Universal Property & Casualty: a $188,920 claim called wear and tear

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.

The Complainant and Insured, [name redacted] (hereinafter referred to as "Complainant"), maintained a homeowner's policy of insurance (hereinafter referred to as "Policy") with UNIVERSAL PROPERTY & CASUALTY INSURANCE COMPANY (hereinafter referred to as "Universal"), which provides coverage for sudden and accidental damages and losses arising from a sudden and accidental roofing system failure which allows ensuing water damages at the subject property which in part may be due to Tropical Storm ETA's heavy wind and rain which said damages first manifested on or about July 1, 2021 ("Loss"). The Loss caused substantial, direct and consequential damages, and Universal's general business practice of willful, wanton, immoral, deceptive and bad faith claim handling policies, procedures, guidelines, protocol, adjusting, investigating, drawing valuations and issuing payment for the claim, has caused the Complainant to suffer further harm and extra-contractual damages which have accrued, and will continue to accrue. The stated misconduct outlined below is collectively referred to as "Bad Faith," and the specific, straightforward factual and/or legal considerations in relation thereto are further outlined below for its consideration in accordance with Fla. Stat. Sec. 624.155 and the cited legal authorities associated therewith. On or about July 1, 2021, the Complainant suffered direct physical loss to the subject property by way of ensuing water damages that first manifested on or about said date. During the adjustment of the claim, the Complainant hired Full Pro Restoration (hereinafter referred to as "Full Pro"), to perform the necessary, industry wide practice of performing moisture meter assessments coupled with the corresponding thermal imaging, to detect latent conditions, which, if undetected, will serve to create toxic conditions at the subject property. During the adjustment of the claim, all relevant documents from Full Pro, were dutifully provided. To date, no adjuster and/or qualified expert has been retained by Universal to dispute findings of elevated latent levels of water moisture at the subject property via the moisture meter assessments coupled with the corresponding thermal imaging. Moreover, the Complainant through his agents hired A1 [name redacted] to perform mold testing at the subject property. All relevant documents from A1 [name redacted] were dutifully provided during the pre-suit adjustment of the claim. To date, no adjuster and/or qualified expert has been retained by Universal to dispute the positive findings of mold at the subject property. Pursuant to the positive findings of mold, the Complainant retained Full Pro to perform the necessary, industry-wide practice of mold remediation, given the positive findings of mold at the subject property. All relevant documentation in relation to the mold remediation performed by Paramount, were dutifully provided too Universal. To date, no adjuster and/or qualified expert has been retained by Universal to dispute the necessity and/or reasonable course of repairs by way of the mold remediation services provided. Universal inspected the subject property by way of a field adjuster by the name of [name redacted] (hereinafter referred to as "Mr. Marin"). It is important to note that Mr. Marin who is not a licensed roofer and all indications as of the date of this filing are that he is not duly qualified to take into consideration latent water damages and the necessary repairs in relation to same. In addition, all indications are that he is not a duly qualified expert that can attest as to the efficient proximate being due to any purported excluded causes of loss. In addition, as of the date of this filing, Mr. Marin has failed to dispute the latent water damages that were detected via the moisture meter assessments and/or corresponding thermal imaging, as well as the necessary water remediation services provided, coupled with the mold testing (which was found positive), and corresponding mold remediation to protect the inhabitants of the subject property from toxic conditions. Based on the insufficient adjustment of the claim as outlined herein, Universal issued a wholly unsatisfactory valuation of $4,896.13 replacement cost value for the loss. In opposition to same, prior to suit being filed, the Complainant through his retained counsel provided an estimate with a valuation of $188,920.53 replacement cost value that duly takes into consideration the full extent of the latent conditions, that serve to create a plethora of extra contractual damages that continue to accrue, given Universal's general business practice of failing to adjust the full extent of the damages as outlined herein. In other words, the Complainant notified Universal of its unsatisfactory, lowball valuation of the underlying claim. On or about March 29, 2022, the Complainant (through his retained counsel) filed its original [name redacted] Notice (hereinafter referred to as "CRN") putting Universal on notice of the alleged bad faith conduct. On or about May 19, 2022, Universal filed its Response. Of importance, therein, Universal alleged that the original CRN failed to provide sufficient specificity as to how the carrier violated the purported 624.155 provisions. As to the purported lack of sufficient specificity, the facts outlined above clearly rebut any perceived prejudice in said regard. The sufficient specificity and/or particularity as to the facts and/or circumstances outlined by this bad faith conduct cannot be clearer. To cure the above stated immoral, deceptive, unlawful and collectively defined general business practice of bad faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the insured's interests being implemented, Universal must perform as follows within 60 days of receiving this CRN: I. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same, and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainant as per the industry wide accepted standards outlined herein. To hold otherwise, would allow Universal's bad faith claims handling described above to leave the insureds, the insured's counsel, the insurer's counsel, and even the judiciary guessing as to when and how Universal will duly perform. These continuously vacillating positions and cherry-picking of the described bad faith conduct outlined herein, not only serves to maximize Universal's prospective financial gains by being able to avoid paying benefits, it also serves to minimize Universal's loss adjusting expenses as it sees fir to the invariable detriment of the insureds, the Complainants, and ultimately the tax paying citizens of this State that bear the expense of the judicial system, which needs to be unraveled due to the tangled web created by Universal.

Florida DFS Civil Remedy Notice, filing number 794865. 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.

Fla. DFS Civil Remedy Notice, Filing No. 794865 (Miami), accepted 12/2/2024 · 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.