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Filing# 137418755 E-Filed 10/27/2021 06:28:45 PM
I
JUDICIAL C1RCU1'1 1N AND FOR
BROWARD COUNTY, FLORIDA
JESUS VILLEDA and JHANETH VILLEDA, CASE NO.. CACE-19-021344
Plaintiffs,
V
CITIZENS PROPERTY INSURANCE
CORPORATION,
Defendant.
I
PLAINTIFFS' RESPONSE IN OPPOSITION TO
DEFENDANT'S MOTION FOR SUMMARY JUDGMENT
Plaintiffs,JESUS VILLEDA and JHANETH VILLEDA (hereinafter,
collectivelythe
"Insured" or the "Plaintiff'),
by and through their undersigned counsel, hereby file this
Memorandum
in
Opposition
to
Defendant,
CITIZENS
PROPERTY INSURANCE
CORPORATION (hereafter"Citizens" or the "Insurance Company" or the "Defendant") Motion
for Summary Judgment, and state as follows:
I.
INTRODUCTION
This lawsuit arises out of a sudden and accidental failure of the plumbing system that
occurred on or about May 27, 2019 at the SubjectProperty,12708 NW 15th Street,Sunrise,
FL 33323 (hereafter,the "Property").Following its investigation,the Insurance Company
acknowledged the loss was covered and provided payment in the amount of $10,000.00.
However, this payment was also inclusive of services provided by Xpress Restoration. A true
and correct copy of the coverage determination letter is attached hereto as Exhibit "A". The
coverage determination letter clearlystates that the $10,000.00 amount being paid is for the
..
"Reasonable Emergency Services and the Building Repairs". However, Xpress Restoration
did not perform any repairsto the covered property that was damaged by water as a result of
the claimed loss. Further,the Policyprovidesunder Section I Additional Coverages that it will
pay for reasonable costs incurred by the Insured for necessary measures taken solelyto protect
*** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 10/27/2021 06:28:45 PM.****
covered property from further damage in addition to a $10,000.00 mold provision.
The Policyprovidesin no uncertain terms, that it providescoverage for "the cost to tear
out and repair...when necessary to access the system or appliance."See the Policy attached
hereto and incorporatedby reference as Exhibit "B". The Insurance Company essentially
only
paid $3,364.80 of what was damaged by water to the Insured, and did not pay any funds to
access the plumbing system and/or perform the repair,therebybreachingthe policy.As a result,
on or about October 15, 2019, the Insured was forced to file suit.
At
..
all times material hereto,there was in full force and effect,a
Dwelling insurance policy issued by the Insurance Company, with a policy number of
02178693-3 (the "Policy").See Exhibit "B". This Policy contains a Managed Repair
Contractor Program Endorsement, which mandates that The Insurance Company will provide
payment for any direct physicalloss to covered property that is damaged by the dischargeor
overflow of water. The sublimit "caps" the Insurance Company's payout at $10,000.00 for the
damages caused by water if the Insured does not participate
in the Managed Repair Program.
Thus, the basis of Citizens' Motion for Final Summary Judgment. In moving for
Summary Judgment, Citizens asserts that all of its obligationsunder the Policy have been
exhausted and is askingthis Court to relieve it from further coverage obligations.
Defendant's
Motion must be denied because Plaintiff has presented substantial,competent, evidence
creatingan issue of material fact precludingthe entry of summary judgment.
LPA, the publicadjustershired by the Insured,prepareda repairestimate in the amount
of $27,438.15 actual cash value. This estimate reflects the total amount of money necessary to
restore the Property to its pre-losscondition. More importantlyhowever, the estimate calculates
the cost to restore the property to its pre-losscondition as a result of the tear out needed to
access the plumbing system. A true and correct copy of this estimate has been attached hereto
as Exhibit "C".
The Insurance Company now argues that it is entitled to summary judgment as a matter of
law because the amount payable is limited to $10,000.00 per the terms and conditions of the
sublimit insurance policy.The Insured does not contest that the damages caused by water are
limited to $10,000.00; however, the Insured has not even been paidthe Policylimit of $10,000.00
nor the cost to tear out and access the pipe,nor the $10,000.00 mold limit are clearlycovered
under the Policyand the Insurance Company has failed to indemnify the Insured for same.
