Civil Remedy Filing

Civil Remedy Notice of Insurer Violations

Filing Number: 822037

Filing Accepted: 5/19/2025

Print Filing

Complainant

Last/Business Name *

CARRIAGE HOMES AT ARTESIA NAPLES CONDO

First Name

Street Address *

1590 OCEANIA DRIVE S.

City, State Zip *

NAPLES, FL 34113

Email Address *

AGMARTELL@COMCAST.NET

Complainant Type: *

Insured

Last/Business Name*		CARRIAGE HOMES AT ARTESIA NAPLES CONDO		First Name
Policy # *		HCP008489		Claim #*		H010018347

Attorney

Attorney is Applicable

Last Name*	WATKINS First Name * MATTHEW Initial
Street Address*		1112 GOODLETTE-FRANK ROAD
City, State Zip*		NAPLES , FLORIDA 34102
Email Address *		MATT@VWFLEGAL.COM

Violation

Insurer Type *		Authorized Insurer Unauthorized Insurer

Insurer Name
Insurer Name*		HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY
Insurer Name*
Street Address*
City, State Zip*		,
NAIC Company Code 14407

Name of individual responsible for violation (if any):* UNKNOWN
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.
	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)(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)(g)		Failing to promptly notify the insured of any additional information necessary for the processing of a claim.

* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Coverage A – including Loss Settlement and Loss Payment Provisions Endorsements Declarations Duties in the Event of Loss Applicable Policy Definitions “We will adjust all losses with you”

* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

In addition to the statutory violations referenced above and as set forth in detail hereafter, the Insured states that this carrier violated the following Florida Administrative Code Sections: 69B-220.201(3)(b) An adjuster shall treat all claims equally. An adjuster shall not provide favored treatment to any claimant. Adjusters shall adjust all claims strictly in accordance with the insurance contract. 69B-220.201(3)(b)2. An adjuster shall adjust all claims strictly in accordance with the insurance contract. 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)(f) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim. 69B-220.201(3)(m) An adjuster shall not knowingly fail to advise a claimant of their rights in accordance with the terms and conditions of the contract and applicable laws of this state. FACTUAL BASIS/ARGUMENT IN SUPPORT In Florida, the work of adjusting insurance claims engages the public trust. This insurance carrier has breached the public’s trust by its improper adjustment of the Insured’s claims of loss. As a preliminary matter, it must be asserted that the following Civil Remedies Notice (“CRN”) is being submitted by the undersigned on behalf of the Insured based upon current knowledge, information, and belief. However, due to the lack of meaningful, good faith disclosures by this carrier as of this date, particularly as it relates to critical issues of causation, investigation, and damages (which is part of this carrier’s pattern and practice in connection with its claims handling) the Insured cannot presently be expected to recite all facts giving rise to these claims nor the nature and extent of all statutory violations set forth hereinafter. Therefore, subject to the foregoing, the following is set forth. Heritage Florida Insurance Company (referred to hereinafter as “HERITAGE” the “insurer”, or the “carrier”), Policy No. HCP008489 (the “Policy”), and its assigned claim number H010018347, has failed to create and implement adequate guidelines for the proper investigation and evaluation of claims, claims handling, and for training and supervising employees, resulting in statutory violations, as set forth above. As is set forth hereafter, among other wrongs, considering the vicissitudes experienced by the Insured, this carrier has failed and refused to thoroughly, accurately, and completely investigate, evaluate, and adjust the Insured’s insurance claims for damages in good faith. This claim concerns the Insured’s well-maintained multi-unit condominium property(s) located at 1590-1610 Oceania Dr. S., Naples, FL 34113, which sustained significant, insidious, and progressive property damage from the effects of a purportedly insured event, namely Hurricane Ian (“Ian” or the “hurricane”) on or about September 28, 2022. All damages were documented in detail and were reported as soon as they were discovered. According to experts retained by the Insured, the damages were also forensically and reliably found to be due to the devastating effects of Ian and found to be of a progressive and serious nature, and all while the Policy was in full force and effect. Some of the damages are obviously ongoing, so the Insured is submitting this CRN with the expectation that additional damages are likely to be discovered, and additional/supplemental claims are to be made, and thus the Insured expressly reserves the right to supplement this CRN. Although significant damage was documented, even by HERITAGE, the claims were de facto denied because they were deemed to be “under deductible”. In other words, no money would be forthcoming. The explanation for these findings was indicated to be as a result of inspections of the property(s) by people retained by HERITAGE and passed off as independent experts in hurricane damage evaluation. However, degrees do not make an expert, and “independence” was sorely lacking here. This claims handling strategy is another in a long line of underhanded defenses routinely manufactured by HERITAGE to deprive their insured of the full value of what was represented to be “bargained for” insurance benefits. However, as explained hereinafter, the bargain was and is illusory in nature. The players in what can only be described as a claims denial charade and acting on behalf of HERITAGE in evaluating these claims were “Martin Skrmetta”, claims adjuster, “Randy Slack” of Advantage Adjustment Group, and most prominently, a forensic engineer from Nelson Forensics, “Bart Barrett”. The results were presaged, particularly when it came to the opinions expressed by Nelson Forensics, as that entity and its employees are credentialled, well known to be biased in their findings. It was opined by these individuals, but mostly by Barrett/Nelson, that a wide variety of pre-existing conditions were present, conditions which exclude coverage as set forth in the Policy, and mostly subjectively observed conditions which are typically found to exist in these cases when claims denials are made. This situation exists in large part because they are well compensated for their work, author deceptively favorable narrative reports, and almost always appear on behalf of insurance carriers and, to the best knowledge of the undersigned, never appear on behalf of the policyholders insured by these insurance carriers. These are all strong indications of witness bias. This scenario is proof positive of the “gotcha” game inherent in breach of insurance contract defenses as asserted by this carrier. So, since HERITAGE continues to rely upon these “experts”, and refuses to pay up, the claims denial process continues. This situation persists as of the date of this filing and necessitates this action in the fervent but unrequited hope that HERITAGE will somehow, in this case, be fair, put aside its own financial interests and be persuaded to meet its contractual and legal responsibilities to the Insured to return the Insured’s property to the condition it was in prior to this event. After all, that is the law but just like the facts, even the law is challenged by HERITAGE when it means full and fair payment. To summarize, and as will be obvious from a review of the matters asserted herein, all which can be reasonably ascertained to date was that HERITAGE and its loyal minions likely recognized this as a valid and fully covered claim for which they did not want to pay, no matter what the facts, no matter what the law, no matter what the evidence, and