1 | A bill to be entitled |
2 | An act relating to property and casualty insurance; |
3 | amending s. 624.407, F.S.; revising the amount of surplus |
4 | funds required for domestic insurers applying for a |
5 | certificate of authority after a certain date; amending s. |
6 | 624.408, F.S.; revising the minimum surplus that must be |
7 | maintained by certain insurers; authorizing the Office of |
8 | Insurance Regulation to reduce the surplus requirement |
9 | under specified circumstances; amending s. 624.4095, F.S.; |
10 | excluding certain premiums for federal multiple-peril crop |
11 | insurance from calculations for an insurer's gross writing |
12 | ratio; requiring insurers to disclose the gross written |
13 | premiums for federal multiple-peril crop insurance in a |
14 | financial statement; amending s. 624.424; revising the |
15 | frequency that an insurer may use the same accountant or |
16 | partner to prepare an annual audited financial report; |
17 | amending s. 626.854, F.S.; providing limitations on the |
18 | amount of compensation that may be received by a public |
19 | adjuster for a reopened or supplemental claim; providing |
20 | statements that may be considered deceptive or misleading |
21 | if made in any public adjuster's advertisement or |
22 | solicitation; providing a definition for the term "written |
23 | advertisement"; requiring that a disclaimer be included in |
24 | any public adjuster's written advertisement; providing |
25 | requirements for such disclaimer; requiring certain |
26 | persons who act on behalf of an insurer to provide notice |
27 | to the insurer, claimant, public adjuster, or legal |
28 | representative for an onsite inspection of the insured |
29 | property; authorizing the insured or claimant to deny |
30 | access to the property if notice is not provided; |
31 | requiring the public adjuster to ensure prompt notice of |
32 | certain property loss claims; providing that an insurer be |
33 | allowed to interview the insured directly about the loss |
34 | claim; prohibiting the insurer from obstructing or |
35 | preventing the public adjuster from communicating with the |
36 | insured; requiring that the insurer communicate with the |
37 | public adjuster in an effort to reach an agreement as to |
38 | the scope of the covered loss under the insurance policy; |
39 | prohibiting a public adjuster from restricting or |
40 | preventing persons acting on behalf of the insured from |
41 | having reasonable access to the insured or the insured's |
42 | property; prohibiting a public adjuster from restricting |
43 | or preventing the insured's adjuster from having |
44 | reasonable access to or inspecting the insured's property; |
45 | authorizing the insured's adjuster to be present for the |
46 | inspection; prohibiting a licensed contractor or |
47 | subcontractor from adjusting a claim on behalf of an |
48 | insured if such contractor or subcontractor is not a |
49 | licensed public adjuster; providing an exception; amending |
50 | s. 626.8651, F.S.; requiring that a public adjuster |
51 | apprentice complete a minimum number of hours of |
52 | continuing education to qualify for licensure; amending s. |
53 | 626.8796, F.S.; providing requirements for a public |
54 | adjuster contract; creating s. 626.70132, F.S.; requiring |
55 | that notice of a claim, supplemental claim, or reopened |
56 | claim be given to the insurer within a specified period |
57 | after a windstorm or hurricane occurs; providing a |
58 | definition for the terms "supplemental claim" or "reopened |
59 | claim"; providing applicability; amending s. 627.0613, |
60 | F.S.; deleting the duty of the consumer advocate to |
61 | prepare an annual report card for each authorized personal |
62 | residential property insurer; amending s. 627.062, F.S.; |
63 | requiring that the office issue an approval rather than a |
64 | notice of intent to approve following its approval of a |
65 | file and use filing; deleting an obsolete provision; |
66 | prohibiting the Office of Insurance Regulation from, |
67 | directly or indirectly, impeding the right of an insurer |
68 | to acquire policyholders, advertise or appoint agents, or |
69 | regulate agent commissions; revising the information that |
70 | must be included in a rate filing relating to certain |
71 | reinsurance or financing products; deleting a provision |
72 | that prohibited an insurer from making certain rate |
73 | filings within a certain period of time after a rate |
74 | increase; deleting a provision prohibiting an insurer from |
75 | filing for a rate increase within 6 months after it makes |
76 | certain rate filings; deleting obsolete provisions |
77 | relating to legislation enacted during the 2003 Special |
78 | Session D of the Legislature; amending s. 627.0629, F.S.; |
79 | providing legislative intent that insurers provide |
80 | consumers with accurate pricing signals for alterations in |
81 | order to minimize losses, but that mitigation discounts |
82 | not result in a loss of income for the insurer; requiring |
83 | rate filings for residential property insurance to include |
84 | actuarially reasonable debits that provide proper pricing; |
85 | providing for an increase in base rates if mitigation |
86 | discounts exceed the aggregate reduction in expected |
87 | losses; deleting obsolete provisions; deleting a |
88 | requirement that the Office of Insurance Regulation |
89 | propose a method for establishing discounts, debits, |
90 | credits, and other rate differentials for hurricane |
91 | mitigation by a certain date; requiring the Financial |
92 | Services Commission to adopt rules relating to such debits |
93 | by a certain date; deleting a provision that prohibits an |
94 | insurer from including an expense or profit load in the |
95 | cost of reinsurance to replace the Temporary Increase in |
96 | Coverage Limits; conforming provisions to changes made by |
97 | the act; amending s. 627.351, F.S.; renaming the "high- |
98 | risk account" as the "coastal account"; revising the |
99 | conditions under which the Citizens policyholder surcharge |
100 | may be imposed; providing that members of the Citizens |
101 | Property Insurance Corporation Board of Governors are not |
102 | prohibited from practicing in a certain profession if not |
103 | prohibited by law or ordinance; prohibiting board members |
104 | from voting on certain measures; changing the date on |
105 | which the boundaries of high-risk areas eligible for |
106 | certain wind-only coverages will be reduced if certain |
107 | circumstances exist; amending s. 627.3511, F.S.; |
108 | conforming provisions to changes made by the act; amending |
109 | s. 627.4133, F.S.; reducing the amount of time before a |
110 | policy nonrenewal, cancellation, or termination is allowed |
111 | to take effect after notification of an insured; deleting |
112 | a prior notification period applicable to the nonrenewal, |
113 | cancellation, or termination of certain policies in effect |
114 | for a specified duration; authorizing an insurer to cancel |
115 | policies after 45 days' notice if the Office of Insurance |
116 | Regulation determines that the cancellation of policies is |
117 | necessary to protect the interests of the public or |
118 | policyholders; authorizing the Office of Insurance |
119 | Regulation to place an insurer under administrative |
120 | supervision or appoint a receiver upon the consent of the |
121 | insurer under certain circumstances; creating s. |
122 | 627.43141, F.S.; providing definitions; requiring the |
123 | delivery of a "Notice of Change in Policy Terms" under |
124 | certain circumstances; specifying requirements for such |
125 | notice; specifying actions constituting proof of notice; |
126 | authorizing policy renewals to contain a change in policy |
127 | terms; providing that receipt of payment by an insurer is |
128 | deemed acceptance of new policy terms by an insured; |
129 | providing that the original policy remains in effect until |
130 | the occurrence of specified events if an insurer fails to |
131 | provide notice; providing intent; amending s. 627.7011, |
132 | F.S.; requiring that an insurer pay the actual cash value |
133 | of an insured loss for a dwelling, less any applicable |
134 | deductible, under certain circumstances; requiring that a |
135 | policyholder enter into a contract for the performance of |
136 | building and structural repairs in order to receive |
137 | payment; requiring that an insurer pay certain remaining |
138 | amounts; restricting insurers and contractors from |
139 | requiring advance payments for certain repairs and |
140 | expenses; providing an exception to requiring advance |
141 | payments; requiring an insurer to pay the replacement |
142 | costs if a total loss occurs; allowing an insurer to limit |
143 | its initial payment for losses to personal property; |
144 | authorizing an insurer to require an insured to provide |
145 | receipts for the purchase of property financed with |
146 | certain actual cash value payments; requiring an insurer |
147 | to use the receipts in a specified manner and as part of a |
148 | continuing process; requiring notice of the process in the |
149 | insurance contract; amending s. 627.70131, F.S.; |
150 | specifying application of certain time periods to initial |
151 | or supplemental property insurance claim notices and |
152 | payments; providing legislative findings with respect to |
153 | 2005 statutory changes relating to sinkhole insurance |
154 | coverage and statutory changes in this act; amending s. |
155 | 627.706, F.S.; authorizing an insurer to limit coverage |
156 | for catastrophic ground cover collapse to the principal |
157 | building and to have discretion to provide additional |
158 | coverage; allowing the deductible to include costs |
159 | relating to an investigation of whether sinkhole activity |
160 | is present; revising definitions; defining the term |
161 | "structural damage"; placing a 2-year statute of repose on |
162 | claims for sinkhole coverage; amending s. 627.7061, F.S.; |
163 | conforming provisions to changes made by the act; |
164 | repealing s. 627.7065, F.S., relating to the establishment |
165 | of a sinkhole database; amending s. 627.707, F.S.; |
166 | revising provisions relating to the investigation of |
167 | sinkholes by insurers; deleting a requirement that the |
168 | insurer provide a policyholder with a statement regarding |
169 | testing for sinkhole activity; providing a time limitation |
170 | for demanding sinkhole testing by a policyholder and |
171 | entering into a contract for repairs; requiring all |
172 | repairs to be completed within a certain time; providing |
173 | exceptions; prohibiting rebates to policyholders from |
174 | persons performing repairs; voiding coverage if a rebate |
175 | is received; requiring policyholders to refund rebates |
176 | from persons performing repairs to insurers; providing a |
177 | criminal penalty on a policyholder for accepting rebates |
178 | from persons performing repairs; limiting a policyholder's |
179 | liability for reimbursement of the costs related to |
180 | certain analyses and services; amending s. 627.7073, F.S.; |
181 | revising provisions relating to inspection reports; |
182 | providing that the presumption that the report is correct |
183 | shifts the burden of proof; requiring an insurer to file a |
184 | neutral evaluator's report and other specific information; |
185 | requiring the policyholder to file certain reports as a |
186 | precondition to accepting payment; requiring certain |
187 | filing and recording costs to be borne by a policyholder; |
188 | specifying that a policyholder's recording of a report |
189 | does not legally affect title or create certain causes of |
190 | action relating to real property; requiring a seller of |
191 | real property to provide a buyer with a copy of any |
192 | inspection reports and certifications; amending s. |
193 | 627.7074, F.S.; revising provisions relating to neutral |
194 | evaluation; requiring evaluation in order to make certain |
195 | determinations; requiring that the neutral evaluator be |
196 | allowed access to structures being evaluated; providing |
197 | grounds for disqualifying an evaluator; allowing the |
198 | Department of Financial Services to appoint an evaluator |
199 | if the parties cannot come to agreement; revising the |
200 | timeframes for scheduling a neutral evaluation conference; |
201 | authorizing an evaluator to enlist another evaluator or |
202 | other professionals; providing a time certain for issuing |
203 | a report; providing that certain information is |
204 | confidential; revising provisions relating to compliance |
205 | with the evaluator's recommendations; providing that the |
206 | evaluator is an agent of the department for the purposes |
207 | of immunity from suit; requiring the department to adopt |
208 | rules; amending s. 627.712, F.S.; conforming provisions to |
209 | changes made by the act; providing legislative intent; |
210 | providing severability; providing effective dates. |
211 |
|
212 | Be It Enacted by the Legislature of the State of Florida: |
213 |
|
214 | Section 1. Section 624.407, Florida Statutes, is amended |
215 | to read: |
216 | 624.407 Surplus Capital funds required; new insurers.- |
217 | (1) To receive authority to transact any one kind or |
218 | combinations of kinds of insurance, as defined in part V of this |
219 | chapter, an insurer applying for its original certificate of |
220 | authority in this state after November 10, 1993, the effective |
221 | date of this section shall possess surplus funds as to |
222 | policyholders at least not less than the greater of: |
223 | (a) Five million dollars For a property and casualty |
224 | insurer, $5 million, or $2.5 million for any other insurer; |
225 | (b) For life insurers, 4 percent of the insurer's total |
226 | liabilities; |
227 | (c) For life and health insurers, 4 percent of the |
228 | insurer's total liabilities, plus 6 percent of the insurer's |
229 | liabilities relative to health insurance; or |
230 | (d) For all insurers other than life insurers and life and |
231 | health insurers, 10 percent of the insurer's total liabilities; |
232 | or |
233 | (e) Notwithstanding paragraph (a) or paragraph (d), for a |
234 | domestic insurer that transacts residential property insurance |
235 | and is: |
236 | 1. Not a wholly owned subsidiary of an insurer domiciled |
237 | in any other state on or before July 1, 2011, and until June 30, |
238 | 2016, $5 million; on or after July 1, 2016, and until June 30, |
239 | 2021, $10 million; and on or after July 1, 2021, $15 million. |
240 | 2. however, a domestic insurer that transacts residential |
241 | property insurance and is A wholly owned subsidiary of an |
242 | insurer domiciled in any other state, shall possess surplus as |
243 | to policyholders of at least $50 million. |
244 | (3) Notwithstanding subsections (1) and (2), a new insurer |
245 | may not be required, but no insurer shall be required under this |
246 | subsection to have surplus as to policyholders greater than $100 |
247 | million. |
248 | (4)(2) The requirements of this section shall be based |
249 | upon all the kinds of insurance actually transacted or to be |
250 | transacted by the insurer in any and all areas in which it |
251 | operates, whether or not only a portion of such kinds of |
252 | insurance are to be transacted in this state. |
253 | (5)(3) As to surplus funds as to policyholders required |
254 | for qualification to transact one or more kinds of insurance, |
255 | domestic mutual insurers are governed by chapter 628, and |
256 | domestic reciprocal insurers are governed by chapter 629. |
257 | (6)(4) For the purposes of this section, liabilities do |
258 | shall not include liabilities required under s. 625.041(4). For |
259 | purposes of computing minimum surplus funds as to policyholders |
260 | pursuant to s. 625.305(1), liabilities shall include liabilities |
261 | required under s. 625.041(4). |
262 | (7)(5) The provisions of this section, as amended by |
263 | chapter 89-360, Laws of Florida this act, shall apply only to |
264 | insurers applying for a certificate of authority on or after |
265 | October 1, 1989 the effective date of this act. |
266 | Section 2. Section 624.408, Florida Statutes, is amended |
267 | to read: |
268 | 624.408 Surplus funds as to policyholders required; |
269 | current new and existing insurers.- |
270 | (1)(a) To maintain a certificate of authority to transact |
271 | any one kind or combinations of kinds of insurance, as defined |
272 | in part V of this chapter, an insurer in this state must shall |
273 | at all times maintain surplus funds as to policyholders at least |
274 | not less than the greater of: |
275 | (a)1. Except as provided in paragraphs (e),(f), and (g) |
276 | subparagraph 5. and paragraph (b), $1.5 million.; |
277 | (b)2. For life insurers, 4 percent of the insurer's total |
278 | liabilities.; |
279 | (c)3. For life and health insurers, 4 percent of the |
280 | insurer's total liabilities plus 6 percent of the insurer's |
281 | liabilities relative to health insurance.; or |
282 | (d)4. For all insurers other than mortgage guaranty |
283 | insurers, life insurers, and life and health insurers, 10 |
284 | percent of the insurer's total liabilities. |
285 | (e)5. For property and casualty insurers, $4 million, |
286 | except for property and casualty insurers authorized to |
287 | underwrite any line of residential property insurance. |
288 | (f)(b) For residential any property insurers not and |
289 | casualty insurer holding a certificate of authority before July |
290 | 1, 2011 on December 1, 1993, $15 million. the |
291 | (g) For residential property insurers holding a |
292 | certificate of authority before July 1, 2011, and until June 30, |
293 | 2016, $5 million; on or after July 1, 2016, and until June 30, |
294 | 2021, $10 million; on or after July 1, 2021, $15 million. The |
295 | office may reduce this surplus requirement if the insurer is not |
296 | writing new business, has premiums in force of less than $1 |
297 | million per year in residential property insurance, or is a |
298 | mutual insurance company. following amounts apply instead of the |
299 | $4 million required by subparagraph (a)5.: |
300 | 1. On December 31, 2001, and until December 30, 2002, $3 |
301 | million. |
302 | 2. On December 31, 2002, and until December 30, 2003, |
303 | $3.25 million. |
304 | 3. On December 31, 2003, and until December 30, 2004, $3.6 |
305 | million. |
306 | 4. On December 31, 2004, and thereafter, $4 million. |
307 | (2) For purposes of this section, liabilities do shall not |
308 | include liabilities required under s. 625.041(4). For purposes |
309 | of computing minimum surplus as to policyholders pursuant to s. |
310 | 625.305(1), liabilities shall include liabilities required under |
311 | s. 625.041(4). |
312 | (3) This section does not require an No insurer shall be |
313 | required under this section to have surplus as to policyholders |
314 | greater than $100 million. |
315 | (4) A mortgage guaranty insurer shall maintain a minimum |
316 | surplus as required by s. 635.042. |
317 | Section 3. Subsection (7) is added to section 624.4095, |
318 | Florida Statutes, to read: |
319 | 624.4095 Premiums written; restrictions.- |
320 | (7) For the purposes of this section and ss. 624.407 and |
321 | 624.408, with respect to capital and surplus requirements, gross |
322 | written premiums for federal multiple-peril crop insurance which |
323 | are ceded to the Federal Crop Insurance Corporation or |
324 | authorized reinsurers may not be included in the calculation of |
325 | an insurer's gross writing ratio. The liabilities for ceded |
326 | reinsurance premiums payable for federal multiple-peril crop |
327 | insurance ceded to the Federal Crop Insurance Corporation and |
328 | authorized reinsurers shall be netted against the asset for |
329 | amounts recoverable from reinsurers. Each insurer that writes |
330 | other insurance products together with federal multiple-peril |
331 | crop insurance must disclose in the notes to its annual and |
332 | quarterly financial statements, or in a supplement to those |
333 | statements, the gross written premiums for federal multiple- |
334 | peril crop insurance. |
335 | Section 4. Paragraph (d) of subsection (8) of section |
336 | 624.424, Florida Statutes, is amended to read: |
337 | 624.424 Annual statement and other information.- |
338 | (8) |
339 | (d) An insurer may not use the same accountant or partner |
340 | of an accounting firm responsible for preparing the report |
341 | required by this subsection for more than 5 7 consecutive years. |
342 | Following this period, the insurer may not use such accountant |
343 | or partner for a period of 5 2 years, but may use another |
344 | accountant or partner of the same firm. An insurer may request |
345 | the office to waive this prohibition based upon an unusual |
346 | hardship to the insurer and a determination that the accountant |
347 | is exercising independent judgment that is not unduly influenced |
348 | by the insurer considering such factors as the number of |
349 | partners, expertise of the partners or the number of insurance |
350 | clients of the accounting firm; the premium volume of the |
351 | insurer; and the number of jurisdictions in which the insurer |
352 | transacts business. |
353 | Section 5. Effective June 1, 2011, subsection (11) of |
354 | section 626.854, Florida Statutes, is amended to read: |
355 | 626.854 "Public adjuster" defined; prohibitions.-The |
356 | Legislature finds that it is necessary for the protection of the |
357 | public to regulate public insurance adjusters and to prevent the |
358 | unauthorized practice of law. |
359 | (11)(a) If a public adjuster enters into a contract with |
360 | an insured or claimant to reopen a claim or to file a |
361 | supplemental claim that seeks additional payments for a claim |
362 | that has been previously paid in part or in full or settled by |
363 | the insurer, the public adjuster may not charge, agree to, or |
364 | accept any compensation, payment, commission, fee, or other |
365 | thing of value based on a previous settlement or previous claim |
366 | payments by the insurer for the same cause of loss. The charge, |
367 | compensation, payment, commission, fee, or other thing of value |
368 | must may be based only on the claim payments or settlement |
369 | obtained through the work of the public adjuster after entering |
370 | into the contract with the insured or claimant. Compensation for |
371 | the reopened or supplemental claim may not exceed 20 percent of |
372 | the reopened or supplemental claim payment. The contracts |
373 | described in this paragraph are not subject to the limitations |
374 | in paragraph (b). |
375 | (b) A public adjuster may not charge, agree to, or accept |
376 | any compensation, payment, commission, fee, or other thing of |
377 | value in excess of: |
378 | 1. Ten percent of the amount of insurance claim payments |
379 | made by the insurer for claims based on events that are the |
380 | subject of a declaration of a state of emergency by the |
381 | Governor. This provision applies to claims made during the |
382 | period of 1 year after the declaration of emergency. After that |
383 | year, the limitations in subparagraph 2. apply. |
384 | 2. Twenty percent of the amount of all other insurance |
385 | claim payments made by the insurer for claims that are not based |
386 | on events that are the subject of a declaration of a state of |
387 | emergency by the Governor. |
388 |
|
389 | The provisions of subsections (5)-(13) apply only to residential |
390 | property insurance policies and condominium association policies |
391 | as defined in s. 718.111(11). |
392 | Section 6. Effective January 1, 2012, section 626.854, |
393 | Florida Statutes, as amended by this act, is amended to read: |
394 | 626.854 "Public adjuster" defined; prohibitions.-The |
395 | Legislature finds that it is necessary for the protection of the |
396 | public to regulate public insurance adjusters and to prevent the |
397 | unauthorized practice of law. |
398 | (1) A "public adjuster" is any person, except a duly |
399 | licensed attorney at law as exempted under hereinafter in s. |
400 | 626.860 provided, who, for money, commission, or any other thing |
401 | of value, prepares, completes, or files an insurance claim form |
402 | for an insured or third-party claimant or who, for money, |
403 | commission, or any other thing of value, acts or aids in any |
404 | manner on behalf of, or aids an insured or third-party claimant |
405 | in negotiating for or effecting the settlement of a claim or |
406 | claims for loss or damage covered by an insurance contract or |
407 | who advertises for employment as an adjuster of such claims. The |
408 | term, and also includes any person who, for money, commission, |
409 | or any other thing of value, solicits, investigates, or adjusts |
410 | such claims on behalf of a any such public adjuster. |
411 | (2) This definition does not apply to: |
412 | (a) A licensed health care provider or employee thereof |
413 | who prepares or files a health insurance claim form on behalf of |
414 | a patient. |
415 | (b) A person who files a health claim on behalf of another |
416 | and does so without compensation. |
417 | (3) A public adjuster may not give legal advice or. A |
418 | public adjuster may not act on behalf of or aid any person in |
419 | negotiating or settling a claim relating to bodily injury, |
420 | death, or noneconomic damages. |
421 | (4) For purposes of this section, the term "insured" |
422 | includes only the policyholder and any beneficiaries named or |
423 | similarly identified in the policy. |
424 | (5) A public adjuster may not directly or indirectly |
425 | through any other person or entity solicit an insured or |
426 | claimant by any means except on Monday through Saturday of each |
427 | week and only between the hours of 8 a.m. and 8 p.m. on those |
428 | days. |
429 | (6) A public adjuster may not directly or indirectly |
430 | through any other person or entity initiate contact or engage in |
431 | face-to-face or telephonic solicitation or enter into a contract |
432 | with any insured or claimant under an insurance policy until at |
433 | least 48 hours after the occurrence of an event that may be the |
434 | subject of a claim under the insurance policy unless contact is |
435 | initiated by the insured or claimant. |
436 | (7) An insured or claimant may cancel a public adjuster's |