Further, in a very similar case in the 17th Circuit in and for Broward County, Florida,
Enrique Berrios v. National SpecialAN?FN'.?mA?, ,/??1?.?I,IY??
WHAT DOES CITIZENS PROPERTY INSURANCE CORPORATION DO
FACTS WITH YOUR PERSONAL INFORMATION?
Why?
Financial companies choose how they share your personal information. Federal law gives
consumers the rightto limit some but not all sharing. Federal law also requires us to tell you
how we collect, share, and protect your personal information. Please read this notice carefully
to understand what we do.
What?
The types of personal information we collect and share depend on the product or service you
have with us. This information can include:
Social Security number
Information you provide on your application for insurance coverage, such as your
name, address, telephone number, date of birth, and occupation
Information gathered from you as our insured, your payment history,type of coverage
you have, underwriting information and claims information
Credit card or bank account information
Mortgage information
Information from your visits to www.citizensfla.com
How?
All financial companies need to share customers' personal information to run their everyday
business. Citizens uses your personal information only as authorized or required by law and
as necessary to provide our products and services to you. In the section below, we list the
reasons financial companies can share their customers' personal information; the reasons
Citizens chooses to share; and whether you can limit this sharing.
Reasons we can share your personal information
Does Citizens share?
Can you limit this
sharing?
For
-
our everyday business purposes
We share with
Yes
No
nonaffiliates to assist us to process your transactions,
underwrite and/or rate your policy,service your policy,
administer claims, respond to court orders and legal
investigations, and, as permitted by federal and state law.
For
-
our marketing purposes
to offer our products and
No
We don't share
services to you
For joint marketing with other financial companies
No
We don't share
For our
-
affiliates' everyday business purposes
No
We don't share
information about your transactions and experiences
-
For our affiliates' everyday business purposes
No
We don't share
information about your creditworthiness
For nonaffiliates to market to you
No
We don't share
Questions? Call 866.411.2742; Deaf/Hard of Hearing: 800.955.8771 (TTY) or 800.955.8770 (Voice); or go
to www.citizensfla.com
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PNMPR-7 08 18
Page 2
What we do
How does Citizens protect my
To protect your personal information from unauthorized access and use, we
personal information?
use security measures that comply with federal law. These measures
include computer safeguards and secured files and buildings. Our
employees and vendors are authorized to access information only for valid
business reasons. They must agree in writingto maintain the confidentiality
of nonpublic personal information. We do not share medical information
unless authorized by you or as required by law.
How does Citizens collect my
We collect your personal information, for example, when:
personal information?
you apply for insurance
we process your application
you pay insurance premiums
you give us your contact information
you give information to your agent or property inspector
you file an insurance claim (or if a claim is made against you)
you show us your government-issued ID or driver's license
you visit Citizens' website if you voluntarily provide the information
We also collect information from other companies, such as your loss history.
Why can't I limit all sharing?
Federal law gives you the rightto limit only:
sharing for affiliates' everyday business
about your creditworthiness
affiliates from using your information to market to you
sharing for nonaffiliates to market to you
State law and individual companies may give you additional rightsto limit
sharing. See below for more on your rights under state law.
Definitions
Affiliates
Companies related by common ownership or control. They can be financial
and nonfinancial companies.
Citizens has no affiliates
Nonaffiliates
Companies not related by common ownership or control. They can be
financial or nonfinancial company. Nonaffiliates we share with can include:
ndependent insurance agents and agencies
ndependent adjusters or claims representatives
nspection companies
Auditors
Insurance support organizations
Attorneys, courts, and government agencies
Joint marketing
A formal agreement between nonaffiliated financial companies that together
market financial products or services to you.
Citizens does not jointlymarket
Other important information
-
State law
The Florida public records law requires that all information received by a state entitybe made
available to anyone upon request, including e-mail addresses, unless the information is subject to a specific
statutory exemption.
