Civil Remedy Notice of Insurer Violations
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Filing Number:     822342
Filing Accepted:  5/20/2025
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Complainant
Last/Business Name *  
ABSOLUTELY OPTICAL, INC.   First Name  
Street Address * 4237 WEST KENNEDY BOULEVARD
City, State Zip * TAMPA, FL 33609
Email Address * CLAY@THEKRFIRM.COM
Complainant Type: * Insured
Insured
Last/Business Name*   ABSOLUTELY OPTICAL, INC.   First Name  
Policy # * 773TA14384 Claim #* BW24007720011
Attorney
Attorney is Applicable
Last Name* KUHN First Name * CLAYTON Initial
Street Address* 2110 WEST PLATT STREET
City, State Zip* TAMPA , FLORIDA 33606
Email Address * CLAY@THEKRFIRM.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   UNDERWRITERS AT LLOYD'S, LONDON
NAIC Company Code
 
Name of individual responsible for violation (if any):* ANY AND ALL PERSONS ASSOCIATED WITH THE CLAIMS HANDLING FROM UNDERWRITERS AT LLOYD'S, LONDON
Type of Insurance * Commercial Property & Casualty   
Reason for Notice *
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)(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)(d) Denying claims without conducting reasonable investigations based upon available information.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE POLICY LANGUAGE RELEVANT TO THE VIOLATIONS INCLUDES ALL APPLICABLE LOSS PAYMENT AND COVERAGE PROVISIONS OF POLICY NUMBER 773TA14384, INCLUDING THE DECLARATIONS PAGE AND ALL ENDORSEMENTS TO THE POLICY, WITH RESPECT TO COVERAGES A, B, C, AND D. ADDITIONALLY, ANY SECTIONS RELIED UPON BY THE INSURER IN ITS DENIAL TO FULLY PAY THE CLAIM, INCLUDING THE DUTIES IN THE EVENT OF LOSS PROVISIONS AND THE POLICY'S EXCLUSION OF COVERAGE PROVISIONS.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

Absolutely Optical, Inc. (hereinafter “Insured”) is a property owner insured with an all-risks commercial policy issued by Underwriters at Lloyd's, London and Convex Insurance Uk Limited (hereinafter “Carrier”). On or about October 9, 2024, Insured’s home located at 4237 West Kennedy Boulevard, Tampa, Florida 33609 sustained significant damage as a result of a windstorm event. Specifically, Hurricane Milton created multiple openings to the roof of Insured’s property. This resulted in interior water damage to various areas of the interior of Insured’s property including but not limited to, the main area, hallway, storage area/room, office 1, office 2, office 3, and office 2 closet. The Loss is covered under Insured’s policy issued by Carrier. Insured promptly reported the claim and fully cooperated with all requests for inspections. Carrier assigned Claim No. BW24007720011 to the loss. The Insured has fully cooperated with Carrier’s investigation of the claim, including providing all requested documentation and complying with all post-loss policy conditions. Specifically, the Insured, with assistance from their public adjuster, submitted an estimate for $91,296.56, which was a fair and reasonable assessment for the repair/replacement of damages. After reporting the claim, Carrier retained an unqualified and biased field adjuster, Darienne Breazeale with Hausch & Company, to adjust the loss. This adjuster had a financial incentive to adjust the loss in a manner that would minimize Carrier’s losses. This adjuster performed a mere cursory inspection of the property on October 23, 2024. Instead of adjusting the claim fairly, honestly, in good faith, and with due regard for the Insured’s interests, this adjuster made a conscious effort to ignore evidence of covered losses to the property. Worse still, Carrier failed to retain qualified experts necessary to identify the repairs necessary to restore the property to its pre-loss condition. Despite Insured providing Carrier with a detailed estimate, Carrier failed to pay Insured the amount necessary to repair/replace the damaged property, less the applicable deductible. Instead, Carrier gave Insured a lowball estimate that failed to encompass all covered damages. The carrier only offered to pay $0.00, after applicable deductible of $18,480.00, a gross underpayment for all the damage associated with this claim. Under the circumstances surrounding this claim, had Carrier acted fairly and honestly toward the Insured and with due regard for the Insured’s interests, Carrier could and should have attempted in good faith to settle this claim. Carrier did not and, instead, dishonestly, and unfairly placed its own interests well ahead of those of the Insured. In doing so, Carrier violated Section 624.155(1)(b)(1), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to