1 | A bill to be entitled |
2 | An act relating to property and casualty insurance; |
3 | amending s. 95.11, F.S.; providing a statute of |
4 | limitations for breach of a property insurance contract; |
5 | specifying the time for commencement of a statute of |
6 | limitations for breach of a property insurance contract; |
7 | amending s. 215.555, F.S.; providing that specified losses |
8 | are excluded from the definition of the term "losses" as |
9 | used in certain provisions relating to the Florida |
10 | Hurricane Catastrophe Fund; providing for application of |
11 | the revisions made by this act to the term "losses"; |
12 | amending s. 215.5595, F.S.; authorizing an insurer to |
13 | renegotiate the terms of a surplus note issued before a |
14 | certain date; amending s. 624.407, F.S.; revising the |
15 | amount of surplus funds required for domestic insurers |
16 | applying for a certificate of authority after a certain |
17 | date; amending s. 624.408, F.S.; revising the minimum |
18 | surplus that must be maintained by certain insurers; |
19 | authorizing the Office of Insurance Regulation to reduce |
20 | specified surplus requirements under specified |
21 | circumstances; amending s. 626.852, F.S.; providing an |
22 | exemption from licensure as an adjuster to certain persons |
23 | who provide mortgage-related claims adjusting services to |
24 | certain institutions; providing an exception to the |
25 | exemption; amending s. 626.854, F.S.; providing |
26 | limitations on the amount of compensation that may be |
27 | received by a public adjuster for a reopened or |
28 | supplemental claim; providing limitations on the amount of |
29 | compensation that may be received by a public adjuster for |
30 | a claim; applying specified provisions regulating the |
31 | conduct of public adjusters to condominium unit owners |
32 | rather than to condominium associations as is currently |
33 | required; providing statements that may be considered |
34 | deceptive or misleading if made in any public adjuster's |
35 | advertisement or solicitation; providing a definition for |
36 | the term "written advertisement"; requiring that a |
37 | disclaimer be included in any public adjuster's written |
38 | advertisement; providing requirements for such disclaimer; |
39 | requiring certain persons who act on behalf of an insurer |
40 | to provide notice to the insurer, claimant, public |
41 | adjuster, or legal representative for an onsite inspection |
42 | of the insured property; authorizing the insured or |
43 | claimant to deny access to the property if notice is not |
44 | provided; requiring the public adjuster to ensure prompt |
45 | notice of certain property loss claims; providing that an |
46 | insurer be allowed to interview the insured directly about |
47 | the loss claim; prohibiting the insurer from excluding the |
48 | public adjuster from the insurer's meetings with the |
49 | insured; requiring that the insurer communicate with the |
50 | public adjuster in an effort to reach an agreement as to |
51 | the scope of the covered loss under the insurance policy; |
52 | prohibiting a public adjuster from restricting or |
53 | preventing persons acting on behalf of the insurer from |
54 | having reasonable access to the insured or the insured's |
55 | property; prohibiting a public adjuster from unreasonably |
56 | obstructing or preventing the insurer's adjuster from |
57 | timely conducting an inspection of the insured's property; |
58 | authorizing the insured's adjuster to be present for the |
59 | inspection; providing an exception to such authorization |
60 | under certain circumstances; prohibiting a licensed |
61 | contractor or subcontractor from adjusting a claim on |
62 | behalf of an insured if such contractor or subcontractor |
63 | is not a licensed public adjuster; providing an exception; |
64 | creating s. 626.70132, F.S.; requiring that notice of a |
65 | claim, supplemental claim, or reopened claim be given to |
66 | the insurer within a specified period after the date of |
67 | loss; providing a definition for the terms "supplemental |
68 | claim" or "reopened claim"; providing applicability; |
69 | amending s. 627.062, F.S.; extending the expiration date |
70 | for making a "file and use" filing; deleting an obsolete |
71 | provision; prohibiting the Office of Insurance Regulation |
72 | from, directly or indirectly, impeding the right of an |
73 | insurer to acquire policyholders, advertise or appoint |
74 | agents, or regulate agent commissions for property and |
75 | casualty insurance; revising the costs that may be |
76 | included in a rate filing; revising the overall premium |
77 | increase for a rate filing; revising the information that |
78 | must be included in a rate filing relating to reinsurance; |
79 | deleting a provision prohibiting an insurer from |
80 | implementing a rate increase within 6 months before it |
81 | makes certain rate filings; deleting a provision |
82 | prohibiting an insurer from filing for a rate increase |
83 | within 6 months after it makes certain rate filings; |
84 | deleting obsolete provisions relating to legislation |
85 | enacted during the 2003 Special Session D of the |
86 | Legislature; revising provisions relating to the |
87 | certifications that are required to be made under oath by |
88 | certain officers or actuaries of an insurer regarding |
89 | information that must accompany a rate filing; amending s. |