437 | contract to adjust a claim without penalty or obligation within |
438 | 3 business days after the date on which the contract is executed |
439 | or within 3 business days after the date on which the insured or |
440 | claimant has notified the insurer of the claim, by phone or in |
441 | writing, whichever is later. The public adjuster's contract must |
442 | shall disclose to the insured or claimant his or her right to |
443 | cancel the contract and advise the insured or claimant that |
444 | notice of cancellation must be submitted in writing and sent by |
445 | certified mail, return receipt requested, or other form of |
446 | mailing that which provides proof thereof, to the public |
447 | adjuster at the address specified in the contract; provided, |
448 | during any state of emergency as declared by the Governor and |
449 | for a period of 1 year after the date of loss, the insured or |
450 | claimant has shall have 5 business days after the date on which |
451 | the contract is executed to cancel a public adjuster's contract. |
452 | (8) It is an unfair and deceptive insurance trade practice |
453 | pursuant to s. 626.9541 for a public adjuster or any other |
454 | person to circulate or disseminate any advertisement, |
455 | announcement, or statement containing any assertion, |
456 | representation, or statement with respect to the business of |
457 | insurance which is untrue, deceptive, or misleading. |
458 | (a) The following statements, made in any public |
459 | adjuster's advertisement or solicitation, are considered |
460 | deceptive or misleading: |
461 | 1. A statement or representation that invites an insured |
462 | policyholder to submit a claim when the policyholder does not |
463 | have covered damage to insured property. |
464 | 2. A statement or representation that invites an insured |
465 | policyholder to submit a claim by offering monetary or other |
466 | valuable inducement. |
467 | 3. A statement or representation that invites an insured |
468 | policyholder to submit a claim by stating that there is "no |
469 | risk" to the policyholder by submitting such claim. |
470 | 4. A statement or representation, or use of a logo or |
471 | shield, that implies or could mistakenly be construed to imply |
472 | that the solicitation was issued or distributed by a |
473 | governmental agency or is sanctioned or endorsed by a |
474 | governmental agency. |
475 | (b) For purposes of this paragraph, the term "written |
476 | advertisement" includes only newspapers, magazines, flyers, and |
477 | bulk mailers. The following disclaimer, which is not required to |
478 | be printed on standard size business cards, must be added in |
479 | bold print and capital letters in typeface no smaller than the |
480 | typeface of the body of the text to all written advertisements |
481 | by a public adjuster: |
482 | "THIS IS A SOLICITATION FOR BUSINESS. IF YOU HAVE HAD |
483 | A CLAIM FOR AN INSURED PROPERTY LOSS OR DAMAGE AND YOU |
484 | ARE SATISFIED WITH THE PAYMENT BY YOUR INSURER, YOU |
485 | MAY DISREGARD THIS ADVERTISEMENT." |
486 |
|
487 | (9) A public adjuster, a public adjuster apprentice, or |
488 | any person or entity acting on behalf of a public adjuster or |
489 | public adjuster apprentice may not give or offer to give a |
490 | monetary loan or advance to a client or prospective client. |
491 | (10) A public adjuster, public adjuster apprentice, or any |
492 | individual or entity acting on behalf of a public adjuster or |
493 | public adjuster apprentice may not give or offer to give, |
494 | directly or indirectly, any article of merchandise having a |
495 | value in excess of $25 to any individual for the purpose of |
496 | advertising or as an inducement to entering into a contract with |
497 | a public adjuster. |
498 | (11)(a) If a public adjuster enters into a contract with |
499 | an insured or claimant to reopen a claim or file a supplemental |
500 | claim that seeks additional payments for a claim that has been |
501 | previously paid in part or in full or settled by the insurer, |
502 | the public adjuster may not charge, agree to, or accept any |
503 | compensation, payment, commission, fee, or other thing of value |
504 | based on a previous settlement or previous claim payments by the |
505 | insurer for the same cause of loss. The charge, compensation, |
506 | payment, commission, fee, or other thing of value must be based |
507 | only on the claim payments or settlement obtained through the |
508 | work of the public adjuster after entering into the contract |
509 | with the insured or claimant. Compensation for the reopened or |
510 | supplemental claim may not exceed 20 percent of the reopened or |
511 | supplemental claim payment. The contracts described in this |
512 | paragraph are not subject to the limitations in paragraph (b). |
513 | (b) A public adjuster may not charge, agree to, or accept |
514 | any compensation, payment, commission, fee, or other thing of |
515 | value in excess of: |
516 | 1. Ten percent of the amount of insurance claim payments |
517 | made by the insurer for claims based on events that are the |
518 | subject of a declaration of a state of emergency by the |
519 | Governor. This provision applies to claims made during the year |
520 | after the declaration of emergency. After that year, the |
521 | limitations in subparagraph 2. apply. |
522 | 2. Twenty percent of the amount of insurance claim |
523 | payments made by the insurer for claims that are not based on |
524 | events that are the subject of a declaration of a state of |
525 | emergency by the Governor. |
526 | (12) Each public adjuster must shall provide to the |
527 | claimant or insured a written estimate of the loss to assist in |
528 | the submission of a proof of loss or any other claim for payment |
529 | of insurance proceeds. The public adjuster shall retain such |
530 | written estimate for at least 5 years and shall make the such |
531 | estimate available to the claimant or insured and the department |
532 | upon request. |
533 | (13) A public adjuster, public adjuster apprentice, or any |
534 | person acting on behalf of a public adjuster or apprentice may |
535 | not accept referrals of business from any person with whom the |
536 | public adjuster conducts business if there is any form or manner |
537 | of agreement to compensate the person, whether directly or |
538 | indirectly, for referring business to the public adjuster. A |
539 | public adjuster may not compensate any person, except for |
540 | another public adjuster, whether directly or indirectly, for the |
541 | principal purpose of referring business to the public adjuster. |
542 | (14) A company employee adjuster, independent adjuster, |
543 | attorney, investigator, or other persons acting on behalf of an |
544 | insurer that needs access to an insured or claimant or to the |
545 | insured property that is the subject of a claim must provide at |
546 | least 48 hours' notice to the insured or claimant, public |
547 | adjuster, or legal representative before scheduling a meeting |
548 | with the claimant or an onsite inspection of the insured |
549 | property. The insured or claimant may deny access to the |
550 | property if the notice has not been provided. The insured or |
551 | claimant may waive the 48-hour notice. |
552 | (15) A public adjuster must ensure prompt notice of |
553 | property loss claims submitted to an insurer by or through a |
554 | public adjuster or on which a public adjuster represents the |
555 | insured at the time the claim or notice of loss is submitted to |
556 | the insurer. The public adjuster must ensure that notice is |
557 | given to the insurer, the public adjuster's contract is provided |
558 | to the insurer, the property is available for inspection of the |
559 | loss or damage by the insurer, and the insurer is given an |
560 | opportunity to interview the insured directly about the loss and |
561 | claim. The insurer must be allowed to obtain necessary |
562 | information to investigate and respond to the claim. |
563 | (a) The insurer may not exclude the public adjuster from |
564 | its in-person meetings with the insured. The insurer shall meet |
565 | or communicate with the public adjuster in an effort to reach |
566 | agreement as to the scope of the covered loss under the |
567 | insurance policy. This section does not impair the terms and |
568 | conditions of the insurance policy in effect at the time the |
569 | claim is filed. |
570 | (b) A public adjuster may not restrict or prevent an |
571 | insurer, company employee adjuster, independent adjuster, |
572 | attorney, investigator, or other person acting on behalf of the |
573 | insurer from having reasonable access at reasonable times to an |
574 | insured or claimant or to the insured property that is the |
575 | subject of a claim. |
576 | (c) A public adjuster may not act or fail to reasonably |
577 | act in any manner that obstructs or prevents an insurer or |
578 | insurer's adjuster from timely conducting an inspection of any |
579 | part of the insured property for which there is a claim for loss |
580 | or damage. The public adjuster representing the insured may be |
581 | present for the insurer's inspection, but if the unavailability |
582 | of the public adjuster otherwise delays the insurer's timely |
583 | inspection of the property, the public adjuster or the insured |
584 | must allow the insurer to have access to the property without |
585 | the participation or presence of the public adjuster or insured |
586 | in order to facilitate the insurer's prompt inspection of the |
587 | loss or damage. |
588 | (16) A licensed contractor under part I of chapter 489, or |
589 | a subcontractor, may not adjust a claim on behalf of an insured |
590 | unless licensed and compliant as a public adjuster under this |
591 | chapter. However, the contractor may discuss or explain a bid |
592 | for construction or repair of covered property with the |
593 | residential property owner who has suffered loss or damage |
594 | covered by a property insurance policy, or the insurer of such |
595 | property, if the contractor is doing so for the usual and |
596 | customary fees applicable to the work to be performed as stated |
597 | in the contract between the contractor and the insured. |
598 | (17) The provisions of subsections (5)-(16) (5)-(13) apply |
599 | only to residential property insurance policies and condominium |
600 | unit owner association policies as defined in s. 718.111(11). |
601 | Section 7. Effective January 1, 2012, subsection (6) of |
602 | section 626.8651, Florida Statutes, is amended to read: |
603 | 626.8651 Public adjuster apprentice license; |
604 | qualifications.- |
605 | (6) To qualify for licensure as a public adjuster, a |
606 | public adjuster apprentice must shall complete: at |
607 | (a) A minimum of 100 hours of employment per month for 12 |
608 | months of employment under the supervision of a licensed and |
609 | appointed all-lines public adjuster in order to qualify for |
610 | licensure as a public adjuster. The department may adopt rules |
611 | that establish standards for such employment requirements. |
612 | (b) A minimum of 8 hours of continuing education specific |
613 | to the practice of a public adjuster, 2 hours of which must |
614 | relate to ethics. The continuing education must be designed to |
615 | inform the licensee about the current insurance laws of this |
616 | state for the purpose of enabling him or her to engage in |
617 | business as an insurance adjuster fairly and without injury to |
618 | the public and to adjust all claims in accordance with the |
619 | insurance contract and the laws of this state. |
620 | Section 8. Effective January 1, 2012, section 626.8796, |
621 | Florida Statutes, is amended to read: |
622 | 626.8796 Public adjuster contracts; fraud statement.- |
623 | (1) All contracts for public adjuster services must be in |
624 | writing and must prominently display the following statement on |
625 | the contract: "Pursuant to s. 817.234, Florida Statutes, any |
626 | person who, with the intent to injure, defraud, or deceive an |
627 | any insurer or insured, prepares, presents, or causes to be |
628 | presented a proof of loss or estimate of cost or repair of |
629 | damaged property in support of a claim under an insurance policy |
630 | knowing that the proof of loss or estimate of claim or repairs |
631 | contains any false, incomplete, or misleading information |
632 | concerning any fact or thing material to the claim commits a |
633 | felony of the third degree, punishable as provided in s. |
634 | 775.082, s. 775.083, or s. 775.084, Florida Statutes." |
635 | (2) A public adjuster contract must contain the full name, |
636 | permanent business address, and license number of the public |
637 | adjuster; the full name of the public adjusting firm; and the |
638 | insured's full name and street address, together with a brief |
639 | description of the loss. The contract must state the percentage |
640 | of compensation for the public adjuster's services; the type of |
641 | claim, including an emergency claim, nonemergency claim, or |
642 | supplemental claim; the signatures of the public adjuster and |
643 | all named insureds; and the signature date. If all of the named |
644 | insureds' signatures are not available, the public adjuster must |
645 | submit an affidavit signed by the available named insureds |
646 | attesting that they have authority to enter into the contract |
647 | and settle all claim issues on behalf of the named insureds. An |
648 | unaltered copy of the executed contract must be remitted to the |
649 | insurer within 30 days after execution. |
650 | Section 9. Effective June 1, 2011, section 626.70132, |
651 | Florida Statutes, is created to read: |
652 | 626.70132 Notice of windstorm or hurricane claim.-A claim, |
653 | supplemental claim, or reopened claim under an insurance policy |
654 | that provides personal lines residential coverage, as defined in |
655 | s. 627.4025, for loss or damage caused by the peril of windstorm |
656 | or hurricane is barred unless notice of the claim, supplemental |
657 | claim, or reopened claim was given to the insurer in accordance |
658 | with the terms of the policy within 3 years after the hurricane |
659 | first made landfall or the windstorm caused the covered damage. |
660 | For purposes of this section, the term "supplemental claim" or |
661 | "reopened claim" means any additional claim for recovery from |
662 | the insurer for losses from the same hurricane or windstorm |
663 | which the insurer has previously adjusted pursuant to the |
664 | initial claim. This section does not affect any applicable |
665 | limitation on civil actions provided in s. 95.11 for claims, |
666 | supplemental claims, or reopened claims timely filed under this |
667 | section. |
668 | Section 10. Subsections (4) and (5) of section 627.0613, |
669 | Florida Statutes, are amended to read: |
670 | 627.0613 Consumer advocate.-The Chief Financial Officer |
671 | must appoint a consumer advocate who must represent the general |
672 | public of the state before the department and the office. The |
673 | consumer advocate must report directly to the Chief Financial |
674 | Officer, but is not otherwise under the authority of the |
675 | department or of any employee of the department. The consumer |
676 | advocate has such powers as are necessary to carry out the |
677 | duties of the office of consumer advocate, including, but not |
678 | limited to, the powers to: |
679 | (4) Prepare an annual report card for each authorized |
680 | personal residential property insurer, on a form and using a |
681 | letter-grade scale developed by the commission by rule, which |
682 | grades each insurer based on the following factors: |
683 | (a) The number and nature of consumer complaints, as a |
684 | market share ratio, received by the department against the |
685 | insurer. |
686 | (b) The disposition of all complaints received by the |
687 | department. |
688 | (c) The average length of time for payment of claims by |
689 | the insurer. |
690 | (d) Any other factors the commission identifies as |
691 | assisting policyholders in making informed choices about |
692 | homeowner's insurance. |
693 | (5) Prepare an annual budget for presentation to the |
694 | Legislature by the department, which budget must be adequate to |
695 | carry out the duties of the office of consumer advocate. |
696 | Section 11. Section 627.062, Florida Statutes, is amended |
697 | to read: |
698 | 627.062 Rate standards.- |
699 | (1) The rates for all classes of insurance to which the |
700 | provisions of this part are applicable may shall not be |
701 | excessive, inadequate, or unfairly discriminatory. |
702 | (2) As to all such classes of insurance: |
703 | (a) Insurers or rating organizations shall establish and |
704 | use rates, rating schedules, or rating manuals that to allow the |
705 | insurer a reasonable rate of return on the such classes of |
706 | insurance written in this state. A copy of rates, rating |
707 | schedules, rating manuals, premium credits or discount |
708 | schedules, and surcharge schedules, and changes thereto, must |
709 | shall be filed with the office under one of the following |
710 | procedures except as provided in subparagraph 3.: |
711 | 1. If the filing is made at least 90 days before the |
712 | proposed effective date and the filing is not implemented during |
713 | the office's review of the filing and any proceeding and |
714 | judicial review, then such filing is shall be considered a "file |
715 | and use" filing. In such case, the office shall finalize its |
716 | review by issuance of an approval a notice of intent to approve |
717 | or a notice of intent to disapprove within 90 days after receipt |
718 | of the filing. The approval notice of intent to approve and the |
719 | notice of intent to disapprove constitute agency action for |
720 | purposes of the Administrative Procedure Act. Requests for |
721 | supporting information, requests for mathematical or mechanical |
722 | corrections, or notification to the insurer by the office of its |
723 | preliminary findings does shall not toll the 90-day period |
724 | during any such proceedings and subsequent judicial review. The |
725 | rate shall be deemed approved if the office does not issue an |
726 | approval a notice of intent to approve or a notice of intent to |
727 | disapprove within 90 days after receipt of the filing. |
728 | 2. If the filing is not made in accordance with the |
729 | provisions of subparagraph 1., such filing must shall be made as |
730 | soon as practicable, but within no later than 30 days after the |
731 | effective date, and is shall be considered a "use and file" |
732 | filing. An insurer making a "use and file" filing is potentially |
733 | subject to an order by the office to return to policyholders |
734 | those portions of rates found to be excessive, as provided in |
735 | paragraph (h). |
736 | 3. For all property insurance filings made or submitted |
737 | after January 25, 2007, but before December 31, 2010, an insurer |
738 | seeking a rate that is greater than the rate most recently |
739 | approved by the office shall make a "file and use" filing. For |
740 | purposes of this subparagraph, motor vehicle collision and |
741 | comprehensive coverages are not considered to be property |
742 | coverages. |
743 | (b) Upon receiving a rate filing, the office shall review |
744 | the rate filing to determine if a rate is excessive, inadequate, |
745 | or unfairly discriminatory. In making that determination, the |
746 | office shall, in accordance with generally accepted and |
747 | reasonable actuarial techniques, consider the following factors: |
748 | 1. Past and prospective loss experience within and without |
749 | this state. |
750 | 2. Past and prospective expenses. |
751 | 3. The degree of competition among insurers for the risk |
752 | insured. |
753 | 4. Investment income reasonably expected by the insurer, |
754 | consistent with the insurer's investment practices, from |
755 | investable premiums anticipated in the filing, plus any other |
756 | expected income from currently invested assets representing the |
757 | amount expected on unearned premium reserves and loss reserves. |
758 | The commission may adopt rules using reasonable techniques of |
759 | actuarial science and economics to specify the manner in which |
760 | insurers shall calculate investment income attributable to such |
761 | classes of insurance written in this state and the manner in |
762 | which such investment income is shall be used to calculate |
763 | insurance rates. Such manner must shall contemplate allowances |
764 | for an underwriting profit factor and full consideration of |
765 | investment income which produce a reasonable rate of return; |
766 | however, investment income from invested surplus may not be |
767 | considered. |
768 | 5. The reasonableness of the judgment reflected in the |
769 | filing. |
770 | 6. Dividends, savings, or unabsorbed premium deposits |
771 | allowed or returned to Florida policyholders, members, or |
772 | subscribers. |
773 | 7. The adequacy of loss reserves. |
774 | 8. The cost of reinsurance. The office may shall not |
775 | disapprove a rate as excessive solely due to the insurer having |
776 | obtained catastrophic reinsurance to cover the insurer's |
777 | estimated 250-year probable maximum loss or any lower level of |
778 | loss. |
779 | 9. Trend factors, including trends in actual losses per |
780 | insured unit for the insurer making the filing. |
781 | 10. Conflagration and catastrophe hazards, if applicable. |
782 | 11. Projected hurricane losses, if applicable, which must |
783 | be estimated using a model or method found to be acceptable or |
784 | reliable by the Florida Commission on Hurricane Loss Projection |
785 | Methodology, and as further provided in s. 627.0628. |
786 | 12. A reasonable margin for underwriting profit and |
787 | contingencies. |
788 | 13. The cost of medical services, if applicable. |
789 | 14. Other relevant factors that affect which impact upon |
790 | the frequency or severity of claims or upon expenses. |
791 | (c) In the case of fire insurance rates, consideration |
792 | must shall be given to the availability of water supplies and |
793 | the experience of the fire insurance business during a period of |
794 | not less than the most recent 5-year period for which such |
795 | experience is available. |
796 | (d) If conflagration or catastrophe hazards are considered |
797 | given consideration by an insurer in its rates or rating plan, |
798 | including surcharges and discounts, the insurer shall establish |
799 | a reserve for that portion of the premium allocated to such |
800 | hazard and shall maintain the premium in a catastrophe reserve. |
801 | Any Removal of such premiums from the reserve for purposes other |
802 | than paying claims associated with a catastrophe or purchasing |
803 | reinsurance for catastrophes must be approved by shall be |
804 | subject to approval of the office. Any ceding commission |
805 | received by an insurer purchasing reinsurance for catastrophes |
806 | must shall be placed in the catastrophe reserve. |
807 | (e) After consideration of the rate factors provided in |
808 | paragraphs (b), (c), and (d), the office may find a rate may be |
809 | found by the office to be excessive, inadequate, or unfairly |
810 | discriminatory based upon the following standards: |
811 | 1. Rates shall be deemed excessive if they are likely to |
812 | produce a profit from Florida business which that is |
813 | unreasonably high in relation to the risk involved in the class |
814 | of business or if expenses are unreasonably high in relation to |
815 | services rendered. |
816 | 2. Rates shall be deemed excessive if, among other things, |
817 | the rate structure established by a stock insurance company |
818 | provides for replenishment of surpluses from premiums, if when |
819 | the replenishment is attributable to investment losses. |
820 | 3. Rates shall be deemed inadequate if they are clearly |
821 | insufficient, together with the investment income attributable |
822 | to them, to sustain projected losses and expenses in the class |
823 | of business to which they apply. |
824 | 4. A rating plan, including discounts, credits, or |
825 | surcharges, shall be deemed unfairly discriminatory if it fails |
826 | to clearly and equitably reflect consideration of the |
827 | policyholder's participation in a risk management program |
828 | adopted pursuant to s. 627.0625. |
829 | 5. A rate shall be deemed inadequate as to the premium |
830 | charged to a risk or group of risks if discounts or credits are |
831 | allowed which exceed a reasonable reflection of expense savings |
832 | and reasonably expected loss experience from the risk or group |
833 | of risks. |
834 | 6. A rate shall be deemed unfairly discriminatory as to a |
835 | risk or group of risks if the application of premium discounts, |
836 | credits, or surcharges among such risks does not bear a |
837 | reasonable relationship to the expected loss and expense |
838 | experience among the various risks. |
839 | (f) In reviewing a rate filing, the office may require the |
840 | insurer to provide, at the insurer's expense, all information |
841 | necessary to evaluate the condition of the company and the |
842 | reasonableness of the filing according to the criteria |
843 | enumerated in this section. |
844 | (g) The office may at any time review a rate, rating |
845 | schedule, rating manual, or rate change; the pertinent records |
846 | of the insurer; and market conditions. If the office finds on a |
847 | preliminary basis that a rate may be excessive, inadequate, or |
848 | unfairly discriminatory, the office shall initiate proceedings |
849 | to disapprove the rate and shall so notify the insurer. However, |
850 | the office may not disapprove as excessive any rate for which it |
851 | has given final approval or which has been deemed approved for a |
852 | period of 1 year after the effective date of the filing unless |
853 | the office finds that a material misrepresentation or material |
854 | error was made by the insurer or was contained in the filing. |
855 | Upon being so notified, the insurer or rating organization |
856 | shall, within 60 days, file with the office all information that |
857 | which, in the belief of the insurer or organization, proves the |
858 | reasonableness, adequacy, and fairness of the rate or rate |
