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 | EDISON INSURANCE COMPANY (NAIC #12482) |
|---|---|
| Who filed it | The policyholder |
| Attorney of record | Michael Cassel |
| Where the property is | Kenansville, Florida |
| When it was accepted by the state | March 4, 2025 |
| When the 60-day cure window closed | May 3, 2025 |
| Why, in the state’s own categories | Claim Delay, Unsatisfactory Settlement Offer, Unfair Trade Practice |
| Type of insurance | Residential Property & Casualty |
| Policy language at issue | The violations asserted herein regarding Edison Insurance Company's bad faith actions are based heavily on the facts and circumstances asserted in the below section designated for same as well as violations of the portions of Florida Insurance Code and Florida Administrative Code upon which the bad faith statutes contained within Sections 624.155 & 626.9541, Florida Statutes, are based. With that said, the following policy language is relevant to Edison Insurance Company's statutory violations and bad faith conduct: COVERAGE D - Loss of Use The limit of liability for Coverage D is the total limit for all the coverages that follow: 1. If a loss covered under Section I makes that part of the "residence premises" where you reside not fit to live in, we cover the Additional Living Expense, meaning: Any necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living. Payment will be for the shortest time required to: a. Repair or replace the damage; or b. If you permanently relocate, the shortest time required for your household to settle elsewhere. In either event, the payments(s) will be limited to twenty-four (24) consecutive months from the date of the covered loss. 12. Law and Ordinance. a. You may use up to ten percent (10%) of the limit of liability that applies to Coverage A for the increased costs you incur due to the enforcement of any law and ordinance which requires or regulates: (1) The construction, demolition, remodeling, renovation or repair of that part of a covered building or other structure damaged by a Peril Insured Against; or (2) The demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must be totally demolished because of damage by a Peril Insured Against to another part of that covered building or other structure; or (3) The remodeling, removal or replacement of the portion of the undamaged part of a covered building or other structure necessary to complete the remodeling, repair or replacement of that part of the covered building or other structure damaged by a Peril Insured Against. LAW AND ORDINANCE - INCREASED AMOUNT OF COVERAGE For the premium charged, the percentage applied to the Coverage A limit of liability under Additional Coverage 12. Law and Ordinance is increased from 10% to the percentage shown below. [name redacted] Percentage 25% * This is Additional Coverage 11. in Form EDI HO 06. * Entry may be left blank if shown elsewhere in the policy for this coverage. All other provisions of this policy apply. 10. Loss Payment. We will adjust all losses with you. Claims payments issued for damage under Coverage A - Dwelling or Coverage B - Other Structures will be made payable to all persons, parties, and entities with an insurable interest in the property covered (including but not limited to, Named Insureds and mortgagees listed on the Declarations page of this Policy), and your "assignee(s)". In the event that any repair services were performed under the Our Option provision, we will pay the retained contractor directly for those services or part or portion of any services the retained contractor performs or provides. For all other claims payments, we will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable upon the earlier of the following: a. Twenty (20) days after we receive your proof of loss and reach written agreement with you; or b. Sixty (60) days after we receive your proof of loss; and (1) There is an entry of a final judgment; or (2) There is a filing of a mediation settlement with us. c. Within ninety (90) days after we receive the notice of a property insurance claim from you, we shall pay or deny such claim or portion of such claim, unless there are circumstances beyond our control, which reasonably prevent such payment. Our failure to comply with this paragraph shall not form the sole basis for an action against us for breach of contract under this policy or for benefits under this policy. |
| Did the insurer respond | Yes, on June 30, 2025 |
Form DFS-10-363, Rev. 10/14/2008, contains a field for the insured to include his email address. Prior to filing the CRN, said form contains an instruction that, in the event the insured does not with for certain information to become part of the public record, the insured must simply include the term "WITHHELD" to satisfy the filing requirement. This is further established through the following statement with appears on Civil Remedy Notices which have been filed: Warning! Information submitted as part of this civil remedy notice is a public record. Data entered into this form will be displayed on the DFS website for public review. Please DO NOT enter [name redacted] Numbers, personal medical information, personal financial information or any other information you do not want available for public