90 | 627.06281, F.S.; providing limitations relating to the |
91 | fees charged for use of the public hurricane model; |
92 | providing an exception to the fees; amending s. 627.0629, |
93 | F.S.; revising legislative intent; deleting obsolete |
94 | provisions; deleting a requirement that the Office of |
95 | Insurance Regulation propose a method for establishing |
96 | discounts, debits, credits, and other rate differentials |
97 | for hurricane mitigation by a certain date; conforming |
98 | provisions to changes made by the act; amending s. |
99 | 627.4133, F.S.; reducing the amount of time that a prior |
100 | notice must provide to specified policyholders before a |
101 | nonrenewal, cancellation, or termination becomes |
102 | effective; authorizing an insurer to cancel policies after |
103 | 45 days' notice if the Office of Insurance Regulation |
104 | determines that the cancellation of policies is necessary |
105 | to protect the interests of the public or policyholders; |
106 | creating s. 627.43141, F.S.; providing definitions; |
107 | requiring the delivery of a "Notice of Change in Policy |
108 | Terms" under certain circumstances; specifying |
109 | requirements for such notice; specifying actions |
110 | constituting proof of notice; authorizing policy renewals |
111 | to contain a change in policy terms; providing that |
112 | receipt of payment by an insurer is deemed acceptance of |
113 | new policy terms by an insured; providing that the |
114 | original policy remains in effect until the occurrence of |
115 | specified events if an insurer fails to provide notice; |
116 | providing intent; amending s. 627.7011, F.S.; revising |
117 | provisions relating to an insurer's payment of replacement |
118 | costs without reservation or holdback of any depreciation |
119 | in value if a loss occurs; amending s. 627.70131, F.S.; |
120 | specifying application of certain time periods to initial, |
121 | reopened, or supplemental property insurance claim notices |
122 | and payments; providing legislative findings with respect |
123 | to 2005 statutory changes relating to sinkhole insurance |
124 | coverage and statutory changes in this act; providing |
125 | legislative intent relating to sinkholes; amending s. |
126 | 627.706, F.S.; authorizing an insurer to require an |
127 | inspection of property before issuing sinkhole coverage; |
128 | authorizing an insurer to limit coverage for catastrophic |
129 | ground cover collapse and sinkhole loss to the principal |
130 | building; revising definitions relating to sinkhole |
131 | coverage; providing definitions relating to sinkhole |
132 | coverage for the terms "neutral evaluation," "neutral |
133 | evaluator," and "structural damage"; revising |
134 | applicability of nonrenewals for sinkhole coverage; |
135 | placing a 4-year statute of repose on claims for sinkhole |
136 | coverage; repealing s. 627.7065, F.S., relating to the |
137 | establishment of a sinkhole database; amending s. 627.707, |
138 | F.S.; revising provisions relating to the investigation of |
139 | sinkholes by insurers; providing a time limitation for |
140 | demanding sinkhole testing by a policyholder and entering |
141 | into a contract for repairs; requiring payment for |
142 | analyses and services; allowing for reimbursement of |
143 | payment for analyses and services; requiring all repairs |
144 | to be completed within a certain time; providing |
145 | exceptions; prohibiting rebates to policyholders from |
146 | persons performing repairs; voiding coverage if a rebate |
147 | is received; requiring policyholders to refund rebates |
148 | from persons performing repairs to insurers; providing |
149 | criminal penalties applicable to persons performing |
150 | repairs who offer or policyholders who accept rebates; |
151 | limiting a policyholder's liability for reimbursement of |
152 | the costs related to certain analyses and services under |
153 | certain circumstances; amending s. 627.7073, F.S.; |
154 | revising provisions relating to sinkhole inspection |
155 | reports; requiring an insurer to file a neutral |
156 | evaluator's report and other specific information; |
157 | requiring the policyholder to file certain reports as a |
158 | precondition to accepting payment; requiring certain |
159 | filing and recording costs to be borne by a policyholder; |
160 | specifying that a policyholder's recording of a report |
161 | does not legally affect title or create certain causes of |
162 | action relating to real property; amending s. 627.7074, |
163 | F.S.; revising provisions relating to neutral evaluation |
164 | of sinkhole insurance claims; requiring evaluation in |
165 | order to make certain determinations; requiring that the |
166 | neutral evaluator be allowed access to structures being |
167 | evaluated; providing grounds for disqualifying an |
168 | evaluator; allowing the Department of Financial Services |
169 | to appoint an evaluator if the parties cannot come to |
170 | agreement; revising the timeframes for scheduling a |
171 | neutral evaluation conference; authorizing an evaluator to |
172 | enlist another evaluator or other professionals; providing |
173 | a time certain for issuing a report; revising provisions |
174 | relating to compliance with the evaluator's |
175 | recommendations; providing that the evaluator is an agent |
176 | of the department for the purposes of immunity from suit; |
177 | requiring the department to adopt rules; amending s. |
