24-010688 CA 04 (the "Lawsuit"). The Lawsuit alleged negligence arising from a slip-and-fall incident purportedly occurring on or about April 30, 2023. ZAIC promptly retained counsel to represent its insured and actively defended the matter. The public court docket reflects that the parties engaged in extensive discovery, including written interrogatories and requests for production. A mediation was conducted on April 25, 2025, at which time the Mediator's Report indicated that the mediation resulted in an impasse. Following the mediation, the Complainant’s two separate counsel of record each moved to withdraw, which motions were granted by court order on May 6, 2025. On May 7, 2025, the Complainant voluntarily dismissed her Lawsuit without prejudice. Given the Complainant’s voluntary dismissal, and that the incident in question allegedly occurred on or about April 30, 2023, the statute of limitations for any negligence claim under Florida Statutes § 95.11(5)(g) has expired. Therefore, any future claim against ZAIC’s insured arising from the same incident would now appear to be time-barred. III. The CRN Improperly Raises Issues Related to Litigation and Counsel Conduct The allegations in the CRN related to the alleged surveillance video, privilege log, and supposed “spoliation” of evidence are matters governed by the procedural rules and oversight of the trial court and are not within the purview of § 624.155. These are discovery-related issues that fall squarely within the scope of the underlying litigation, and are not indicative of a statutory violation by ZAIC. Similarly, allegations pertaining to Complainant’s own counsel—including alleged withdrawal without proper procedure or unauthorized representation at mediation—are not attributable to ZAIC and do not support any assertion of insurer bad faith. These are internal issues between the Complainant and her retained counsel and are not actionable under a Civil Remedy Notice. The Complainant’s assertion that defense counsel engaged in “abusive deposition conduct” is vague and lacks factual detail or substantiating evidence. Again, such claims are properly addressed within the litigation framework, and do not constitute a violation of insurance claims handling statutes. With regard to the allegation that ZAIC failed to make a good faith effort to resolve the claim, that assertion is belied by the record. The parties participated in a court-ordered mediation on April 25, 2025, in a good faith effort to resolve the matter. Details of the mediation are protected by privilege under Florida law, but the occurrence of mediation itself is a clear indication of ZAIC’s willingness to explore settlement opportunities. The CRN also asserts that ZAIC failed to provide a certified copy of the Policy; however, a review of the discovery requests served by Complainant in the Lawsuit reflects that no such request was ever made. The alleged failure to produce a certified copy of the Policy that was never actually requested does not constitute evidence of bad faith or wrongful conduct by ZAIC. IV. The CRN is Legally Insufficient and Invalid This CRN is legally deficient and invalid under Florida law for the following reasons: 1. Lack of Specificity: The CRN fails to describe with sufficient specificity how ZAIC allegedly violated § 624.155(1)(b)(1), § 624.155(1)(b)(3), or any of the cited provisions of § 626.9541(1)(i), as required under Florida law. 2. Improper Use of CRN Process: The CRN improperly seeks to litigate issues related to discovery disputes, litigation conduct, and attorney conduct. These matters are not appropriate for a CRN under § 624.155 and are more properly addressed in the judicial process, where Complainant had the opportunity to raise them. 3. Unsupported and Irrelevant Allegations: The CRN attempts to impute responsibility to ZAIC for the alleged acts or omissions of Complainant’s own counsel, for which ZAIC bears no responsibility and which are not relevant to any insurer duty under Florida law. 4. Failure to Acknowledge Good Faith Efforts: The CRN ignores the actions taken by ZAIC to investigate, evaluate, defend, and attempt to resolve the claim, including the retention of defense counsel, participation in discovery, and attendance at mediation. 5. Time-Barred Claim: As a result of Complainant’s own voluntary dismissal of the Lawsuit and the passage of the applicable statute of limitations under § 95.11(5)(g), any negligence claim against the Insured is now time-barred. For these reasons, the CRN fails to meet the standards set forth by Florida law and applicable regulations governing civil remedy notices. V. Conclusion At all times, ZAIC acted in good faith and with due regard for the interests of its insured and the Complainant. Upon receipt of the claim, ZAIC promptly investigated the matter, retained legal counsel, actively defended the litigation, and participated in settlement efforts in a good faith manner, including mediation. The allegations raised in the CRN are without merit and almost entirely misdirected at ZAIC. For the foregoing reasons, and pursuant to the applicable law, ZAIC respectfully denies any violation of Florida Statutes §§ 624.155 or 626.9541 or any other statute cited in the CRN. This response is provided in full and complete good faith compliance with Florida law, and in an effort to fully respond to the allegations raised in the subject CRN. ZAIC’s response to the CRN is not, and should not be construed as, a waiver of any terms, conditions, exclusions, or other policy provisions, or any other insurance policies issued by ZAIC or any of its affiliates. Nothing herein should be considered an exhaustive interpretation of the above referenced Policy. ZAIC expressly reserves all its rights under the Policy and applicable law. Should the Department require any additional information, please do not hesitate to contact the undersigned. Very truly yours, Ilana B. Olman, Esq., Segal McCambridge Singer & Mahoney 200 E Las Olas Blvd, Suite 1820 Fort Lauderdale, FL 33301 Phone: 954-869-0376 E-mail: iolman@smsm.com A copy of this CRN response has also been provided to Complainant, via e-mail at gabby1guajardo@gmail.com and Certified Mail at 3410 McBroom St., Dallas, TX, 75212, Return Receipt Requested.
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