adopt and implement standards for the proper investigation of claims in violation of Section 626.9541(1)(i)(3)(a), Florida Statutes. Carrier’s use of unqualified and biased adjusters, and failure to retain experts necessary to identify the repairs necessary to restore the property to its pre-loss condition, evidence Carrier’s failure to conduct a reasonable investigation based upon available information. In denying full coverage for this claim without conducting reasonable investigations based upon available information, Carrier has violated Section 626.9541(1)(i)(3)(d), Florida Statutes. By representing to Insured that the Policy does not afford full coverage for this loss, Carrier is misrepresenting pertinent facts and/or insurance policy provisions relating to coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes. When applying the facts present here to Florida law, it is clear that Carrier is acting in bad faith. Florida Statute § 624.02 defines insurance as a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit based on determinable contingencies. Inherent is the fact that payment must be made timely and promptly so that insureds may mitigate their damages and be put back into the position they were in prior to the loss as quickly as possible. Carrier has breached this duty by refusing to properly and timely adjust the loss. Moreover, Section 69B-220.201 of the Florida Administrative Code defines Carrier’s adjusters conduct here as an unfair claims settlement practice. Specifically, Section 69B-220.201(3) provides that “[a]n adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured” and that “[a]n adjuster shall make truthful and unbiased reports of the facts after making a complete investigation.” As detailed above, Carrier’s investigation and adjustment of this claim was done in a manner prejudicial to Insured, was incomplete, and lacked truthful and unbiased reports of the facts. Carrier has more than enough information and is still refusing to accept coverage for the Insured’s claim. This continued and repeated reckless claim delay and denial of coverage will result in a significant punitive damage award if a bad faith lawsuit is filed. Carrier can cure the defects outlined in this Civil Remedy Notice and avoid a lawsuit for bad faith by immediately accepting full coverage under the subject insurance policy for this claim and by paying Insured’s estimate of damages $91,296.56, less applicable deductible and prior payments, which is the reasonable amount of the covered loss pursuant to the policy. A copy of this form has been submitted to the Florida Department of Financial Services who has transmitted the same to the following parties providing them notice of the filing of this Civil Remedy Notice: Underwriters At Lloyd's, London and Convex Insurance Uk Limited
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michael.rinaldi@phelps.com 07-16-2025 Dear Counsel: We write on behalf of Certain Underwriters at Lloyd’s, London Subscribing to Policy Number 773TA14384 (“Underwriters”) and Convex Insurance UK Limited (“Convex”) (collectively, the “Insurers”), the commercial property insurers for Absolutely Optical, Inc. (the “Insured”) under Policy Number 773TA14384 with effective dates of October 7, 2024 to October 7, 2025 (the “Policy”) providing coverage for the property located at 4237 West Kennedy Boulevard Tampa, FL 33609 (the “Property”). We write on the Insurers’ behalf in response to the Civil Remedy Notices of Insurer Violations (“the Notices”) submitted to the Department of Financial Services, Division of Consumer Services (“the Department”) by you on behalf of the Insured. The Notices bear filing numbers 822342 and 822345, respectively, with an acceptance date of May 20, 2025. The Notices allege that the Insurers violated multiple sections of the Florida Statutes with regard to the Insured’s claim under the Policy for alleged damage to the Property, which reportedly occurred as a result of Hurricane Milton on or about October 9, 2024 (the “Loss”). The Notices generally allege the “Reasons for Notice” are “Unfair Trade Practice,” and “Unsatisfactory Settlement Offer.” I. Deficiencies in the Insured’s Notices We initially note that the Notices are defective because they incorrectly refer to Underwriters and Convex as authorized insurers. Underwriters and Convex operate as an eligible surplus lines insurers as defined in section 626.914(2), Florida Statutes. Section 624.155(3)(b), Florida Statutes, sets forth the requirement that the Notice shall state with specificity all of the