178 | 627.711, F.S.; allowing an insurer to independently verify |
179 | mitigation forms from additional sources; amending s. |
180 | 631.54, F.S.; revising the definition of the term "covered |
181 | claim" for purposes of the Florida Insurance Guaranty |
182 | Association Act; providing severability; providing |
183 | effective dates. |
184 |
|
185 | Be It Enacted by the Legislature of the State of Florida: |
186 |
|
187 | Section 1. Subsection (11) is added to section 95.11, |
188 | Florida Statutes, to read: |
189 | 95.11 Limitations other than for the recovery of real |
190 | property.-Actions other than for recovery of real property shall |
191 | be commenced as follows: |
192 | (11) WITHIN SIX YEARS.-Notwithstanding paragraph (2)(b), |
193 | an action for breach of a property insurance contract, with the |
194 | period running from the date of loss. |
195 | Section 2. Paragraph (d) of subsection (2) of section |
196 | 215.555, Florida Statutes, is amended to read: |
197 | 215.555 Florida Hurricane Catastrophe Fund.- |
198 | (2) DEFINITIONS.-As used in this section: |
199 | (d) "Losses" means direct incurred losses under covered |
200 | policies, including which shall include losses for additional |
201 | living expenses not to exceed 40 percent of the insured value of |
202 | a residential structure or its contents and shall exclude loss |
203 | adjustment expenses. The term "Losses" does not include: |
204 | 1. Losses for fair rental value, loss of rent or rental |
205 | income, or business interruption losses;. |
206 | 2. Losses under liability coverages; |
207 | 3. Property losses that are proximately caused by any |
208 | peril other than a covered event, including, but not limited to, |
209 | fire, theft, flood or rising water, or a windstorm that does not |
210 | constitute a covered event; |
211 | 4. Amounts paid as the result of a voluntary expansion of |
212 | coverage by the insurer, including, but not limited to, a waiver |
213 | of an applicable deductible; |
214 | 5. Amounts paid to reimburse a policyholder for |
215 | condominium association or homeowners' association loss |
216 | assessments or under similar coverages for contractual |
217 | liabilities; |
218 | 6. Amounts paid as bad faith awards, punitive damage |
219 | awards, or other court-imposed fines, sanctions, or penalties; |
220 | 7. Amounts in excess of the coverage limits under the |
221 | covered policy; or |
222 | 8. Allocated or unallocated loss adjustment expenses. |
223 | Section 3. The amendments made by this act to s. 215.555, |
224 | Florida Statutes, apply first to the Florida Hurricane |
225 | Catastrophe Fund reimbursement contract that takes effect on |
226 | June 1, 2011. |
227 | Section 4. Subsection (12) is added to section 215.5595, |
228 | Florida Statutes, to read: |
229 | 215.5595 Insurance Capital Build-Up Incentive Program.- |
230 | (12) The insurer may request that the board renegotiate |
231 | the terms of any surplus note that was issued under this section |
232 | before January 1, 2011. The request must be submitted to the |
233 | board by January 1, 2012. If the insurer agrees to accelerate |
234 | the payment period of the note by at least 5 years, the board |
235 | must agree to exempt the insurer from the premium-to-surplus |
236 | ratios required under paragraph (2)(d). If the insurer agrees to |
237 | an acceleration of the payment period for less than 5 years, the |
238 | board may, after consultation with the Office of Insurance |
239 | Regulation, agree to an appropriate revision of the premium-to- |
240 | surplus ratios required under paragraph (2)(d) for the remaining |
241 | term of the note if the revised ratios are not lower than a |
242 | minimum writing ratio of net premium to surplus of at least 1 to |
243 | 1 and, alternatively, a minimum writing ratio of gross premium |
244 | to surplus of at least 3 to 1. |
245 | Section 5. Section 624.407, Florida Statutes, is amended |
246 | to read: |
247 | 624.407 Surplus Capital funds required; new insurers.- |
248 | (1) To receive authority to transact any one kind or |
249 | combinations of kinds of insurance, as defined in part V of this |
250 | chapter, an insurer applying for its original certificate of |
251 | authority in this state after November 10, 1993, the effective |
252 | date of this section shall possess surplus as to policyholders |
253 | at least not less than the greater of: |
254 | (a) Five million dollars For a property and casualty |
255 | insurer, $5 million, or $2.5 million for any other insurer; |
256 | (b) For life insurers, 4 percent of the insurer's total |
257 | liabilities; |
258 | (c) For life and health insurers, 4 percent of the |
259 | insurer's total liabilities, plus 6 percent of the insurer's |
260 | liabilities relative to health insurance; or |
261 | (d) For all insurers other than life insurers and life and |
262 | health insurers, 10 percent of the insurer's total liabilities; |
263 | or |
264 | (e) Notwithstanding paragraph (a) or paragraph (d), for a |
265 | domestic insurer that transacts residential property insurance |
266 | and is: |
267 | 1. Not a wholly owned subsidiary of an insurer domiciled |
268 | in any other state, $15 million. |
269 | 2. however, a domestic insurer that transacts residential |
270 | property insurance and is A wholly owned subsidiary of an |
271 | insurer domiciled in any other state, shall possess surplus as |
272 | to policyholders of at least $50 million. |