859 | change. The office shall issue an approval a notice of intent to |
860 | approve or a notice of intent to disapprove pursuant to the |
861 | procedures of paragraph (a) within 90 days after receipt of the |
862 | insurer's initial response. In such instances and in any |
863 | administrative proceeding relating to the legality of the rate, |
864 | the insurer or rating organization shall carry the burden of |
865 | proof by a preponderance of the evidence to show that the rate |
866 | is not excessive, inadequate, or unfairly discriminatory. After |
867 | the office notifies an insurer that a rate may be excessive, |
868 | inadequate, or unfairly discriminatory, unless the office |
869 | withdraws the notification, the insurer may shall not alter the |
870 | rate except to conform to with the office's notice until the |
871 | earlier of 120 days after the date the notification was provided |
872 | or 180 days after the date of implementing the implementation of |
873 | the rate. The office may, subject to chapter 120, may disapprove |
874 | without the 60-day notification any rate increase filed by an |
875 | insurer within the prohibited time period or during the time |
876 | that the legality of the increased rate is being contested. |
877 | (h) If In the event the office finds that a rate or rate |
878 | change is excessive, inadequate, or unfairly discriminatory, the |
879 | office shall issue an order of disapproval specifying that a new |
880 | rate or rate schedule, which responds to the findings of the |
881 | office, be filed by the insurer. The office shall further order, |
882 | for any "use and file" filing made in accordance with |
883 | subparagraph (a)2., that premiums charged each policyholder |
884 | constituting the portion of the rate above that which was |
885 | actuarially justified be returned to the such policyholder in |
886 | the form of a credit or refund. If the office finds that an |
887 | insurer's rate or rate change is inadequate, the new rate or |
888 | rate schedule filed with the office in response to such a |
889 | finding is shall be applicable only to new or renewal business |
890 | of the insurer written on or after the effective date of the |
891 | responsive filing. |
892 | (i) Except as otherwise specifically provided in this |
893 | chapter, the office may shall not, directly or indirectly: |
894 | 1. Prohibit any insurer, including any residual market |
895 | plan or joint underwriting association, from paying acquisition |
896 | costs based on the full amount of premium, as defined in s. |
897 | 627.403, applicable to any policy, or prohibit any such insurer |
898 | from including the full amount of acquisition costs in a rate |
899 | filing; or. |
900 | 2. Impede, abridge, or otherwise compromise an insurer's |
901 | right to acquire policyholders, advertise, or appoint agents, |
902 | including the calculation, manner, or amount of such agent |
903 | commissions, if any. |
904 | (j) With respect to residential property insurance rate |
905 | filings, the rate filing must account for mitigation measures |
906 | undertaken by policyholders to reduce hurricane losses. |
907 | (k)1. An insurer may make a separate filing limited solely |
908 | to an adjustment of its rates for reinsurance or financing costs |
909 | incurred in the purchase of reinsurance or financing products to |
910 | replace or finance the payment of the amount covered by the |
911 | Temporary Increase in Coverage Limits (TICL) portion of the |
912 | Florida Hurricane Catastrophe Fund including replacement |
913 | reinsurance for the TICL reductions made pursuant to s. |
914 | 215.555(17)(e); the actual cost paid due to the application of |
915 | the TICL premium factor pursuant to s. 215.555(17)(f); and the |
916 | actual cost paid due to the application of the cash build-up |
917 | factor pursuant to s. 215.555(5)(b) if the insurer: |
918 | a. Elects to purchase financing products such as a |
919 | liquidity instrument or line of credit, in which case the cost |
920 | included in the filing for the liquidity instrument or line of |
921 | credit may not result in a premium increase exceeding 3 percent |
922 | for any individual policyholder. All costs contained in the |
923 | filing may not result in an overall premium increase of more |
924 | than 10 percent for any individual policyholder. |
925 | b. An insurer that makes a separate filing relating to |
926 | reinsurance or financing products must include Includes in the |
927 | filing a copy of all of its reinsurance, liquidity instrument, |
928 | or line of credit contracts; proof of the billing or payment for |
929 | the contracts; and the calculation upon which the proposed rate |
930 | change is based demonstrating demonstrates that the costs meet |
931 | the criteria of this section and are not loaded for expenses or |
932 | profit for the insurer making the filing. |
933 | c. Includes no other changes to its rates in the filing. |
934 | d. Has not implemented a rate increase within the 6 months |
935 | immediately preceding the filing. |
936 | e. Does not file for a rate increase under any other |
937 | paragraph within 6 months after making a filing under this |
938 | paragraph. |
939 | c.f. An insurer that purchases reinsurance or financing |
940 | products from an affiliated company may make a separate filing |
941 | in compliance with this paragraph does so only if the costs for |
942 | such reinsurance or financing products are charged at or below |
943 | charges made for comparable coverage by nonaffiliated reinsurers |
944 | or financial entities making such coverage or financing products |
945 | available in this state. |
946 | 2. An insurer may only make only one filing per in any 12- |
947 | month period under this paragraph. |
948 | 3. An insurer that elects to implement a rate change under |
949 | this paragraph must file its rate filing with the office at |
950 | least 45 days before the effective date of the rate change. |
951 | After an insurer submits a complete filing that meets all of the |
952 | requirements of this paragraph, the office has 45 days after the |
953 | date of the filing to review the rate filing and determine if |
954 | the rate is excessive, inadequate, or unfairly discriminatory. |
955 |
|
956 | The provisions of this subsection do shall not apply to workers' |
957 | compensation, and employer's liability insurance, and to motor |
958 | vehicle insurance. |
959 | (3)(a) For individual risks that are not rated in |
960 | accordance with the insurer's rates, rating schedules, rating |
961 | manuals, and underwriting rules filed with the office and that |
962 | which have been submitted to the insurer for individual rating, |
963 | the insurer must maintain documentation on each risk subject to |
964 | individual risk rating. The documentation must identify the |
965 | named insured and specify the characteristics and classification |
966 | of the risk supporting the reason for the risk being |
967 | individually risk rated, including any modifications to existing |
968 | approved forms to be used on the risk. The insurer must maintain |
969 | these records for a period of at least 5 years after the |
970 | effective date of the policy. |
971 | (b) Individual risk rates and modifications to existing |
972 | approved forms are not subject to this part or part II, except |
973 | for paragraph (a) and ss. 627.402, 627.403, 627.4035, 627.404, |
974 | 627.405, 627.406, 627.407, 627.4085, 627.409, 627.4132, |
975 | 627.4133, 627.415, 627.416, 627.417, 627.419, 627.425, 627.426, |
976 | 627.4265, 627.427, and 627.428, but are subject to all other |
977 | applicable provisions of this code and rules adopted thereunder. |
978 | (c) This subsection does not apply to private passenger |
979 | motor vehicle insurance. |
980 | (d)1. The following categories or kinds of insurance and |
981 | types of commercial lines risks are not subject to paragraph |
982 | (2)(a) or paragraph (2)(f): |
983 | a. Excess or umbrella. |
984 | b. Surety and fidelity. |
985 | c. Boiler and machinery and leakage and fire extinguishing |
986 | equipment. |
987 | d. Errors and omissions. |
988 | e. Directors and officers, employment practices, and |
989 | management liability. |
990 | f. Intellectual property and patent infringement |
991 | liability. |
992 | g. Advertising injury and Internet liability insurance. |
993 | h. Property risks rated under a highly protected risks |
994 | rating plan. |
995 | i. Any other commercial lines categories or kinds of |
996 | insurance or types of commercial lines risks that the office |
997 | determines should not be subject to paragraph (2)(a) or |
998 | paragraph (2)(f) because of the existence of a competitive |
999 | market for such insurance, similarity of such insurance to other |
1000 | categories or kinds of insurance not subject to paragraph (2)(a) |
1001 | or paragraph (2)(f), or to improve the general operational |
1002 | efficiency of the office. |
1003 | 2. Insurers or rating organizations shall establish and |
1004 | use rates, rating schedules, or rating manuals to allow the |
1005 | insurer a reasonable rate of return on insurance and risks |
1006 | described in subparagraph 1. which are written in this state. |
1007 | 3. An insurer must notify the office of any changes to |
1008 | rates for insurance and risks described in subparagraph 1. |
1009 | within no later than 30 days after the effective date of the |
1010 | change. The notice must include the name of the insurer, the |
1011 | type or kind of insurance subject to rate change, total premium |
1012 | written during the immediately preceding year by the insurer for |
1013 | the type or kind of insurance subject to the rate change, and |
1014 | the average statewide percentage change in rates. Underwriting |
1015 | files, premiums, losses, and expense statistics with regard to |
1016 | such insurance and risks described in subparagraph 1. written by |
1017 | an insurer must shall be maintained by the insurer and subject |
1018 | to examination by the office. Upon examination, the office |
1019 | shall, in accordance with generally accepted and reasonable |
1020 | actuarial techniques, shall consider the rate factors in |
1021 | paragraphs (2)(b), (c), and (d) and the standards in paragraph |
1022 | (2)(e) to determine if the rate is excessive, inadequate, or |
1023 | unfairly discriminatory. |
1024 | 4. A rating organization must notify the office of any |
1025 | changes to loss cost for insurance and risks described in |
1026 | subparagraph 1. within no later than 30 days after the effective |
1027 | date of the change. The notice must include the name of the |
1028 | rating organization, the type or kind of insurance subject to a |
1029 | loss cost change, loss costs during the immediately preceding |
1030 | year for the type or kind of insurance subject to the loss cost |
1031 | change, and the average statewide percentage change in loss |
1032 | cost. Loss and exposure statistics with regard to risks |
1033 | applicable to loss costs for a rating organization not subject |
1034 | to paragraph (2)(a) or paragraph (2)(f) must shall be maintained |
1035 | by the rating organization and are subject to examination by the |
1036 | office. Upon examination, the office shall, in accordance with |
1037 | generally accepted and reasonable actuarial techniques, shall |
1038 | consider the rate factors in paragraphs (2)(b)-(d) and the |
1039 | standards in paragraph (2)(e) to determine if the rate is |
1040 | excessive, inadequate, or unfairly discriminatory. |
1041 | 5. In reviewing a rate, the office may require the insurer |
1042 | to provide, at the insurer's expense, all information necessary |
1043 | to evaluate the condition of the company and the reasonableness |
1044 | of the rate according to the applicable criteria described in |
1045 | this section. |
1046 | (4) The establishment of any rate, rating classification, |
1047 | rating plan or schedule, or variation thereof in violation of |
1048 | part IX of chapter 626 is also in violation of this section. In |
1049 | order to enhance the ability of consumers to compare premiums |
1050 | and to increase the accuracy and usefulness of rate-comparison |
1051 | information provided by the office to the public, the office |
1052 | shall develop a proposed standard rating territory plan to be |
1053 | used by all authorized property and casualty insurers for |
1054 | residential property insurance. In adopting the proposed plan, |
1055 | the office may consider geographical characteristics relevant to |
1056 | risk, county lines, major roadways, existing rating territories |
1057 | used by a significant segment of the market, and other relevant |
1058 | factors. Such plan shall be submitted to the President of the |
1059 | Senate and the Speaker of the House of Representatives by |
1060 | January 15, 2006. The plan may not be implemented unless |
1061 | authorized by further act of the Legislature. |
1062 | (5) With respect to a rate filing involving coverage of |
1063 | the type for which the insurer is required to pay a |
1064 | reimbursement premium to the Florida Hurricane Catastrophe Fund, |
1065 | the insurer may fully recoup in its property insurance premiums |
1066 | any reimbursement premiums paid to the Florida Hurricane |
1067 | Catastrophe fund, together with reasonable costs of other |
1068 | reinsurance; however, but except as otherwise provided in this |
1069 | section, the insurer may not recoup reinsurance costs that |
1070 | duplicate coverage provided by the Florida Hurricane Catastrophe |
1071 | fund. An insurer may not recoup more than 1 year of |
1072 | reimbursement premium at a time. Any under-recoupment from the |
1073 | prior year may be added to the following year's reimbursement |
1074 | premium, and any over-recoupment must shall be subtracted from |
1075 | the following year's reimbursement premium. |
1076 | (6)(a) If an insurer requests an administrative hearing |
1077 | pursuant to s. 120.57 related to a rate filing under this |
1078 | section, the director of the Division of Administrative Hearings |
1079 | shall expedite the hearing and assign an administrative law |
1080 | judge who shall commence the hearing within 30 days after the |
1081 | receipt of the formal request and shall enter a recommended |
1082 | order within 30 days after the hearing or within 30 days after |
1083 | receipt of the hearing transcript by the administrative law |
1084 | judge, whichever is later. Each party shall have be allowed 10 |
1085 | days in which to submit written exceptions to the recommended |
1086 | order. The office shall enter a final order within 30 days after |
1087 | the entry of the recommended order. The provisions of this |
1088 | paragraph may be waived upon stipulation of all parties. |
1089 | (b) Upon entry of a final order, the insurer may request a |
1090 | expedited appellate review pursuant to the Florida Rules of |
1091 | Appellate Procedure. It is the intent of the Legislature that |
1092 | the First District Court of Appeal grant an insurer's request |
1093 | for an expedited appellate review. |
1094 | (7)(a) The provisions of this subsection apply only with |
1095 | respect to rates for medical malpractice insurance and shall |
1096 | control to the extent of any conflict with other provisions of |
1097 | this section. |
1098 | (a)(b) Any portion of a judgment entered or settlement |
1099 | paid as a result of a statutory or common-law bad faith action |
1100 | and any portion of a judgment entered which awards punitive |
1101 | damages against an insurer may not be included in the insurer's |
1102 | rate base, and shall not be used to justify a rate or rate |
1103 | change. Any common-law bad faith action identified as such, any |
1104 | portion of a settlement entered as a result of a statutory or |
1105 | common-law action, or any portion of a settlement wherein an |
1106 | insurer agrees to pay specific punitive damages may not be used |
1107 | to justify a rate or rate change. The portion of the taxable |
1108 | costs and attorney's fees which is identified as being related |
1109 | to the bad faith and punitive damages in these judgments and |
1110 | settlements may not be included in the insurer's rate base and |
1111 | used may not be utilized to justify a rate or rate change. |
1112 | (b)(c) Upon reviewing a rate filing and determining |
1113 | whether the rate is excessive, inadequate, or unfairly |
1114 | discriminatory, the office shall consider, in accordance with |
1115 | generally accepted and reasonable actuarial techniques, past and |
1116 | present prospective loss experience, either using loss |
1117 | experience solely for this state or giving greater credibility |
1118 | to this state's loss data after applying actuarially sound |
1119 | methods of assigning credibility to such data. |
1120 | (c)(d) Rates shall be deemed excessive if, among other |
1121 | standards established by this section, the rate structure |
1122 | provides for replenishment of reserves or surpluses from |
1123 | premiums when the replenishment is attributable to investment |
1124 | losses. |
1125 | (d)(e) The insurer must apply a discount or surcharge |
1126 | based on the health care provider's loss experience or shall |
1127 | establish an alternative method giving due consideration to the |
1128 | provider's loss experience. The insurer must include in the |
1129 | filing a copy of the surcharge or discount schedule or a |
1130 | description of the alternative method used, and must provide a |
1131 | copy of such schedule or description, as approved by the office, |
1132 | to policyholders at the time of renewal and to prospective |
1133 | policyholders at the time of application for coverage. |
1134 | (e)(f) Each medical malpractice insurer must make a rate |
1135 | filing under this section, sworn to by at least two executive |
1136 | officers of the insurer, at least once each calendar year. |
1137 | (8)(a)1. No later than 60 days after the effective date of |
1138 | medical malpractice legislation enacted during the 2003 Special |
1139 | Session D of the Florida Legislature, the office shall calculate |
1140 | a presumed factor that reflects the impact that the changes |
1141 | contained in such legislation will have on rates for medical |
1142 | malpractice insurance and shall issue a notice informing all |
1143 | insurers writing medical malpractice coverage of such presumed |
1144 | factor. In determining the presumed factor, the office shall use |
1145 | generally accepted actuarial techniques and standards provided |
1146 | in this section in determining the expected impact on losses, |
1147 | expenses, and investment income of the insurer. To the extent |
1148 | that the operation of a provision of medical malpractice |
1149 | legislation enacted during the 2003 Special Session D of the |
1150 | Florida Legislature is stayed pending a constitutional |
1151 | challenge, the impact of that provision shall not be included in |
1152 | the calculation of a presumed factor under this subparagraph. |
1153 | 2. No later than 60 days after the office issues its |
1154 | notice of the presumed rate change factor under subparagraph 1., |
1155 | each insurer writing medical malpractice coverage in this state |
1156 | shall submit to the office a rate filing for medical malpractice |
1157 | insurance, which will take effect no later than January 1, 2004, |
1158 | and apply retroactively to policies issued or renewed on or |
1159 | after the effective date of medical malpractice legislation |
1160 | enacted during the 2003 Special Session D of the Florida |
1161 | Legislature. Except as authorized under paragraph (b), the |
1162 | filing shall reflect an overall rate reduction at least as great |
1163 | as the presumed factor determined under subparagraph 1. With |
1164 | respect to policies issued on or after the effective date of |
1165 | such legislation and prior to the effective date of the rate |
1166 | filing required by this subsection, the office shall order the |
1167 | insurer to make a refund of the amount that was charged in |
1168 | excess of the rate that is approved. |
1169 | (b) Any insurer or rating organization that contends that |
1170 | the rate provided for in paragraph (a) is excessive, inadequate, |
1171 | or unfairly discriminatory shall separately state in its filing |
1172 | the rate it contends is appropriate and shall state with |
1173 | specificity the factors or data that it contends should be |
1174 | considered in order to produce such appropriate rate. The |
1175 | insurer or rating organization shall be permitted to use all of |
1176 | the generally accepted actuarial techniques provided in this |
1177 | section in making any filing pursuant to this subsection. The |
1178 | office shall review each such exception and approve or |
1179 | disapprove it prior to use. It shall be the insurer's burden to |
1180 | actuarially justify any deviations from the rates required to be |
1181 | filed under paragraph (a). The insurer making a filing under |
1182 | this paragraph shall include in the filing the expected impact |
1183 | of medical malpractice legislation enacted during the 2003 |
1184 | Special Session D of the Florida Legislature on losses, |
1185 | expenses, and rates. |
1186 | (c) If any provision of medical malpractice legislation |
1187 | enacted during the 2003 Special Session D of the Florida |
1188 | Legislature is held invalid by a court of competent |
1189 | jurisdiction, the office shall permit an adjustment of all |
1190 | medical malpractice rates filed under this section to reflect |
1191 | the impact of such holding on such rates so as to ensure that |
1192 | the rates are not excessive, inadequate, or unfairly |
1193 | discriminatory. |
1194 | (d) Rates approved on or before July 1, 2003, for medical |
1195 | malpractice insurance shall remain in effect until the effective |
1196 | date of a new rate filing approved under this subsection. |
1197 | (e) The calculation and notice by the office of the |
1198 | presumed factor pursuant to paragraph (a) is not an order or |
1199 | rule that is subject to chapter 120. If the office enters into a |
1200 | contract with an independent consultant to assist the office in |
1201 | calculating the presumed factor, such contract shall not be |
1202 | subject to the competitive solicitation requirements of s. |
1203 | 287.057. |
1204 | (8)(9)(a) The chief executive officer or chief financial |
1205 | officer of a property insurer and the chief actuary of a |
1206 | property insurer must certify under oath and subject to the |
1207 | penalty of perjury, on a form approved by the commission, the |
1208 | following information, which must accompany a rate filing: |
1209 | 1. The signing officer and actuary have reviewed the rate |
1210 | filing; |
1211 | 2. Based on the signing officer's and actuary's knowledge, |
1212 | the rate filing does not contain any untrue statement of a |
1213 | material fact or omit to state a material fact necessary in |
1214 | order to make the statements made, in light of the circumstances |
1215 | under which such statements were made, not misleading; |
1216 | 3. Based on the signing officer's and actuary's knowledge, |
1217 | the information and other factors described in paragraph (2)(b), |
1218 | including, but not limited to, investment income, fairly present |
1219 | in all material respects the basis of the rate filing for the |
1220 | periods presented in the filing; and |
1221 | 4. Based on the signing officer's and actuary's knowledge, |
1222 | the rate filing reflects all premium savings that are reasonably |
1223 | expected to result from legislative enactments and are in |
1224 | accordance with generally accepted and reasonable actuarial |
1225 | techniques. |
1226 | (b) A signing officer or actuary who knowingly makes |
1227 | making a false certification under this subsection commits a |
1228 | violation of s. 626.9541(1)(e) and is subject to the penalties |
1229 | under s. 626.9521. |
1230 | (c) Failure to provide such certification by the officer |
1231 | and actuary shall result in the rate filing being disapproved |
1232 | without prejudice to be refiled. |
1233 | (d) A certification made pursuant to paragraph (a) is not |
1234 | rendered false if, after making the subject rate filing, the |
1235 | insurer provides the office with additional or supplementary |
1236 | information pursuant to a formal or informal request from the |
1237 | office. |
1238 | (e)(d) The commission may adopt rules and forms pursuant |
1239 | to ss. 120.536(1) and 120.54 to administer this subsection. |
1240 | (9)(10) The burden is on the office to establish that |
1241 | rates are excessive for personal lines residential coverage with |
1242 | a dwelling replacement cost of $1 million or more or for a |
1243 | single condominium unit with a combined dwelling and contents |
1244 | replacement cost of $1 million or more. Upon request of the |
1245 | office, the insurer shall provide to the office such loss and |
1246 | expense information as the office reasonably needs to meet this |
1247 | burden. |
1248 | (10)(11) Any interest paid pursuant to s. 627.70131(5) may |
1249 | not be included in the insurer's rate base and may not be used |
1250 | to justify a rate or rate change. |
1251 | Section 12. Subsections (1) and (5) and paragraph (b) of |
1252 | subsection (8) of section 627.0629, Florida Statutes, are |
1253 | amended to read: |
1254 | 627.0629 Residential property insurance; rate filings.- |
1255 | (1)(a) It is the intent of the Legislature that insurers |
1256 | must provide the most accurate pricing signals available in |
1257 | order savings to encourage consumers to who install or implement |
1258 | windstorm damage mitigation techniques, alterations, or |
1259 | solutions to their properties to prevent windstorm losses. It is |
1260 | also the intent of the Legislature that implementation of |
1261 | mitigation discounts not result in a loss of income to the |
1262 | insurers granting the discounts, so that the aggregate of such |
1263 | discounts not exceed the aggregate of the expected reduction in |
1264 | loss attributable to the mitigation efforts for which discounts |
1265 | are granted. A rate filing for residential property insurance |
1266 | must include actuarially reasonable discounts, credits, debits, |
1267 | or other rate differentials, or appropriate reductions in |
1268 | deductibles, which provide the proper pricing for all |
1269 | properties. The rate filing must take into account the presence |
1270 | or absence of on which fixtures or construction techniques |