review. As any information contained herein becomes part of the public record, the insured has withheld his email address so as not to make same available for public review and indicated same accordingly. Furthermore, as the insured is represented by counsel, it would be improper for any representative of Edison Insurance Company to contact the insured directly for any reason utilizing his email address and, as such, the information is neither material to Edison Insurance Company's ability to correct the violations contained herein nor required by the Department of Financial Services. Edison Insurance Company should direct all follow-up correspondences to the attorney listed above. Furthermore, as the above section requesting people with knowledge as to the allegations in the instant CRN often gets cut off, the following are those responsible for the violations alleged herein: [name redacted] Bob McAloney, [name redacted] all other adjusters, supervisors, management and individuals associated with or retained by Edison Insurance Company involved in this claim. The facts and circumstances giving rise to the insurer's violation as the insured understands them at this time: [name redacted] (hereinafter the "insured") purchased an all-risk property insurance policy, policy no. [redacted] (hereinafter the "Subject Policy") from Edison Insurance Company (hereinafter "Edison") which, at all times material hereto, provided property insurance for the property located at [address redacted], Kenansville, FL (hereinafter the "Subject Property"). On or about March 11, 2023, a devastating fire caused direct physical loss and resultant ensuing damages to the Subject Property. After the fire department put out the fire, the insured timely notified Edison of the loss. Edison assigned claim no. [redacted] to the loss (hereinafter the "claim") and assigned adjustment of the claim to [name redacted] . On March 12, 2023, the insured retained [name redacted] Restoration to board up the windows and doors at his fire-ravaged home using plywood sheathing and was charged $1,625.30. On March 14, 2023, Mr. [name redacted] inspected the property. On March 27, 2023, Mr. Hallowell sent the insured a letter indicating that the fire loss was a covered claim and that payments in the amounts of $58,824.05 under Coverage A - Dwelling, and $2,758.00 under Coverage B - Other Structures were being issued. This letter also advised the insured that the carrier was continuing to handle the claim which remained open for adjustment of both Additional Living Expenses and Contents. On April 10, 2023, Mr. [name redacted] sent the insured a second payment letter indicating that an additional payment in the amount of $25,614.61 was being issued for recoverable depreciation, despite the attached estimate representing a summary for contents in the amount of $25,614.61. This letter's parting paragraph advised the insured that "[t]his concludes the handling of your claim. The claim file has been closed. We thank you for the trust you have placed in our company to insure your home." Interestingly, also on April 10, 2023, a third payment letter was sent to the insured, this time advising that a supplemental payment in the amount of $14,665.31 was being issued under Coverage A - Dwelling. The letter indicated that the supplemental payment was based on a comparative estimate completed by Belfor Property Restoration and that this concluded the handling of Coverage A - Dwelling unless additional documentation was presented for review. On April 27, 2023, being left completely dissatisfied by the carrier's improper scope of damages and piecemeal, confusing payments, the insured executed a contract with [name redacted] Claims Adjjsting for assistance with the claim. On May 2, 2023, the insured obtained a fire damage new construction estimate from DBR Construction totaling $248,170.73 to re-build the fire destroyed home. On September 28, 2023, [name redacted] Claims Adjusting prepared an estimate totaling $246,447.32 for Coverage A - Dwelling alone, which exceeded the limits of the subject policy. On October 6, 2023, the insured executed a sworn proof of loss in the amount of $243,947.32 based on the estimate prepared by [name redacted] Claims Adjusting. On November 3, 2023, the carrier sent a letter to the insured explaining that it issued an initial Dwelling payment, after which discussions were had wherein the estimated amount was not sufficient. Thereafter, the carrier retained Belfor, a biased restoration company the carrier routinely uses to undercut the value of its insureds' claims, and relied upon its estimate to issue a paltry supplemental payment. The letter indicated that the carrier received the demand from the insured's public adjuster, but baldly disagreed with it. This letter also advised that the carrier would not pay the insured's request for additional living expenses. Again, in closing, this letter stated "[t]his concludes our handling of your claim. The claim file has been closed. We thank you for the trust you have placed in our company to insure your home." On December 15, 2023, the carrier sent the insured a letter indicating that payments in the amount of $10,338.83 and $6,403.65 would be issued for recoverable depreciation. On December 