273 | (2) Notwithstanding subsection (1), a new insurer may not |
274 | be required, but no insurer shall be required under this |
275 | subsection to have surplus as to policyholders greater than $100 |
276 | million. |
277 | (3)(2) The requirements of this section shall be based |
278 | upon all the kinds of insurance actually transacted or to be |
279 | transacted by the insurer in any and all areas in which it |
280 | operates, whether or not only a portion of such kinds of |
281 | insurance are to be transacted in this state. |
282 | (4)(3) As to surplus as to policyholders required for |
283 | qualification to transact one or more kinds of insurance, |
284 | domestic mutual insurers are governed by chapter 628, and |
285 | domestic reciprocal insurers are governed by chapter 629. |
286 | (5)(4) For the purposes of this section, liabilities do |
287 | shall not include liabilities required under s. 625.041(4). For |
288 | purposes of computing minimum surplus as to policyholders |
289 | pursuant to s. 625.305(1), liabilities shall include liabilities |
290 | required under s. 625.041(4). |
291 | (6)(5) The provisions of this section, as amended by |
292 | chapter 89-360, Laws of Florida this act, shall apply only to |
293 | insurers applying for a certificate of authority on or after |
294 | October 1, 1989 the effective date of this act. |
295 | Section 6. Section 624.408, Florida Statutes, is amended |
296 | to read: |
297 | 624.408 Surplus as to policyholders required; current new |
298 | and existing insurers.- |
299 | (1)(a) To maintain a certificate of authority to transact |
300 | any one kind or combinations of kinds of insurance, as defined |
301 | in part V of this chapter, an insurer in this state must shall |
302 | at all times maintain surplus as to policyholders at least not |
303 | less than the greater of: |
304 | (a)1. Except as provided in paragraphs (e), (f), and (g) |
305 | subparagraph 5. and paragraph (b), $1.5 million.; |
306 | (b)2. For life insurers, 4 percent of the insurer's total |
307 | liabilities.; |
308 | (c)3. For life and health insurers, 4 percent of the |
309 | insurer's total liabilities plus 6 percent of the insurer's |
310 | liabilities relative to health insurance.; or |
311 | (d)4. For all insurers other than mortgage guaranty |
312 | insurers, life insurers, and life and health insurers, 10 |
313 | percent of the insurer's total liabilities. |
314 | (e)5. For property and casualty insurers, $4 million, |
315 | except for property and casualty insurers authorized to |
316 | underwrite any line of residential property insurance. |
317 | (f)(b) For residential any property insurers not and |
318 | casualty insurer holding a certificate of authority before July |
319 | 1, 2011 on December 1, 1993, $15 million. the |
320 | (g) For residential property insurers holding a |
321 | certificate of authority before July 1, 2011, and until June 30, |
322 | 2016, $5 million; on or after July 1, 2016, and until June 30, |
323 | 2021, $10 million; on or after July 1, 2021, $15 million. |
324 |
|
325 | The office may reduce the surplus requirement in paragraphs (f) |
326 | and (g) if the insurer is not writing new business, has premiums |
327 | in force of less than $1 million per year in residential |
328 | property insurance, or is a mutual insurance company. following |
329 | amounts apply instead of the $4 million required by subparagraph |
330 | (a)5.: |
331 | 1. On December 31, 2001, and until December 30, 2002, $3 |
332 | million. |
333 | 2. On December 31, 2002, and until December 30, 2003, |
334 | $3.25 million. |
335 | 3. On December 31, 2003, and until December 30, 2004, $3.6 |
336 | million. |
337 | 4. On December 31, 2004, and thereafter, $4 million. |
338 | (2) For purposes of this section, liabilities do shall not |
339 | include liabilities required under s. 625.041(4). For purposes |
340 | of computing minimum surplus as to policyholders pursuant to s. |
341 | 625.305(1), liabilities shall include liabilities required under |
342 | s. 625.041(4). |
343 | (3) This section does not require an No insurer shall be |
344 | required under this section to have surplus as to policyholders |
345 | greater than $100 million. |
346 | (4) A mortgage guaranty insurer shall maintain a minimum |
347 | surplus as required by s. 635.042. |
348 | Section 7. Subsection (7) is added to section 626.852, |
349 | Florida Statutes, to read: |
350 | 626.852 Scope of this part.- |
351 | (7) Notwithstanding any other provision of law, a person |
352 | providing claims adjusting services solely to institutions |
353 | servicing or guaranteeing mortgages shall be exempt from |
354 | licensure as an adjuster for services provided to the mortgage |
355 | institution with regards to policies covering the mortgaged |
356 | properties. This exemption does not apply to any person |
357 | providing insurance or property repair or preservation services |
358 | or to any affiliate of such persons. |
359 | Section 8. Effective June 1, 2011, section 626.854, |
360 | Florida Statutes, is amended to read: |
361 | 626.854 "Public adjuster" defined; prohibitions.-The |
362 | Legislature finds that it is necessary for the protection of the |
363 | public to regulate public insurance adjusters and to prevent the |
364 | unauthorized practice of law. |
365 | (1) A "public adjuster" is any person, except a duly |
366 | licensed attorney at law as hereinafter in s. 626.860 provided, |