1271 | demonstrated to reduce the amount of loss in a windstorm which |
1272 | have been installed or implemented. The fixtures or construction |
1273 | techniques must shall include, but not be limited to, fixtures |
1274 | or construction techniques that which enhance roof strength, |
1275 | roof covering performance, roof-to-wall strength, wall-to-floor- |
1276 | to-foundation strength, opening protection, and window, door, |
1277 | and skylight strength. Credits, debits, discounts, or other rate |
1278 | differentials, or appropriate reductions or increases in |
1279 | deductibles, which recognize the presence or absence of for |
1280 | fixtures and construction techniques that which meet the minimum |
1281 | requirements of the Florida Building Code must be included in |
1282 | the rate filing. If an insurer demonstrates that the aggregate |
1283 | of its mitigation discounts results in a reduction to revenue |
1284 | which exceeds the reduction of the aggregate loss that is |
1285 | expected to result from the mitigation, the insurer may recover |
1286 | the lost revenue through an increase in its base rates. All |
1287 | insurance companies must make a rate filing which includes the |
1288 | credits, discounts, or other rate differentials or reductions in |
1289 | deductibles by February 28, 2003. By July 1, 2007, the office |
1290 | shall reevaluate the discounts, credits, other rate |
1291 | differentials, and appropriate reductions in deductibles for |
1292 | fixtures and construction techniques that meet the minimum |
1293 | requirements of the Florida Building Code, based upon actual |
1294 | experience or any other loss relativity studies available to the |
1295 | office. The office shall determine the discounts, credits, |
1296 | debits, other rate differentials, and appropriate reductions or |
1297 | increases in deductibles that reflect the full actuarial value |
1298 | of such revaluation, which may be used by insurers in rate |
1299 | filings. |
1300 | (b) By February 1, 2011, the Office of Insurance |
1301 | Regulation, in consultation with the Department of Financial |
1302 | Services and the Department of Community Affairs, shall develop |
1303 | and make publicly available a proposed method for insurers to |
1304 | establish discounts, credits, or other rate differentials for |
1305 | hurricane mitigation measures which directly correlate to the |
1306 | numerical rating assigned to a structure pursuant to the uniform |
1307 | home grading scale adopted by the Financial Services Commission |
1308 | pursuant to s. 215.55865, including any proposed changes to the |
1309 | uniform home grading scale. By October 1, 2011, the commission |
1310 | shall adopt rules requiring insurers to make rate filings for |
1311 | residential property insurance which revise insurers' discounts, |
1312 | credits, or other rate differentials for hurricane mitigation |
1313 | measures so that such rate differentials correlate directly to |
1314 | the uniform home grading scale. The rules may include such |
1315 | changes to the uniform home grading scale as the commission |
1316 | determines are necessary, and may specify the minimum required |
1317 | discounts, credits, or other rate differentials. Such rate |
1318 | differentials must be consistent with generally accepted |
1319 | actuarial principles and wind-loss mitigation studies. The rules |
1320 | shall allow a period of at least 2 years after the effective |
1321 | date of the revised mitigation discounts, credits, or other rate |
1322 | differentials for a property owner to obtain an inspection or |
1323 | otherwise qualify for the revised credit, during which time the |
1324 | insurer shall continue to apply the mitigation credit that was |
1325 | applied immediately prior to the effective date of the revised |
1326 | credit. Discounts, credits, and other rate differentials |
1327 | established for rate filings under this paragraph shall |
1328 | supersede, after adoption, the discounts, credits, and other |
1329 | rate differentials included in rate filings under paragraph (a). |
1330 | (5) In order to provide an appropriate transition period, |
1331 | an insurer may, in its sole discretion, implement an approved |
1332 | rate filing for residential property insurance over a period of |
1333 | years. Such An insurer electing to phase in its rate filing must |
1334 | provide an informational notice to the office setting out its |
1335 | schedule for implementation of the phased-in rate filing. The An |
1336 | insurer may include in its rate the actual cost of private |
1337 | market reinsurance that corresponds to available coverage of the |
1338 | Temporary Increase in Coverage Limits, TICL, from the Florida |
1339 | Hurricane Catastrophe Fund. The insurer may also include the |
1340 | cost of reinsurance to replace the TICL reduction implemented |
1341 | pursuant to s. 215.555(17)(d)9. However, this cost for |
1342 | reinsurance may not include any expense or profit load or result |
1343 | in a total annual base rate increase in excess of 10 percent. |
1344 | (8) EVALUATION OF RESIDENTIAL PROPERTY STRUCTURAL |
1345 | SOUNDNESS.- |
1346 | (b) To the extent that funds are provided for this purpose |
1347 | in the General Appropriations Act, the Legislature hereby |
1348 | authorizes the establishment of a program to be administered by |
1349 | the Citizens Property Insurance Corporation for homeowners |
1350 | insured in the coastal high-risk account is authorized. |
1351 | Section 13. Paragraphs (b), (c), (d), (v), and (y) of |
1352 | subsection (6) of section 627.351, Florida Statutes, are amended |
1353 | to read: |
1354 | 627.351 Insurance risk apportionment plans.- |
1355 | (6) CITIZENS PROPERTY INSURANCE CORPORATION.- |
1356 | (b)1. All insurers authorized to write one or more subject |
1357 | lines of business in this state are subject to assessment by the |
1358 | corporation and, for the purposes of this subsection, are |
1359 | referred to collectively as "assessable insurers." Insurers |
1360 | writing one or more subject lines of business in this state |
1361 | pursuant to part VIII of chapter 626 are not assessable |
1362 | insurers, but insureds who procure one or more subject lines of |
1363 | business in this state pursuant to part VIII of chapter 626 are |
1364 | subject to assessment by the corporation and are referred to |
1365 | collectively as "assessable insureds." An authorized insurer's |
1366 | assessment liability begins shall begin on the first day of the |
1367 | calendar year following the year in which the insurer was issued |
1368 | a certificate of authority to transact insurance for subject |
1369 | lines of business in this state and terminates shall terminate 1 |
1370 | year after the end of the first calendar year during which the |
1371 | insurer no longer holds a certificate of authority to transact |
1372 | insurance for subject lines of business in this state. |
1373 | 2.a. All revenues, assets, liabilities, losses, and |
1374 | expenses of the corporation shall be divided into three separate |
1375 | accounts as follows: |
1376 | (I) A personal lines account for personal residential |
1377 | policies issued by the corporation, or issued by the Residential |
1378 | Property and Casualty Joint Underwriting Association and renewed |
1379 | by the corporation, which provides that provide comprehensive, |
1380 | multiperil coverage on risks that are not located in areas |
1381 | eligible for coverage by in the Florida Windstorm Underwriting |
1382 | Association as those areas were defined on January 1, 2002, and |
1383 | for such policies that do not provide coverage for the peril of |
1384 | wind on risks that are located in such areas; |
1385 | (II) A commercial lines account for commercial residential |
1386 | and commercial nonresidential policies issued by the |
1387 | corporation, or issued by the Residential Property and Casualty |
1388 | Joint Underwriting Association and renewed by the corporation, |
1389 | which provides that provide coverage for basic property perils |
1390 | on risks that are not located in areas eligible for coverage by |
1391 | in the Florida Windstorm Underwriting Association as those areas |
1392 | were defined on January 1, 2002, and for such policies that do |
1393 | not provide coverage for the peril of wind on risks that are |
1394 | located in such areas; and |
1395 | (III) A coastal high-risk account for personal residential |
1396 | policies and commercial residential and commercial |
1397 | nonresidential property policies issued by the corporation, or |
1398 | transferred to the corporation, which provides that provide |
1399 | coverage for the peril of wind on risks that are located in |
1400 | areas eligible for coverage by in the Florida Windstorm |
1401 | Underwriting Association as those areas were defined on January |
1402 | 1, 2002. The corporation may offer policies that provide |
1403 | multiperil coverage and the corporation shall continue to offer |
1404 | policies that provide coverage only for the peril of wind for |
1405 | risks located in areas eligible for coverage in the coastal |
1406 | high-risk account. In issuing multiperil coverage, the |
1407 | corporation may use its approved policy forms and rates for the |
1408 | personal lines account. An applicant or insured who is eligible |
1409 | to purchase a multiperil policy from the corporation may |
1410 | purchase a multiperil policy from an authorized insurer without |
1411 | prejudice to the applicant's or insured's eligibility to |
1412 | prospectively purchase a policy that provides coverage only for |
1413 | the peril of wind from the corporation. An applicant or insured |
1414 | who is eligible for a corporation policy that provides coverage |
1415 | only for the peril of wind may elect to purchase or retain such |
1416 | policy and also purchase or retain coverage excluding wind from |
1417 | an authorized insurer without prejudice to the applicant's or |
1418 | insured's eligibility to prospectively purchase a policy that |
1419 | provides multiperil coverage from the corporation. It is the |
1420 | goal of the Legislature that there would be an overall average |
1421 | savings of 10 percent or more for a policyholder who currently |
1422 | has a wind-only policy with the corporation, and an ex-wind |
1423 | policy with a voluntary insurer or the corporation, and who then |
1424 | obtains a multiperil policy from the corporation. It is the |
1425 | intent of the Legislature that the offer of multiperil coverage |
1426 | in the coastal high-risk account be made and implemented in a |
1427 | manner that does not adversely affect the tax-exempt status of |
1428 | the corporation or creditworthiness of or security for currently |
1429 | outstanding financing obligations or credit facilities of the |
1430 | coastal high-risk account, the personal lines account, or the |
1431 | commercial lines account. The coastal high-risk account must |
1432 | also include quota share primary insurance under subparagraph |
1433 | (c)2. The area eligible for coverage under the coastal high-risk |
1434 | account also includes the area within Port Canaveral, which is |
1435 | bordered on the south by the City of Cape Canaveral, bordered on |
1436 | the west by the Banana River, and bordered on the north by |
1437 | Federal Government property. |
1438 | b. The three separate accounts must be maintained as long |
1439 | as financing obligations entered into by the Florida Windstorm |
1440 | Underwriting Association or Residential Property and Casualty |
1441 | Joint Underwriting Association are outstanding, in accordance |
1442 | with the terms of the corresponding financing documents. If When |
1443 | the financing obligations are no longer outstanding, in |
1444 | accordance with the terms of the corresponding financing |
1445 | documents, the corporation may use a single account for all |
1446 | revenues, assets, liabilities, losses, and expenses of the |
1447 | corporation. Consistent with the requirement of this |
1448 | subparagraph and prudent investment policies that minimize the |
1449 | cost of carrying debt, the board shall exercise its best efforts |
1450 | to retire existing debt or to obtain the approval of necessary |
1451 | parties to amend the terms of existing debt, so as to structure |
1452 | the most efficient plan to consolidate the three separate |
1453 | accounts into a single account. |
1454 | c. Creditors of the Residential Property and Casualty |
1455 | Joint Underwriting Association and of the accounts specified in |
1456 | sub-sub-subparagraphs a.(I) and (II) may have a claim against, |
1457 | and recourse to, those the accounts referred to in sub-sub- |
1458 | subparagraphs a.(I) and (II) and shall have no claim against, or |
1459 | recourse to, the account referred to in sub-sub-subparagraph |
1460 | a.(III). Creditors of the Florida Windstorm Underwriting |
1461 | Association shall have a claim against, and recourse to, the |
1462 | account referred to in sub-sub-subparagraph a.(III) and shall |
1463 | have no claim against, or recourse to, the accounts referred to |
1464 | in sub-sub-subparagraphs a.(I) and (II). |
1465 | d. Revenues, assets, liabilities, losses, and expenses not |
1466 | attributable to particular accounts shall be prorated among the |
1467 | accounts. |
1468 | e. The Legislature finds that the revenues of the |
1469 | corporation are revenues that are necessary to meet the |
1470 | requirements set forth in documents authorizing the issuance of |
1471 | bonds under this subsection. |
1472 | f. No part of the income of the corporation may inure to |
1473 | the benefit of any private person. |
1474 | 3. With respect to a deficit in an account: |
1475 | a. After accounting for the Citizens policyholder |
1476 | surcharge imposed under sub-subparagraph h. i., if when the |
1477 | remaining projected deficit incurred in a particular calendar |
1478 | year: |
1479 | (I) Is not greater than 6 percent of the aggregate |
1480 | statewide direct written premium for the subject lines of |
1481 | business for the prior calendar year, the entire deficit shall |
1482 | be recovered through regular assessments of assessable insurers |
1483 | under paragraph (q) and assessable insureds. |
1484 | (II)b. After accounting for the Citizens policyholder |
1485 | surcharge imposed under sub-subparagraph i., when the remaining |
1486 | projected deficit incurred in a particular calendar year Exceeds |
1487 | 6 percent of the aggregate statewide direct written premium for |
1488 | the subject lines of business for the prior calendar year, the |
1489 | corporation shall levy regular assessments on assessable |
1490 | insurers under paragraph (q) and on assessable insureds in an |
1491 | amount equal to the greater of 6 percent of the deficit or 6 |
1492 | percent of the aggregate statewide direct written premium for |
1493 | the subject lines of business for the prior calendar year. Any |
1494 | remaining deficit shall be recovered through emergency |
1495 | assessments under sub-subparagraph c. d. |
1496 | b.c. Each assessable insurer's share of the amount being |
1497 | assessed under sub-subparagraph a. must or sub-subparagraph b. |
1498 | shall be in the proportion that the assessable insurer's direct |
1499 | written premium for the subject lines of business for the year |
1500 | preceding the assessment bears to the aggregate statewide direct |
1501 | written premium for the subject lines of business for that year. |
1502 | The applicable assessment percentage applicable to each |
1503 | assessable insured is the ratio of the amount being assessed |
1504 | under sub-subparagraph a. or sub-subparagraph b. to the |
1505 | aggregate statewide direct written premium for the subject lines |
1506 | of business for the prior year. Assessments levied by the |
1507 | corporation on assessable insurers under sub-subparagraphs a. |
1508 | and b. must shall be paid as required by the corporation's plan |
1509 | of operation and paragraph (q),. Assessments levied by the |
1510 | corporation on assessable insureds under sub-subparagraphs a. |
1511 | and b. shall be collected by the surplus lines agent at the time |
1512 | the surplus lines agent collects the surplus lines tax required |
1513 | by s. 626.932, and shall be paid to the Florida Surplus Lines |
1514 | Service Office at the time the surplus lines agent pays the |
1515 | surplus lines tax to that the Florida Surplus Lines Service |
1516 | office. Upon receipt of regular assessments from surplus lines |
1517 | agents, the Florida Surplus Lines Service Office shall transfer |
1518 | the assessments directly to the corporation as determined by the |
1519 | corporation. |
1520 | c.d. Upon a determination by the board of governors that a |
1521 | deficit in an account exceeds the amount that will be recovered |
1522 | through regular assessments under sub-subparagraph a. or sub- |
1523 | subparagraph b., plus the amount that is expected to be |
1524 | recovered through surcharges under sub-subparagraph h. i., as to |
1525 | the remaining projected deficit the board shall levy, after |
1526 | verification by the office, shall levy emergency assessments, |
1527 | for as many years as necessary to cover the deficits, to be |
1528 | collected by assessable insurers and the corporation and |
1529 | collected from assessable insureds upon issuance or renewal of |
1530 | policies for subject lines of business, excluding National Flood |
1531 | Insurance policies. The amount of the emergency assessment |
1532 | collected in a particular year must shall be a uniform |
1533 | percentage of that year's direct written premium for subject |
1534 | lines of business and all accounts of the corporation, excluding |
1535 | National Flood Insurance Program policy premiums, as annually |
1536 | determined by the board and verified by the office. The office |
1537 | shall verify the arithmetic calculations involved in the board's |
1538 | determination within 30 days after receipt of the information on |
1539 | which the determination was based. Notwithstanding any other |
1540 | provision of law, the corporation and each assessable insurer |
1541 | that writes subject lines of business shall collect emergency |
1542 | assessments from its policyholders without such obligation being |
1543 | affected by any credit, limitation, exemption, or deferment. |
1544 | Emergency assessments levied by the corporation on assessable |
1545 | insureds shall be collected by the surplus lines agent at the |
1546 | time the surplus lines agent collects the surplus lines tax |
1547 | required by s. 626.932 and shall be paid to the Florida Surplus |
1548 | Lines Service Office at the time the surplus lines agent pays |
1549 | the surplus lines tax to that the Florida Surplus Lines Service |
1550 | office. The emergency assessments so collected shall be |
1551 | transferred directly to the corporation on a periodic basis as |
1552 | determined by the corporation and shall be held by the |
1553 | corporation solely in the applicable account. The aggregate |
1554 | amount of emergency assessments levied for an account under this |
1555 | sub-subparagraph in any calendar year may, at the discretion of |
1556 | the board of governors, be less than but may not exceed the |
1557 | greater of 10 percent of the amount needed to cover the deficit, |
1558 | plus interest, fees, commissions, required reserves, and other |
1559 | costs associated with financing of the original deficit, or 10 |
1560 | percent of the aggregate statewide direct written premium for |
1561 | subject lines of business and for all accounts of the |
1562 | corporation for the prior year, plus interest, fees, |
1563 | commissions, required reserves, and other costs associated with |
1564 | financing the deficit. |
1565 | d.e. The corporation may pledge the proceeds of |
1566 | assessments, projected recoveries from the Florida Hurricane |
1567 | Catastrophe Fund, other insurance and reinsurance recoverables, |
1568 | policyholder surcharges and other surcharges, and other funds |
1569 | available to the corporation as the source of revenue for and to |
1570 | secure bonds issued under paragraph (q), bonds or other |
1571 | indebtedness issued under subparagraph (c)3., or lines of credit |
1572 | or other financing mechanisms issued or created under this |
1573 | subsection, or to retire any other debt incurred as a result of |
1574 | deficits or events giving rise to deficits, or in any other way |
1575 | that the board determines will efficiently recover such |
1576 | deficits. The purpose of the lines of credit or other financing |
1577 | mechanisms is to provide additional resources to assist the |
1578 | corporation in covering claims and expenses attributable to a |
1579 | catastrophe. As used in this subsection, the term "assessments" |
1580 | includes regular assessments under sub-subparagraph a., sub- |
1581 | subparagraph b., or subparagraph (q)1. and emergency assessments |
1582 | under sub-subparagraph d. Emergency assessments collected under |
1583 | sub-subparagraph d. are not part of an insurer's rates, are not |
1584 | premium, and are not subject to premium tax, fees, or |
1585 | commissions; however, failure to pay the emergency assessment |
1586 | shall be treated as failure to pay premium. The emergency |
1587 | assessments under sub-subparagraph c. d. shall continue as long |
1588 | as any bonds issued or other indebtedness incurred with respect |
1589 | to a deficit for which the assessment was imposed remain |
1590 | outstanding, unless adequate provision has been made for the |
1591 | payment of such bonds or other indebtedness pursuant to the |
1592 | documents governing such bonds or other indebtedness. |
1593 | e.f. As used in this subsection for purposes of any |
1594 | deficit incurred on or after January 25, 2007, the term "subject |
1595 | lines of business" means insurance written by assessable |
1596 | insurers or procured by assessable insureds for all property and |
1597 | casualty lines of business in this state, but not including |
1598 | workers' compensation or medical malpractice. As used in this |
1599 | the sub-subparagraph, the term "property and casualty lines of |
1600 | business" includes all lines of business identified on Form 2, |
1601 | Exhibit of Premiums and Losses, in the annual statement required |
1602 | of authorized insurers under by s. 624.424 and any rule adopted |
1603 | under this section, except for those lines identified as |
1604 | accident and health insurance and except for policies written |
1605 | under the National Flood Insurance Program or the Federal Crop |
1606 | Insurance Program. For purposes of this sub-subparagraph, the |
1607 | term "workers' compensation" includes both workers' compensation |
1608 | insurance and excess workers' compensation insurance. |
1609 | f.g. The Florida Surplus Lines Service Office shall |
1610 | determine annually the aggregate statewide written premium in |
1611 | subject lines of business procured by assessable insureds and |
1612 | shall report that information to the corporation in a form and |
1613 | at a time the corporation specifies to ensure that the |
1614 | corporation can meet the requirements of this subsection and the |
1615 | corporation's financing obligations. |
1616 | g.h. The Florida Surplus Lines Service Office shall verify |
1617 | the proper application by surplus lines agents of assessment |
1618 | percentages for regular assessments and emergency assessments |
1619 | levied under this subparagraph on assessable insureds and shall |
1620 | assist the corporation in ensuring the accurate, timely |
1621 | collection and payment of assessments by surplus lines agents as |
1622 | required by the corporation. |
1623 | h.i. If a deficit is incurred in any account in 2008 or |
1624 | thereafter, the board of governors shall levy a Citizens |
1625 | policyholder surcharge against all policyholders of the |
1626 | corporation. for a 12-month period, which |
1627 | (I) The surcharge shall be levied collected at the time of |
1628 | issuance or renewal of a policy, as a uniform percentage of the |
1629 | premium for the policy of up to 15 percent of such premium, |
1630 | which funds shall be used to offset the deficit. |
1631 | (II) The surcharge is payable upon cancellation or |
1632 | termination of the policy, upon renewal of the policy, or upon |
1633 | issuance of a new policy by the corporation within the first 12 |
1634 | months after the date of the levy or the period of time |
1635 | necessary to fully collect the surcharge amount. |
1636 | (III) The corporation may not levy any regular assessments |
1637 | under paragraph (q) pursuant to sub-subparagraph a. or sub- |
1638 | subparagraph b. with respect to a particular year's deficit |
1639 | until the corporation has first levied the full amount of the |
1640 | surcharge authorized by this sub-subparagraph. |
1641 | (IV) The surcharge is Citizens policyholder surcharges |
1642 | under this sub-subparagraph are not considered premium and is |
1643 | are not subject to commissions, fees, or premium taxes. However, |
1644 | failure to pay the surcharge such surcharges shall be treated as |
1645 | failure to pay premium. |
1646 | i.j. If the amount of any assessments or surcharges |
1647 | collected from corporation policyholders, assessable insurers or |
1648 | their policyholders, or assessable insureds exceeds the amount |
1649 | of the deficits, such excess amounts shall be remitted to and |
1650 | retained by the corporation in a reserve to be used by the |
1651 | corporation, as determined by the board of governors and |
1652 | approved by the office, to pay claims or reduce any past, |
1653 | present, or future plan-year deficits or to reduce outstanding |
1654 | debt. |
1655 | (c) The corporation's plan of operation of the |
1656 | corporation: |
1657 | 1. Must provide for adoption of residential property and |
1658 | casualty insurance policy forms and commercial residential and |
1659 | nonresidential property insurance forms, which forms must be |
1660 | approved by the office before prior to use. The corporation |
1661 | shall adopt the following policy forms: |
1662 | a. Standard personal lines policy forms that are |
1663 | comprehensive multiperil policies providing full coverage of a |
1664 | residential property equivalent to the coverage provided in the |
1665 | private insurance market under an HO-3, HO-4, or HO-6 policy. |
1666 | b. Basic personal lines policy forms that are policies |
1667 | similar to an HO-8 policy or a dwelling fire policy that provide |
1668 | coverage meeting the requirements of the secondary mortgage |