following: (1) the statutory provision allegedly violated, including the specific language of the statute; (2) the facts and circumstances that give rise to a violation of those statutes referenced in the civil remedy notice; (3) the name of any individual involved in the alleged violation; (4) the specific policy language that is relevant to the alleged violation; and (5) a statement that the notice is given in order to perfect the right to pursue the civil remedy authorized by this section. Florida courts have interpreted section 624.155(3)(b) to require that a civil remedy notice be specific enough to provide insurers notice of wrongdoing so an insurer can timely cure the alleged violations within sixty days. See, e.g., Heritage Corp. of S. Fla. v. Nat. Union Fire Ins. Co. of Pittsburgh, 580 F. Supp. 2d 1294, 1298-99 (S.D. Fla. 2008) (insured did not state with specificity the facts giving rise to the specific statutory violation so as to put insurer on notice of wrongful acts being alleged); Nowak v. Lexington Ins. Co., 464 F. Supp. 2d 1248, 1251-52 (S.D. Fla. 2006) (holding that the insured could not proceed with a cause of action based upon an alleged violation of section 626.9541 when that statute was not specifically listed in the CRN); Valenti v. Unum Life Ins. Co. of Am., No. 8:04-CV-1615-T-30TGW, 2006 WL 1627276, at *2 (M.D. Fla. June 6, 2006) (disallowing certain actions for bad faith that were not specific enough to put insurer on notice of alleged violations). Additionally, a Notice that cites numerous statutes with no factual support fails to meet this specificity requirement. See Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). The Notices are vague and deficient in that they fail to describe any facts and/or circumstances giving rise to the alleged statutory violations. In fact, the Insured’s Notices make multiple allegations without any supporting facts whatsoever. For example, the Notices contend the Insurers “retained an unqualified and biased field adjuster, Darienne Breazeale with Hausch & Company, to adjust the loss” and that “[t]his adjuster had a financial incentive to adjust the loss in a manner that would minimize Carrier’s losses.” The Notices also state that Mr. Breazeale “made a conscious effort to ignore evidence of covered losses to the property.” There is zero factual or anecdotal support for these baseless allegations. Moreover, the Notices go on to state that the “[c]arrier failed to retain qualified experts necessary to identify the repairs necessary to restore the property to its pre-loss condition.” Another baseless allegations within the Notices. As outlined further below, the Insurers retained an engineer, Forensic Engineering Co. (“FEC”) who conducted a thorough inspection of the Property and prepared a report of their engineering findings – which the Insured nor its representatives ever provided any substantive comments to and still have not as of the date of this letter. The Insured provides no facts whatsoever to support these baseless allegations within their Notices. Another example of the Insured’s failure to state any factual basis for its allegations of bad faith conduct are the broad statements that the Insurers “dishonestly, and unfairly placed its own interests well ahead of those of the Insured” and “refus[ed] to properly and timely adjust the loss.” The Notices, untruly again, state that the Insurers “den[ied] full coverage for this claim without conducting reasonable investigations based upon available information.” The Insurers did not deny coverage for the subject claim. Rather, as the Insurers advised the Insured, the covered damage under the Policy did not exceed the Policy’s applicable deductible. The Notices further allege that “[b]y representing to Insured that the Policy does not afford full coverage for this loss, Carrier is misrepresenting pertinent facts and/or insurance policy provisions relating to coverages at issue, in violation of Section 626.9541(1)(i)(3)(b), Florida Statutes.” While the Insured clearly disputes the amount of damages and the causes of loss, the Insurers’ explanations of their position under the Policy were neither misleading nor false, and were clearly conveyed to the Insured. Further, the Notices fail to identify the specific policy language relevant to the alleged violations as required by section 624.155(3)(b)(4), Florida Statutes, which requires that Notices must state with specificity the policy language that is relevant to the alleged violation. A civil remedy notice fails to satisfy the statutory requirement that an insured “state with