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PNMPR-7 08 18
CITIZENS
PROPERTY INSIJRANCG CORPORATION
Acknowledgement of Potential Surcharge and Assessment Liability
We are required by law to send you this notice to inform you about the potentialfor surcharges and
assessments to be applied to your policy.
1.
AS A POLICYHOLDER OF CITIZENS PROPERTY INSURANCE CORPORATION, I UNDERSTAND
THAT IF THE CORPORATION SUSTAINS A DEFICIT AS A RESULT OF HURRICANE LOSSES OR
FOR ANY OTHER REASON, MY POLICY COULD BE SUBJECT TO SURCHARGES, WHICH WILL
BE DUE AND PAYABLE UPON RENEWAL, CANCELLATION, OR TERMINATION OF THE POLICY,
AND THAT THE SURCHARGES COULD BE AS HIGH AS 45 PERCENT OF MY PREMIUM, OR A
DIFFERENT AMOUNT AS IMPOSED BY THE FLORIDA LEGISLATURE.
2.
I UNDERSTAND THAT I CAN AVOID THE CITIZENS POLICYHOLDER SURCHARGE, WHICH
COULD BE AS HIGH AS 45 PERCENT OF MY PREMIUM, BY OBTAINING COVERAGE FROM A
PRIVATE MARKET INSURER AND THAT TO BE ELIGIBLE FOR COVERAGE BY CITIZENS, I MUST
FIRST TRY TO OBTAIN PRIVATE MARKET COVERAGE BEFORE APPLYING FOR OR RENEWING
COVERAGE WITH CITIZENS. I UNDERSTAND THAT PRIVATE MARKET INSURANCE RATES ARE
REGULATED AND APPROVED BY THE STATE.
3.
I UNDERSTAND THAT I MAY BE SUBJECT TO EMERGENCY ASSESSMENTS TO THE SAME
EXTENT AS POLICYHOLDERS OF OTHER INSURANCE COMPANIES, OR A DIFFERENT AMOUNT
AS IMPOSED BY THE FLORIDA LEGISLATURE.
4.
I ALSO UNDERSTAND THAT CITIZENS PROPERTY INSURANCE CORPORATION IS NOT
SUPPORTED BY THE FULL FAITH AND CREDIT OF THE STATE OF FLORIDA.
More information regarding assessments and surcharges is available under the Po#cyho/der section
of our website, www. citizens#a. com.
Citizens Property Insurance Corporation
POLICYHOLDER ASSESSMENT EXAMPLE
To illustrate the potential assessment obligation of a Citizens policyholder compared to a
policyholder insured by a private insurer, we have prepared an example based on an annual
premium of $2,000. Your actual assessment amount will vary based on your annual premium.
The assessment will be in addition to the premium you pay for insurance coverage.
ABC Insurance
Citizens Policy
Policy
If your annual premium is:
$2,000
$2,000
Tier 1: Potential Citizens Policyholder Surcharge (one- time assessment
$900
NLA
up to 45% of premium)
Tier 2: Potential Regular Assessment (one -time assessment up to 2% of
1
N/A
$40
premium)
Tier 3: Potential Emergency Assessment (up to 30% of premium
2
$600
$600
annually, may apply for multiple years)
Potential Annual Assessment:
$1,500
$640
Tiers are used to demonstrate the multiple levels of assessment defined by Florida Law.
Assessment tiers are triggered based on the severity of the deficit.
Assessments are based on the greater of the projected deficit or the aggregate statewide
written premium for the subject lines of business. The above example is based
on the use of premium.
Notes:
-
1
Tier 2 additional assessments may be incurred for other property/casualty policies that are subject to assessment.
2 - Tier 3 assessment may be collected each year over multiple years, depending on the extent of the deficit. In the event that subsequent
years also generate a deficit, additional assessments could occur.
ACK-1 11 13
-.' CITI -iS
PROPERTY INSURANCE CORPORATION
POLICYHOLDER NOTICE
IMPORTANT INFORMATION
Dear Policyholder,
This offer of renewal contains a separate deductible for hurricane losses and a
separate deductible for all other peril(AOP) losses. The hurricane deductible and
AOP deductible you previously selected are shown in the enclosed Declaration
page(s) of this renewal offer.