no matter what the terms of the Policy fairly indicated. But it is certain that HERITAGE pays their “experts” and, indeed, HERITAGE pays them well. HERITAGE expects the Insured to run through the unfamiliar and frustrating gauntlet of the claim handling/adjustment process. Then, in the unlikely event that the Insured somehow survives, run through another frustrating and delaying process, the legal system gauntlet, which can be equally or even more frustrating. As appears from the evidence in this case, the Insured has been presented with unreasonable delays in the rightful adjustment of these claims and no sums of money commensurate with this loss. This was a serious lack of fair evaluation and an equal lack of full candor for all open and obvious losses, but this claim handling is wholly consistent with HERITAGE’s sordid pattern and practice of abandoning policyholders. Such abandonment occurs particularly in a time of great need, as here, as the property is now vulnerable to further damage due to the state of disrepair, for which the Insured is advised she must now accept sole responsibility. The basis for these findings lies in poorly detailed inspections and legal analysis by “go to” individuals, with “go to” hackneyed findings, with little or no supporting objective evidence and data, with little or no experience in evaluating Florida claims, and most likely in unilaterally and broadly applying Policy exclusions and/or amendments, similarly without data and explanations, in a manner to solely benefit HERITAGE’s financial interests. Lack of details coupled with delay and a lack of a fair offer based upon an unfair evaluation by biased people, employed by biased insurance carriers, is the epitome of insurance carrier bad faith. HERITAGE obviously expects everyone to ignore both the evidence and a fair application of Florida law. Such onerous conduct by HERITAGE is contrary to the law, but is invoked by this carrier, with regularity and unabashed impunity, and with little or no regard for the consequences, as it suits their purposes, albeit temporarily. The discrepancy between these conclusions and the conclusions, documentation, and the conclusions and estimates cogently presented by the Insured, as discussed later, will certainly be attempted to be explained by HERITAGE as an “honest difference in evaluation”, a trite phrase which seems to only live up to half of its billing. Indeed, there is a difference, a significant difference, but there will also eventually have to be an explanation as to why the “honest” difference always seems to benefit this insurance carrier, as documentation and statistics obtained in discovery will undoubtedly demonstrate, as well as explain why their unilateral interpretation and selective application of Policy terms and exclusions by persons whom are frequently retained by and financially beholden to HERITAGE, as here, likewise always benefits HERITAGE. The alternatives available to the Insured were few, surrender, or arrange to have an independent, competent valuation of their losses, both as to the critical issues of causation and damage, by truly fair and highly respected teams of damage estimate and repair professionals, not beholden to HERITAGE, but rather beholden to professional standards and true costs, familiar with the fair evaluation of claims. So, experienced and highly respected professionals were called upon to fully and fairly evaluate the damage, and it was found, in pertinent part, that the damage was much more severe than HERITAGE would accept. Accordingly, Devin Hunt, P.E., of Synergyn Forensics was retained to provide a true assessment of the cause of the obvious damage, and as a result of his inspection, and as set forth in a state-of-the-art narrative report, utilizing professionally accepted data, methods and measurements, he found, in pertinent part, as follows: On October 10th, 2024, Synergyn inspected the buildings located at 1590 – 1610 OCEANIA DR S NAPLES, FL 34113. The purpose of this inspection was to investigate reported damage to the property. Also, to identify its nature, duration and cause based on Hurricane Ian on and around September 28th, 2022. The information contained in this report is a depiction of our examination, available eyewitnesses, past accounts, and documented on-site damages. Background The (6) buildings we inspected are multi-family complexes with (4) units in each building. The buildings having slab on grade foundation and CMU exterior walls. The main roof is covered with concrete interlocking tiles. It is in Synergyn’s professional opinion within a reasonable degree of engineering certainty that the properties inspected have sustained damage due to the storm event brought on by hurricane Ian. The following opinion and recommendations are held to the same reasonable degree of engineering certainty. The wind pressure mixed with the precipitation observed was able to create hurricane event roof openings that allowed water to penetrate the interior of the properties as described in Appendix A-1. Water staining and damage in both the interior ceilings, walls and attic spaces above them were present during inspection. Elevated dynamic and static wind pressures caused by high winds has caused the displacement (slipping, shifting, uplifting) of series of numerous tiles along the roof. Dynamic forces brought to by the hurricane force winds caused damage to the properties, and evidence of water can be seen inside the attic. In order to prevent further/future damage, the building material should be replaced. Several instances of broken tiles, uplifted tile, shifting and slipping tiles, unadhered hip and ridge caps, and damage and cracking to the mortar bonds surrounding said hips and ridges. Several of these damages were present around roof transitions, ridges, and hip sections. These areas are known as high pressure zones and are more susceptible to high wind pressures, and correlate to the wind speed, wind direction, and wind duration of the storm event brought on by hurricane Ian. There was also presence of multiple broken tiles, many in concentration from tile debris and wind-borne debris from high winds. The damage from the shifting and lifting of the field tiles from the passage of hurricane Ian has damaged the field tile and transferred stress to the connection (screw type fastener) which attaches the field tile through the water proofing membrane and into the roof decking. This has allowed areas for water travel