Southern Oak: Milton denied for neglect, citing the unrepaired Ian claim

This Civil Remedy Notice is hereby withdrawn.

01-24-2025

[name redacted] Esquire, on behalf of Southern Oak Insurance Company, responded to the Civil Remedy Notice in letter format on January 24, 2025 via electronic mail to: [name redacted] c/o [name redacted] R. Elimelech, Esq. [address redacted]reet Miami, Florida 33162

RE: Insureds : [name redacted] Claim Number : 66118 Date of Loss : October 9, 2024 Policy no. [redacted] DFS File Number : 796039 Filing Accepted Date : December 9, 2024

Dear Ms. Elimelech,

This firm has the pleasure of representing Southern Oak Insurance Company ("Southern Oak") in connection with the above-referenced matter. Southern Oak is in receipt of the above-referenced Civil Remedy Notice of Insurer Violations ("Notice") filed against Southern Oak Insurance Company ("Southern Oak"). The Florida Department of Financial Services assigned Filing Number 796039 and an acceptance date of December 9, 2024. Southern Oak's response to the Notice will follow.

The Notice alleges "Claim Denial," "Claim Delay," "Unsatisfactory Settlement Offer, and "Unfair Trade Practice," as well as violations of Sections 624.155(1)(b)(1) & (3), and 626.9541(1)(i)(3)(a), (c), (d) & (f), Florida Statutes. The allegations contained in the Notice constitute generic, boilerplate accusations against Southern Oak, are wholly without merit, and lack sufficient legal and factual support. Accordingly, Southern Oak denies each and every alleged violation of Florida law.

As an initial matter, the Notice is deficient because it fails to comply with the requirements of the Florida Statutes. Section 624.155(3)(b), Florida Statutes, requires that a Civil Remedy Notice "state with specificity" the statutory provisions allegedly violated, the facts and circumstances giving rise to the violation, the name of any individual involved in the violation, and the specific policy language relevant to the violation. Rather than include the specifics required by Statute, when asked to identify the specific policy language relevant to the alleged violations, the Notice references the insuring clause and property coverages sections for Coverages A and B. The Notice does not explain how Southern Oak failed to comply with the specific terms of the policy with specific factual support or specific language in the policy pertaining to the alleged incident. The failure to include the information required by Florida Statute §624.155(3)(b) renders the Notice defective. See Julien v. United Property & Casualty Insurance Company, 311 So. 3d 875 (Fla. 4th DCA 2021); and Demase v. State Farm Fla. Ins. Co., 351 So. 3d 136 (Fla. 5th DCA 2022).

Additionally, the Civil Remedy Notice is defective as a matter of law. As stated by the Florida Supreme Court, the purpose of a Civil Remedy Notice is to put the insurer on notice of an alleged violation, the circumstances surrounding same, and indicate the details of the alleged violation in order to provide an insurer with 60 days to "cure" the alleged claim defects. See Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So.2d 1278 (Fla. 2000). The purpose of Fla. Stat. §624.155 is to provide the insurer with an opportunity to resolve a first-party coverage dispute and otherwise avoid litigation. See Talat Enterprises, Inc.; see also Lane v. Westfield Ins. Co., 862 So.2d 744 (Fla. 5th DCA 2003). Further, a Civil Remedy Notice must be sufficiently specific to provide the insurer with an opportunity to cure the alleged violations. This would include i) identifying the specific policy provision(s) at issue, ii) citing specific language of the statutory provision(s) the insurer allegedly violated, and iii) specifically identifying what actions the insurer must take to remedy the alleged violations. Rousso v. Liberty Surplus Ins. Corp., 2010 WL 7367059 (S.D. Fla. Aug. 13, 2010); Heritage Corp. of South Florida v. National Union Fire Ins. Co. of Pittsburgh, PA, 580 F. Supp. 2d 1294, 1299-1300 (S.D. Fla. 2008). Instead of including the required information, the Notice includes vague and improper cure requests. For instance, the Notice states that the Insurer must stipulate to the Insureds' entitlement to attorney's fees and court costs pursuant to §§ 627.428 and 626.9373; however, there is no statutory right to attorney's fees and § 627.428 has been repealed. Further, it's improper to include attorney's fees and costs in a cure request.

Further, the "facts and circumstances" section of the Notice is not in compliance with Florida law. Contrary to the requirements of Florida Statutes, the Notice makes false, boilerplate accusations, and does not contain any specific facts supporting the violations alleged. For example, the Notice alleges that Southern Oak violated Florida Statute §626.9541(1)(i)(3)(a) - Failing to adopt and implement standards for the proper investigation of claims. However, the body of the Notice does not explain how Southern Oak allegedly failed to properly investigate the claim. Instead, the Notice includes vague allegations without any factual support. Similarly, the Notice does not provide factual support for various allegations listed above, including but not limited to how Southern Oak's investigation was conducted in bad faith or how Southern Oak has engaged in claim delay and unfair trade practices. As more fully discussed below, the allegations contained within the Notice are untrue, and the Notice contains no facts to support them. Contrary to the allegations in the Notice, Southern Oak acted promptly, responsibly, and in good faith at every opportunity in connection with this claim. The failure to provide any factual support for the alleged violations of Florida law renders the Notice deficient and in violation of Florida Statute §624.155(3)(b).

A summary of the pertinent facts regarding the investigation and handling of this claim will follow. On or about October 13, 2024, Southern Oak was notified of a claim for Hurricane damage at the property located at [address redacted]reet NW, Palm Bay, Florida, with an alleged date of loss of October 9, 2024. It was reported that the fence in the yard was damaged, the porch screen was damaged, and the sliding door screen was damaged. Southern Oak immediately began investigating the claim and sent the Insureds a copy of the Homeowner Claims Bill of Rights. Thereafter, Southern Oak set up an inspection of the property. Southern Oak, through its field adjuster, inspected the property on or about October 24, 2024.

On or about November 9, 2024, Southern Oak sent a letter to the Insureds, discussing its investigation of the claim. The letter discussed the Insureds' prior claim for damage caused during Hurricane Ian, for which Southern Oak estimated for the fence, repairs to the porch screen, and replacement of the roof. The letter advised that during Southern Oak's inspection, it was confirmed that the Hurricane Ian repairs have not been completed. Further, the letter advised that there is no coverage for neglect and the Insureds cannot be indemnified for the same damage twice. The letter cited to the following policy language:

SECTION I - EXCLUSIONS

1. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. . . .

e. Neglect, meaning neglect of the "insured" to use all reasonable means to save and preserve property at and after the time of a loss. . . . * * * * On or about November 20, 2024, Southern Oak received a letter of representation from your law firm, which included a request for a copy of the subject policy of insurance. Subsequent requests for the policy were received on November 25, 2024 and November 27, 2024. Southern Oak sent correspondence to your office on December 6, 2024, requesting documents, including an estimate and photos of the damage when discovered. Then, on December 9, 2024, you filed the Notice.

Without waiving its rights to contest the validity of the subject defective and improper Notice, as the facts clearly demonstrate, Southern Oak has, and continues to comply with both Florida law and the applicable policy of insurance throughout the entire handling of this claim.

As outlined above, with regard to the investigation and handling of this claim, Southern Oak's actions were prompt, thorough, and conducted in good faith. Therefore, Southern Oak specifically denies each and every violation alleged in the Notice.

I trust this response addressed all concerns raised by the Notice. However, please do not hesitate to contact the undersigned should you require additional information.

Sincerely,

RYAN S. PARKER TYLER T. CALEY

cc: Southern Oak Insurance Company

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.