20, 2023, a full nine months after the claim was reported, the carrier sent a letter to the insured advising that checks in the amounts of $434.67 and $269.23 would be mailed out and that the payments were for interest on the carrier's Coverage A and Coverage C payments that were not issued timely in accordance with Florida law. All available information leads to one conclusion - the insured's home was destroyed by a covered cause of loss, to wit a fire, for which the insured is entitled to full and complete compensation. To make matters worse, the carrier has made material misrepresentations to its insured regarding the scope and amount of their covered damages, for the purpose and with the intent to settle the claim on less favorable terms than those provided for in the Policy, quite clearly by severely under-scoping and undervaluing the actual amount of the insured's covered loss. The carrier is acutely aware that the amount of the loss was in dispute but failed to make any real effort to fully and fairly adjust the loss and to appropriately indemnify the insured. Moreover, Edison has clearly denied and undervalued the insured's claim through their actions in violation of Florida's Valued Policy Law (hereinafter "VPL"). Florida's VPL, which has been in existence since 1899, provides, in pertinent part: In the event of the total loss of any building… located in this state and insured by any insurer as to a covered peril, in the absence of any change increasing the risk without the insurer's consent and in the absence of fraudulent or criminal fault on the part of the insured or one acting in her or his behalf, the insurer's liability under the policy for such total loss, if caused by a covered peril, shall be in the amount of money for which such property was so insured as specified in the policy and for which a premium has been charged and paid. Fla. Stat. § 627.702(1)(a) (2022). Furthermore, "if the covered perils alone would have caused the total loss," coverage shall be afforded in the amount of the applicable policy limits. Id. at (b). The VPL requires an insurance company to set its maximum liability, for which it sets an appropriate premium, in order to eliminate any dispute over the amount of loss payable where the insured loss is total. [name redacted] Policy Law... sets the amount payable when there is a total loss. 'Its principle object and purpose is to fix the measure of damages in case of loss total, or partial; and, to this end, it requires the insurer to ascertain the insurable value at the time of writing the policy, and to write it therein.'***Undoubtedly an important object of the statute is also to simplify and facilitate prompt settlement of insurance claims when a total loss occurs… Thus vexatious contest on this [value of the property] issue would persist when the best interests of all demanded prompt settlement and relief from the loss. A solution to this is found in the statute which in effect requires the parties to ascertain and agree in advance what the value is and in the case of total loss by the insured peril this amount shall be paid as liquidated damages. This is not an unfair scheme, as the insured is stating the limits of his recovery and at the same time the insurer is basing his premium charges on his maximum exposure. When the total loss occurs neither can contend the value of the destroyed property is any different from what they had previously specified. [name redacted] Ins. Co. v. Boswell, 167 So.2d 780, 783-84 (1st DCA 1964); see also Ceballo v. Citizens Prop. Ins. Corp., 967 So.2d 811, 813 (2007)("Florida's VPL was originally enacted in 1899 to promote clarity and predictability for property insurers and insureds alike by predetermining the value of insured real property and having that value set out in the policy of insurance."); Citizens Prop. Ins. Corp. v. Hamilton, 43 So.3d 746, 756 (1st DCA 2010)("Once the jury found a total loss caused by wind, damages were fixed by statute."). The insured has been left with no choice but to hire an attorney in order to pursue the correct value of this claim. Based on the documentation previously submitted, and the coverage afforded, Edison could have requested participation in alternative dispute resolution in line with the terms and conditions of the Subject Policy and governing Florida law or, at a minimum, engaged in settlement negotiations with the insured in order to allow him to move on from this chapter and effectuate the necessary repairs to the Subject Property; instead, Edison chose to sit back and wait before Edison ever thought to act in a manner inconsistent with their own self-interest, forcing the insured into hiring an attorney, thereby coming further out of pocket and leaving less of the outstanding due and owing insurance proceeds for actual repairs. This delay in claims adjustment constitutes a pattern of de facto bad faith conduct. As an additional showing of bad faith, [name redacted] the claim representative from Edison, has repeatedly shown a bias against this particular insured, likely due to race/ethnicity and socioeconomic status. The insured lost his home, his belongings, and, frankly, his whole life, in a fire for which the insurance company should have simply liquidated the policy but, instead