1669 | market, but which coverage is more limited than the coverage |
1670 | under a standard policy. |
1671 | c. Commercial lines residential and nonresidential policy |
1672 | forms that are generally similar to the basic perils of full |
1673 | coverage obtainable for commercial residential structures and |
1674 | commercial nonresidential structures in the admitted voluntary |
1675 | market. |
1676 | d. Personal lines and commercial lines residential |
1677 | property insurance forms that cover the peril of wind only. The |
1678 | forms are applicable only to residential properties located in |
1679 | areas eligible for coverage under the coastal high-risk account |
1680 | referred to in sub-subparagraph (b)2.a. |
1681 | e. Commercial lines nonresidential property insurance |
1682 | forms that cover the peril of wind only. The forms are |
1683 | applicable only to nonresidential properties located in areas |
1684 | eligible for coverage under the coastal high-risk account |
1685 | referred to in sub-subparagraph (b)2.a. |
1686 | f. The corporation may adopt variations of the policy |
1687 | forms listed in sub-subparagraphs a.-e. which that contain more |
1688 | restrictive coverage. |
1689 | 2.a. Must provide that the corporation adopt a program in |
1690 | which the corporation and authorized insurers enter into quota |
1691 | share primary insurance agreements for hurricane coverage, as |
1692 | defined in s. 627.4025(2)(a), for eligible risks, and adopt |
1693 | property insurance forms for eligible risks which cover the |
1694 | peril of wind only. |
1695 | a. As used in this subsection, the term: |
1696 | (I) "Quota share primary insurance" means an arrangement |
1697 | in which the primary hurricane coverage of an eligible risk is |
1698 | provided in specified percentages by the corporation and an |
1699 | authorized insurer. The corporation and authorized insurer are |
1700 | each solely responsible for a specified percentage of hurricane |
1701 | coverage of an eligible risk as set forth in a quota share |
1702 | primary insurance agreement between the corporation and an |
1703 | authorized insurer and the insurance contract. The |
1704 | responsibility of the corporation or authorized insurer to pay |
1705 | its specified percentage of hurricane losses of an eligible |
1706 | risk, as set forth in the quota share primary insurance |
1707 | agreement, may not be altered by the inability of the other |
1708 | party to the agreement to pay its specified percentage of |
1709 | hurricane losses. Eligible risks that are provided hurricane |
1710 | coverage through a quota share primary insurance arrangement |
1711 | must be provided policy forms that set forth the obligations of |
1712 | the corporation and authorized insurer under the arrangement, |
1713 | clearly specify the percentages of quota share primary insurance |
1714 | provided by the corporation and authorized insurer, and |
1715 | conspicuously and clearly state that neither the authorized |
1716 | insurer and nor the corporation may not be held responsible |
1717 | beyond their its specified percentage of coverage of hurricane |
1718 | losses. |
1719 | (II) "Eligible risks" means personal lines residential and |
1720 | commercial lines residential risks that meet the underwriting |
1721 | criteria of the corporation and are located in areas that were |
1722 | eligible for coverage by the Florida Windstorm Underwriting |
1723 | Association on January 1, 2002. |
1724 | b. The corporation may enter into quota share primary |
1725 | insurance agreements with authorized insurers at corporation |
1726 | coverage levels of 90 percent and 50 percent. |
1727 | c. If the corporation determines that additional coverage |
1728 | levels are necessary to maximize participation in quota share |
1729 | primary insurance agreements by authorized insurers, the |
1730 | corporation may establish additional coverage levels. However, |
1731 | the corporation's quota share primary insurance coverage level |
1732 | may not exceed 90 percent. |
1733 | d. Any quota share primary insurance agreement entered |
1734 | into between an authorized insurer and the corporation must |
1735 | provide for a uniform specified percentage of coverage of |
1736 | hurricane losses, by county or territory as set forth by the |
1737 | corporation board, for all eligible risks of the authorized |
1738 | insurer covered under the quota share primary insurance |
1739 | agreement. |
1740 | e. Any quota share primary insurance agreement entered |
1741 | into between an authorized insurer and the corporation is |
1742 | subject to review and approval by the office. However, such |
1743 | agreement shall be authorized only as to insurance contracts |
1744 | entered into between an authorized insurer and an insured who is |
1745 | already insured by the corporation for wind coverage. |
1746 | f. For all eligible risks covered under quota share |
1747 | primary insurance agreements, the exposure and coverage levels |
1748 | for both the corporation and authorized insurers shall be |
1749 | reported by the corporation to the Florida Hurricane Catastrophe |
1750 | Fund. For all policies of eligible risks covered under such |
1751 | quota share primary insurance agreements, the corporation and |
1752 | the authorized insurer must shall maintain complete and accurate |
1753 | records for the purpose of exposure and loss reimbursement |
1754 | audits as required by Florida Hurricane Catastrophe fund rules. |
1755 | The corporation and the authorized insurer shall each maintain |
1756 | duplicate copies of policy declaration pages and supporting |
1757 | claims documents. |
1758 | g. The corporation board shall establish in its plan of |
1759 | operation standards for quota share agreements which ensure that |
1760 | there is no discriminatory application among insurers as to the |
1761 | terms of the quota share agreements, pricing of the quota share |
1762 | agreements, incentive provisions if any, and consideration paid |
1763 | for servicing policies or adjusting claims. |
1764 | h. The quota share primary insurance agreement between the |
1765 | corporation and an authorized insurer must set forth the |
1766 | specific terms under which coverage is provided, including, but |
1767 | not limited to, the sale and servicing of policies issued under |
1768 | the agreement by the insurance agent of the authorized insurer |
1769 | producing the business, the reporting of information concerning |
1770 | eligible risks, the payment of premium to the corporation, and |
1771 | arrangements for the adjustment and payment of hurricane claims |
1772 | incurred on eligible risks by the claims adjuster and personnel |
1773 | of the authorized insurer. Entering into a quota sharing |
1774 | insurance agreement between the corporation and an authorized |
1775 | insurer is shall be voluntary and at the discretion of the |
1776 | authorized insurer. |
1777 | 3. May provide that the corporation may employ or |
1778 | otherwise contract with individuals or other entities to provide |
1779 | administrative or professional services that may be appropriate |
1780 | to effectuate the plan. The corporation may shall have the power |
1781 | to borrow funds, by issuing bonds or by incurring other |
1782 | indebtedness, and shall have other powers reasonably necessary |
1783 | to effectuate the requirements of this subsection, including, |
1784 | without limitation, the power to issue bonds and incur other |
1785 | indebtedness in order to refinance outstanding bonds or other |
1786 | indebtedness. The corporation may, but is not required to, seek |
1787 | judicial validation of its bonds or other indebtedness under |
1788 | chapter 75. The corporation may issue bonds or incur other |
1789 | indebtedness, or have bonds issued on its behalf by a unit of |
1790 | local government pursuant to subparagraph (q)2., in the absence |
1791 | of a hurricane or other weather-related event, upon a |
1792 | determination by the corporation, subject to approval by the |
1793 | office, that such action would enable it to efficiently meet the |
1794 | financial obligations of the corporation and that such |
1795 | financings are reasonably necessary to effectuate the |
1796 | requirements of this subsection. The corporation may is |
1797 | authorized to take all actions needed to facilitate tax-free |
1798 | status for any such bonds or indebtedness, including formation |
1799 | of trusts or other affiliated entities. The corporation may |
1800 | shall have the authority to pledge assessments, projected |
1801 | recoveries from the Florida Hurricane Catastrophe Fund, other |
1802 | reinsurance recoverables, market equalization and other |
1803 | surcharges, and other funds available to the corporation as |
1804 | security for bonds or other indebtedness. In recognition of s. |
1805 | 10, Art. I of the State Constitution, prohibiting the impairment |
1806 | of obligations of contracts, it is the intent of the Legislature |
1807 | that no action be taken whose purpose is to impair any bond |
1808 | indenture or financing agreement or any revenue source committed |
1809 | by contract to such bond or other indebtedness. |
1810 | 4.a. Must require that the corporation operate subject to |
1811 | the supervision and approval of a board of governors consisting |
1812 | of eight individuals who are residents of this state, from |
1813 | different geographical areas of this state. |
1814 | a. The Governor, the Chief Financial Officer, the |
1815 | President of the Senate, and the Speaker of the House of |
1816 | Representatives shall each appoint two members of the board. At |
1817 | least one of the two members appointed by each appointing |
1818 | officer must have demonstrated expertise in insurance, and is |
1819 | deemed to be within the scope of the exemption provided in s. |
1820 | 112.313(7)(b). The Chief Financial Officer shall designate one |
1821 | of the appointees as chair. All board members serve at the |
1822 | pleasure of the appointing officer. All members of the board of |
1823 | governors are subject to removal at will by the officers who |
1824 | appointed them. All board members, including the chair, must be |
1825 | appointed to serve for 3-year terms beginning annually on a date |
1826 | designated by the plan. However, for the first term beginning on |
1827 | or after July 1, 2009, each appointing officer shall appoint one |
1828 | member of the board for a 2-year term and one member for a 3- |
1829 | year term. A Any board vacancy shall be filled for the unexpired |
1830 | term by the appointing officer. The Chief Financial Officer |
1831 | shall appoint a technical advisory group to provide information |
1832 | and advice to the board of governors in connection with the |
1833 | board's duties under this subsection. The executive director and |
1834 | senior managers of the corporation shall be engaged by the board |
1835 | and serve at the pleasure of the board. Any executive director |
1836 | appointed on or after July 1, 2006, is subject to confirmation |
1837 | by the Senate. The executive director is responsible for |
1838 | employing other staff as the corporation may require, subject to |
1839 | review and concurrence by the board. |
1840 | b. The board shall create a Market Accountability Advisory |
1841 | Committee to assist the corporation in developing awareness of |
1842 | its rates and its customer and agent service levels in |
1843 | relationship to the voluntary market insurers writing similar |
1844 | coverage. |
1845 | (I) The members of the advisory committee shall consist of |
1846 | the following 11 persons, one of whom must be elected chair by |
1847 | the members of the committee: four representatives, one |
1848 | appointed by the Florida Association of Insurance Agents, one by |
1849 | the Florida Association of Insurance and Financial Advisors, one |
1850 | by the Professional Insurance Agents of Florida, and one by the |
1851 | Latin American Association of Insurance Agencies; three |
1852 | representatives appointed by the insurers with the three highest |
1853 | voluntary market share of residential property insurance |
1854 | business in the state; one representative from the Office of |
1855 | Insurance Regulation; one consumer appointed by the board who is |
1856 | insured by the corporation at the time of appointment to the |
1857 | committee; one representative appointed by the Florida |
1858 | Association of Realtors; and one representative appointed by the |
1859 | Florida Bankers Association. All members shall be appointed to |
1860 | must serve for 3-year terms and may serve for consecutive terms. |
1861 | (II) The committee shall report to the corporation at each |
1862 | board meeting on insurance market issues which may include rates |
1863 | and rate competition with the voluntary market; service, |
1864 | including policy issuance, claims processing, and general |
1865 | responsiveness to policyholders, applicants, and agents; and |
1866 | matters relating to depopulation. |
1867 | 5. Must provide a procedure for determining the |
1868 | eligibility of a risk for coverage, as follows: |
1869 | a. Subject to the provisions of s. 627.3517, with respect |
1870 | to personal lines residential risks, if the risk is offered |
1871 | coverage from an authorized insurer at the insurer's approved |
1872 | rate under either a standard policy including wind coverage or, |
1873 | if consistent with the insurer's underwriting rules as filed |
1874 | with the office, a basic policy including wind coverage, for a |
1875 | new application to the corporation for coverage, the risk is not |
1876 | eligible for any policy issued by the corporation unless the |
1877 | premium for coverage from the authorized insurer is more than 15 |
1878 | percent greater than the premium for comparable coverage from |
1879 | the corporation. If the risk is not able to obtain any such |
1880 | offer, the risk is eligible for either a standard policy |
1881 | including wind coverage or a basic policy including wind |
1882 | coverage issued by the corporation; however, if the risk could |
1883 | not be insured under a standard policy including wind coverage |
1884 | regardless of market conditions, the risk is shall be eligible |
1885 | for a basic policy including wind coverage unless rejected under |
1886 | subparagraph 8. However, with regard to a policyholder of the |
1887 | corporation or a policyholder removed from the corporation |
1888 | through an assumption agreement until the end of the assumption |
1889 | period, the policyholder remains eligible for coverage from the |
1890 | corporation regardless of any offer of coverage from an |
1891 | authorized insurer or surplus lines insurer. The corporation |
1892 | shall determine the type of policy to be provided on the basis |
1893 | of objective standards specified in the underwriting manual and |
1894 | based on generally accepted underwriting practices. |
1895 | (I) If the risk accepts an offer of coverage through the |
1896 | market assistance plan or an offer of coverage through a |
1897 | mechanism established by the corporation before a policy is |
1898 | issued to the risk by the corporation or during the first 30 |
1899 | days of coverage by the corporation, and the producing agent who |
1900 | submitted the application to the plan or to the corporation is |
1901 | not currently appointed by the insurer, the insurer shall: |
1902 | (A) Pay to the producing agent of record of the policy, |
1903 | for the first year, an amount that is the greater of the |
1904 | insurer's usual and customary commission for the type of policy |
1905 | written or a fee equal to the usual and customary commission of |
1906 | the corporation; or |
1907 | (B) Offer to allow the producing agent of record of the |
1908 | policy to continue servicing the policy for at least a period of |
1909 | not less than 1 year and offer to pay the agent the greater of |
1910 | the insurer's or the corporation's usual and customary |
1911 | commission for the type of policy written. |
1912 |
|
1913 | If the producing agent is unwilling or unable to accept |
1914 | appointment, the new insurer shall pay the agent in accordance |
1915 | with sub-sub-sub-subparagraph (A). |
1916 | (II) If When the corporation enters into a contractual |
1917 | agreement for a take-out plan, the producing agent of record of |
1918 | the corporation policy is entitled to retain any unearned |
1919 | commission on the policy, and the insurer shall: |
1920 | (A) Pay to the producing agent of record of the |
1921 | corporation policy, for the first year, an amount that is the |
1922 | greater of the insurer's usual and customary commission for the |
1923 | type of policy written or a fee equal to the usual and customary |
1924 | commission of the corporation; or |
1925 | (B) Offer to allow the producing agent of record of the |
1926 | corporation policy to continue servicing the policy for at least |
1927 | a period of not less than 1 year and offer to pay the agent the |
1928 | greater of the insurer's or the corporation's usual and |
1929 | customary commission for the type of policy written. |
1930 |
|
1931 | If the producing agent is unwilling or unable to accept |
1932 | appointment, the new insurer shall pay the agent in accordance |
1933 | with sub-sub-sub-subparagraph (A). |
1934 | b. With respect to commercial lines residential risks, for |
1935 | a new application to the corporation for coverage, if the risk |
1936 | is offered coverage under a policy including wind coverage from |
1937 | an authorized insurer at its approved rate, the risk is not |
1938 | eligible for a any policy issued by the corporation unless the |
1939 | premium for coverage from the authorized insurer is more than 15 |
1940 | percent greater than the premium for comparable coverage from |
1941 | the corporation. If the risk is not able to obtain any such |
1942 | offer, the risk is eligible for a policy including wind coverage |
1943 | issued by the corporation. However, with regard to a |
1944 | policyholder of the corporation or a policyholder removed from |
1945 | the corporation through an assumption agreement until the end of |
1946 | the assumption period, the policyholder remains eligible for |
1947 | coverage from the corporation regardless of an any offer of |
1948 | coverage from an authorized insurer or surplus lines insurer. |
1949 | (I) If the risk accepts an offer of coverage through the |
1950 | market assistance plan or an offer of coverage through a |
1951 | mechanism established by the corporation before a policy is |
1952 | issued to the risk by the corporation or during the first 30 |
1953 | days of coverage by the corporation, and the producing agent who |
1954 | submitted the application to the plan or the corporation is not |
1955 | currently appointed by the insurer, the insurer shall: |
1956 | (A) Pay to the producing agent of record of the policy, |
1957 | for the first year, an amount that is the greater of the |
1958 | insurer's usual and customary commission for the type of policy |
1959 | written or a fee equal to the usual and customary commission of |
1960 | the corporation; or |
1961 | (B) Offer to allow the producing agent of record of the |
1962 | policy to continue servicing the policy for at least a period of |
1963 | not less than 1 year and offer to pay the agent the greater of |
1964 | the insurer's or the corporation's usual and customary |
1965 | commission for the type of policy written. |
1966 |
|
1967 | If the producing agent is unwilling or unable to accept |
1968 | appointment, the new insurer shall pay the agent in accordance |
1969 | with sub-sub-sub-subparagraph (A). |
1970 | (II) If When the corporation enters into a contractual |
1971 | agreement for a take-out plan, the producing agent of record of |
1972 | the corporation policy is entitled to retain any unearned |
1973 | commission on the policy, and the insurer shall: |
1974 | (A) Pay to the producing agent of record of the |
1975 | corporation policy, for the first year, an amount that is the |
1976 | greater of the insurer's usual and customary commission for the |
1977 | type of policy written or a fee equal to the usual and customary |
1978 | commission of the corporation; or |
1979 | (B) Offer to allow the producing agent of record of the |
1980 | corporation policy to continue servicing the policy for at least |
1981 | a period of not less than 1 year and offer to pay the agent the |
1982 | greater of the insurer's or the corporation's usual and |
1983 | customary commission for the type of policy written. |
1984 |
|
1985 | If the producing agent is unwilling or unable to accept |
1986 | appointment, the new insurer shall pay the agent in accordance |
1987 | with sub-sub-sub-subparagraph (A). |
1988 | c. For purposes of determining comparable coverage under |
1989 | sub-subparagraphs a. and b., the comparison must shall be based |
1990 | on those forms and coverages that are reasonably comparable. The |
1991 | corporation may rely on a determination of comparable coverage |
1992 | and premium made by the producing agent who submits the |
1993 | application to the corporation, made in the agent's capacity as |
1994 | the corporation's agent. A comparison may be made solely of the |
1995 | premium with respect to the main building or structure only on |
1996 | the following basis: the same coverage A or other building |
1997 | limits; the same percentage hurricane deductible that applies on |
1998 | an annual basis or that applies to each hurricane for commercial |
1999 | residential property; the same percentage of ordinance and law |
2000 | coverage, if the same limit is offered by both the corporation |
2001 | and the authorized insurer; the same mitigation credits, to the |
2002 | extent the same types of credits are offered both by the |
2003 | corporation and the authorized insurer; the same method for loss |
2004 | payment, such as replacement cost or actual cash value, if the |
2005 | same method is offered both by the corporation and the |
2006 | authorized insurer in accordance with underwriting rules; and |
2007 | any other form or coverage that is reasonably comparable as |
2008 | determined by the board. If an application is submitted to the |
2009 | corporation for wind-only coverage in the coastal high-risk |
2010 | account, the premium for the corporation's wind-only policy plus |
2011 | the premium for the ex-wind policy that is offered by an |
2012 | authorized insurer to the applicant must shall be compared to |
2013 | the premium for multiperil coverage offered by an authorized |
2014 | insurer, subject to the standards for comparison specified in |
2015 | this subparagraph. If the corporation or the applicant requests |
2016 | from the authorized insurer a breakdown of the premium of the |
2017 | offer by types of coverage so that a comparison may be made by |
2018 | the corporation or its agent and the authorized insurer refuses |
2019 | or is unable to provide such information, the corporation may |
2020 | treat the offer as not being an offer of coverage from an |
2021 | authorized insurer at the insurer's approved rate. |
2022 | 6. Must include rules for classifications of risks and |
2023 | rates therefor. |
2024 | 7. Must provide that if premium and investment income for |
2025 | an account attributable to a particular calendar year are in |
2026 | excess of projected losses and expenses for the account |
2027 | attributable to that year, such excess shall be held in surplus |
2028 | in the account. Such surplus must shall be available to defray |
2029 | deficits in that account as to future years and shall be used |
2030 | for that purpose before prior to assessing assessable insurers |
2031 | and assessable insureds as to any calendar year. |
2032 | 8. Must provide objective criteria and procedures to be |
2033 | uniformly applied to for all applicants in determining whether |
2034 | an individual risk is so hazardous as to be uninsurable. In |
2035 | making this determination and in establishing the criteria and |
2036 | procedures, the following must shall be considered: |
2037 | a. Whether the likelihood of a loss for the individual |
2038 | risk is substantially higher than for other risks of the same |
2039 | class; and |
2040 | b. Whether the uncertainty associated with the individual |
2041 | risk is such that an appropriate premium cannot be determined. |
2042 |
|
2043 | The acceptance or rejection of a risk by the corporation shall |
2044 | be construed as the private placement of insurance, and the |
2045 | provisions of chapter 120 do shall not apply. |
2046 | 9. Must provide that the corporation shall make its best |
2047 | efforts to procure catastrophe reinsurance at reasonable rates, |
2048 | to cover its projected 100-year probable maximum loss as |
2049 | determined by the board of governors. |
2050 | 10. The policies issued by the corporation must provide |
2051 | that, if the corporation or the market assistance plan obtains |
2052 | an offer from an authorized insurer to cover the risk at its |
2053 | approved rates, the risk is no longer eligible for renewal |
2054 | through the corporation, except as otherwise provided in this |
2055 | subsection. |
2056 | 11. Corporation policies and applications must include a |
2057 | notice that the corporation policy could, under this section, be |
2058 | replaced with a policy issued by an authorized insurer which |
2059 | that does not provide coverage identical to the coverage |
2060 | provided by the corporation. The notice must shall also specify |
2061 | that acceptance of corporation coverage creates a conclusive |
2062 | presumption that the applicant or policyholder is aware of this |
2063 | potential. |
2064 | 12. May establish, subject to approval by the office, |
2065 | different eligibility requirements and operational procedures |
2066 | for any line or type of coverage for any specified county or |
2067 | area if the board determines that such changes to the |
2068 | eligibility requirements and operational procedures are |
2069 | justified due to the voluntary market being sufficiently stable |
2070 | and competitive in such area or for such line or type of |
2071 | coverage and that consumers who, in good faith, are unable to |
2072 | obtain insurance through the voluntary market through ordinary |
2073 | methods would continue to have access to coverage from the |
2074 | corporation. If When coverage is sought in connection with a |
2075 | real property transfer, the such requirements and procedures may |
2076 | shall not provide for an effective date of coverage later than |