367 | who, for money, commission, or any other thing of value, |
368 | prepares, completes, or files an insurance claim form for an |
369 | insured or third-party claimant or who, for money, commission, |
370 | or any other thing of value, acts or aids in any manner on |
371 | behalf of an insured or third-party claimant in negotiating for |
372 | or effecting the settlement of a claim or claims for loss or |
373 | damage covered by an insurance contract or who advertises for |
374 | employment as an adjuster of such claims, and also includes any |
375 | person who, for money, commission, or any other thing of value, |
376 | solicits, investigates, or adjusts such claims on behalf of any |
377 | such public adjuster. |
378 | (2) This definition does not apply to: |
379 | (a) A licensed health care provider or employee thereof |
380 | who prepares or files a health insurance claim form on behalf of |
381 | a patient. |
382 | (b) A person who files a health claim on behalf of another |
383 | and does so without compensation. |
384 | (3) A public adjuster may not give legal advice. A public |
385 | adjuster may not act on behalf of or aid any person in |
386 | negotiating or settling a claim relating to bodily injury, |
387 | death, or noneconomic damages. |
388 | (4) For purposes of this section, the term "insured" |
389 | includes only the policyholder and any beneficiaries named or |
390 | similarly identified in the policy. |
391 | (5) A public adjuster may not directly or indirectly |
392 | through any other person or entity solicit an insured or |
393 | claimant by any means except on Monday through Saturday of each |
394 | week and only between the hours of 8 a.m. and 8 p.m. on those |
395 | days. |
396 | (6) A public adjuster may not directly or indirectly |
397 | through any other person or entity initiate contact or engage in |
398 | face-to-face or telephonic solicitation or enter into a contract |
399 | with any insured or claimant under an insurance policy until at |
400 | least 48 hours after the occurrence of an event that may be the |
401 | subject of a claim under the insurance policy unless contact is |
402 | initiated by the insured or claimant. |
403 | (7) An insured or claimant may cancel a public adjuster's |
404 | contract to adjust a claim without penalty or obligation within |
405 | 3 business days after the date on which the contract is executed |
406 | or within 3 business days after the date on which the insured or |
407 | claimant has notified the insurer of the claim, by phone or in |
408 | writing, whichever is later. The public adjuster's contract |
409 | shall disclose to the insured or claimant his or her right to |
410 | cancel the contract and advise the insured or claimant that |
411 | notice of cancellation must be submitted in writing and sent by |
412 | certified mail, return receipt requested, or other form of |
413 | mailing which provides proof thereof, to the public adjuster at |
414 | the address specified in the contract; provided, during any |
415 | state of emergency as declared by the Governor and for a period |
416 | of 1 year after the date of loss, the insured or claimant shall |
417 | have 5 business days after the date on which the contract is |
418 | executed to cancel a public adjuster's contract. |
419 | (8) It is an unfair and deceptive insurance trade practice |
420 | pursuant to s. 626.9541 for a public adjuster or any other |
421 | person to circulate or disseminate any advertisement, |
422 | announcement, or statement containing any assertion, |
423 | representation, or statement with respect to the business of |
424 | insurance which is untrue, deceptive, or misleading. |
425 | (9) A public adjuster, a public adjuster apprentice, or |
426 | any person or entity acting on behalf of a public adjuster or |
427 | public adjuster apprentice may not give or offer to give a |
428 | monetary loan or advance to a client or prospective client. |
429 | (10) A public adjuster, public adjuster apprentice, or any |
430 | individual or entity acting on behalf of a public adjuster or |
431 | public adjuster apprentice may not give or offer to give, |
432 | directly or indirectly, any article of merchandise having a |
433 | value in excess of $25 to any individual for the purpose of |
434 | advertising or as an inducement to entering into a contract with |
435 | a public adjuster. |
436 | (11)(a) If a public adjuster enters into a contract with |
437 | an insured or claimant to reopen a claim or to file a |
438 | supplemental claim that seeks additional payments for a claim |
439 | that has been previously paid in part or in full or settled by |
440 | the insurer, the public adjuster may not charge, agree to, or |
441 | accept any compensation, payment, commission, fee, or other |
442 | thing of value based on a previous settlement or previous claim |
443 | payments by the insurer for the same cause of loss. The charge, |
444 | compensation, payment, commission, fee, or other thing of value |
445 | may be based only on the claim payments or settlement obtained |
446 | through the work of the public adjuster after entering into the |
447 | contract with the insured or claimant. Compensation for the |
448 | reopened or supplemental claim may not exceed 20 percent of the |
449 | reopened or supplemental claim payment. The contracts described |
450 | in this paragraph are not subject to the limitations in |
451 | paragraph (b). |
452 | (b) A public adjuster may not charge, agree to, or accept |