specificity” the relevant policy language when the insured lists nearly every provision in the insurance policy. See Julien v. United Prop. & Cas. Ins. Co., 311 So.3d 875 (Fla. 4th DCA 2021). Similarly, the Middle District addressed a Civil Remedy Notice that was also improperly broad in scope and concluded that listing nearly all policy provisions does not satisfy the requirements of § 624.155(3)(b)(4). See Fox v. Starr Indem. & Liab. Co., No. 8:16-CV-3254-T-23-MAP, 2017 WL 1541294 (M.D. Fla. 2017). The court found that “[i]f the statute contained no specificity requirement, [then] the [insureds’] casual ‘reference’ to the entire insurance policy undoubtedly would suffice;” however, “the Legislature included ‘specific’ or a variant not once but twice in the statute.” Id. As a result, the insured’s listing of whole sections of the insurance policy “appear[ed] to lack specificity” as clearly required by the statute. The Insured’s Notices here do not state with any specificity the relevant policy language. Rather, the Notices do exactly what Florida courts hold as deficient – which is to just broadly list “all applicable loss payment and coverage provisions of policy number 773TA14384.” The Notices do not provide any specific examples of how the Policy provisions are relevant to the alleged violations. Therefore, the Notices are invalid for their failure to specifically allege the Policy provisions in accordance with the requirements of section 624.155(3)(b)(4), Florida Statutes. Further, the Notices are deficient because they do not state with specificity what the Insurers must do to “cure” the violations alleged in the Notices as required by Florida law and therefore do not offer a valid “cure.” Florida courts have long held that the purpose of a civil remedy notice is to provide the insurer with an opportunity to settle a claim with the insured within a sixty-day period in order to avoid unnecessary bad faith litigation. Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003). However, the civil remedy notice must be specific enough to provide insurers notice of the wrongdoing so the insurer can cure the same within sixty days. Id. Accordingly, because the Notices are, at best vague and unsupported, and do not provide the Insurers with a meaningful opportunity to “cure,” the Notices are legally deficient, and the Insurers respectfully request that they be rejected by the Department. II. The Insurers’ Good Faith Investigation of the Insured’s Loss and Claim Despite the deficiencies in the Notices, the Insurers deny that they or any of their representatives violated any of the statutes listed in the Notices or engaged in any prohibited conduct with respect to this claim. The Insurers have acted in good faith, without delay, and with due regard for the interests of the Insured at all times during the investigation, handling, and adjustment of the claim. The Insurers further disagree with the Insured’s characterization of the facts and circumstances giving rise to the alleged violations. The Insurers summarize the salient facts as follows. The Insured reported the loss on or about October 18, 2024 as damage from Hurricane Milton on October 9, 2024. The Insurers appointed Hausch & Co. as the third-party administrator and independent adjusting firm to investigate and adjust the claim. The independent adjuster (“IA”) conducted the initial inspection of the Property on October 23, 2024. Pursuant to the investigation and the IA’s observations, a coverage position letter dated December 30, 2024 was sent, advising that the covered damage under the Policy totaled $5,862.22 RCV/$4,002.26 ACV, below the Policy’s 5% Windstorm or Hail deductible of $18,480.00. The Insured’s public adjuster, Quality Plus Claims Public Adjusters, Inc. (“PA”) submitted its contract of representation of the Insured, which was executed on January 21, 2025. The PA subsequently submitted the Insured’s Sworn Statement in Proof of Loss (“SPOL”), which was executed on February 12, 2025 and based on the PA’s newly provided estimate of $91,296.56 RCV less the applicable deductible of $18,480.00 for a total net claim of $72,816.56 RCV. The Insurers responded to the Insured’s SPOL via letter dated February 28, 2025, advising that the PA’s estimate presented damages not previously identified and that a re-inspection of the Property would be needed in order to fully respond to the Insured’s SPOL. The Insurers retained engineer, Forensic Engineering Co. (“FEC”) to evaluate the cause and extent of the alleged damage. On March 5, 2025, FEC inspected the Property and on March 13, 2025, FEC