Citizens offers you the choice of several hurricane deductible options. If your
policydwelling limit is $100,000 or more (or personal property limit,if applicable),
you may choose a hurricane deductible of 2, 5 or 10 percent of your lim-t. In
addition to these deductibles, you may also choose a hurricane deductib e of
$500 if your policy dwelling limit is less than $100,000 (or personal property imit,
if applicable).
The all other perils(AOP) deductible options you may choose are $500, $1,000
or $2,500, but may not exceed the hurricane deductible you select.
All of these deductible options may not be available due to the policy dwelling
limit (or personal property limit,if applicable).
You may select different deductibles now or at any future renewal. If you have
suffered hurricane losses in the current calendar year, a request to reduce your
hurricane deductible will not be effective until January 1 of the following year.
A mandatory sinkhole deductible may apply in some policiesand will be shown in
your Declarations, if applicable.
If
you have questions about these deductibles or want to change your
deductibles, contact your Citizens agent for assistance. The request to change
your deductibles must be received by Citizens prior to the renewal date of
your policy.
This notice does not provide coverage nor does this notice replace any
provisions of your policy.
You should read your policy and review your
declarations page for complete information on the coverages you are provided
with.
If there is any conflict between the policy and this notice, the provisions of
the policyshall prevail.
PNMPR-8 06 12
Checklist of Coverage
Policy Type: Dwelling
(Indicate: Homeowner's, Condominium Unit Owner's, Tenant's, Dwelling, or Mobile Home Owner's)
The following checklist is for informational purposes only. Florida law prohibits this checklist from changing any of the provisions of
the insurance contract which is the subject of this checklist. Any endorsement regarding changes in types of coverage, exclusions,
limitations,reductions, deductibles, coinsurance, renewal provisions, cancellation provisions, surcharges, or credits will be sent
separately.
Reviewing this checklist together with your policy can help you gain a better understanding of your policy's actual coverages and
limitations, and may even generate questions. By addressing any questions now, you will be more prepared later in the event of a
claim. Experience has shown that many questions tend to arise regarding the coverage of attached or detached screened pool
enclosures, screened porches, and other types of enclosures. Likewise, if your policy insures a condominium unit, questions may
arise regarding the coverage of certain items, such as individual heating and air conditioning units; individual water heaters; floor,
wall, and ceiling coverings; built-in cabinets and counter tops; appliances; window treatments and hardware; and electrical fixtures.
A clear understanding of your policy'scoverages and limitations will reduce confusion that may arise during claims settlement.
Please refer to the policy for details and any exceptions to the coverages listed in this checklist. All coverages are subject to the
provisions and conditions of the policy and any endorsements. If you have questions regarding your policy, please contact your
agent or company. Consumer assistance is available from the Department of Financial Services, Division of Consumer Services'
Helpline at (800) 342-2762 or www.fldfs.com.
This form was adopted by the Florida Financial Services Commission.
Dwelling Structure Coverage (Place of Residence)
Limit of Insurance:
$228,000
Loss Settlement Basis: Replacement Cost
(i.e.:Replacement Cost, Actual Cash Value, Stated Value, etc )
Other Structures Coverage (Detached from Dwelling)
Limit of Insurance:
$4,560
Loss Settlement Basis:
Replacement Cost
(i.e.:Replacement Cost, Actual Cash Value, Stated Value, etc )
Personal Property Coverage
Limit of Insurance:
$0
Loss Settlement Basis:
(i.e.:Replacement Cost, Actual Cash Value, Stated Value, etc )
Deductibles
$4,560 (2%)
$2,500
Annual Hurricane:
All Perils (Othgr Than Hyrricane)
Sinkhole: $22,800 (10%)
OIR-Bl-1670 (1-1-06)
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Checklist of Coverage (continued)
The above Limit of Insurance, Deductibles, and Loss Settlement Basis apply to the following perils insured against: