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Filing # 191327315 E-Filed 02/06/2024 10:26:15 AM
IN THE CIRCUIT COURT OF THE
THIRTEENTH JUDICIAL CIRCUIT IN
AND FOR HILLSBOROUGH COUNTY,
FLORIDA
CASE NO.:
THEODORE ROYAL
AND ALISIA ROYAL
Plaintiff,
v.
CITIZENS PROPERTY INSURANCE
CORPORATION,
Defendant.
,
COMPLAINT
COMES NOW the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, by and
through their undersigned attorney, and sue the Defendant, CITIZENS PROPERTY INSURANCE
CORPORATION, and allege as follows:
1. This is an action for breach of contract with damages of more than Fifty Thousand Dollars
($50,000.00), exclusive of interest, costs, and attorney’s fees.
2. At all material times hereto, the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL,
(hereinafter “Plaintiffs”) was and is a resident of Florida.
3. At all material times hereto, Defendant, FL CITIZENS PROPERTY INSURANCE
CORPORATION, was a corporation duly licensed to transact insurance business in the State
of Florida. Defendant does business, has offices, and/or maintained agents for the
transaction of its customary business in Hillsborough County, Florida.
4. Prior to August 20, 2023, Plaintiffs sought and purchased homeowner’s insurance from
Defendant to cover the property located at 3804 Coral Dr Tampa, FL 33619
2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1
(hereinafter “Insured’s Property”). Said property was insured under a policy of insurance
issued by Defendant bearing policy number 01760533-8. A true and correct copy of the
Certified Policy is hereby attached as Exhibit “A”.
5. The policy described above was in full force and effect as of August 20, 2023, and provided
benefits for damage caused to the Insured’s Property from a covered loss including, but not
limited to, wind, rain, hail, and/or water damage.
6. On or about August 20, 2023, Insured’s Property and dwelling at 3804 Coral Dr Tampa, FL
33619, was damaged by a windstorm event. Said event was covered under the Insured’s
Policy issued by Defendant to Insured and was assigned claim number 001-00-449288.
7. As a result of the windstorm event described above, Plaintiff sustained severe roof and
interior damage at the insured property.
8. This is an action related to Defendant’s breach of contract and failure to pay Plaintiff for the
repairs necessary to return the insured property to its pre-loss condition.
9. Plaintiffs have complied with all duties after loss and pre-suit requirements by providing
Defendant with a Notice of Intent to Initiate Litigation on January 9, 2024, through the
Florida Department of Financial Services in compliance with Section 627.70152 Florida
Statutes. See Notice of Intent to Initiate Litigation attached hereto as Exhibit “B”.
10. Jurisdiction and venue of this matter are proper in Circuit Court for Hillsborough County,
Florida.
11. Plaintiffs timely notified the Defendant of the loss and otherwise performed all conditions
precedent to entitle Plaintiffs to coverage and benefits under the policy or Defendant
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waived the conditions.
COUNT I-BREACH OF CONTRACT AGAINST DEFENDANT
COMES NOW the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, by and
through their undersigned attorney sue the Defendant, CITIZENS PROPERTY INSURANCE
CORPORATION, and allege as follows:
12. The Plaintiffs hereby repeat and re-alleges Paragraphs 1 through 11 above and incorporates
the same by reference herein.
13. The Plaintiffs are the named insureds under the homeowner’s insurance policy, and said
policy was in full force and effect on the date of loss.
14. Despite demand for payment, Defendant has failed or refused to either: provide coverage,
pay Plaintiffs in full for repairs necessary to return the home to its pre-loss condition, issue
payment for personal property or provide payment for alternative living expenses/loss of
use.
15. Defendant’s refusal to provide coverage or adequately reimburse Plaintiffs, or otherwise
make Plaintiffs whole, constitutes a breach of contract.
16. Due to Defendant’s breach of contract, Plaintiffs have been damaged in the form of
insurance proceeds which have not been paid, interest, costs, and attorney’s fees.
17. Due to Defendant’s breach of contract, Plaintiffs had to retain the services of the
undersigned attorney to initiate and prosecute this action. Plaintiffs are obligated to pay their
attorney a reasonable fee and costs for the services provided.
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18. Plaintiffs have been and remain fully prepared to comply with all of the obligations pursuant to
the aforesaid contract of insurance.
19. Plaintiffs are entitled to recover costs under §57.041.
WHEREFORE, Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, demands judgment against
Defendant, CITIZENS PROPERTY INSURANCE CORPORATION, for all unpaid bills with interest on any
overdue payments, costs pursuant to Fla. Stat. §57.041, and any other relief this Court deems just and proper.
PLAINTIFFS HEREBY DEMANDS A JURY TRIAL ON ALL ISSUES SO TRIABLE.
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JURY TRIAL DEMAND
Plaintiff hereby demands a trial by jury on all issues so triable.
Dated this February 6, 2024.
Respectfully Submitted,
Cordova Law Firm, PLLC
/s/ Leslie Cabrera
Leslie Cabrera, Esq.