2077 | the date of the closing of the transfer as established by the |
2078 | transferor, the transferee, and, if applicable, the lender. |
2079 | 13. Must provide that, with respect to the coastal high- |
2080 | risk account, any assessable insurer with a surplus as to |
2081 | policyholders of $25 million or less writing 25 percent or more |
2082 | of its total countrywide property insurance premiums in this |
2083 | state may petition the office, within the first 90 days of each |
2084 | calendar year, to qualify as a limited apportionment company. A |
2085 | regular assessment levied by the corporation on a limited |
2086 | apportionment company for a deficit incurred by the corporation |
2087 | for the coastal high-risk account in 2006 or thereafter may be |
2088 | paid to the corporation on a monthly basis as the assessments |
2089 | are collected by the limited apportionment company from its |
2090 | insureds pursuant to s. 627.3512, but the regular assessment |
2091 | must be paid in full within 12 months after being levied by the |
2092 | corporation. A limited apportionment company shall collect from |
2093 | its policyholders any emergency assessment imposed under sub- |
2094 | subparagraph (b)3.d. The plan must shall provide that, if the |
2095 | office determines that any regular assessment will result in an |
2096 | impairment of the surplus of a limited apportionment company, |
2097 | the office may direct that all or part of such assessment be |
2098 | deferred as provided in subparagraph (q)4. However, there shall |
2099 | be no limitation or deferment of an emergency assessment to be |
2100 | collected from policyholders under sub-subparagraph (b)3.d. may |
2101 | not be limited or deferred. |
2102 | 14. Must provide that the corporation appoint as its |
2103 | licensed agents only those agents who also hold an appointment |
2104 | as defined in s. 626.015(3) with an insurer who at the time of |
2105 | the agent's initial appointment by the corporation is authorized |
2106 | to write and is actually writing personal lines residential |
2107 | property coverage, commercial residential property coverage, or |
2108 | commercial nonresidential property coverage within the state. |
2109 | 15. Must provide, by July 1, 2007, a premium payment plan |
2110 | option to its policyholders which, allows at a minimum, allows |
2111 | for quarterly and semiannual payment of premiums. A monthly |
2112 | payment plan may, but is not required to, be offered. |
2113 | 16. Must limit coverage on mobile homes or manufactured |
2114 | homes built before prior to 1994 to actual cash value of the |
2115 | dwelling rather than replacement costs of the dwelling. |
2116 | 17. May provide such limits of coverage as the board |
2117 | determines, consistent with the requirements of this subsection. |
2118 | 18. May require commercial property to meet specified |
2119 | hurricane mitigation construction features as a condition of |
2120 | eligibility for coverage. |
2121 | (d)1. All prospective employees for senior management |
2122 | positions, as defined by the plan of operation, are subject to |
2123 | background checks as a prerequisite for employment. The office |
2124 | shall conduct the background checks on such prospective |
2125 | employees pursuant to ss. 624.34, 624.404(3), and 628.261. |
2126 | 2. On or before July 1 of each year, employees of the |
2127 | corporation must are required to sign and submit a statement |
2128 | attesting that they do not have a conflict of interest, as |
2129 | defined in part III of chapter 112. As a condition of |
2130 | employment, all prospective employees must are required to sign |
2131 | and submit to the corporation a conflict-of-interest statement. |
2132 | 3. Senior managers and members of the board of governors |
2133 | are subject to the provisions of part III of chapter 112, |
2134 | including, but not limited to, the code of ethics and public |
2135 | disclosure and reporting of financial interests, pursuant to s. |
2136 | 112.3145. Notwithstanding s. 112.3143(2), a board member may not |
2137 | vote on any measure that would inure to his or her special |
2138 | private gain or loss; that he or she knows would inure to the |
2139 | special private gain or loss of any principal by whom he or she |
2140 | is retained or to the parent organization or subsidiary of a |
2141 | corporate principal by which he or she is retained, other than |
2142 | an agency as defined in s. 112.312; or that he or she knows |
2143 | would inure to the special private gain or loss of a relative or |
2144 | business associate of the public officer. Before the vote is |
2145 | taken, such member shall publicly state to the assembly the |
2146 | nature of his or her interest in the matter from which he or she |
2147 | is abstaining from voting and, within 15 days after the vote |
2148 | occurs, disclose the nature of his or her interest as a public |
2149 | record in a memorandum filed with the person responsible for |
2150 | recording the minutes of the meeting, who shall incorporate the |
2151 | memorandum in the minutes. Senior managers and board members are |
2152 | also required to file such disclosures with the Commission on |
2153 | Ethics and the Office of Insurance Regulation. The executive |
2154 | director of the corporation or his or her designee shall notify |
2155 | each existing and newly appointed and existing appointed member |
2156 | of the board of governors and senior managers of their duty to |
2157 | comply with the reporting requirements of part III of chapter |
2158 | 112. At least quarterly, the executive director or his or her |
2159 | designee shall submit to the Commission on Ethics a list of |
2160 | names of the senior managers and members of the board of |
2161 | governors who are subject to the public disclosure requirements |
2162 | under s. 112.3145. |
2163 | 4. Notwithstanding s. 112.3148 or s. 112.3149, or any |
2164 | other provision of law, an employee or board member may not |
2165 | knowingly accept, directly or indirectly, any gift or |
2166 | expenditure from a person or entity, or an employee or |
2167 | representative of such person or entity, which that has a |
2168 | contractual relationship with the corporation or who is under |
2169 | consideration for a contract. An employee or board member who |
2170 | fails to comply with subparagraph 3. or this subparagraph is |
2171 | subject to penalties provided under ss. 112.317 and 112.3173. |
2172 | 5. Any senior manager of the corporation who is employed |
2173 | on or after January 1, 2007, regardless of the date of hire, who |
2174 | subsequently retires or terminates employment is prohibited from |
2175 | representing another person or entity before the corporation for |
2176 | 2 years after retirement or termination of employment from the |
2177 | corporation. |
2178 | 6. Any senior manager of the corporation who is employed |
2179 | on or after January 1, 2007, regardless of the date of hire, who |
2180 | subsequently retires or terminates employment is prohibited from |
2181 | having any employment or contractual relationship for 2 years |
2182 | with an insurer that has entered into a take-out bonus agreement |
2183 | with the corporation. |
2184 | (v)1. Effective July 1, 2002, policies of the Residential |
2185 | Property and Casualty Joint Underwriting Association shall |
2186 | become policies of the corporation. All obligations, rights, |
2187 | assets and liabilities of the Residential Property and Casualty |
2188 | Joint Underwriting association, including bonds, note and debt |
2189 | obligations, and the financing documents pertaining to them |
2190 | become those of the corporation as of July 1, 2002. The |
2191 | corporation is not required to issue endorsements or |
2192 | certificates of assumption to insureds during the remaining term |
2193 | of in-force transferred policies. |
2194 | 2. Effective July 1, 2002, policies of the Florida |
2195 | Windstorm Underwriting Association are transferred to the |
2196 | corporation and shall become policies of the corporation. All |
2197 | obligations, rights, assets, and liabilities of the Florida |
2198 | Windstorm Underwriting association, including bonds, note and |
2199 | debt obligations, and the financing documents pertaining to them |
2200 | are transferred to and assumed by the corporation on July 1, |
2201 | 2002. The corporation is not required to issue endorsements or |
2202 | certificates of assumption to insureds during the remaining term |
2203 | of in-force transferred policies. |
2204 | 3. The Florida Windstorm Underwriting Association and the |
2205 | Residential Property and Casualty Joint Underwriting Association |
2206 | shall take all actions necessary as may be proper to further |
2207 | evidence the transfers and shall provide the documents and |
2208 | instruments of further assurance as may reasonably be requested |
2209 | by the corporation for that purpose. The corporation shall |
2210 | execute assumptions and instruments as the trustees or other |
2211 | parties to the financing documents of the Florida Windstorm |
2212 | Underwriting Association or the Residential Property and |
2213 | Casualty Joint Underwriting Association may reasonably request |
2214 | to further evidence the transfers and assumptions, which |
2215 | transfers and assumptions, however, are effective on the date |
2216 | provided under this paragraph whether or not, and regardless of |
2217 | the date on which, the assumptions or instruments are executed |
2218 | by the corporation. Subject to the relevant financing documents |
2219 | pertaining to their outstanding bonds, notes, indebtedness, or |
2220 | other financing obligations, the moneys, investments, |
2221 | receivables, choses in action, and other intangibles of the |
2222 | Florida Windstorm Underwriting Association shall be credited to |
2223 | the coastal high-risk account of the corporation, and those of |
2224 | the personal lines residential coverage account and the |
2225 | commercial lines residential coverage account of the Residential |
2226 | Property and Casualty Joint Underwriting Association shall be |
2227 | credited to the personal lines account and the commercial lines |
2228 | account, respectively, of the corporation. |
2229 | 4. Effective July 1, 2002, a new applicant for property |
2230 | insurance coverage who would otherwise have been eligible for |
2231 | coverage in the Florida Windstorm Underwriting Association is |
2232 | eligible for coverage from the corporation as provided in this |
2233 | subsection. |
2234 | 5. The transfer of all policies, obligations, rights, |
2235 | assets, and liabilities from the Florida Windstorm Underwriting |
2236 | Association to the corporation and the renaming of the |
2237 | Residential Property and Casualty Joint Underwriting Association |
2238 | as the corporation does not shall in no way affect the coverage |
2239 | with respect to covered policies as defined in s. 215.555(2)(c) |
2240 | provided to these entities by the Florida Hurricane Catastrophe |
2241 | Fund. The coverage provided by the Florida Hurricane Catastrophe |
2242 | fund to the Florida Windstorm Underwriting Association based on |
2243 | its exposures as of June 30, 2002, and each June 30 thereafter |
2244 | shall be redesignated as coverage for the coastal high-risk |
2245 | account of the corporation. Notwithstanding any other provision |
2246 | of law, the coverage provided by the Florida Hurricane |
2247 | Catastrophe fund to the Residential Property and Casualty Joint |
2248 | Underwriting Association based on its exposures as of June 30, |
2249 | 2002, and each June 30 thereafter shall be transferred to the |
2250 | personal lines account and the commercial lines account of the |
2251 | corporation. Notwithstanding any other provision of law, the |
2252 | coastal high-risk account shall be treated, for all Florida |
2253 | Hurricane Catastrophe Fund purposes, as if it were a separate |
2254 | participating insurer with its own exposures, reimbursement |
2255 | premium, and loss reimbursement. Likewise, the personal lines |
2256 | and commercial lines accounts shall be viewed together, for all |
2257 | Florida Hurricane Catastrophe fund purposes, as if the two |
2258 | accounts were one and represent a single, separate participating |
2259 | insurer with its own exposures, reimbursement premium, and loss |
2260 | reimbursement. The coverage provided by the Florida Hurricane |
2261 | Catastrophe fund to the corporation shall constitute and operate |
2262 | as a full transfer of coverage from the Florida Windstorm |
2263 | Underwriting Association and Residential Property and Casualty |
2264 | Joint Underwriting to the corporation. |
2265 | (y) It is the intent of the Legislature that the |
2266 | amendments to this subsection enacted in 2002 should, over time, |
2267 | reduce the probable maximum windstorm losses in the residual |
2268 | markets and should reduce the potential assessments to be levied |
2269 | on property insurers and policyholders statewide. In furtherance |
2270 | of this intent: |
2271 | 1. The board shall, on or before February 1 of each year, |
2272 | provide a report to the President of the Senate and the Speaker |
2273 | of the House of Representatives showing the reduction or |
2274 | increase in the 100-year probable maximum loss attributable to |
2275 | wind-only coverages and the quota share program under this |
2276 | subsection combined, as compared to the benchmark 100-year |
2277 | probable maximum loss of the Florida Windstorm Underwriting |
2278 | Association. For purposes of this paragraph, the benchmark 100- |
2279 | year probable maximum loss of the Florida Windstorm Underwriting |
2280 | Association is shall be the calculation dated February 2001 and |
2281 | based on November 30, 2000, exposures. In order to ensure |
2282 | comparability of data, the board shall use the same methods for |
2283 | calculating its probable maximum loss as were used to calculate |
2284 | the benchmark probable maximum loss. |
2285 | 2. Beginning December 1, 2013 2010, if the report under |
2286 | subparagraph 1. for any year indicates that the 100-year |
2287 | probable maximum loss attributable to wind-only coverages and |
2288 | the quota share program combined does not reflect a reduction of |
2289 | at least 25 percent from the benchmark, the board shall reduce |
2290 | the boundaries of the high-risk area eligible for wind-only |
2291 | coverages under this subsection in a manner calculated to reduce |
2292 | the such probable maximum loss to an amount at least 25 percent |
2293 | below the benchmark. |
2294 | 3. Beginning February 1, 2015, if the report under |
2295 | subparagraph 1. for any year indicates that the 100-year |
2296 | probable maximum loss attributable to wind-only coverages and |
2297 | the quota share program combined does not reflect a reduction of |
2298 | at least 50 percent from the benchmark, the boundaries of the |
2299 | high-risk area eligible for wind-only coverages under this |
2300 | subsection shall be reduced by the elimination of any area that |
2301 | is not seaward of a line 1,000 feet inland from the Intracoastal |
2302 | Waterway. |
2303 | Section 14. Paragraph (a) of subsection (5) of section |
2304 | 627.3511, Florida Statutes, is amended to read: |
2305 | 627.3511 Depopulation of Citizens Property Insurance |
2306 | Corporation.- |
2307 | (5) APPLICABILITY.- |
2308 | (a) The take-out bonus provided by subsection (2) and the |
2309 | exemption from assessment provided by paragraph (3)(a) apply |
2310 | only if the corporation policy is replaced by either a standard |
2311 | policy including wind coverage or, if consistent with the |
2312 | insurer's underwriting rules as filed with the office, a basic |
2313 | policy including wind coverage; however, for with respect to |
2314 | risks located in areas where coverage through the coastal high- |
2315 | risk account of the corporation is available, the replacement |
2316 | policy need not provide wind coverage. The insurer must renew |
2317 | the replacement policy at approved rates on substantially |
2318 | similar terms for four additional 1-year terms, unless canceled |
2319 | or not renewed by the policyholder. If an insurer assumes the |
2320 | corporation's obligations for a policy, it must issue a |
2321 | replacement policy for a 1-year term upon expiration of the |
2322 | corporation policy and must renew the replacement policy at |
2323 | approved rates on substantially similar terms for four |
2324 | additional 1-year terms, unless canceled or not renewed by the |
2325 | policyholder. For each replacement policy canceled or nonrenewed |
2326 | by the insurer for any reason during the 5-year coverage period |
2327 | required by this paragraph, the insurer must remove from the |
2328 | corporation one additional policy covering a risk similar to the |
2329 | risk covered by the canceled or nonrenewed policy. In addition |
2330 | to these requirements, the corporation must place the bonus |
2331 | moneys in escrow for a period of 5 years; such moneys may be |
2332 | released from escrow only to pay claims. If the policy is |
2333 | canceled or nonrenewed before the end of the 5-year period, the |
2334 | amount of the take-out bonus must be prorated for the time |
2335 | period the policy was insured. A take-out bonus provided by |
2336 | subsection (2) or subsection (6) is shall not be considered |
2337 | premium income for purposes of taxes and assessments under the |
2338 | Florida Insurance Code and shall remain the property of the |
2339 | corporation, subject to the prior security interest of the |
2340 | insurer under the escrow agreement until it is released from |
2341 | escrow;, and after it is released from escrow it is shall be |
2342 | considered an asset of the insurer and credited to the insurer's |
2343 | capital and surplus. |
2344 | Section 15. Paragraph (b) of subsection (2) of section |
2345 | 627.4133, Florida Statutes, is amended to read: |
2346 | 627.4133 Notice of cancellation, nonrenewal, or renewal |
2347 | premium.- |
2348 | (2) With respect to any personal lines or commercial |
2349 | residential property insurance policy, including, but not |
2350 | limited to, any homeowner's, mobile home owner's, farmowner's, |
2351 | condominium association, condominium unit owner's, apartment |
2352 | building, or other policy covering a residential structure or |
2353 | its contents: |
2354 | (b) The insurer shall give the named insured written |
2355 | notice of nonrenewal, cancellation, or termination at least 90 |
2356 | 100 days before prior to the effective date of the nonrenewal, |
2357 | cancellation, or termination. However, the insurer shall give at |
2358 | least 100 days' written notice, or written notice by June 1, |
2359 | whichever is earlier, for any nonrenewal, cancellation, or |
2360 | termination that would be effective between June 1 and November |
2361 | 30. The notice must include the reason or reasons for the |
2362 | nonrenewal, cancellation, or termination, except that: |
2363 | 1. The insurer shall give the named insured written notice |
2364 | of nonrenewal, cancellation, or termination at least 180 days |
2365 | prior to the effective date of the nonrenewal, cancellation, or |
2366 | termination for a named insured whose residential structure has |
2367 | been insured by that insurer or an affiliated insurer for at |
2368 | least a 5-year period immediately prior to the date of the |
2369 | written notice. |
2370 | 1.2. If When cancellation is for nonpayment of premium, at |
2371 | least 10 days' written notice of cancellation accompanied by the |
2372 | reason therefor must shall be given. As used in this |
2373 | subparagraph, the term "nonpayment of premium" means failure of |
2374 | the named insured to discharge when due any of her or his |
2375 | obligations in connection with the payment of premiums on a |
2376 | policy or any installment of such premium, whether the premium |
2377 | is payable directly to the insurer or its agent or indirectly |
2378 | under any premium finance plan or extension of credit, or |
2379 | failure to maintain membership in an organization if such |
2380 | membership is a condition precedent to insurance coverage. The |
2381 | term "Nonpayment of premium" also means the failure of a |
2382 | financial institution to honor an insurance applicant's check |
2383 | after delivery to a licensed agent for payment of a premium, |
2384 | even if the agent has previously delivered or transferred the |
2385 | premium to the insurer. If a dishonored check represents the |
2386 | initial premium payment, the contract and all contractual |
2387 | obligations are shall be void ab initio unless the nonpayment is |
2388 | cured within the earlier of 5 days after actual notice by |
2389 | certified mail is received by the applicant or 15 days after |
2390 | notice is sent to the applicant by certified mail or registered |
2391 | mail, and if the contract is void, any premium received by the |
2392 | insurer from a third party must shall be refunded to that party |
2393 | in full. |
2394 | 2.3. If When such cancellation or termination occurs |
2395 | during the first 90 days during which the insurance is in force |
2396 | and the insurance is canceled or terminated for reasons other |
2397 | than nonpayment of premium, at least 20 days' written notice of |
2398 | cancellation or termination accompanied by the reason therefor |
2399 | must shall be given unless except where there has been a |
2400 | material misstatement or misrepresentation or failure to comply |
2401 | with the underwriting requirements established by the insurer. |
2402 | 3.4. The requirement for providing written notice of |
2403 | nonrenewal by June 1 of any nonrenewal that would be effective |
2404 | between June 1 and November 30 does not apply to the following |
2405 | situations, but the insurer remains subject to the requirement |
2406 | to provide such notice at least 100 days before prior to the |
2407 | effective date of nonrenewal: |
2408 | a. A policy that is nonrenewed due to a revision in the |
2409 | coverage for sinkhole losses and catastrophic ground cover |
2410 | collapse pursuant to s. 627.706, as amended by s. 30, chapter |
2411 | 2007-1, Laws of Florida. |
2412 | b. A policy that is nonrenewed by Citizens Property |
2413 | Insurance Corporation, pursuant to s. 627.351(6), for a policy |
2414 | that has been assumed by an authorized insurer offering |
2415 | replacement or renewal coverage to the policyholder is exempt |
2416 | from the notice requirements of paragraph (a) and this |
2417 | paragraph. In such cases, the corporation must give the named |
2418 | insured written notice of nonrenewal at least 45 days before the |
2419 | effective date of the nonrenewal. |
2420 |
|
2421 | After the policy has been in effect for 90 days, the policy may |
2422 | shall not be canceled by the insurer unless except when there |
2423 | has been a material misstatement, a nonpayment of premium, a |
2424 | failure to comply with underwriting requirements established by |
2425 | the insurer within 90 days after of the date of effectuation of |
2426 | coverage, or a substantial change in the risk covered by the |
2427 | policy or if when the cancellation is for all insureds under |
2428 | such policies for a given class of insureds. This paragraph does |
2429 | not apply to individually rated risks having a policy term of |
2430 | less than 90 days. |
2431 | 4. Notwithstanding any other provision of law, an insurer |
2432 | may cancel or nonrenew a property insurance policy after at |
2433 | least 45 days' notice if the office finds that the early |
2434 | cancellation of some or all of the insurer's policies is |
2435 | necessary to protect the best interests of the public or |
2436 | policyholders and the office approves the insurer's plan for |
2437 | early cancellation or nonrenewal of some or all of its policies. |
2438 | The office may base such finding upon the financial condition of |
2439 | the insurer, lack of adequate reinsurance coverage for hurricane |
2440 | risk, or other relevant factors. The office may condition its |
2441 | finding on the consent of the insurer to be placed under |
2442 | administrative supervision pursuant to s. 624.81 or to the |
2443 | appointment of a receiver under chapter 631. |
2444 | Section 16. Section 627.43141, Florida Statutes, is |
2445 | created to read: |
2446 | 627.43141 Notice of change in policy terms.- |
2447 | (1) As used in this section, the term: |
2448 | (a) "Change in policy terms" means the modification, |
2449 | addition, or deletion of any term, coverage, duty, or condition |
2450 | from the previous policy. The correction of typographical or |
2451 | scrivener's errors or the application of mandated legislative |
2452 | changes is not a change in policy terms. |
2453 | (b) "Policy" means a written contract of personal lines |
2454 | property and casualty insurance or a written agreement for |
2455 | insurance, or the certificate of such insurance, by whatever |
2456 | name called, and includes all clauses, riders, endorsements, and |
2457 | papers that are a part of such policy. The term does not include |
2458 | a binder as defined in s. 627.420 unless the duration of the |
2459 | binder period exceeds 60 days. |
2460 | (c) "Renewal" means the issuance and delivery by an |
2461 | insurer of a policy superseding at the end of the policy period |
2462 | a policy previously issued and delivered by the same insurer or |
2463 | the issuance and delivery of a certificate or notice extending |
2464 | the term of a policy beyond its policy period or term. Any |
2465 | policy that has a policy period or term of less than 6 months or |
2466 | that does not have a fixed expiration date shall, for purposes |
2467 | of this section, be considered as written for successive policy |
2468 | periods or terms of 6 months. |
2469 | (2) A renewal policy may contain a change in policy terms. |
2470 | If a renewal policy does contains such change, the insurer must |
2471 | give the named insured written notice of the change, which must |
2472 | be enclosed along with the written notice of renewal premium |
2473 | required by ss. 627.4133 and 627.728. Such notice shall be |
2474 | entitled "Notice of Change in Policy Terms." |
2475 | (3) Although not required, proof of mailing or registered |
2476 | mailing through the United States Postal Service of the Notice |
2477 | of Change in Policy Terms to the named insured at the address |
2478 | shown in the policy is sufficient proof of notice. |