to penetrate through the roof envelope and damage the building components underside of the waterproofing system. This damage to the roofing components will need replacement in order to prevent further/future damage to the roofing system. Furthermore, during a replacement, a roofing system shall not be applied over an existing roof deck without proper condition per FBC Building 1521.5 which will require the replacement of damaged roof sheathing in order for the roof to perform as design for lateral/gravity force distribution as design intended. FBC Building 1521.5 “A roofing system shall not be applied over an existing roof or over an existing roof deck where the roof sheathing has not been fastened in compliance with this code or where the roof sheathing will not permit effective fastening or where sheathing is water soaked or deteriorated so that effective attachment is not possible. All areas of deteriorated sheathing shall be removed and replaced.” Damage to the roof system created openings in which rainwater was able to enter the properties, causing damage to the interior of the building. Water staining in the attic is present, which was caused by the storm event openings that lead to water leaking from the roof surface into the interior. Given our findings we recommend a full roof replacement, and the replacement and refinishing of all interior damages highlighted and noted in Appendix A-1. Then in a detailed, professionally rendered damage estimate including a line-item summary of findings with many supporting photographs, all provided to HERITAGE, it was opined by Maple Leaf, P.A., that it would require at least $1,691,554.93 to return the property to its pre-loss condition, as required by the terms of the Policy and Florida law, an amount significantly higher than the HERITAGE evaluation; however, if this estimated amount is found to be in need of upward revision, or is additional estimates of damage under other coverages are determined, HERITAGE will be so advised. HERITAGE wrongfully expected the Insured to trust their handling of these claims, and to honor their contractual duties, but that inexplicable lack of common courtesy, lack of detail and lack of honest damage evaluation has resulted in just the opposite, a lack of trust, which has only festered over the passage of time, primarily due to HERITAGE’s refusal to reconsider its biased position and fairly and fully evaluate the totality and fair value of these claims The Insured has been provided with a dismissal of legitimate claims, in other words, the bum’s rush. A bad faith approach to the handling of these claims by HERITAGE was substituted for fairness, a policy which was not befitting an insurance carrier holding itself out to the public as a fair and honest broker, and based not upon a fair evaluation of the damages, but rather based upon a result-oriented, skewed claims handling process, unquestionably designed to take advantage of the superior economic and bargaining position of this carrier. HERITAGE’s statements and representations to its Insured, aided and abetted by their agents, that the loss was not fully covered and/or subject to misguided terms and conditions, are violations of the Coverages, Loss Settlement and Loss Payment Provisions, as well as the provisions of the Policy that provide policy limits coverage for damage such as this. This was a fully covered and timely reported loss. HERITAGE is contractually obligated to pay, yet they refuse to fully acknowledge their obligations. As in so many cases involving HERITAGE, they repeatedly take this approach, in a systematic and concerted effort to induce the Insured to abandon these claims or accept their pittance of an offer. But that will not work here, as the withing legal counsel has been retained. These acts are a violation of Florida Statutes 626.9541 (1)(i)(3)(b) and (1)(i)(2). HERITAGE’s “coverage evaluation”, such as it was, will not return the subject property(s) to their pre-loss condition as required under the Policy and Florida law. It used adjusters and unknown others assigned to this claim, practiced in the art of deception, who did not adjust and treat all claims equally and in so doing utilized unacceptable, scientifically unreliabl,e and parsimonious standards. This unfair treatment is shown by the total unwillingness to fairly investigate the totality of the Insured’s claims. Instead of paying what the Insured are rightfully owed, fair and full damages for many obvious losses, as required, HERITAGE continues to take steps to delay the handling and adjustment of the Insured’s claims, and require the Insured to unnecessarily incur out-of-pocket costs, retain legal counsel and wait for the legal system to slowly grind to a conclusion, in what appears to be a concerted attempt to frustrate the Insured and delay, deny, defer, and/or decrease the value of the Insured’s claims. The adjusters and attorneys assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim, the representatives acting on behalf of HERITAGE have carried out this investigation in a manner highly prejudicial manner to the Insured. HERITAGE has placed its financial interests above the interests of its Insured, which conduct is the centerpiece of its claims handling strategy. The Insured fully cooperated with HERITAGE in all respects but when it came time for this insurance company to step up to its duties, and exercise its reciprocal duties to its policyholder, HERITAGE instead side-stepped its responsibilities and ignored and failed the Insured miserably. By refusing to acknowledge full coverage and failure to provide prompt, full payment in violation of the Policy’s Loss Settlement and Loss Payment provisions as detailed above, HERITAGE has shown that it has abdicated its Policy responsibilities and failed to implement standards for the proper investigation of a claim in violation of Florida Statute 626.9541(1)(i)(3)(a). This may sound familiar, particularly to HERITAGE: a carrier and its adjusters and others working on its behalf have been known to arrange for “creative” reports and estimates for the purpose of being able to deny and/or underpay insurance claims related to damage as well as arrange for creative ways to delay payment of rightful amounts due to Insured. HERITAGE, like many other insurance carriers “skilled” in the art of deception, will also certainly retain a small army of highly compensated defense lawyers and expert witnesses to defend what should not, in the exercise of good faith, be defended. This carrier also knows that, when a severe weather event occurs, even an event causing obvious, widespread damage to a particular area ravaged by a hurricane, not every policyholder will submit a claim for coverage, even if there is coverage under the terms of the Policy. HERITAGE also knows that, and plays the odds to its considerable advantage, as even when a covered event occurs, and the policyholder submits the claim, many individuals will be unable to assess whether this carrier undervalued the full extent of the damage, as here. And, if HERITAGE wrongfully denies full coverage, as here, this carrier knows that many an insured will not turn to litigation to enforce their rights under a policy, most of whom have little to no experience negotiating (let alone litigating) against insurers. Worse yet, a steady stream of well publicized insurance carrier cries of poverty and protestations of lawsuit abuse, a change in the law and a few recent misguided victories by insurance carriers in litigating these cases have only served to embolden this conduct and exacerbate their unfair and bad faith claims handling. As the Florida Supreme Court has noted, “the average policyholder has neither the finances nor the expertise to single-handedly take on an insurance carrier.” Johnson v. UPC Ins. Co., 200 So. 3d 1207, 1215 (Fla. 2016). This case, and others which have resulted in large verdicts not only for indemnity but also for bad faith conduct, should serve as a cautionary tale to TYPTAP, as well as a strong message to recognize its exposure and fully resolve this matter promptly and in good faith. Pursuant to the scheme utilized by this carrier, when one of its insured submits a claim for coverage related to a purportedly covered event, a field adjuster or forensic engineer (typically unnamed or only partially named, as here) is assigned to visit the property. These individuals are likely unfamiliar with, or indifferent to, the pricing in this area and are charged with generating insurance carrier-friendly reports and/or creating estimates and/or making coverage determinations and valuations of the respective losses reported by an insured. Instead of ensuring that honest, accurate reports are generated to confirm that an Insured receives an assessment that reflected the true losses, this carrier specifically instructed desk adjusters and forensic people to modify the reports and estimates created by field adjusters to deny coverage and/or decrease estimates to ultimately decrease the amount of money HERITAGE pays. This can fairly be characterized as a pattern and practice of outright denial or de facto denial of claims, and well below true loss value, as here, resulting in the unstated goal of HERITAGE: little or no money due to its insured. This carrier also has been known to instruct their minions to modify reports to provide a “factual basis” to deny coverage altogether. and pressure adjusters to create factual bases that were false and misleading to deny claims. As this scheme has come to light, some field adjusters for some carriers have had an unexpected attack of honesty, and subsequently were demeaned and have even been “black balled”, when they stated, both off the record and under oath, that some carriers have not so subtly pressured or tacitly encouraged them to add language to their reports which eventually proved to be inaccurate or outright false. But there was no fair investigation and no full payment of fair money from the carrier, which purportedly insures the property for just such a vicissitude and contingency. HERITAGE now attempts to save money by not paying full value for these losses, not paying full policy limits, although policy limits are due, all of which are part of a pattern and practice which is likely to work a large percentage of the time in connection with these cases. If HERITAGE did not want to fully pay for a loss, it should not have written the Policy. Insurance coverage means nothing if premiums are taken in and claims are not paid out, a tactic that has consequences. It is a calculated and unfair claims practice of HERITAGE to act in this manner and, accordingly, is a violation of Florida Statute 626.9541(1)(i)(3)(i). HERITAGE’s opportunistic conduct in the face of the great need of its Insured here and its handling of this claim was facially biased from start to finish – for now, as it is obvious that they will only pay a fair amount when compelled to do so through the legal process, so this filing is the first step in that necessary process. The acts giving rise to this violation have occurred with such frequency and regularity by HERITAGE so as not to be an aberration. A carrier assumes the risk in consideration of handsome premiums and high deductibles. Post policy underwriting by the carrier, as exists here, is prohibited by law, but it is also unfortunately the norm, particularly as practiced by HERITAGE. Unfortunately, this effete and onerous conduct is deliberately calculated to frustrate the Insured in the hope that, as exists in so many claims, the Insured would be intimidated by a seemingly omnipotent insurance carrier. Now, the filing of this CRN is the first step in leveling the playing field. HERITAGE was obligated to make its coverage determinations based upon reasonable explanations and reasonable investigations. The denial of the full value of this loss when it was fully covered and should have been paid was not reasonable and was not the result of a reasonable investigation. As such, HERITAGE has violated these statutes. A fair and reasonable investigation would have found that the full damage to the property(s), as claimed and documented by the Insured and its own, qualified experts, was caused by Ian, and was covered, and the result of a reasonable investigation would have been to provide full coverage and prompt payment to the Insured, without invoking inapplicable and unenforceable policy defenses. These acts are violations of Florida Statutes 626.9541(1)(i)(2) and 626.9541(1)(i)(3)(a). The concept of insurance is that an insurer will investigate and timely and promptly provide indemnity or security against a contingent loss. Florida Statute 624.02 defines "insurance" as a contract whereby one party, the insurer, undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Inherent in that definition is the fact that payment must be made timely and promptly so that the Insured may mitigate damages and be