Florida Bar No.: 1025277
Cordova Law Firm, PLLC
496 Delaney Avenue, Ste 508
Orlando, FL 32801
Phone: (321) 267-3682
Fax: (407) 442-0654
Primary Email:
Leslie@justcallmyattorney.com
Secondary Email:
AdrianaM@justcallmyattorney.com
Attorney for Plaintiffs
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Exhibit A
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CitizensProperty Inusrance Corporation
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Certified Policy Request
Date: 10/31/2023
Requestor’s Name: Lesley Anderson Contact Number: 321-267-3682
Requestor’s Employer: Cordova Law Firm Email Address: Lesley@justcallmyattorney.com
Insured’s Name: Alisia Royal Date of Loss: 08/20/2023
Policy Number: 01760533-8 Policy Term: Claim Number: 001-00-449807
Type of documents needed (Please check all that apply):
Certified Copy of the Policy in Force on the Date of Loss (includes the policy form, the dec page and policy
✔
endorsements in force on the date of loss).
Renewal Packet sent to the policyholder for the most recent renewal prior to the date of loss (in addition to the renewal
offer, this includes the “Notice of Change in Policy Terms”, policy documents, and other policy-related information).
Certified Copy of Other Policy (or Policies) and Renewal Packet(s) for terms unrelated to the Date of Loss:
o For each policy being requested, list the year the policy was in force: _______________________
o For each renewal packet being requested, please specify the year of each policy for which a renewal packet
is being requested. ______________
Underwriting information, including the completed application, inspection reports, and agent communications regarding
the risk.
✔ Policy notes relating to the Policy in Force on the Date of Loss.*
*Please allow two to three weeks for a reply to a request that includes policy notes.
For other information, please send a public records request to Citizens’ Records Custodian at the mailing address,
email address, or fax number provided on this form.
Where should the documents be sent; please select one. ✔ E-mail US Mail
Email Address: Lesley@justcallmyattorney.com
Mailing Address: 496 Delaney Ave., Ste. 508 City: Orlando State: FL Zip Code: 32801
Please note that if you chose to have your documents sent by mail, it will add additional processing time to your request.
Requirements
Insured – Complete and return the form
Public Adjusters - Complete and return the form with a copy of the letter of representation with your request.
Attorneys - Complete and return the form. Please include a copy of the letter of representation with your request.
Agents – In order to receive a copy of the policy, you must be the agent of record for the policy term you are requesting. Complete and
return the form.
Please return this document to
CertifiedPolicyRequests@Citizensfla.com
Please be advised that failure to return this document to the email address provided above may result in a delay
in the processing of your request.
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AFFIDAVIT OF CUSTODIAN OF RECORDS
7052(Florida Evidence Code §§ 90.803(6) and 90.902(11), Fla. Stat.)
1. I, Sandashia Dennis, am the Records Assistant for Citizens Property
Insurance Corporation (Citizens) and in such capacity I have the authority to
certify the attached records.
2. Attached hereto is a copy of Citizens’ Policy No. 01760533 of Policyholder
THEODORE ROYAL.
3. This policy was kept by Citizens in the regular course of business, and it was
the regular practice of Citizens for an employee or representative with
knowledge of the act recorded to make the record or transmit information
thereof to be included in such record.
4. This record was made at or near the time of the act.
5. The records attached hereto are exact duplicates of the original.
Under penalties of perjury, I declare that I have read the foregoing Affidavit and
that the facts stated in it are true.
November 1, 2023 _____________________________________
Date Sandashia Dennis
Records Assistant
Citizens Property Insurance Corporation
CarlosBeruf, Chairman, Manatee County ● Josh Becksmith, St. JohnsCounty ● Jason Butts, PinellasCounty
● ErinKnight, Miami-Dade County
Jillian Hasner, Palm Beach County ● JoAnne Leznoff, NasauCounty
sia County ● Nelson Telemaco, Broward County
Charlie Lydecker,Volu ● M. Scott Thomas, St. JohnsCounty
Timothy M. Cerio, President/CEO and Executive Director
2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 8
CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY STREET, SUITE 1300
JACKSONVILLE FL 32202-5142
Homeowners HO-3 Special Form Policy - Declarations
POLICY NUMBER: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023
at 12:01 a.m. Eastern Time at the Location of the Residence Premises
Transaction: RENEWAL
Named Insured and Mailing Address: Location Of Residence Premises: Agent: Fl. Agent Lic. #: A223179
First Named Insured: 3804 CORAL DR JOSE ROCA, PA
THEODORE ROYAL TAMPA FL 33619 JOSE ROCA
3804 CORAL DR County:HILLSBOROUGH 10039 E ADAMO DR
TAMPA, FL 33619-1231 TAMPA, FL 33619
Phone Number: 813-621-9687 Phone Number: 813-662-1940
Citizens Agency ID#: 22054
Primary Email Address:
tedlisa3@verizon.net
Additional Named Insured: Please refer to “ADDITIONAL NAMED INSURED(S)” section for details
Coverage is only provided where a premium and a limit of liability is shown