2479 | (4) Receipt of the premium payment for the renewal policy |
2480 | by the insurer is deemed to be acceptance of the new policy |
2481 | terms by the named insured. |
2482 | (5) If an insurer fails to provide the notice required in |
2483 | subsection (2), the original policy terms remain in effect until |
2484 | the next renewal and the proper service of the notice, or until |
2485 | the effective date of replacement coverage obtained by the named |
2486 | insured, whichever occurs first. |
2487 | (6) The intent of this section is to: |
2488 | (a) Allow an insurer to make a change in policy terms |
2489 | without nonrenewing those policyholders that the insurer wishes |
2490 | to continue insuring. |
2491 | (b) Alleviate concern and confusion to the policyholder |
2492 | caused by the required policy nonrenewal for the limited issue |
2493 | if an insurer intends to renew the insurance policy, but the new |
2494 | policy contains a change in policy terms. |
2495 | (c) Encourage policyholders to discuss their coverages |
2496 | with their insurance agents. |
2497 | Section 17. Section 627.7011, Florida Statutes, is amended |
2498 | to read: |
2499 | 627.7011 Homeowners' policies; offer of replacement cost |
2500 | coverage and law and ordinance coverage.- |
2501 | (1) Before Prior to issuing or renewing a homeowner's |
2502 | insurance policy on or after October 1, 2005, or prior to the |
2503 | first renewal of a homeowner's insurance policy on or after |
2504 | October 1, 2005, the insurer must offer each of the following: |
2505 | (a) A policy or endorsement providing that any loss that |
2506 | which is repaired or replaced will be adjusted on the basis of |
2507 | replacement costs to the dwelling not exceeding policy limits as |
2508 | to the dwelling, rather than actual cash value, but not |
2509 | including costs necessary to meet applicable laws and ordinances |
2510 | regulating the construction, use, or repair of any property or |
2511 | requiring the tearing down of any property, including the costs |
2512 | of removing debris. |
2513 | (b) A policy or endorsement providing that, subject to |
2514 | other policy provisions, any loss that which is repaired or |
2515 | replaced at any location will be adjusted on the basis of |
2516 | replacement costs to the dwelling not exceeding policy limits as |
2517 | to the dwelling, rather than actual cash value, and also |
2518 | including costs necessary to meet applicable laws and ordinances |
2519 | regulating the construction, use, or repair of any property or |
2520 | requiring the tearing down of any property, including the costs |
2521 | of removing debris.; However, such additional costs necessary to |
2522 | meet applicable laws and ordinances may be limited to either 25 |
2523 | percent or 50 percent of the dwelling limit, as selected by the |
2524 | policyholder, and such coverage applies shall apply only to |
2525 | repairs of the damaged portion of the structure unless the total |
2526 | damage to the structure exceeds 50 percent of the replacement |
2527 | cost of the structure. |
2528 |
|
2529 | An insurer is not required to make the offers required by this |
2530 | subsection with respect to the issuance or renewal of a |
2531 | homeowner's policy that contains the provisions specified in |
2532 | paragraph (b) for law and ordinance coverage limited to 25 |
2533 | percent of the dwelling limit, except that the insurer must |
2534 | offer the law and ordinance coverage limited to 50 percent of |
2535 | the dwelling limit. This subsection does not prohibit the offer |
2536 | of a guaranteed replacement cost policy. |
2537 | (2) Unless the insurer obtains the policyholder's written |
2538 | refusal of the policies or endorsements specified in subsection |
2539 | (1), any policy covering the dwelling is deemed to include the |
2540 | law and ordinance coverage limited to 25 percent of the dwelling |
2541 | limit. The rejection or selection of alternative coverage shall |
2542 | be made on a form approved by the office. The form must shall |
2543 | fully advise the applicant of the nature of the coverage being |
2544 | rejected. If this form is signed by a named insured, it is will |
2545 | be conclusively presumed that there was an informed, knowing |
2546 | rejection of the coverage or election of the alternative |
2547 | coverage on behalf of all insureds. Unless the policyholder |
2548 | requests in writing the coverage specified in this section, it |
2549 | need not be provided in or supplemental to any other policy that |
2550 | renews, insures, extends, changes, supersedes, or replaces an |
2551 | existing policy if when the policyholder has rejected the |
2552 | coverage specified in this section or has selected alternative |
2553 | coverage. The insurer must provide the such policyholder with |
2554 | notice of the availability of such coverage in a form approved |
2555 | by the office at least once every 3 years. The failure to |
2556 | provide such notice constitutes a violation of this code, but |
2557 | does not affect the coverage provided under the policy. |
2558 | (3)(a) If In the event of a loss occurs for which a |
2559 | dwelling or personal property is insured on the basis of |
2560 | replacement costs, the insurer shall initially pay at least the |
2561 | actual cash value of the insured loss, less any applicable |
2562 | deductible. In order to receive payment from an insurer under |
2563 | this paragraph, a policyholder must enter into a contract for |
2564 | the performance of building and structural repairs. The insurer |
2565 | shall pay any remaining amounts necessary to perform such |
2566 | repairs as work is performed and expenses are incurred. Other |
2567 | than incidental expenses to mitigate further damage, the insurer |
2568 | or any contractor or subcontractor may not require the |
2569 | policyholder to advance payment for such repairs or expenses. |
2570 | The insurer may waive the requirement for a contract under this |
2571 | paragraph. If a total loss for a dwelling occurs, the insurer |
2572 | shall pay the replacement cost coverage without reservation or |
2573 | holdback of any depreciation in value, whether or not the |
2574 | insured replaces or repairs the dwelling or property. |
2575 | (b) If a loss occurs for which personal property is |
2576 | insured on the basis of replacement costs, the insurer may limit |
2577 | an initial payment to the actual cash value of the personal |
2578 | property to be replaced. An insurer may require that an insured |
2579 | provide the receipts from the purchase of property financed by |
2580 | the initial actual cash value payment mandated under this |
2581 | paragraph, and the insurer shall use such receipts to make the |
2582 | next payment requested by the insured for the replacement of |
2583 | insured personal property. The insurer shall continue this |
2584 | process until the insured remits all receipts up to the policy |
2585 | limits for replacement costs. The insurer must provide clear |
2586 | notice of this process in the insurance contract. The insurer |
2587 | may not require the policyholder to advance payment for the |
2588 | replaced property. |
2589 | (4) A Any homeowner's insurance policy issued or renewed |
2590 | on or after October 1, 2005, must include in bold type no |
2591 | smaller than 18 points the following statement: |
2592 |
|
2593 | "LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE |
2594 | THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO |
2595 | CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE |
2596 | NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS |
2597 | COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE |
2598 | DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT." |
2599 |
|
2600 | The intent of this subsection is to encourage policyholders to |
2601 | purchase sufficient coverage to protect them in case events |
2602 | excluded from the standard homeowners policy, such as law and |
2603 | ordinance enforcement and flood, combine with covered events to |
2604 | produce damage or loss to the insured property. The intent is |
2605 | also to encourage policyholders to discuss these issues with |
2606 | their insurance agent. |
2607 | (5) Nothing in This section does not: shall be construed |
2608 | to |
2609 | (a) Apply to policies not considered to be "homeowners' |
2610 | policies," as that term is commonly understood in the insurance |
2611 | industry. This section specifically does not |
2612 | (b) Apply to mobile home policies. Nothing in this section |
2613 | (c) Limit shall be construed as limiting the ability of an |
2614 | any insurer to reject or nonrenew any insured or applicant on |
2615 | the grounds that the structure does not meet underwriting |
2616 | criteria applicable to replacement cost or law and ordinance |
2617 | policies or for other lawful reasons. |
2618 | (d)(6) This section does not Prohibit an insurer from |
2619 | limiting its liability under a policy or endorsement providing |
2620 | that loss will be adjusted on the basis of replacement costs to |
2621 | the lesser of: |
2622 | 1.(a) The limit of liability shown on the policy |
2623 | declarations page; |
2624 | 2.(b) The reasonable and necessary cost to repair the |
2625 | damaged, destroyed, or stolen covered property; or |
2626 | 3.(c) The reasonable and necessary cost to replace the |
2627 | damaged, destroyed, or stolen covered property. |
2628 | (e)(7) This section does not Prohibit an insurer from |
2629 | exercising its right to repair damaged property in compliance |
2630 | with its policy and s. 627.702(7). |
2631 | Section 18. Paragraph (a) of subsection (5) of section |
2632 | 627.70131, Florida Statutes, is amended to read: |
2633 | 627.70131 Insurer's duty to acknowledge communications |
2634 | regarding claims; investigation.- |
2635 | (5)(a) Within 90 days after an insurer receives notice of |
2636 | an initial, reopened, or supplemental a property insurance claim |
2637 | from a policyholder, the insurer shall pay or deny such claim or |
2638 | a portion of the claim unless the failure to pay such claim or a |
2639 | portion of the claim is caused by factors beyond the control of |
2640 | the insurer which reasonably prevent such payment. Any payment |
2641 | of an initial or supplemental a claim or portion of such a claim |
2642 | made paid 90 days after the insurer receives notice of the |
2643 | claim, or made paid more than 15 days after there are no longer |
2644 | factors beyond the control of the insurer which reasonably |
2645 | prevented such payment, whichever is later, bears shall bear |
2646 | interest at the rate set forth in s. 55.03. Interest begins to |
2647 | accrue from the date the insurer receives notice of the claim. |
2648 | The provisions of this subsection may not be waived, voided, or |
2649 | nullified by the terms of the insurance policy. If there is a |
2650 | right to prejudgment interest, the insured shall select whether |
2651 | to receive prejudgment interest or interest under this |
2652 | subsection. Interest is payable when the claim or portion of the |
2653 | claim is paid. Failure to comply with this subsection |
2654 | constitutes a violation of this code. However, failure to comply |
2655 | with this subsection does shall not form the sole basis for a |
2656 | private cause of action. |
2657 | Section 19. The Legislature finds and declares: |
2658 | (1) There is a compelling state interest in maintaining a |
2659 | viable and orderly private-sector market for property insurance |
2660 | in this state. The lack of a viable and orderly property market |
2661 | reduces the availability of property insurance coverage to state |
2662 | residents, increases the cost of property insurance, and |
2663 | increases the state's reliance on a residual property insurance |
2664 | market and its potential for imposing assessments on |
2665 | policyholders throughout the state. |
2666 | (2) In 2005, the Legislature revised ss. 627.706-627.7074, |
2667 | Florida Statutes, to adopt certain geological or technical |
2668 | terms; to increase reliance on objective, scientific testing |
2669 | requirements; and generally to reduce the number of sinkhole |
2670 | claims and related disputes arising under prior law. The |
2671 | Legislature determined that since the enactment of these |
2672 | statutory revisions, both private-sector insurers and Citizens |
2673 | Property Insurance Corporation have, nevertheless, continued to |
2674 | experience high claims frequency and severity for sinkhole |
2675 | insurance claims. In addition, many properties remain unrepaired |
2676 | even after loss payments, which reduces the local property tax |
2677 | base and adversely affects the real estate market. Therefore, |
2678 | the Legislature finds that losses associated with sinkhole |
2679 | claims adversely affect the public health, safety, and welfare |
2680 | of this state and its citizens. |
2681 | (3) Pursuant to sections 19 through 24 of this act, |
2682 | technical or scientific definitions adopted in the 2005 |
2683 | legislation are clarified to implement and advance the |
2684 | Legislature's intended reduction of sinkhole claims and |
2685 | disputes. The legal presumption intended by the Legislature is |
2686 | clarified to reduce disputes and litigation associated with the |
2687 | technical reviews associated with sinkhole claims. Certain other |
2688 | revisions to ss. 627.706-627.7074, Florida Statutes, are enacted |
2689 | to advance legislative intent to rely on scientific or technical |
2690 | determinations relating to sinkholes and sinkhole claims, reduce |
2691 | the number and cost of disputes relating to sinkhole claims, and |
2692 | ensure that repairs are made commensurate with the scientific |
2693 | and technical determinations and insurance claims payments. |
2694 | Section 20. Section 627.706, Florida Statutes, is |
2695 | reordered and amended to read: |
2696 | 627.706 Sinkhole insurance; catastrophic ground cover |
2697 | collapse; definitions.- |
2698 | (1) Every insurer authorized to transact residential |
2699 | property insurance, as described in s. 627.4025, in this state |
2700 | must shall provide coverage for a catastrophic ground cover |
2701 | collapse. However, the insurer may restrict such coverage to the |
2702 | principal building, as defined in the applicable policy. The |
2703 | insurer may and shall make available, for an appropriate |
2704 | additional premium, coverage for sinkhole losses on any |
2705 | structure, including the contents of personal property contained |
2706 | therein, to the extent provided in the form to which the |
2707 | coverage attaches. A policy for residential property insurance |
2708 | may include a deductible amount applicable to sinkhole losses, |
2709 | including any expenses incurred by an insurer investigating |
2710 | whether sinkhole activity is present. The deductible may be |
2711 | equal to 1 percent, 2 percent, 5 percent, or 10 percent of the |
2712 | policy dwelling limits, with appropriate premium discounts |
2713 | offered with each deductible amount. |
2714 | (2) As used in ss. 627.706-627.7074, and as used in |
2715 | connection with any policy providing coverage for a catastrophic |
2716 | ground cover collapse or for sinkhole losses, the term: |
2717 | (a) "Catastrophic ground cover collapse" means geological |
2718 | activity that results in all the following: |
2719 | 1. The abrupt collapse of the ground cover; |
2720 | 2. A depression in the ground cover clearly visible to the |
2721 | naked eye; |
2722 | 3. Structural damage to the covered building, including |
2723 | the foundation; and |
2724 | 4. The insured structure being condemned and ordered to be |
2725 | vacated by the governmental agency authorized by law to issue |
2726 | such an order for that structure. |
2727 |
|
2728 | Contents coverage applies if there is a loss resulting from a |
2729 | catastrophic ground cover collapse. Structural Damage consisting |
2730 | merely of the settling or cracking of a foundation, structure, |
2731 | or building does not constitute a loss resulting from a |
2732 | catastrophic ground cover collapse. |
2733 | (b) "Neutral evaluation" means the alternative dispute |
2734 | resolution provided in s. 627.7074. |
2735 | (c) "Neutral evaluator" means a professional engineer or a |
2736 | professional geologist who has completed a course of study in |
2737 | alternative dispute resolution designed or approved by the |
2738 | department for use in the neutral evaluation process and who is |
2739 | determined to be fair and impartial. |
2740 | (f)(b) "Sinkhole" means a landform created by subsidence |
2741 | of soil, sediment, or rock as underlying strata are dissolved by |
2742 | groundwater. A sinkhole forms may form by collapse into |
2743 | subterranean voids created by dissolution of limestone or |
2744 | dolostone or by subsidence as these strata are dissolved. |
2745 | (h)(c) "Sinkhole loss" means structural damage to the |
2746 | covered building, including the foundation, caused by sinkhole |
2747 | activity. Contents coverage and additional living expenses shall |
2748 | apply only if there is structural damage to the covered building |
2749 | caused by sinkhole activity. |
2750 | (g)(d) "Sinkhole activity" means settlement or systematic |
2751 | weakening of the earth supporting such property only if the when |
2752 | such settlement or systematic weakening results from |
2753 | contemporary movement or raveling of soils, sediments, or rock |
2754 | materials into subterranean voids created by the effect of water |
2755 | on a limestone or similar rock formation. |
2756 | (d)(e) "Professional engineer" means a person, as defined |
2757 | in s. 471.005, who has a bachelor's degree or higher in |
2758 | engineering and has successfully completed at least five courses |
2759 | in any combination of the following: geotechnical engineering, |
2760 | structural engineering, soil mechanics, foundations, or geology |
2761 | with a specialty in the geotechnical engineering field. A |
2762 | professional engineer must also have geotechnical experience and |
2763 | expertise in the identification of sinkhole activity as well as |
2764 | other potential causes of structural damage to the structure. |
2765 | (e)(f) "Professional geologist" means a person, as defined |
2766 | in by s. 492.102, who has a bachelor's degree or higher in |
2767 | geology or related earth science and with expertise in the |
2768 | geology of Florida. A professional geologist must have |
2769 | geological experience and expertise in the identification of |
2770 | sinkhole activity as well as other potential geologic causes of |
2771 | structural damage to the structure. |
2772 | (i) "Structural damage" means: |
2773 | 1. A covered building that suffers foundation movement |
2774 | outside an acceptable variance under the applicable building |
2775 | code; |
2776 | 2. Damage to a covered building, including the foundation, |
2777 | which prevents the primary structural members or primary |
2778 | structural systems from supporting the loads and forces they |
2779 | were designed to support; and |
2780 | 3. As may be further defined by the applicable policy. |
2781 | (3) On or before June 1, 2007, Every insurer authorized to |
2782 | transact property insurance in this state shall make a proper |
2783 | filing with the office for the purpose of extending the |
2784 | appropriate forms of property insurance to include coverage for |
2785 | catastrophic ground cover collapse or for sinkhole losses. |
2786 | coverage for catastrophic ground cover collapse may not go into |
2787 | effect until the effective date provided for in the filing |
2788 | approved by the office. |
2789 | (3)(4) Insurers offering policies that exclude coverage |
2790 | for sinkhole losses must shall inform policyholders in bold type |
2791 | of not less than 14 points as follows: "YOUR POLICY PROVIDES |
2792 | COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS |
2793 | IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, |
2794 | YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU |
2795 | MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN |
2796 | ADDITIONAL PREMIUM." |
2797 | (4)(5) An insurer offering sinkhole coverage to |
2798 | policyholders before or after the adoption of s. 30, chapter |
2799 | 2007-1, Laws of Florida, may nonrenew the policies of |
2800 | policyholders maintaining sinkhole coverage in Pasco County or |
2801 | Hernando County, at the option of the insurer, and provide an |
2802 | offer of coverage that to such policyholders which includes |
2803 | catastrophic ground cover collapse and excludes sinkhole |
2804 | coverage. Insurers acting in accordance with this subsection are |
2805 | subject to the following requirements: |
2806 | (a) Policyholders must be notified that a nonrenewal is |
2807 | for purposes of removing sinkhole coverage, and that the |
2808 | policyholder is still being offered a policy that provides |
2809 | coverage for catastrophic ground cover collapse. |
2810 | (b) Policyholders must be provided an actuarially |
2811 | reasonable premium credit or discount for the removal of |
2812 | sinkhole coverage and provision of only catastrophic ground |
2813 | cover collapse. |
2814 | (c) Subject to the provisions of this subsection and the |
2815 | insurer's approved underwriting or insurability guidelines, the |
2816 | insurer may shall provide each policyholder with the opportunity |
2817 | to purchase an endorsement to his or her policy providing |
2818 | sinkhole coverage and may require an inspection of the property |
2819 | before issuance of a sinkhole coverage endorsement. |
2820 | (d) Section 624.4305 does not apply to nonrenewal notices |
2821 | issued pursuant to this subsection. |
2822 | (5) Any claim, including, but not limited to, initial, |
2823 | supplemental, and reopened claims under an insurance policy that |
2824 | provides sinkhole coverage is barred unless notice of the claim |
2825 | was given to the insurer in accordance with the terms of the |
2826 | policy within 2 years after the policyholder knew or reasonably |
2827 | should have known about the sinkhole loss. |
2828 | Section 21. Section 627.7061, Florida Statutes, is amended |
2829 | to read: |
2830 | 627.7061 Coverage inquiries.-Inquiries about coverage on a |
2831 | property insurance contract are not claim activity, unless an |
2832 | actual claim is filed by the policyholder which insured that |
2833 | results in a company investigation of the claim. |
2834 | Section 22. Section 627.7065, Florida Statutes, is |
2835 | repealed. |
2836 | Section 23. Section 627.707, Florida Statutes, is amended |
2837 | to read: |
2838 | 627.707 Standards for Investigation of sinkhole claims by |
2839 | policyholders insurers; insurer payment; nonrenewals.-Upon |
2840 | receipt of a claim for a sinkhole loss to a covered building, an |
2841 | insurer must meet the following standards in investigating a |
2842 | claim: |
2843 | (1) The insurer must inspect make an inspection of the |
2844 | policyholder's insured's premises to determine if there is |
2845 | structural has been physical damage that to the structure which |
2846 | may be the result of sinkhole activity. |
2847 | (2) If the insurer confirms that structural damage exists |
2848 | but is unable to identify a valid cause of such damage or |
2849 | discovers that such damage is consistent with sinkhole loss |
2850 | Following the insurer's initial inspection, the insurer shall |
2851 | engage a professional engineer or a professional geologist to |
2852 | conduct testing as provided in s. 627.7072 to determine the |
2853 | cause of the loss within a reasonable professional probability |
2854 | and issue a report as provided in s. 627.7073, only if sinkhole |
2855 | loss is covered under the policy. Except as provided in |
2856 | subsection (6), the fees and costs of the professional engineer |
2857 | or professional geologist shall be paid by the insurer.: |
2858 | (a) The insurer is unable to identify a valid cause of the |
2859 | damage or discovers damage to the structure which is consistent |
2860 | with sinkhole loss; or |
2861 | (b) The policyholder demands testing in accordance with |
2862 | this section or s. 627.7072. |
2863 | (3) Following the initial inspection of the policyholder's |
2864 | insured premises, the insurer shall provide written notice to |
2865 | the policyholder disclosing the following information: |
2866 | (a) What the insurer has determined to be the cause of |
2867 | damage, if the insurer has made such a determination. |
2868 | (b) A statement of the circumstances under which the |
2869 | insurer is required to engage a professional engineer or a |
2870 | professional geologist to verify or eliminate sinkhole loss and |
2871 | to engage a professional engineer to make recommendations |
2872 | regarding land and building stabilization and foundation repair. |
2873 | (c) A statement regarding the right of the policyholder to |
2874 | request testing by a professional engineer or a professional |
2875 | geologist and the circumstances under which the policyholder may |
2876 | demand certain testing. |
2877 | (4) If the insurer determines that there is no sinkhole |
2878 | loss, the insurer may deny the claim. If coverage for sinkhole |
2879 | loss is available and If the insurer denies the claim on such |
2880 | basis, without performing testing under s. 627.7072, the |
2881 | policyholder may demand testing by the insurer under s. |
2882 | 627.7072. The policyholder's demand for testing must be |
2883 | communicated to the insurer in writing within 60 days after the |
2884 | policyholder's receipt of the insurer's denial of the claim. |
2885 | (5)(a) Subject to paragraph (b), If a sinkhole loss is |
2886 | verified, the insurer shall pay to stabilize the land and |
2887 | building and repair the foundation in accordance with the |
2888 | recommendations of the professional engineer retained pursuant |
2889 | to subsection (2), as provided under s. 627.7073, and in |
2890 | consultation with notice to the policyholder, subject to the |
2891 | coverage and terms of the policy. The insurer shall pay for |
2892 | other repairs to the structure and contents in accordance with |
2893 | the terms of the policy. |
2894 | (a)(b) The insurer may limit its total claims payment to |
2895 | the actual cash value of the sinkhole loss, which does not |
2896 | include including underpinning or grouting or any other repair |
2897 | technique performed below the existing foundation of the |
2898 | building, until the policyholder enters into a contract for the |