put back into the position they were in prior to the loss as quickly as possible, not get dragged through the interminable, agonizing, and highly frustrating HERITAGE claims denial process. SUMMARY OF STATUTORY VIOLATIONS: HERITAGE is no stranger to controversy when it comes to mishandling claims of its insureds. Thus, the statutory violations here, based upon present available information, which is unfortunately scarce due to lack of disclosure by this insurance carrier, are many and varied and have occurred simultaneously and concurrently, generally serve as an unfortunate, devious model for insurer unfair claims practices, and they include but are not limited to the following: This intentional, willful, wanton, and malicious conduct referenced above is a clear violation of multiple Florida Statutes, including but not limited to 624.155(1)(b)(1), and shows that the carrier did not attempt in good faith to settle the Insured’s claim(s) when, under all the circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insured and with due regard for the Insured’s interests. HERITAGE’s refusal and/or failure to settle the full value of the claim when, under all circumstances, it could have and should have done so had it acted fairly and honestly toward the Insured is actionable conduct. This insurer’s illusory bargain and subsequent acceptance of payment for a policy for which the insured cannot recover from during this policy period to date, amounts to an unfair and deceptive trade practice as, at a minimum, it is a misrepresentation of the benefits, advantages, conditions of terms of any insurance policy. HERITAGE’s conduct and express and implied statements and representations to its Insured that the loss was not fully covered, without the responsibility of conducting a fair and impartial property inspection, as detailed above, and particularly in invoking policy provisions which are neither applicable nor enforceable, are in violation of the Loss Settlement and Loss Payment Provisions, as well as the provisions of the Policy that facially provide coverage for damage. This was a fully covered loss. HERITAGE is obligated to pay, yet they refuse to fully acknowledge their obligations. HERITAGE repeatedly misstates and misrepresents the facts and circumstances of this loss in a concerted and conflicted effort to induce the Insured to accept less money than HERITAGE is obligated to pay under the Policy or to abandon these claims. These acts are a violation of Florida Statutes 626.9541 (1)(i)(3)(b) and (1)(i)(2). By relying upon a result oriented, biased and out of touch evaluation which will not survive a rigorous cross examination, relying on flawed legal theories, with no relevant principles, details, methods, or measurements, and by refusing to acknowledge coverage and provide prompt and full payment in violation of the Policy’s Loss Settlement and Loss Payment provisions as detailed above, HERITAGE has shown that it has failed to implement standards for the proper investigation of a claim in violation of Florida Statute 626.9541(1)(i)(3)(a). HERITAGE was obligated to make its coverage determinations based upon reasonable explanations and reasonable investigations, and without unreasonable delays. This did not happen. As such, HERITAGE has violated these statutes. A reasonable investigation would have found that the damage to the Insured’s property was fully covered, and the result of a reasonable investigation would have been to provide coverage and tender prompt, full payment, which HERITAGE has not chosen to do. These acts are violations of Florida Statutes 626.9541and (1)(i)(3)(a). The totality of the actions, inactions, obfuscations, and insurer misconduct as set forth above are material misrepresentations to its Insured constitute unfair claims practices. Further, these actions and omissions by HERITAGE concurrently violate many, if not all, of the Florida Statutes referenced and are intentionally designed to lead to this ill-conceived and intended result. It is unfair for HERITAGE to low-ball a loss that is fully covered based upon only partially disclosed or undisclosed information that are not supported by the facts, misstate other facts with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those specified in, and contemplated by such contract or policy, to wrongfully invoke Policy exclusions which do not apply, are in violation of Florida Statute 626.9541(1)(i), set forth below: 626.9541(1)(i) Unfair claim settlement practices – 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 specified in, and contemplated by such contract or policy; This insurance company clearly misrepresented the extent of the damage it discovered in its inspection of the Insured’s property with the intent of effecting a settlement on less favorable terms than those specified in the applicable insurance contract. THEREFORE: This insurance carrier, “HERITAGE”, must: (1) create and implement adequate guidelines for the proper investigation and evaluation of these types of claims and for the training and supervision of employees in connection with legitimate claims to ensure that the claims handling procedures are adequate to prevent other insureds from being treated unfairly and wrongly; and (2) immediately tender all undisputed insurance proceeds to the Insured while continuing to adjust the loss with the Insured in accordance with Florida law, including but not limited to honoring their reciprocal duties and agreement to abide by all Policy terms; and (3) tender to the Insured all amounts representing all damages, plus monies due for other coverages, incidental and consequential damages, all monies due and/or paid for remedial or temporary repairs, and less any prior payments other than noted herein, applicable depreciation, and deductibles; and (4) pay interest on untimely payments from the date the carrier was notified of the loss or, upon the election of the Insured, pay such other interest payments as may be available under Florida law, including prejudgment interest; and (5) pay all attorney fees and costs; and (6) pay the present, provisional estimate totaling $1,691,554.93, plus interest, less the applicable deductible; and (7) exercise good faith efforts to resolve these claim(s) by acting fairly and honestly toward the Insured and with due regard for the Insured interests in disclosing all evidence which supports their position, and in attempting to fully settle the entirety of its Insured’s claim(s).