All Other Perils Deductible: $2,500 Hurricane Deductible: $4,412 (2%)
LIMIT OF LIABILITY ANNUAL PREMIUM
SECTION I - PROPERTY COVERAGES $3,813
A. Dwelling : $220,600
B. Other Structures: $4,410
C. Personal Property: $55,150
D. Loss of Use: $22,060
SECTION II - LIABILITY COVERAGES
E. Personal Liability: $100,000 $10
F. Medical Payments: $2,000 INCLUDED
OTHER COVERAGES
Ordinance or Law Limit (25% of Cov A) (See Policy) Included
SUBTOTAL: $3,823
Florida Hurricane Catastrophe Fund Build-Up Premium: $44
Premium Adjustment Due To Allowable Rate Change: ($1,648)
MANDATORY ADDITIONAL CHARGES:
2022 Florida Insurance Guaranty Association (FIGA) Regular Assessment $16
2022-B Florida Insurance Guaranty Association (FIGA) Regular Assessment $29
Emergency Management Preparedness and Assistance Trust Fund (EMPA) $2
Tax-Exempt Surcharge $39
TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $2,305
The portion of your premium for:
Hurricane Coverage is $1,045 Non-Hurricane Coverage is $1,174
Authorized By: JOSE ROCA Processed Date: 10/29/2022
DEC HO3 12 19 First & Additional Named Insured Page 1 of 4
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CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY STREET, SUITE 1300
JACKSONVILLE FL 32202-5142
Homeowners HO-3 Special Form Policy - Declarations
Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023
First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises
Forms and Endorsements applicable to this policy:
CIT HO 01 09 06 22, CIT 04 86 02 21, CIT 24 07 08, IL P 001 01 04, CIT HO-3 02 22, CIT 04 96 02 16, CIT 04 85 02 21
Rating/Underwriting Information
Year Built: 1962 Protective Device - Burglar Alarm: No
Town / Row House: No Protective Device - Fire Alarm: No
Construction Type: Masonry Protective Device - Sprinkler: None
BCEGS: Ungraded No Prior Insurance Surcharge: No
Territory / Coastal Territory: 080 / 00 Terrain: B
Wind / Hail Exclusion: No Roof Cover: Unknown
Municipal Code - Police: 999 Roof Cover - FBC Wind Speed: N/A
Municipal Code - Fire: 999 Roof Cover - FBC Wind Design: N/A
Occupancy: Owner Occupied Roof Deck Attachment: Unknown
Use: Primary Roof-Wall Connection: Unknown
Number of Families: 1 Secondary Water Resistance: Unknown
Protection Class: 3 Roof Shape: Gable
Distance to Hydrant (ft.): 500 Opening Protection: Unknown
Distance to Fire Station (mi.): 3
A premium adjustment of $0 is included to reflect the building's wind loss mitigation features or construction techniques that exists.
A premium adjustment of $0 is included to reflect the building code effectiveness grade for your area. Adjustments range from a 2%
surcharge to a 13% credit.
Your property coverage limits have been adjusted for inflation.
Your policy premium has increased by $564. Of this amount:
The premium difference due to an approved rate change is $215
The premium difference due to changes in your coverage is $280
The premium difference due to mandatory additional charges plus FHCF Build-up is $69
ADDITIONAL NAMED INSURED(S)
Name Address
ALISIA ROYAL 3804 CORAL DR TAMPA, FL 33619-1231
ADDITIONAL INTEREST(S)
# Interest Type Name and Address Loan Number
MIDFLORIDA CREDIT UNION ISAOA
1 1st Mortgagee C/O INSURANCE SERVICE CENTER PO BOX 948077 Maitland, FL 693044
32794-8077
DEC HO3 12 19 First & Additional Named Insured Page 2 of 4
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CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY STREET, SUITE 1300
JACKSONVILLE FL 32202-5142
Homeowners HO-3 Special Form Policy - Declarations
Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023
First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises
FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY.
THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE
FOR HURRICANE LOSSES, WHICH MAY RESULT
IN HIGH OUT-OF-POCKET EXPENSES TO YOU.
YOUR POLICY PROVIDES COVERAGE FOR A
CATASTROPHIC GROUND COVER COLLAPSE THAT
RESULTS IN THE PROPERTY BEING CONDEMNED AND
UNINHABITABLE. OTHERWISE, YOUR POLICY DOES
NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES.
YOU MAY PURCHASE ADDITIONAL COVERAGE FOR
SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM.
LAW AND ORDINANCE: LAW AND ORDINANCE
COVERAGE IS AN IMPORTANT COVERAGE
THAT YOU MAY WISH TO PURCHASE. PLEASE
DISCUSS WITH YOUR INSURANCE AGENT.
DEC HO3 12 19 First & Additional Named Insured Page 3 of 4
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CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY STREET, SUITE 1300
JACKSONVILLE FL 32202-5142
Homeowners HO-3 Special Form Policy - Declarations
Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023
First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises
FLOOD INSURANCE: YOU MAY ALSO NEED TO
CONSIDER THE PURCHASE OF FLOOD INSURANCE.
YOUR HOMEOWNER'S INSURANCE POLICY DOES
NOT INCLUDE COVERAGE FOR DAMAGE RESULTING
FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN
CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE
FLOOD INSURANCE COVERAGE, YOU MAY HAVE
UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE
DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD
INSURANCE COVERAGE WITH YOUR INSURANCE AGENT.
TO REPORT A LOSS OR CLAIM CALL 866.411.2742
IN CASE OF LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT
THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS.
PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE
EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF: (A) 72 HOURS
AFTER WE ARE NOTIFIED OF THE LOSS, (B) THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL
BY US.
THIS POLICY CONTAINS LIMITS ON CERTAIN COVERED LOSSES, ALL SUBJECT TO THE TERMS AND CONDITIONS OF YOUR
POLICY. THESE LIMITS MAY INCLUDE A $10,000 LIMIT ON COVERAGE FOR COVERED LOSSES CAUSED BY ACCIDENTAL
DISCHARGE OR OVERFLOW OF WATER OR STEAM FROM SPECIFIED HOUSEHOLD SYSTEMS, SEEPAGE OR LEAKAGE OF
WATER OR STEAM, CONDENSATION, MOISTURE OR VAPOR, AS DESCRIBED AND INSURED IN YOUR POLICY (HEREAFTER
COLLECTIVELY REFERRED TO AS ACCIDENTAL DISCHARGE OF WATER IN THIS PARAGRAPH). AS ANOTHER EXAMPLE,THERE
IS ALSO LIMIT OF $3,000 APPLICABLE TO REASONABLE EMERGENCY MEASURES TAKEN TO PROTECT COVERED PROPERTY
FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER. THE AMOUNT WE PAY FOR THE NECESSARY REASONABLE
EMERGENCY MEASURES YOU TAKE SOLELY TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL
DISCHARGE OF WATER WILL BE DEDUCTED FROM THE $10,000 LIMIT ON COVERAGE FOR ACCIDENTAL DISCHARGE OF
WATER.
INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST
THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS.
PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. IF YOU ARE UNABLE TO
CONTACT YOUR AGENT, YOU MAY REACH CITIZENS AT 866.411.2742.
DEC HO3 12 19 First & Additional Named Insured Page 4 of 4
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NOTICE OF PRIVACY POLICY
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 right to 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
When you are no longer our customer, your information will be retained in accordance with
Citizens’ records retention schedule. While your information is retained, it may continue to be
shared as described in this notice.
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 Can you limit this
share? 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, comply with authorized depopulation
programs, respond to court orders and legal investigations,
and when permitted by federal or 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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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 writing to 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, such as your loss history, from other
companies.
Why can’t I limit all sharing? Federal law gives you the right to limit only:
- Sharing for affiliates’ everyday business purposes –
information 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 rights to limit
sharing. See below for more on your rights under state law.
Definitions
Affiliates These are 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:
- Independent insurance agents and agencies
- Independent adjusters or claims representatives
- Inspection companies
- Auditors
- Insurance support organizations
- Attorneys, courts, and government agencies
Joint marketing This is a formal agreement between nonaffiliated financial companies that
together market financial products or services to you.
Citizens does not jointly market.
Other important information
State law: The Florida public records law requires that all information received by a state entity be made
available to anyone upon request, including e-mail addresses, unless the information is subject to a specific
statutory exemption.
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Page 3
Notice of Collection and Use of Social Security Numbers
Introduction Section 119.071(5), Florida Statutes, governs the collection of Social
Security numbers by certain government entities, including Citizens.
Citizens collects Social Security numbers only in cases where it is
specifically authorized to do so or when it is imperative for performance of
Citizens’ duties. To protect your identity, Citizens secures your Social
Security number from unauthorized access and strictly prohibits the release
of your Social Security number to unauthorized parties contrary to state or
federal law.
Social Security numbers are collected from prospective policyholders during
How are Social Security
the underwriting process for the following purposes:
numbers used to underwrite
and service my policy? - Obtaining loss history reports for underwriting purposes
- Implementing the enhanced Property Insurance Clearinghouse
application authorized by paragraph 627.3518(3)(e), Florida
Statutes
- Reporting unclaimed property to state government agencies
- Processing insurance claims
- Ensuring compliance with US Department of Treasury Office of
Foreign Asset Control requirements
Table of Laws and Regulations
The table below summarizes the purposes for which Citizens collects Social Security numbers and the laws
and regulations under which collection is authorized or required. It also identifies whether collection is
authorized by statute or mandatory for the performance of that agency’s duties and responsibilities as
prescribed by law.
Mandatory for
Authorized by
Purpose for Collection Law or Regulation Performance of
Statute
Agency Duties
Obtaining Loss History
Reports
627.351(6)(n), Florida Statutes
Implementing the enhanced
clearinghouse application
627.3518(3)(e), Florida Statutes
Reporting unclaimed
property
Chapter 717, Florida Statutes
Processing insurance
claims
627.351(6)(k)
Office of Foreign Asset
Control requirements
31 CFR 501 et seq
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POLICYHOLDER NOTICE
IMPORTANT INFORMATION
Dear Policyholder,
Ordinance or Law coverage is an important coverage provided to help meet the
increased costs incurred to repair or replace damaged buildings in accordance
with ordinances or laws that regulate construction, repair or demolition. This
coverage is available at either 25% or 50% of the Coverage A limit of liability
shown in your policy Declarations.
Ordinance or Law coverage in the amount of 25% of the Coverage A limit of
liability may be included in your policy at no additional premium. If you choose
(or have chosen) the 50% option, the additional coverage and premium will be
reflected in your policy Declarations.
However, for those insureds with a Citizens Homeowners 8 policy (Policy form
CIT HO-8), if you have chosen (or choose) actual cash value loss settlement
and Form CIT 04 81, Actual Cash Value And Exclusion of Ordinance or Law, is
shown in your policy Declarations, Ordinance or Law Coverage is not provided in
your policy.
If you wish to add or change Ordinance or Law coverage, you must request this
from your agent. Please note this addition or change in coverage may only occur
at renewal.
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 policy shall prevail. PNMPR-4 01 15
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Acknowledgement of Potential Surcharge and Assessment Liability
We are required by law to send you this notice to inform you about the potential for 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 Policyholder section
of our website, www.citizensfla.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 N/A
up to 45% of premium)
Tier 2: Potential Regular Assessment (one -time assessment up to 2% of
N/A $40
premium) 1
Tier 3: Potential Emergency Asses
Preview
Filing # 191327315 E-Filed 02/06/2024 10:26:15 AM IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT IN AND FOR HILLSBOROUGH COUNTY, FLORIDA CASE NO.: THEODORE ROYAL AND ALISIA ROYAL Plaintiff, v. CITIZENS PROPERTY INSURANCE CORPORATION, Defendant. , COMPLAINT COMES NOW the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, by and through their undersigned attorney, and sue the Defendant, CITIZENS PROPERTY INSURANCE CORPORATION, and allege as follows: 1. This is an action for breach of contract with damages of more than Fifty Thousand Dollars ($50,000.00), exclusive of interest, costs, and attorney’s fees. 2. At all material times hereto, the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, (hereinafter “Plaintiffs”) was and is a resident of Florida. 3. At all material times hereto, Defendant, FL CITIZENS PROPERTY INSURANCE CORPORATION, was a corporation duly licensed to transact insurance business in the State of Florida. Defendant does business, has offices, and/or maintained agents for the transaction of its customary business in Hillsborough County, Florida. 4. Prior to August 20, 2023, Plaintiffs sought and purchased homeowner’s insurance from Defendant to cover the property located at 3804 Coral Dr Tampa, FL 33619 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1 (hereinafter “Insured’s Property”). Said property was insured under a policy of insurance issued by Defendant bearing policy number 01760533-8. A true and correct copy of the Certified Policy is hereby attached as Exhibit “A”. 5. The policy described above was in full force and effect as of August 20, 2023, and provided benefits for damage caused to the Insured’s Property from a covered loss including, but not limited to, wind, rain, hail, and/or water damage. 6. On or about August 20, 2023, Insured’s Property and dwelling at 3804 Coral Dr Tampa, FL 33619, was damaged by a windstorm event. Said event was covered under the Insured’s Policy issued by Defendant to Insured and was assigned claim number 001-00-449288. 7. As a result of the windstorm event described above, Plaintiff sustained severe roof and interior damage at the insured property. 8. This is an action related to Defendant’s breach of contract and failure to pay Plaintiff for the repairs necessary to return the insured property to its pre-loss condition. 9. Plaintiffs have complied with all duties after loss and pre-suit requirements by providing Defendant with a Notice of Intent to Initiate Litigation on January 9, 2024, through the Florida Department of Financial Services in compliance with Section 627.70152 Florida Statutes. See Notice of Intent to Initiate Litigation attached hereto as Exhibit “B”. 10. Jurisdiction and venue of this matter are proper in Circuit Court for Hillsborough County, Florida. 11. Plaintiffs timely notified the Defendant of the loss and otherwise performed all conditions precedent to entitle Plaintiffs to coverage and benefits under the policy or Defendant 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 2 waived the conditions. COUNT I-BREACH OF CONTRACT AGAINST DEFENDANT COMES NOW the Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, by and through their undersigned attorney sue the Defendant, CITIZENS PROPERTY INSURANCE CORPORATION, and allege as follows: 12. The Plaintiffs hereby repeat and re-alleges Paragraphs 1 through 11 above and incorporates the same by reference herein. 13. The Plaintiffs are the named insureds under the homeowner’s insurance policy, and said policy was in full force and effect on the date of loss. 14. Despite demand for payment, Defendant has failed or refused to either: provide coverage, pay Plaintiffs in full for repairs necessary to return the home to its pre-loss condition, issue payment for personal property or provide payment for alternative living expenses/loss of use. 15. Defendant’s refusal to provide coverage or adequately reimburse Plaintiffs, or otherwise make Plaintiffs whole, constitutes a breach of contract. 16. Due to Defendant’s breach of contract, Plaintiffs have been damaged in the form of insurance proceeds which have not been paid, interest, costs, and attorney’s fees. 17. Due to Defendant’s breach of contract, Plaintiffs had to retain the services of the undersigned attorney to initiate and prosecute this action. Plaintiffs are obligated to pay their attorney a reasonable fee and costs for the services provided. 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 3 18. Plaintiffs have been and remain fully prepared to comply with all of the obligations pursuant to the aforesaid contract of insurance. 