2899 | performance of building stabilization or foundation repairs in |
2900 | the insurer's report issued pursuant to s. 627.7073. |
2901 | (b) In order to prevent additional damage to the building |
2902 | or structure, the policyholder must enter into a contract for |
2903 | the performance of building stabilization or foundation repairs |
2904 | within 90 days after the insurance company confirms coverage for |
2905 | the sinkhole loss and notifies the policyholder of such |
2906 | confirmation. This time period is tolled if either party invokes |
2907 | the neutral evaluation process. |
2908 | (c) After the policyholder enters into the contract for |
2909 | the performance of building stabilization or foundation repairs, |
2910 | the insurer shall pay the amounts necessary to begin and perform |
2911 | such repairs as the work is performed and the expenses are |
2912 | incurred. The insurer may not require the policyholder to |
2913 | advance payment for such repairs. If repair covered by a |
2914 | personal lines residential property insurance policy has begun |
2915 | and the professional engineer selected or approved by the |
2916 | insurer determines that the repair cannot be completed within |
2917 | the policy limits, the insurer must either complete the |
2918 | professional engineer's recommended repair or tender the policy |
2919 | limits to the policyholder without a reduction for the repair |
2920 | expenses incurred. |
2921 | (d) The stabilization and all other repairs to the |
2922 | structure and contents must be completed within 12 months after |
2923 | entering into the contract for repairs described in paragraph |
2924 | (b) unless: |
2925 | 1. There is a mutual agreement between the insurer and the |
2926 | policyholder; |
2927 | 2. The claim is involved with the neutral evaluation |
2928 | process; |
2929 | 3. The claim is in litigation; or |
2930 | 4. The claim is under appraisal. |
2931 | (e)(c) Upon the insurer's obtaining the written approval |
2932 | of the policyholder and any lienholder, the insurer may make |
2933 | payment directly to the persons selected by the policyholder to |
2934 | perform the land and building stabilization and foundation |
2935 | repairs. The decision by the insurer to make payment to such |
2936 | persons does not hold the insurer liable for the work performed. |
2937 | The policyholder may not accept a rebate from any person |
2938 | performing the repairs specified in this section. If a |
2939 | policyholder does receive a rebate, coverage is void and the |
2940 | policyholder must refund the amount of the rebate to the |
2941 | insurer. Any person making the repairs specified in this section |
2942 | who offers a rebate, or any policyholder who accepts a rebate |
2943 | for such repairs, commits insurance fraud, a felony of the third |
2944 | degree punishable as provided in s. 775.082, s. 775.083, or s. |
2945 | 775.084. |
2946 | (6) Except as provided in subsection (7), the fees and |
2947 | costs of the professional engineer or the professional geologist |
2948 | shall be paid by the insurer. |
2949 | (6)(7) If the insurer obtains, pursuant to s. 627.7073, |
2950 | written certification that there is no sinkhole loss or that the |
2951 | cause of the damage was not sinkhole activity, and if the |
2952 | policyholder has submitted the sinkhole claim without good faith |
2953 | grounds for submitting such claim, the policyholder shall |
2954 | reimburse the insurer for 50 percent of the actual costs of the |
2955 | analyses and services provided under ss. 627.7072 and 627.7073; |
2956 | however, a policyholder is not required to reimburse an insurer |
2957 | more than the deductible or $2,500, whichever is greater, with |
2958 | respect to any claim. A policyholder is required to pay |
2959 | reimbursement under this subsection only if the policyholder |
2960 | requested the analysis and services provided under ss. 627.7072 |
2961 | and 627.7073 and the insurer, before prior to ordering the |
2962 | analysis under s. 627.7072, informs the policyholder in writing |
2963 | of the policyholder's potential liability for reimbursement and |
2964 | gives the policyholder the opportunity to withdraw the claim. |
2965 | (7)(8) An No insurer may not shall nonrenew any policy of |
2966 | property insurance on the basis of filing of claims for partial |
2967 | loss caused by sinkhole damage or clay shrinkage if as long as |
2968 | the total of such payments does not equal or exceed the current |
2969 | policy limits of coverage for the policy in effect on the date |
2970 | of loss, for property damage to the covered building, as set |
2971 | forth on the declarations page, or if and provided the |
2972 | policyholder insured has repaired the structure in accordance |
2973 | with the engineering recommendations made pursuant to subsection |
2974 | (2) upon which any payment or policy proceeds were based. If the |
2975 | insurer pays such limits, it may nonrenew the policy. |
2976 | (8)(9) The insurer may engage a professional structural |
2977 | engineer to make recommendations as to the repair of the |
2978 | structure. |
2979 | Section 24. Section 627.7073, Florida Statutes, is amended |
2980 | to read: |
2981 | 627.7073 Sinkhole reports.- |
2982 | (1) Upon completion of testing as provided in s. 627.7072, |
2983 | the professional engineer or professional geologist shall issue |
2984 | a report and certification to the insurer and the policyholder |
2985 | as provided in this section. |
2986 | (a) Sinkhole loss is verified if, based upon tests |
2987 | performed in accordance with s. 627.7072, a professional |
2988 | engineer or a professional geologist issues a written report and |
2989 | certification stating: |
2990 | 1. That structural damage to the covered building has been |
2991 | identified within a reasonable professional probability. |
2992 | 2.1. That the cause of the actual physical and structural |
2993 | damage is sinkhole activity within a reasonable professional |
2994 | probability. |
2995 | 3.2. That the analyses conducted were of sufficient scope |
2996 | to identify sinkhole activity as the cause of damage within a |
2997 | reasonable professional probability. |
2998 | 4.3. A description of the tests performed. |
2999 | 5.4. A recommendation by the professional engineer of |
3000 | methods for stabilizing the land and building and for making |
3001 | repairs to the foundation. |
3002 | (b) If there is no structural damage or if sinkhole |
3003 | activity is eliminated as the cause of such damage to the |
3004 | covered building structure, the professional engineer or |
3005 | professional geologist shall issue a written report and |
3006 | certification to the policyholder and the insurer stating: |
3007 | 1. That there is no structural damage or the cause of such |
3008 | the damage is not sinkhole activity within a reasonable |
3009 | professional probability. |
3010 | 2. That the analyses and tests conducted were of |
3011 | sufficient scope to eliminate sinkhole activity as the cause of |
3012 | the structural damage within a reasonable professional |
3013 | probability. |
3014 | 3. A statement of the cause of the structural damage |
3015 | within a reasonable professional probability. |
3016 | 4. A description of the tests performed. |
3017 | (c) The respective findings, opinions, and recommendations |
3018 | of the professional engineer or professional geologist as to the |
3019 | cause of distress to the property and the findings, opinions, |
3020 | and recommendations of the insurer's professional engineer as to |
3021 | land and building stabilization and foundation repair set forth |
3022 | by s. 627.7072 shall be presumed correct, which presumption |
3023 | shifts the burden of proof in accordance with s. 90.302(2). The |
3024 | presumption of correctness is based upon public policy concerns |
3025 | regarding the affordability of sinkhole coverage, consistency in |
3026 | claims handling, and a reduction in the number of disputed |
3027 | sinkhole claims. |
3028 | (2)(a) Any insurer that has paid a claim for a sinkhole |
3029 | loss shall file a copy of the report and certification, prepared |
3030 | pursuant to subsection (1), including the legal description of |
3031 | the real property and the name of the property owner, the |
3032 | neutral evaluator's report, if any, that indicates that sinkhole |
3033 | activity caused the damage claimed, a copy of the certification |
3034 | indicating that stabilization has been completed, if applicable, |
3035 | and the amount of the payment, with the county clerk of court, |
3036 | who shall record the report and certification. The insurer shall |
3037 | bear the cost of filing and recording one or more reports and |
3038 | certifications the report and certification. There shall be no |
3039 | cause of action or liability against an insurer for compliance |
3040 | with this section. |
3041 | (a) The recording of the report and certification does |
3042 | not: |
3043 | 1. Constitute a lien, encumbrance, or restriction on the |
3044 | title to the real property or constitute a defect in the title |
3045 | to the real property; |
3046 | 2. Create any cause of action or liability against any |
3047 | grantor of the real property for breach of any warranty of good |
3048 | title or warranty against encumbrances; or |
3049 | 3. Create any cause of action or liability against any |
3050 | title insurer that insures the title to the real property. |
3051 | (b) As a precondition to accepting payment for a sinkhole |
3052 | loss, the policyholder must file a copy of any report prepared |
3053 | on behalf or at the request of the policyholder regarding the |
3054 | insured property. The policyholder shall bear the cost of filing |
3055 | and recording such sinkhole report. The recording of the report |
3056 | does not: |
3057 | 1. Constitute a lien, encumbrance, or restriction on the |
3058 | title to the real property or constitute a defect in the title |
3059 | to the real property; |
3060 | 2. Create any cause of action or liability against any |
3061 | grantor of the real property for breach of any warranty of good |
3062 | title or warranty against encumbrances; or |
3063 | 3. Create any cause of action or liability against any |
3064 | title insurer that insures the title to the real property. |
3065 | (c)(b) The seller of real property upon which a sinkhole |
3066 | claim has been made by the seller and paid by the insurer must |
3067 | shall disclose to the buyer of such property, before the |
3068 | closing, that a claim has been paid, the amount of the payment, |
3069 | and whether or not the full amount of the proceeds were used to |
3070 | repair the sinkhole damage. |
3071 | Section 25. Section 627.7074, Florida Statutes, is amended |
3072 | to read: |
3073 | 627.7074 Alternative procedure for resolution of disputed |
3074 | sinkhole insurance claims.- |
3075 | (1) As used in this section, the term: |
3076 | (a) "Neutral evaluation" means the alternative dispute |
3077 | resolution provided for in this section. |
3078 | (b) "Neutral evaluator" means a professional engineer or a |
3079 | professional geologist who has completed a course of study in |
3080 | alternative dispute resolution designed or approved by the |
3081 | department for use in the neutral evaluation process, who is |
3082 | determined to be fair and impartial. |
3083 | (1)(2)(a) The department shall: |
3084 | (a) Certify and maintain a list of persons who are neutral |
3085 | evaluators. |
3086 | (b) The department shall Prepare a consumer information |
3087 | pamphlet for distribution by insurers to policyholders which |
3088 | clearly describes the neutral evaluation process and includes |
3089 | information and forms necessary for the policyholder to request |
3090 | a neutral evaluation. |
3091 | (2) Neutral evaluation is available to either party if a |
3092 | sinkhole report has been issued pursuant to s. 627.7073. At a |
3093 | minimum, neutral evaluation must determine: |
3094 | (a) Causation; |
3095 | (b) All methods of stabilization and repair both above and |
3096 | below ground; |
3097 | (c) The costs for stabilization and all repairs; and |
3098 | (d) Information necessary to carry out subsection (12). |
3099 | (3) Following the receipt of the report provided under s. |
3100 | 627.7073 or the denial of a claim for a sinkhole loss, the |
3101 | insurer shall notify the policyholder of his or her right to |
3102 | participate in the neutral evaluation program under this |
3103 | section. Neutral evaluation supersedes the alternative dispute |
3104 | resolution process under s. 627.7015, but does not invalidate |
3105 | the appraisal clause of the insurance policy. The insurer shall |
3106 | provide to the policyholder the consumer information pamphlet |
3107 | prepared by the department pursuant to subsection (1) |
3108 | electronically or by United States mail paragraph (2)(b). |
3109 | (4) Neutral evaluation is nonbinding, but mandatory if |
3110 | requested by either party. A request for neutral evaluation may |
3111 | be filed with the department by the policyholder or the insurer |
3112 | on a form approved by the department. The request for neutral |
3113 | evaluation must state the reason for the request and must |
3114 | include an explanation of all the issues in dispute at the time |
3115 | of the request. Filing a request for neutral evaluation tolls |
3116 | the applicable time requirements for filing suit for a period of |
3117 | 60 days following the conclusion of the neutral evaluation |
3118 | process or the time prescribed in s. 95.11, whichever is later. |
3119 | (5) Neutral evaluation shall be conducted as an informal |
3120 | process in which formal rules of evidence and procedure need not |
3121 | be observed. A party to neutral evaluation is not required to |
3122 | attend neutral evaluation if a representative of the party |
3123 | attends and has the authority to make a binding decision on |
3124 | behalf of the party. All parties shall participate in the |
3125 | evaluation in good faith. The neutral evaluator must be allowed |
3126 | reasonable access to the interior and exterior of insured |
3127 | structures to be evaluated or for which a claim has been made. |
3128 | Any reports initiated by the policyholder, or an agent of the |
3129 | policyholder, confirming a sinkhole loss or disputing another |
3130 | sinkhole report regarding insured structures must be provided to |
3131 | the neutral evaluator before the evaluator's physical inspection |
3132 | of the insured property. |
3133 | (6) The insurer shall pay reasonable the costs associated |
3134 | with the neutral evaluation. However, if a party chooses to hire |
3135 | a court reporter or stenographer to contemporaneously record and |
3136 | document the neutral evaluation, that party must bear such |
3137 | costs. |
3138 | (7) Upon receipt of a request for neutral evaluation, the |
3139 | department shall provide the parties a list of certified neutral |
3140 | evaluators. The parties shall mutually select a neutral |
3141 | evaluator from the list and promptly inform the department. If |
3142 | the parties cannot agree to a neutral evaluator within 10 |
3143 | business days, The department shall allow the parties to submit |
3144 | requests to disqualify evaluators on the list for cause. |
3145 | (a) The department shall disqualify neutral evaluators for |
3146 | cause based only on any of the following grounds: |
3147 | 1. A familial relationship exists between the neutral |
3148 | evaluator and either party or a representative of either party |
3149 | within the third degree. |
3150 | 2. The proposed neutral evaluator has, in a professional |
3151 | capacity, previously represented either party or a |
3152 | representative of either party, in the same or a substantially |
3153 | related matter. |
3154 | 3. The proposed neutral evaluator has, in a professional |
3155 | capacity, represented another person in the same or a |
3156 | substantially related matter and that person's interests are |
3157 | materially adverse to the interests of the parties. The term |
3158 | "substantially related matter" means participation by the |
3159 | neutral evaluator on the same claim, property, or adjacent |
3160 | property. |
3161 | 4. The proposed neutral evaluator has, within the |
3162 | preceding 5 years, worked as an employer or employee of any |
3163 | party to the case. |
3164 | (b) The parties shall appoint a neutral evaluator from the |
3165 | department list and promptly inform the department. If the |
3166 | parties cannot agree to a neutral evaluator within 14 days, the |
3167 | department shall appoint a neutral evaluator from the list of |
3168 | certified neutral evaluators. The department shall allow each |
3169 | party to disqualify two neutral evaluators without cause. Upon |
3170 | selection or appointment, the department shall promptly refer |
3171 | the request to the neutral evaluator. |
3172 | (c) Within 14 5 business days after the referral, the |
3173 | neutral evaluator shall notify the policyholder and the insurer |
3174 | of the date, time, and place of the neutral evaluation |
3175 | conference. The conference may be held by telephone, if feasible |
3176 | and desirable. The neutral evaluator shall make reasonable |
3177 | efforts to hold the neutral evaluation conference shall be held |
3178 | within 90 45 days after the receipt of the request by the |
3179 | department. Failure of the neutral evaluator to hold the |
3180 | conference within 90 days does not invalidate either party's |
3181 | right to neutral evaluation or to a neutral evaluation |
3182 | conference held outside this timeframe. |
3183 | (8) The department shall adopt rules of procedure for the |
3184 | neutral evaluation process. |
3185 | (8)(9) For policyholders not represented by an attorney, a |
3186 | consumer affairs specialist of the department or an employee |
3187 | designated as the primary contact for consumers on issues |
3188 | relating to sinkholes under s. 20.121 shall be available for |
3189 | consultation to the extent that he or she may lawfully do so. |
3190 | (9)(10) Evidence of an offer to settle a claim during the |
3191 | neutral evaluation process, as well as any relevant conduct or |
3192 | statements made in negotiations concerning the offer to settle a |
3193 | claim, is inadmissible to prove liability or absence of |
3194 | liability for the claim or its value, except as provided in |
3195 | subsection (14) (13). |
3196 | (10)(11) Regardless of when noticed, any court proceeding |
3197 | related to the subject matter of the neutral evaluation shall be |
3198 | stayed pending completion of the neutral evaluation and for 5 |
3199 | days after the filing of the neutral evaluator's report with the |
3200 | court. |
3201 | (11) If, based upon his or her professional training and |
3202 | credentials, a neutral evaluator is qualified to determine only |
3203 | disputes relating to causation or method of repair, the |
3204 | department shall allow the neutral evaluator to enlist the |
3205 | assistance of another professional from the neutral evaluators |
3206 | list not previously stricken, who, based upon his or her |
3207 | professional training and credentials, is able to provide an |
3208 | opinion as to other disputed issues. A professional who would be |
3209 | disqualified for any reason listed in subsection (7) must be |
3210 | disqualified. The neutral evaluator may also use the services of |
3211 | professional engineers and professional geologists who are not |
3212 | certified as neutral evaluators, as well as licensed building |
3213 | contractors, in order to ensure that all items in dispute are |
3214 | addressed and the neutral evaluation can be completed. Any |
3215 | professional engineer, professional geologist, or licensed |
3216 | building contractor retained may be disqualified for any of the |
3217 | reasons listed in subsection (7). The neutral evaluator may |
3218 | request the entity that performed the investigation pursuant to |
3219 | s. 627.7072 perform such additional and reasonable testing as |
3220 | deemed necessary in the professional opinion of the neutral |
3221 | evaluator. |
3222 | (12) At For matters that are not resolved by the parties |
3223 | at the conclusion of the neutral evaluation, the neutral |
3224 | evaluator shall prepare a report describing all matters that are |
3225 | the subject of the neutral evaluation, including whether, |
3226 | stating that in his or her opinion, the sinkhole loss has been |
3227 | verified or eliminated within a reasonable degree of |
3228 | professional probability and, if verified, whether the sinkhole |
3229 | activity caused structural damage to the covered building, and |
3230 | if so, the need for and estimated costs of stabilizing the land |
3231 | and any covered structures or buildings and other appropriate |
3232 | remediation or necessary building structural repairs due to the |
3233 | sinkhole loss. The evaluator's report shall be sent to all |
3234 | parties in attendance at the neutral evaluation and to the |
3235 | department, within 14 days after completing the neutral |
3236 | evaluation conference. |
3237 | (13) The recommendation of the neutral evaluator is not |
3238 | binding on any party, and the parties retain access to the |
3239 | court. The neutral evaluator's written recommendation, oral |
3240 | testimony, and full report shall be admitted is admissible in |
3241 | any subsequent action, litigation, or proceeding relating to the |
3242 | claim or to the cause of action giving rise to the claim. |
3243 | However, oral or written statements or nonverbal conduct |
3244 | intended to make an assertion made by a party or neutral |
3245 | evaluator during the course of neutral evaluation, other than |
3246 | those statements or conduct expressly required to be admitted by |
3247 | this subsection, are confidential and may not be disclosed to a |
3248 | person other than a party to neutral evaluation or a party's |
3249 | counsel. |
3250 | (14) If the neutral evaluator first verifies the existence |
3251 | of a sinkhole that caused structural damage and, second, |
3252 | recommends the need for and estimates costs of stabilizing the |
3253 | land and any covered structures or buildings and other |
3254 | appropriate remediation or building structural repairs, which |
3255 | costs exceed the amount that the insurer estimates as necessary |
3256 | to stabilize and repair, and the insurer refuses to comply with |
3257 | the neutral evaluator's findings and recommendations has offered |
3258 | to pay the policyholder, the insurer is liable to the |
3259 | policyholder for up to $2,500 in attorney's fees for the |
3260 | attorney's participation in the neutral evaluation process. For |
3261 | purposes of this subsection, the term "offer to pay" means a |
3262 | written offer signed by the insurer or its legal representative |
3263 | and delivered to the policyholder within 10 days after the |
3264 | insurer receives notice that a request for neutral evaluation |
3265 | has been made under this section. |
3266 | (15) If the insurer timely agrees in writing to comply and |
3267 | timely complies with the recommendation of the neutral |
3268 | evaluator, but the policyholder declines to resolve the matter |
3269 | in accordance with the recommendation of the neutral evaluator |
3270 | pursuant to this section: |
3271 | (a) The insurer is not liable for extracontractual damages |
3272 | related to a claim for a sinkhole loss but only as related to |
3273 | the issues determined by the neutral evaluation process. This |
3274 | section does not affect or impair claims for extracontractual |
3275 | damages unrelated to the issues determined by the neutral |
3276 | evaluation process contained in this section; and |
3277 | (b) The actions of the insurer are not a confession of |
3278 | judgment or admission of liability, and the insurer is not |
3279 | liable for attorney's fees under s. 627.428 or other provisions |
3280 | of the insurance code unless the policyholder obtains a judgment |
3281 | that is more favorable than the recommendation of the neutral |
3282 | evaluator. |
3283 | (16) If the insurer agrees to comply with the neutral |
3284 | evaluator's report, payments shall be made in accordance with |
3285 | the terms and conditions of the applicable insurance policy |
3286 | pursuant to s. 627.707(5). |
3287 | (17) Neutral evaluators are deemed to be agents of the |
3288 | department and have immunity from suit as provided in s. 44.107. |
3289 | (18) The department shall adopt rules of procedure for the |
3290 | neutral evaluation process. |
3291 | Section 26. Subsection (1) of section 627.712, Florida |
3292 | Statutes, is amended to read: |
3293 | 627.712 Residential windstorm coverage required; |
3294 | availability of exclusions for windstorm or contents.- |
3295 | (1) An insurer issuing a residential property insurance |
3296 | policy must provide windstorm coverage. Except as provided in |
3297 | paragraph (2)(c), this section does not apply with respect to |
3298 | risks that are eligible for wind-only coverage from Citizens |
3299 | Property Insurance Corporation under s. 627.351(6), and with |
3300 | respect to risks that are not eligible for coverage from |
3301 | Citizens Property Insurance Corporation under s. 627.351(6)(a)3. |
3302 | or 5. A risk ineligible for Citizens coverage by the corporation |
3303 | under s. 627.351(6)(a)3. or 5. is exempt from the requirements |
3304 | of this section only if the risk is located within the |
3305 | boundaries of the coastal high-risk account of the corporation. |
3306 | Section 27. If any provision of this act, or the |
3307 | application thereof to any person or circumstance is held |
3308 | invalid, such invalidity shall not affect other provisions or |
3309 | applications of this act which can be given effect without the |
3310 | invalid provision or application. It is the express intent of |
3311 | the Legislature to enact multiple important, but independent, |
3312 | reforms to Florida law relating to sinkhole insurance coverage |
3313 | and related claims. The Legislature further intends that the |
3314 | multiple reforms in the act could and should be enforced if one |
3315 | or more provisions are held invalid. To this end, the provisions |
3316 | of this act are declared to be severable. |
3317 | Section 28. Except as otherwise expressly provided in this |
3318 | act and except for this section, which shall take effect June 1, |
3319 | 2011, this act shall take effect July 1, 2011. |