Civil Remedy Notice of Insurer Violations: Complainant

Civil Remedy Notice of Insurer Violations
Filing Number: 349060

Filing Accepted: 6/21/2017
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 Social Security
Numbers, personal medical information, personal financial information or any other information you do not
want available for public review.
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.
Complainant
Name: STANLEY & DENISE ZALESKI

Street Address: 11257 NW 7TH STREET
City, State Zip: CORAL SPRINGS, FL 33071
Email Address:
Complainant Type: Insured
Insured
Name: STANLEY & DENISE ZALESKI

Policy #: 79-B2-M652-2
Claim #: 59-0148-Z43
Attorney
Name: MATTHEW STRUBLE

Street Address: 101 NE THIRD AVE, SUITE 1110
City, State Zip: FORT LAUDERDALE, FLORIDA 33301
Email Address:
Notice Against
Insurer Type: Authorized Insurer

Name: STATE FARM FLORIDA INSURANCE COMPANY
Please identify the person or persons representing the insurer who are most responsible for/knowledgeable of the
facts giving rise to the allegations in this notice.
KEVIN JASMIN AND ALL ADJUSTERS, SUPERVISORS, MANAGEMENT AND INDIVIDUALS ASSOCIATED
WITH OR RETAINED BY STATE FARM FLORIDA INSURANCE COMPANY (“STATE FARM”) RELATED TO
THIS CLAIM.
Type of Insurance: Residential Property & Casualty
DFS-10-363
Rev. 10/14/2008
Civil Remedy Notice of Insurer Violations
Filing Number: 349060
Reason for Notice
Reasons for Notice:
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
PURSUANT TO SECTION 624.155, F.S. please indicate all statutory provisions alleged to have been 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.
624.155(1)(b)(2) Making claims payments to insureds or beneficiaries not accompanied by a
statement setting forth the coverage under which payments are being made.
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)(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)(d) Denying claims without conducting reasonable investigations based upon
available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial
coverage, the dollar amount or extent of coverage, or failing to provide a
written statement that the claim is being investigated, upon the written request
of the insured within 30 days after proof-of-loss statements have been
completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured
of the basis in the insurance policy, in relation to the facts or applicable law,
for denial of a claim or for the offer of a compromise settlement.
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)(3)(h) Failing to clearly explain the nature of the requested information and the
reasons why such information is necessary.
626.9541(1)(i)(3)(i) Unfair claim settlement practices
Reference to specific policy language that is relevant to the violation, if any. If the person bringing the civil action is a
third party claimant, she or he shall not be required to reference the specific policy language if the authorized insurer
has not provided a copy of the policy to the third party claimant pursuant to written request.
DFS-10-363
Rev. 10/14/2008
Section I Property Coverages provides coverage for the claim and there are no exclusions that apply.
STATE FARM FLORIDA INSURANCE COMPANY (“STATE FARM”) has failed to issue payment pursuant to
the Loss Settlement Provision.
To enable the insurer to investigate and resolve your claim, describe the facts and circumstances giving rise to the
insurer's violation as you understand them at this time.
On or about MAY 17, 2017 while the policy was in full force and effect, the subject property sustained a
sudden and accidental covered loss as a result of water damage and related damages along with additional
damages, including mold. STATE FARM FLORIDA INSURANCE COMPANY (“STATE FARM”) received notice
of the claim and assigned claim number 59-0148-Z43 to the claim. STATE FARM performed a cursory
inspection of the property, failing to retain the experts necessary to identify the repairs necessary to restore
the property to its pre-loss condition. The insured retained a representative to assist with the claim, and this
representative performed a comprehensive investigation identifying covered damages STATE FARM knew
existed, but failed to address. STATE FARM had a low-ball estimate prepared that failed to encompass all
covered damages. STATE FARM knows its aforementioned “low ball” estimate and investigation is
insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition.
By failing to issue proper payment for the claim, STATE FARM is failing to comply with its loss settlement
provision. Rather than issuing the proper payment or attempting to reach an agreement with its insured,
STATE FARM is delaying the claim. Upon information and belief, STATE FARM performs the subject actions
as a business practice, including delaying the claim, issuing "low ball" payments and denying the claim in
an attempt to dissuade its insureds from pursuing the claim to the detriment of its insureds to increase
financial profits. STATE FARM FLORIDA INSURANCE COMPANY (“STATE FARM”) can cure the violations
contained herein by issuing a payment for all contractual damages owed.
Comments
User Id Date Added Comment

florida.civilremedy@statefarm.com 07-25-2017 Our CRN response letter was sent to the insured's attorney on July
20, 2017.
DFS-10-363
Rev. 10/14/2008

Civil Remedy Notice of Insurer Violations: Complainant

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Civil Remedy Notice of Insurer Violations

Filing Number: 349060

Name: STANLEY & DENISE ZALESKI

Name: STANLEY & DENISE ZALESKI

Name: MATTHEW STRUBLE

Insurer Type: Authorized Insurer

Type of Insurance: Residential Property & Casualty

Reason for Notice

Reasons for Notice:

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