19. Plaintiffs are entitled to recover costs under §57.041. WHEREFORE, Plaintiffs, THEODORE ROYAL AND ALISIA ROYAL, demands judgment against Defendant, CITIZENS PROPERTY INSURANCE CORPORATION, for all unpaid bills with interest on any overdue payments, costs pursuant to Fla. Stat. §57.041, and any other relief this Court deems just and proper. PLAINTIFFS HEREBY DEMANDS A JURY TRIAL ON ALL ISSUES SO TRIABLE. 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 4 JURY TRIAL DEMAND Plaintiff hereby demands a trial by jury on all issues so triable. Dated this February 6, 2024. Respectfully Submitted, Cordova Law Firm, PLLC /s/ Leslie Cabrera Leslie Cabrera, Esq. Florida Bar No.: 1025277 Cordova Law Firm, PLLC 496 Delaney Avenue, Ste 508 Orlando, FL 32801 Phone: (321) 267-3682 Fax: (407) 442-0654 Primary Email: Leslie@justcallmyattorney.com Secondary Email: AdrianaM@justcallmyattorney.com Attorney for Plaintiffs 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 5 Exhibit A 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 6 CitizensProperty Inusrance Corporation 012M ndayrlC ecrli eT hsa,lF L302 Certified Policy Request Date: 10/31/2023 Requestor’s Name: Lesley Anderson Contact Number: 321-267-3682 Requestor’s Employer: Cordova Law Firm Email Address: Lesley@justcallmyattorney.com Insured’s Name: Alisia Royal Date of Loss: 08/20/2023 Policy Number: 01760533-8 Policy Term: Claim Number: 001-00-449807 Type of documents needed (Please check all that apply): Certified Copy of the Policy in Force on the Date of Loss (includes the policy form, the dec page and policy ✔ endorsements in force on the date of loss). Renewal Packet sent to the policyholder for the most recent renewal prior to the date of loss (in addition to the renewal offer, this includes the “Notice of Change in Policy Terms”, policy documents, and other policy-related information). Certified Copy of Other Policy (or Policies) and Renewal Packet(s) for terms unrelated to the Date of Loss: o For each policy being requested, list the year the policy was in force: _______________________ o For each renewal packet being requested, please specify the year of each policy for which a renewal packet is being requested. ______________ Underwriting information, including the completed application, inspection reports, and agent communications regarding the risk. ✔ Policy notes relating to the Policy in Force on the Date of Loss.* *Please allow two to three weeks for a reply to a request that includes policy notes. For other information, please send a public records request to Citizens’ Records Custodian at the mailing address, email address, or fax number provided on this form. Where should the documents be sent; please select one. ✔ E-mail US Mail Email Address: Lesley@justcallmyattorney.com Mailing Address: 496 Delaney Ave., Ste. 508 City: Orlando State: FL Zip Code: 32801 Please note that if you chose to have your documents sent by mail, it will add additional processing time to your request. Requirements Insured – Complete and return the form Public Adjusters - Complete and return the form with a copy of the letter of representation with your request. Attorneys - Complete and return the form. Please include a copy of the letter of representation with your request. Agents – In order to receive a copy of the policy, you must be the agent of record for the policy term you are requesting. Complete and return the form. Please return this document to CertifiedPolicyRequests@Citizensfla.com Please be advised that failure to return this document to the email address provided above may result in a delay in the processing of your request. 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 7 C TIZ N E IS PO R PR ET Y IN U S R A NC E CO R O P R AT O N I 1 2 0 MARYLAND CIRCLE TAL LAHASSEE , FL3 2 0 TELEPHONE :8() 6 8 5-1 5 AFFIDAVIT OF CUSTODIAN OF RECORDS 7052(Florida Evidence Code §§ 90.803(6) and 90.902(11), Fla. Stat.) 1. I, Sandashia Dennis, am the Records Assistant for Citizens Property Insurance Corporation (Citizens) and in such capacity I have the authority to certify the attached records. 2. Attached hereto is a copy of Citizens’ Policy No. 01760533 of Policyholder THEODORE ROYAL. 3. This policy was kept by Citizens in the regular course of business, and it was the regular practice of Citizens for an employee or representative with knowledge of the act recorded to make the record or transmit information thereof to be included in such record. 4. This record was made at or near the time of the act. 5. The records attached hereto are exact duplicates of the original. Under penalties of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true. November 1, 2023 _____________________________________ Date Sandashia Dennis Records Assistant Citizens Property Insurance Corporation CarlosBeruf, Chairman, Manatee County ● Josh Becksmith, St. JohnsCounty ● Jason Butts, PinellasCounty ● ErinKnight, Miami-Dade County Jillian Hasner, Palm Beach County ● JoAnne Leznoff, NasauCounty sia County ● Nelson Telemaco, Broward County Charlie Lydecker,Volu ● M. Scott Thomas, St. JohnsCounty Timothy M. Cerio, President/CEO and Executive Director 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 8 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations POLICY NUMBER: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023 at 12:01 a.m. Eastern Time at the Location of the Residence Premises Transaction: RENEWAL Named Insured and Mailing Address: Location Of Residence Premises: Agent: Fl. Agent Lic. #: A223179 First Named Insured: 3804 CORAL DR JOSE ROCA, PA THEODORE ROYAL TAMPA FL 33619 JOSE ROCA 3804 CORAL DR County:HILLSBOROUGH 10039 E ADAMO DR