A Civil Remedy Notice is a formal complaint filed against an insurance company with Florida's Department of Financial Services. Filing one is the step Florida law requires before a policyholder can sue an insurer for bad faith. It is a public record, and the insurer gets 60 days to fix the problem before that right opens up.
So this is the policyholder's side of a dispute, written by their side, and it is an allegation rather than a finding. The insurer answered it, and its answer is published below alongside the complaint. Read both. Names, addresses, and policy and claim numbers have been removed here; everything else is quoted from the filing.
| Who the filing is against | AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA (NAIC #12841) |
|---|---|
| Who filed it | The policyholder |
| Attorney of record | Monica Sablon |
| Where the property is | Cape Coral, Florida |
| When it was accepted by the state | April 3, 2023 |
| When the 60-day cure window closed | June 2, 2023 |
| Why, in the state’s own categories | Claim Denial, Unsatisfactory Settlement Offer, Unfair Trade Practice |
| Type of insurance | Residential Property & Casualty |
| Policy language at issue | The specific policy language relevant to the insurer's misconduct and violations is the Loss Payment provision and the coverage that is afforded under Coverage A-Dwelling of the policy, as well as the coverage afforded under the "[name redacted] (s), [name redacted] (s), and Screen Enclosure(s)." |
| Did the insurer respond | Yes, on September 20, 2023 |
The violations alleged are based failure to pay the claim in full and relevant to the insurer's misconduct is the Loss Payment provision and coverage afforded under Coverage A-Dwelling of the policy. The persons representing the insurer most responsible for and/or knowledgeable of the facts giving rise to the allegations herein are [name redacted] . The specific policy language relevant to the insurer's misconduct and violations is the Loss Payment provision and the coverage that is afforded under Coverage A-Dwelling of the policy. The facts and circumstances giving rise to the violations are: The insured's claim results from windstorm and water, with ensuing damages, caused by hurricane Ian on or about September 28, 2022, to the insured property located at [address redacted], Cape Coral, Florida. The insureds reported the loss to American Integrity Insurance Company of Florida (hereinafter referred to as "the insurer"). While the insurer did send an adjuster to evaluate the damages, there was no genuine adjustment of the claim by the insurer. That is to say, the insurer did not adjust the loss to include obviously related damages or ensuing damages related to Hurricane Ian. Not made whole by the insurer, the insured has been forced to seek legal counsel to protect the insureds' interests. The insured requested that the insurer provide coverage for the insureds' damaged pool screen enclosure, but the insureds have been informed no coverage would be extended or afforded. In stark contrast, the declarations page of the relevant insurance policy for which this insured paid a premium clearly reflects additional, which the insureds paid a $43.00 premium, to receive $10,000.00 of coverage for "[name redacted] (s), [name redacted] (s), and Screen Enclosure(s)." The insureds' informed the insurer of its inaccurate and detrimental determination that there is indeed coverage under this particular insurance policy for damage to screen enclosures at the insured property. The insureds repeatedly informed the insurer of their claim, including in writing on December 21, 2022, to no avail. To date, the insurer failed to acknowledge claims communications and supply information or correct the misapplication of coverage by stating that coverage would be extended for the screen enclosure. The aforementioned conduct is an example of misconduct consistent with unfair claim settlement practices as well as failing to adopt and implement standards for the proper investigation of claims. This conduct is also a specific example of this insurer not attempting in good faith to settle this insureds' claim 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 and his interests. The failure of the insurer to extend coverage that is obviously listed on the declarations page, coupled with having been given an opportunity to inspect and investigate the claim, and still refusing the extend coverage is bad faith, unfair trade practices, improper investigation and unfair claim settlement practices, which demonstrate the insurer 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 their interests. The insurer failed to adopt proper standards of investigation and adjustment of losses and is otherwise not implementing those standards because full payment and prompt payment for the loss is not occurring and the adjustment has been improper demonstrating unfair trade practices and unfair claim settlement practices. In addition, when the insurer was asked for copies of the policy and claim communications, it failed to comply with the insureds' request through their counsel. The insureds give this notice in order to perfect the right to pursue the civil remedy authorized by section 624.155, Florida Statutes, in order to cure the conduct giving rise to the violations described herein, the insurer must complete the proper evaluation of the damages and issue payment for all the covered damages.
These are the statutes named on the form. The wording under each is the statute's own, as the state prints it on the notice.
| 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)(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)(i) | Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). |
Filed with the state on September 20, 2023. This is the insurer's own written response to the complaint above, quoted from the same public record.
Florida DFS Civil Remedy Notice, filing number 686293. Read the filing on the state's site ↗
A Civil Remedy Notice records an allegation, not a finding. Nothing here has been decided by a court or by the Department. Not legal advice; consult an attorney about your specific claim.
A Cape Coral Ian claim where the carrier denied the screen enclosure, the single most common Ian loss item in Lee County, while the policyholder’s own declarations page showed a $10,000 screened-enclosure endorsement, purchased for $43 in premium.
The counter here is not an argument, it is a document: the dec page. When a denial contradicts an endorsement the carrier itself sold, the response letter writes itself, and the DFS Civil Remedy filing shows exactly that play being run.
Fla. DFS Civil Remedy Notice, Filing No. 686293 (Hill/Laughlin v. American Integrity), Cape Coral, FL · public record ↗
Quotes are verbatim from the cited public record. Case status and statute summaries drafted August 2026; verify against the current docket and statute. Not legal advice; consult an attorney about your specific claim.
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