of doing right by him, Edison, and specifically Ms. Tucker, has engaged in behavior that exhibits prejudice as a means of strong-arming the insured. Edison, through Ms. Tucker, is undertaking a campaign to punish an insured for their perception of his socioeconomic class and for living in a rural area as opposed to a major metropolitan area. Ms. Tucker's behavior is prima facie evidence of discrimination against the insured both due to his race/ethnicity as well as his socioeconomic status. Through bad faith discovery, the conduct of Edison as it relates to minorities and lower-policy-limit insureds will be vigorously explored. Through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Edison has violated the following sections of Florida Statutes: §624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all circumstances, it could have and should have done so, had it acted fairly and honestly toward its Insured and with due regard. §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)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim; §626.9541(1)(i)(4) Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed. Additionally, through its actions/inactions, subject to the facts and circumstances understood at this time as outlined herein, Edison has failed to comply with the following sections of Florida Administrative Code: 69B-220.201(3)(b) An adjuster shall treat all claimants equally. 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)(k) An adjuster shall not undertake the adjustment of any claim concerning which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster's current expertise. As a direct result of Edison's actions, the insured has sustained irreparable harm. Upon information and belief, the aforementioned actions complained of herein, among others, are effectuated by Edison so often as to constitute a general business practice evidencing a motive to enhance Edison's profits and cause a detrimental effect to its policyholders. Edison clearly failed to adopt and implement standards for the proper investigations of claims. As a direct and proximate result of Edison's handling of the claim, the insured sustained extra-contractual damages, including, but not limited to, a public adjuster's fee and attorneys' fees and costs. Edison's implemented claims programs and practices that were improper which directly resulted in additional losses to its insured. Edison, as part of its routine business pattern and practices, employs outcome-oriented adjusters/vendors/experts who purposely looked for ways to minimize coverage instead of affording coverage to its policyholders. In contrast to the legislative intent which motivated the enumeration of an insurance adjuster's responsibilities outlined in the Florida Administrative Code, the insured were not afforded the professional duties entrusted and imposed on Edison by the Public Trust. The outcome-oriented claim adjustment practices undertaken by Edison led to Edison's failure to adequately adjust the Claim. This notice is given in order to perfect the right to pursue the civil remedy authorized by Section 624.155, Florida Statutes, should Edison fail to cure the violations set forth in this Civil Remedy Notice within the given cure period. In order to cure the defects outlined in this Civil Remedy Notice, Edison must act as follows: immediately deliver payment of all insurance proceeds due and owing to the insured which would reasonably place the Subject Property back in its pre-loss condition, namely, policy limits under Florida's Valued Policy Law; and keep the claim open for the adjustment of any supplemental claim and payment of any as of yet unincurred costs. If Edison disagrees with the extent of the cure requested or asserts that the payment of any of the above cure categories may not be required, Edison should cure to the extent it believes it must under the Subject Policy and governing laws to correct the allegations of bad faith contained herein. While it is not being requested as a cure for the bad faith alleged herein, the insured remains willing to entertain any reasonable counteroffer of settlement. While it is not being requested as a cure, Edison should also consider sending [name redacted] to sensitivity and professionalism training.
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. |
|---|---|
| 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)(g) | Failing to promptly notify the insured of any additional information necessary for the processing of a claim. |
| 626.9541(1)(i)(4) | Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 60 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by factors beyond the control of the insurer as defined in s. 627.70131(5). |
Filed with the state on June 30, 2025. 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 809544. 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.
Selected from the Civil Remedy Notices read for the archive as a documented example of a claim valued far below the repair. The pattern page shows how often that argument appears and which carriers the filings name.
Fla. DFS Civil Remedy Notice, Filing No. 809544 (Kenansville), accepted 3/4/2025 · 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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