TAMPA, FL 33619-1231 TAMPA, FL 33619 Phone Number: 813-621-9687 Phone Number: 813-662-1940 Citizens Agency ID#: 22054 Primary Email Address: tedlisa3@verizon.net Additional Named Insured: Please refer to “ADDITIONAL NAMED INSURED(S)” section for details Coverage is only provided where a premium and a limit of liability is shown All Other Perils Deductible: $2,500 Hurricane Deductible: $4,412 (2%) LIMIT OF LIABILITY ANNUAL PREMIUM SECTION I - PROPERTY COVERAGES $3,813 A. Dwelling : $220,600 B. Other Structures: $4,410 C. Personal Property: $55,150 D. Loss of Use: $22,060 SECTION II - LIABILITY COVERAGES E. Personal Liability: $100,000 $10 F. Medical Payments: $2,000 INCLUDED OTHER COVERAGES Ordinance or Law Limit (25% of Cov A) (See Policy) Included SUBTOTAL: $3,823 Florida Hurricane Catastrophe Fund Build-Up Premium: $44 Premium Adjustment Due To Allowable Rate Change: ($1,648) MANDATORY ADDITIONAL CHARGES: 2022 Florida Insurance Guaranty Association (FIGA) Regular Assessment $16 2022-B Florida Insurance Guaranty Association (FIGA) Regular Assessment $29 Emergency Management Preparedness and Assistance Trust Fund (EMPA) $2 Tax-Exempt Surcharge $39 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: $2,305 The portion of your premium for: Hurricane Coverage is $1,045 Non-Hurricane Coverage is $1,174 Authorized By: JOSE ROCA Processed Date: 10/29/2022 DEC HO3 12 19 First & Additional Named Insured Page 1 of 4 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 9 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023 First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises Forms and Endorsements applicable to this policy: CIT HO 01 09 06 22, CIT 04 86 02 21, CIT 24 07 08, IL P 001 01 04, CIT HO-3 02 22, CIT 04 96 02 16, CIT 04 85 02 21 Rating/Underwriting Information Year Built: 1962 Protective Device - Burglar Alarm: No Town / Row House: No Protective Device - Fire Alarm: No Construction Type: Masonry Protective Device - Sprinkler: None BCEGS: Ungraded No Prior Insurance Surcharge: No Territory / Coastal Territory: 080 / 00 Terrain: B Wind / Hail Exclusion: No Roof Cover: Unknown Municipal Code - Police: 999 Roof Cover - FBC Wind Speed: N/A Municipal Code - Fire: 999 Roof Cover - FBC Wind Design: N/A Occupancy: Owner Occupied Roof Deck Attachment: Unknown Use: Primary Roof-Wall Connection: Unknown Number of Families: 1 Secondary Water Resistance: Unknown Protection Class: 3 Roof Shape: Gable Distance to Hydrant (ft.): 500 Opening Protection: Unknown Distance to Fire Station (mi.): 3 A premium adjustment of $0 is included to reflect the building's wind loss mitigation features or construction techniques that exists. A premium adjustment of $0 is included to reflect the building code effectiveness grade for your area. Adjustments range from a 2% surcharge to a 13% credit. Your property coverage limits have been adjusted for inflation. Your policy premium has increased by $564. Of this amount: The premium difference due to an approved rate change is $215 The premium difference due to changes in your coverage is $280 The premium difference due to mandatory additional charges plus FHCF Build-up is $69 ADDITIONAL NAMED INSURED(S) Name Address ALISIA ROYAL 3804 CORAL DR TAMPA, FL 33619-1231 ADDITIONAL INTEREST(S) # Interest Type Name and Address Loan Number MIDFLORIDA CREDIT UNION ISAOA 1 1st Mortgagee C/O INSURANCE SERVICE CENTER PO BOX 948077 Maitland, FL 693044 32794-8077 DEC HO3 12 19 First & Additional Named Insured Page 2 of 4 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 10 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023 First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. DEC HO3 12 19 First & Additional Named Insured Page 3 of 4 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 11 CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY STREET, SUITE 1300 JACKSONVILLE FL 32202-5142 Homeowners HO-3 Special Form Policy - Declarations Policy Number: 01760533 - 8 POLICY PERIOD: FROM 12/19/2022 TO 12/19/2023 First Named Insured: THEODORE ROYAL at 12:01 a.m. Eastern Time at the Location of the Residence Premises FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. TO REPORT A LOSS OR CLAIM CALL 866.411.2742 IN CASE OF LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS. PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF: (A) 72 HOURS AFTER WE ARE NOTIFIED OF THE LOSS, (B) THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL BY US. THIS POLICY CONTAINS LIMITS ON CERTAIN COVERED LOSSES, ALL SUBJECT TO THE TERMS AND CONDITIONS OF YOUR POLICY. THESE LIMITS MAY INCLUDE A $10,000 LIMIT ON COVERAGE FOR COVERED LOSSES CAUSED BY ACCIDENTAL DISCHARGE OR OVERFLOW OF WATER OR STEAM FROM SPECIFIED HOUSEHOLD SYSTEMS, SEEPAGE OR LEAKAGE OF WATER OR STEAM, CONDENSATION, MOISTURE OR VAPOR, AS DESCRIBED AND INSURED IN YOUR POLICY (HEREAFTER COLLECTIVELY REFERRED TO AS ACCIDENTAL DISCHARGE OF WATER IN THIS PARAGRAPH). AS ANOTHER EXAMPLE,THERE IS ALSO LIMIT OF $3,000 APPLICABLE TO REASONABLE EMERGENCY MEASURES TAKEN TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER. THE AMOUNT WE PAY FOR THE NECESSARY REASONABLE EMERGENCY MEASURES YOU TAKE SOLELY TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER WILL BE DEDUCTED FROM THE $10,000 LIMIT ON COVERAGE FOR ACCIDENTAL DISCHARGE OF WATER. INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. IF YOU ARE UNABLE TO CONTACT YOUR AGENT, YOU MAY REACH CITIZENS AT 866.411.2742. DEC HO3 12 19 First & Additional Named Insured Page 4 of 4 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 12 NOTICE OF PRIVACY POLICY 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 right to 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 When you are no longer our customer, your information will be retained in accordance with Citizens’ records retention schedule. While your information is retained, it may continue to be shared as described in this notice. 