453 | any compensation, payment, commission, fee, or other thing of |
454 | value in excess of: |
455 | 1. Ten percent of the amount of insurance claim payments |
456 | made by the insurer for claims based on events that are the |
457 | subject of a declaration of a state of emergency by the |
458 | Governor. This provision applies to claims made during the |
459 | period of 1 year after the declaration of emergency. After that |
460 | 1-year period, 20 percent of the amount of insurance claim |
461 | payments made by the insurer. |
462 | 2. Twenty percent of the amount of all other insurance |
463 | claim payments made by the insurer for claims that are not based |
464 | on events that are the subject of a declaration of a state of |
465 | emergency by the Governor. |
466 | (12) Each public adjuster shall provide to the claimant or |
467 | insured a written estimate of the loss to assist in the |
468 | submission of a proof of loss or any other claim for payment of |
469 | insurance proceeds. The public adjuster shall retain such |
470 | written estimate for at least 5 years and shall make such |
471 | estimate available to the claimant or insured and the department |
472 | upon request. |
473 | (13) A public adjuster, public adjuster apprentice, or any |
474 | person acting on behalf of a public adjuster or apprentice may |
475 | not accept referrals of business from any person with whom the |
476 | public adjuster conducts business if there is any form or manner |
477 | of agreement to compensate the person, whether directly or |
478 | indirectly, for referring business to the public adjuster. A |
479 | public adjuster may not compensate any person, except for |
480 | another public adjuster, whether directly or indirectly, for the |
481 | principal purpose of referring business to the public adjuster. |
482 |
|
483 | The provisions of subsections (5)-(13) apply only to residential |
484 | property insurance policies and condominium unit owner |
485 | association policies as defined in s. 718.111(11). |
486 | Section 9. Effective January 1, 2012, section 626.854, |
487 | Florida Statutes, as amended by this act, is amended to read: |
488 | 626.854 "Public adjuster" defined; prohibitions.-The |
489 | Legislature finds that it is necessary for the protection of the |
490 | public to regulate public insurance adjusters and to prevent the |
491 | unauthorized practice of law. |
492 | (1) A "public adjuster" is any person, except a duly |
493 | licensed attorney at law as exempted under hereinafter in s. |
494 | 626.860 provided, who, for money, commission, or any other thing |
495 | of value, prepares, completes, or files an insurance claim form |
496 | for an insured or third-party claimant or who, for money, |
497 | commission, or any other thing of value, acts or aids in any |
498 | manner on behalf of, or aids an insured or third-party claimant |
499 | in negotiating for or effecting the settlement of a claim or |
500 | claims for loss or damage covered by an insurance contract or |
501 | who advertises for employment as an adjuster of such claims. The |
502 | term, and also includes any person who, for money, commission, |
503 | or any other thing of value, solicits, investigates, or adjusts |
504 | such claims on behalf of a any such public adjuster. |
505 | (2) This definition does not apply to: |
506 | (a) A licensed health care provider or employee thereof |
507 | who prepares or files a health insurance claim form on behalf of |
508 | a patient. |
509 | (b) A person who files a health claim on behalf of another |
510 | and does so without compensation. |
511 | (3) A public adjuster may not give legal advice or. A |
512 | public adjuster may not act on behalf of or aid any person in |
513 | negotiating or settling a claim relating to bodily injury, |
514 | death, or noneconomic damages. |
515 | (4) For purposes of this section, the term "insured" |
516 | includes only the policyholder and any beneficiaries named or |
517 | similarly identified in the policy. |
518 | (5) A public adjuster may not directly or indirectly |
519 | through any other person or entity solicit an insured or |
520 | claimant by any means except on Monday through Saturday of each |
521 | week and only between the hours of 8 a.m. and 8 p.m. on those |
522 | days. |
523 | (6) A public adjuster may not directly or indirectly |
524 | through any other person or entity initiate contact or engage in |
525 | face-to-face or telephonic solicitation or enter into a contract |
526 | with any insured or claimant under an insurance policy until at |
527 | least 48 hours after the occurrence of an event that may be the |
528 | subject of a claim under the insurance policy unless contact is |
529 | initiated by the insured or claimant. |
530 | (7) An insured or claimant may cancel a public adjuster's |
531 | contract to adjust a claim without penalty or obligation within |
532 | 3 business days after the date on which the contract is executed |
533 | or within 3 business days after the date on which the insured or |
534 | claimant has notified the insurer of the claim, by phone or in |
535 | writing, whichever is later. The public adjuster's contract must |
536 | shall disclose to the insured or claimant his or her right to |
537 | cancel the contract and advise the insured or claimant that |
538 | notice of cancellation must be submitted in writing and sent by |
539 | certified mail, return receipt requested, or other form of |