Comments

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avicenty@heritagepci.com		07-08-2025		July 8, 2025 VIA ELECTRONIC SUBMISSION Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 VIA Certified Mail: E-mail Correspondence: matt@vwflegal.com Carriage Homes at Artesia Naples Condo c/o Matthew Watkins, Esq. Vishio Watkins Forry 1112 Goodlette-Frank Road, Suite 204 Naples, FL 34102 RE: Complainant: Carriage Homes at Artesia Naples Condo Policy No. HCP008489 Claim No. H010018347 Filing No. 822037 Filing Accepted: 05/19/2025 Dear Sir or Madam, This correspondence constitutes Heritage Property & Casualty Insurance Company’s (hereinafter “Heritage”) response to the Civil Remedy Notice (“CRN”) (filing number 822037 with a filing acceptance date of 05/19/2025) of Insurer Violation filed by Mr. Matthew Watkins, Esq., on behalf of Complainant, regarding the claim listed above. Our office represents Heritage in reference to the claim presented by Carriage Homes at Artesia Naples Condo. (“Complainant”) for alleged damages sustained to the subject property on or about September 28, 2022, the subject claim of this CRN. Without waiving Heritage’s arguments that the subject Civil Remedy Notice should be stricken as it is legally insufficient and non-compliant with Florida law, Heritage and its representatives/agents have at all times performed its obligations under the insurance policy in a prompt and diligent manner with due regard for the interest of Carriage Homes at Artesia Naples Condo. The Notice contains a list of violations which are alleged to have been committed by Heritage. In fact, none of the listed violations/allegations have occurred and Heritage categorically denies any violations of §624.155, §626.9541, Fla. Stat., 69B-220.201 Fla. Admin., as well as any and all other statutes/regulations/codes/rules. Moreover, Heritage denies any and all allegations of any kind referenced in the Civil Remedy Notice. Specifically, Heritage conducted four separate inspections of the subject property utilizing an independent adjusting firm, Advantage Adjustment Group. and a forensic engineering firm, Nelson Forensics (“Nelson”). In addition, an engineer and an architect inspected the property to determine the cause and originof all reported damages, as well as the price and scope of the same. The initial inspection took place with Complainant’s association representative on April 23, 2024. During the inspection, Heritage found limited storm damage to some areas of the property. Thereafter, on June 27, 2024, June 28, 2024, and July 23, 2024, a reinspection was conducted of the subject property utilizing Nelson, a forensic engineering firm, to determine the cause and origin of all reported damages, as well as the price and scope of same. This inspection took place with Complainant’s representatives. During the inspection Nelson found minimal storm damage to some structures on the property. The estimate for the covered wind damage to the property, which is the responsibility of the Association, totaled $33,124.84. Moreover, on August 6, 2024, Heritage provided the Complainant with a detailed statement of loss that included the damage assessment for the buildings, as well as a coverage determination letter advising the damages, totaling $33,124.84 failed to meet and/or exceed the applicable deductible of $247,852.08 and as such, no payment would be forthcoming. Finally, the Complainant provided Heritage with a Synergyn Engineering report (“Synergyn Report”), dated January 9, 2025. Heritage, in turn, provided the Synergyn Report to Nelson to undertake a peer review. Nelson reviewed the Synergyn Report and disagreed with the methodology incorporated by Synergyn during their inspection, as well as Synergyn’s causation, opinion, and the nature and extent of damages. The method for curing the violations alleged in a civil remedy notice is not determined by the Insureds. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: Section §624.155 does not impose on an insurer the obligation to pay whatever the Insureds demands. . . . Section 624.155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624.155(2)(d). . . . To cure an alleged violation and to avoid a civil action, an insurer must pay the claim . . . before the sixty days expire. Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F.Supp. 773, 777-778 (M.D. Fla. 1996). Notwithstanding the above, Civil Remedy Notice is legally insufficient as it fails to specify who at Heritage committed the alleged violations, when the alleged violations were committed and fails to give specific facts supporting the alleged violations. Here the Notice alleges the reasons for the Notice are the following: Claim Denial The Insureds indicate the claim was denied while contradicting itself within the same Civil Remedy Notice filed by Complainant. The Notice states, “the claims were de facto denied because they were deemed to be “under deductible”. In other words, no money would be forthcoming.” The Complainant, in its CivilRemedy Notice, acknowledges that Heritage afforded coverage for the claimed loss, yet attempts to perform a routine of legal gymnastics to contort the facts to suit the Claimant’s narrative. In