published its report, which has been provided to the Insured, with the following conclusions: · The subject property experienced strong winds and heavy rains produced by Hurricane Milton on or around October 9, 2024, the reported storm event date. · The following conditions were wind-related distress to the site and exterior of the subject structures caused by the strong winds produced during the reported storm event: The damaged/missing panels at the pylon sign adjacent to the roadway. · The curled/raised sections of flooring adjacent to the front entry door were caused by historical and ongoing water intrusion through gaps in the weatherstripping around the door panel and from normal foot traffic. · The stains/discolorations on ceiling tiles in the hallway east of the Storage Room, the Lab, and at the southeast corner of the Reception area were caused by water intrusion from heavy winds and rain through existing openings in or around the rooftop HVAC units and/or pipe chase. The openings predated the storm event and were not caused by Hurricane Milton. · The stains/discolorations on ceiling tiles within the Storage Room and the reported water intrusion and cupped and/or raised sections of flooring adjacent to the Private Rooms were caused by water infiltration due to premature deterioration of the roof covering due to inadequate slope that began prior to the storm event. No openings were in the roof membrane caused by Hurricane Milton. · The stains/discolorations near the south exterior wall were caused by water infiltration due to aged/deteriorated sealant along the T-bar. · The envelope and roof of the subject structure were not damaged by the storm event. Based on FEC’s expert engineering findings, the Insurers issued a coverage position letter dated April 7, 2025, reaffirming the position that was issued in its previous December 30, 2024 letter, advising that the covered damage under the Policy does not exceed the 5% Windstorm or Hail deductible of $18,480.00. On May 20, 2025, the Insured filed Notices of Intent to Initiate Litigation (“NOIs”) against the Insurers. The Insurers timely responded to the NOIs by requiring mediation with a mutually agreed upon mediator within 90 days after expiration of the NOIs per 627.70152(4)(b), Florida Statutes. III. Conclusion Despite their good faith handling of the claim, the Insurers, in good faith, took actions to “cure” the alleged violations in the Notices. Specifically, the Insurers requested to have a telephone conference with your office regarding the claim, which took place on June 10, 2025. Additionally, the Insurers’ response to the NOIs made several requests for information and documents pertaining to the claim. The Insurers’ requests and the Insured’s responses are as follows. 1. Please advise if the Insured has retained an expert to opine on the cause and origin of the alleged damage. If so, please provide the expert’s report of their findings and conclusions. Insured’s Response: No. 2. Any contractor proposals, bids, or quotes received by the Insured for repairs and/or replacement of the subject roof section. Insured’s Response: None. 3. All documents related to any post loss repairs to the Property, including but not limited to, invoices, receipts, statements, warranties, permits, and any payment(s) made for such repairs. Insured’s Response: None. Furthermore, the Insurers have provided various proposed dates and mediators in their continued efforts to facilitate mediation within 90 days after the expiration of the NOIs per section 627.70152(4)(b), Fla. Stat. Mediation is in the process of being scheduled in the near future. Based on the foregoing, the Insured has not alleged in the Notices any facts that would support a determination that the Insurers have engaged in any prohibited conduct or violated the statutes referenced in the Notices. At all times, the Insurers acted with honesty and candor and with due regard for the Insured’s interests. The Notices were filed without sufficient factual or legal basis. The Insurers promptly and thoroughly investigated all aspects of the Insured’s claim and acted in good faith and with due regard for the Insured’s interests in their investigation, evaluation, handling, and adjustment of the claim. The Insurers categorically deny that they or any of their representatives engaged in any prohibited conduct or violated the statutes referenced in the Notices. If you have any questions or require any additional information, please contact us. Regards, Matthew L. Litsky Michael B. Rinaldi
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