540 | mailing that which provides proof thereof, to the public |
541 | adjuster at the address specified in the contract; provided, |
542 | during any state of emergency as declared by the Governor and |
543 | for a period of 1 year after the date of loss, the insured or |
544 | claimant has shall have 5 business days after the date on which |
545 | the contract is executed to cancel a public adjuster's contract. |
546 | (8) It is an unfair and deceptive insurance trade practice |
547 | pursuant to s. 626.9541 for a public adjuster or any other |
548 | person to circulate or disseminate any advertisement, |
549 | announcement, or statement containing any assertion, |
550 | representation, or statement with respect to the business of |
551 | insurance which is untrue, deceptive, or misleading. |
552 | (a) The following statements, made in any public |
553 | adjuster's advertisement or solicitation, are considered |
554 | deceptive or misleading: |
555 | 1. A statement or representation that invites an insured |
556 | policyholder to submit a claim when the policyholder does not |
557 | have covered damage to insured property. |
558 | 2. A statement or representation that invites an insured |
559 | policyholder to submit a claim by offering monetary or other |
560 | valuable inducement. |
561 | 3. A statement or representation that invites an insured |
562 | policyholder to submit a claim by stating that there is "no |
563 | risk" to the policyholder by submitting such claim. |
564 | 4. A statement or representation, or use of a logo or |
565 | shield, that implies or could mistakenly be construed to imply |
566 | that the solicitation was issued or distributed by a |
567 | governmental agency or is sanctioned or endorsed by a |
568 | governmental agency. |
569 | (b) For purposes of this paragraph, the term "written |
570 | advertisement" includes only newspapers, magazines, flyers, and |
571 | bulk mailers. The following disclaimer, which is not required to |
572 | be printed on standard size business cards, must be added in |
573 | bold print and capital letters in typeface no smaller than the |
574 | typeface of the body of the text to all written advertisements |
575 | by a public adjuster: |
576 |
|
577 | "THIS IS A SOLICITATION FOR BUSINESS. IF YOU HAVE HAD |
578 | A CLAIM FOR AN INSURED PROPERTY LOSS OR DAMAGE AND YOU |
579 | ARE SATISFIED WITH THE PAYMENT BY YOUR INSURER, YOU |
580 | MAY DISREGARD THIS ADVERTISEMENT." |
581 |
|
582 | (9) A public adjuster, a public adjuster apprentice, or |
583 | any person or entity acting on behalf of a public adjuster or |
584 | public adjuster apprentice may not give or offer to give a |
585 | monetary loan or advance to a client or prospective client. |
586 | (10) A public adjuster, public adjuster apprentice, or any |
587 | individual or entity acting on behalf of a public adjuster or |
588 | public adjuster apprentice may not give or offer to give, |
589 | directly or indirectly, any article of merchandise having a |
590 | value in excess of $25 to any individual for the purpose of |
591 | advertising or as an inducement to entering into a contract with |
592 | a public adjuster. |
593 | (11)(a) If a public adjuster enters into a contract with |
594 | an insured or claimant to reopen a claim or file a supplemental |
595 | claim that seeks additional payments for a claim that has been |
596 | previously paid in part or in full or settled by the insurer, |
597 | the public adjuster may not charge, agree to, or accept any |
598 | compensation, payment, commission, fee, or other thing of value |
599 | based on a previous settlement or previous claim payments by the |
600 | insurer for the same cause of loss. The charge, compensation, |
601 | payment, commission, fee, or other thing of value may be based |
602 | only on the claim payments or settlement obtained through the |
603 | work of the public adjuster after entering into the contract |
604 | with the insured or claimant. Compensation for the reopened or |
605 | supplemental claim may not exceed 20 percent of the reopened or |
606 | supplemental claim payment. The contracts described in this |
607 | paragraph are not subject to the limitations in paragraph (b). |
608 | (b) A public adjuster may not charge, agree to, or accept |
609 | any compensation, payment, commission, fee, or other thing of |
610 | value in excess of: |
611 | 1. Ten percent of the amount of insurance claim payments |
612 | made by the insurer for claims based on events that are the |
613 | subject of a declaration of a state of emergency by the |
614 | Governor. This provision applies to claims made during the |
615 | period of 1 year after the declaration of emergency. After that |
616 | 1-year period, 20 percent of the amount of insurance claim |
617 | payments made by the insurer. |
618 | 2. Twenty percent of the amount of insurance claim |
619 | payments made by the insurer for claims that are not based on |
620 | events that are the subject of a declaration of a state of |
621 | emergency by the Governor. |
622 | (12) Each public adjuster must shall provide to the |
623 | claimant or insured a written estimate of the loss to assist in |
624 | the submission of a proof of loss or any other claim for payment |
625 | of insurance proceeds. The public adjuster shall retain such |
626 | written estimate for at least 5 years and shall make the such |
627 | estimate available to the claimant or insured and the department |