fact, and as acknowledged by instant Civil Remedy Notice, Heritage determined that coverage existed but that the damage failed to meet and/or exceed the applicable deductible and as such, no payment would be forthcoming. Therefore, this allegation, on its face, contradicts and disproves this allegation by the Claimant and lacks the specificity required by Florida Statute §624.155 and thus does not place Heritage on the requisite notice. Claim Delay The Insureds indicate the claim was delayed, yet fails to provide any facts to support this assertion, other than the fact that Heritage diligently conducted inspections of the property utilizing experts which the Insured disagrees with their opinion. It must be noted that the Complainant’s own engineer, Synergy Forensics, did not conduct a recorded inspection of the property until October 10, 2024, some three months after the inspections by Heritage’s representatives. The Civil Remedy Notice, filed by Complainant, fails to allege any undue or unnecessary delay in the claims handling process, but rather takes issue with the result. Therefore, it lacks a factual basis to support this allegation and lacks the specificity required by Florida Statute §624.155 and thus does not put Heritage on the requisite notice. Unfair Trade Practice The Notice fails to state who, how and when an unfair trade practice occurred therefore it lacks the specificity required by Florida Statute §624.155 and thus does not place Heritage on the requisite notice. Unsatisfactory Settlement Offer The Insureds fail to state who, how and when an unsatisfactory settlement offer was made therefore it lacks the specificity required by Florida Statute §624.155 and thus does not place Heritage on the requisite notice. The Notice alleges the following violations: §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 The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Specifically, Complainant fails to confront that they are futilely seeking inflated or uncovered items unnecessary to bring the subject property to its pre-loss condition, along with a complete lack of specific examples evidencing the alleged gross underpayment by Heritage. §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 policyThe Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Specifically, Complainant refuses to acknowledge that they are seeking inflated or uncovered items unnecessary to bring the subject property to its pre-loss condition, along with a complete lack of specific examples evidencing the alleged gross underpayment by Heritage. §626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims. The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Nowhere in the notice does it state what the alleged standards for proper investigations are that Heritage failed to adopt or implement, and who failed to adopt and implement the standards. Furthermore, the Notice outlines that Heritage performed inspections of the property with a licensed adjuster and also sent an engineer, so it is unclear and unsupported how Heritage failed to investigate the loss. §626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue. The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Nowhere in the notice does it state what, if any, misrepresentations were made to the Complainant by Heritage or its agents. §626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims. The Notice does not provide any specifics by way of who, when and how Heritage committed this violation and therefore fails to comply with the specificity required. Again, the Civil Remedy Notice fails to indicate any specific occurrence, topic or communication in which Heritage failed to act promptly with respect to claims. §626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information The Insureds fail to state who, how and when a claim denial was made. In fact, The Notice states, “the claims were de facto denied because they were deemed to be “under deductible.” In other words, no money would be forthcoming.” The Complainant, in their Civil Remedy Notice, acknowledges that coverage was afforded for the loss, but that the damage failed to meet and/or exceed the applicable deductible and as such, no payment would be forthcoming. Again, the Civil Remedy Notice contradicts this assertion by the Complainant. §626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim. The Insureds fail to state who, how and when Heritage failed to promptly notify the insured of any additional information necessary for processing the claim or any other pertinent facts to allow Heritage to understand the basis of these allegations.Heritage does not waive any of its defenses regarding the Notice including but not limited to any technical and factual deficiencies contained in the Notice. We trust that this response addresses the allegations of insurer violation alleged in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. If you have any questions, please contact our office anytime. Sincerely, /s/ Andrew Bruce, Esq. Andrew Bruce, Esquire (727) 465-4711 AB/rr

Acknowledgement
*	The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes. Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.

DFS-10-363
Rev. 10/14/2008