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 Can you limit this share? 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, comply with authorized depopulation programs, respond to court orders and legal investigations, and when permitted by federal or 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 1 PNMPR-7 02 22 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 13 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 writing to 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, such as your loss history, from other companies. Why can’t I limit all sharing? Federal law gives you the right to limit only: - Sharing for affiliates’ everyday business purposes – information 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 rights to limit sharing. See below for more on your rights under state law. Definitions Affiliates These are 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: - Independent insurance agents and agencies - Independent adjusters or claims representatives - Inspection companies - Auditors - Insurance support organizations - Attorneys, courts, and government agencies Joint marketing This is a formal agreement between nonaffiliated financial companies that together market financial products or services to you. Citizens does not jointly market. Other important information State law: The Florida public records law requires that all information received by a state entity be made available to anyone upon request, including e-mail addresses, unless the information is subject to a specific statutory exemption. 2 PNMPR-7 02 22 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 14 Page 3 Notice of Collection and Use of Social Security Numbers Introduction Section 119.071(5), Florida Statutes, governs the collection of Social Security numbers by certain government entities, including Citizens. Citizens collects Social Security numbers only in cases where it is specifically authorized to do so or when it is imperative for performance of Citizens’ duties. To protect your identity, Citizens secures your Social Security number from unauthorized access and strictly prohibits the release of your Social Security number to unauthorized parties contrary to state or federal law. Social Security numbers are collected from prospective policyholders during How are Social Security the underwriting process for the following purposes: numbers used to underwrite and service my policy? - Obtaining loss history reports for underwriting purposes - Implementing the enhanced Property Insurance Clearinghouse application authorized by paragraph 627.3518(3)(e), Florida Statutes - Reporting unclaimed property to state government agencies - Processing insurance claims - Ensuring compliance with US Department of Treasury Office of Foreign Asset Control requirements Table of Laws and Regulations The table below summarizes the purposes for which Citizens collects Social Security numbers and the laws and regulations under which collection is authorized or required. It also identifies whether collection is authorized by statute or mandatory for the performance of that agency’s duties and responsibilities as prescribed by law. Mandatory for Authorized by Purpose for Collection Law or Regulation Performance of Statute Agency Duties Obtaining Loss History Reports 627.351(6)(n), Florida Statutes Implementing the enhanced clearinghouse application 627.3518(3)(e), Florida Statutes Reporting unclaimed property Chapter 717, Florida Statutes Processing insurance claims 627.351(6)(k) Office of Foreign Asset Control requirements 31 CFR 501 et seq 3 PNMPR-7 02 22 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 15 POLICYHOLDER NOTICE IMPORTANT INFORMATION Dear Policyholder, Ordinance or Law coverage is an important coverage provided to help meet the increased costs incurred to repair or replace damaged buildings in accordance with ordinances or laws that regulate construction, repair or demolition. This coverage is available at either 25% or 50% of the Coverage A limit of liability shown in your policy Declarations. Ordinance or Law coverage in the amount of 25% of the Coverage A limit of liability may be included in your policy at no additional premium. If you choose (or have chosen) the 50% option, the additional coverage and premium will be reflected in your policy Declarations. However, for those insureds with a Citizens Homeowners 8 policy (Policy form CIT HO-8), if you have chosen (or choose) actual cash value loss settlement and Form CIT 04 81, Actual Cash Value And Exclusion of Ordinance or Law, is shown in your policy Declarations, Ordinance or Law Coverage is not provided in your policy. If you wish to add or change Ordinance or Law coverage, you must request this from your agent. Please note this addition or change in coverage may only occur at renewal. 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 policy shall prevail. PNMPR-4 01 15 2/6/2024 10:26 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 16 Acknowledgement of Potential Surcharge and Assessment Liability We are required by law to send you this notice to inform you about the potential for 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 Policyholder section of our website, www.citizensfla.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 N/A up to 45% of premium) Tier 2: Potential Regular Assessment (one -time assessment up to 2% of N/A $40 premium) 1 Tier 3: Potential Emergency Asses