628 | upon request. |
629 | (13) A public adjuster, public adjuster apprentice, or any |
630 | person acting on behalf of a public adjuster or apprentice may |
631 | not accept referrals of business from any person with whom the |
632 | public adjuster conducts business if there is any form or manner |
633 | of agreement to compensate the person, whether directly or |
634 | indirectly, for referring business to the public adjuster. A |
635 | public adjuster may not compensate any person, except for |
636 | another public adjuster, whether directly or indirectly, for the |
637 | principal purpose of referring business to the public adjuster. |
638 | (14) A company employee adjuster, independent adjuster, |
639 | attorney, investigator, or other persons acting on behalf of an |
640 | insurer that needs access to an insured or claimant or to the |
641 | insured property that is the subject of a claim must provide at |
642 | least 48 hours' notice to the insured or claimant, public |
643 | adjuster, or legal representative before scheduling a meeting |
644 | with the claimant or an onsite inspection of the insured |
645 | property. The insured or claimant may deny access to the |
646 | property if the notice has not been provided. The insured or |
647 | claimant may waive the 48-hour notice. |
648 | (15) A public adjuster must ensure prompt notice of |
649 | property loss claims submitted to an insurer by or through a |
650 | public adjuster or on which a public adjuster represents the |
651 | insured at the time the claim or notice of loss is submitted to |
652 | the insurer. The public adjuster must ensure that notice is |
653 | given to the insurer, the public adjuster's contract is provided |
654 | to the insurer, the property is available for inspection of the |
655 | loss or damage by the insurer, and the insurer is given an |
656 | opportunity to interview the insured directly about the loss and |
657 | claim. The insurer must be allowed to obtain necessary |
658 | information to investigate and respond to the claim. |
659 | (a) The insurer may not exclude the public adjuster from |
660 | its in-person meetings with the insured. The insurer shall meet |
661 | or communicate with the public adjuster in an effort to reach |
662 | agreement as to the scope of the covered loss under the |
663 | insurance policy. This section does not impair the terms and |
664 | conditions of the insurance policy in effect at the time the |
665 | claim is filed. |
666 | (b) A public adjuster may not restrict or prevent an |
667 | insurer, company employee adjuster, independent adjuster, |
668 | attorney, investigator, or other person acting on behalf of the |
669 | insurer from having reasonable access at reasonable times to an |
670 | insured or claimant or to the insured property that is the |
671 | subject of a claim. |
672 | (c) A public adjuster may not act or fail to reasonably |
673 | act in any manner that obstructs or prevents an insurer or |
674 | insurer's adjuster from timely conducting an inspection of any |
675 | part of the insured property for which there is a claim for loss |
676 | or damage. The public adjuster representing the insured may be |
677 | present for the insurer's inspection, but if the unavailability |
678 | of the public adjuster otherwise delays the insurer's timely |
679 | inspection of the property, the public adjuster or the insured |
680 | must allow the insurer to have access to the property without |
681 | the participation or presence of the public adjuster or insured |
682 | in order to facilitate the insurer's prompt inspection of the |
683 | loss or damage. |
684 | (16) A licensed contractor under part I of chapter 489, or |
685 | a subcontractor, may not adjust a claim on behalf of an insured |
686 | unless licensed and compliant as a public adjuster under this |
687 | chapter. However, the contractor may discuss or explain a bid |
688 | for construction or repair of covered property with the |
689 | residential property owner who has suffered loss or damage |
690 | covered by a property insurance policy, or the insurer of such |
691 | property, if the contractor is doing so for the usual and |
692 | customary fees applicable to the work to be performed as stated |
693 | in the contract between the contractor and the insured. |
694 | (17) The provisions of subsections (5)-(16) (5)-(13) apply |
695 | only to residential property insurance policies and condominium |
696 | unit owner policies as defined in s. 718.111(11). |
697 | Section 10. Effective June 1, 2011, section 626.70132, |
698 | Florida Statutes, is created to read: |
699 | 626.70132 Notice of property insurance claim.-Except as |
700 | provided in s. 627.706(5), a claim, supplemental claim, or |
701 | reopened claim under an insurance policy that provides property |
702 | insurance, as defined in s. 624.604, is barred unless notice of |
703 | the claim, supplemental claim, or reopened claim was given to |
704 | the insurer in accordance with the terms of the policy within 4 |
705 | years after the date of loss that caused the covered damage. For |
706 | purposes of this section, the term "supplemental claim" or |
707 | "reopened claim" means any additional claim for recovery from |
708 | the insurer for losses from the same peril which the insurer has |
709 | previously adjusted pursuant to the initial claim. This section |
710 | does not affect any applicable limitation on civil actions |
711 | provided in s. 95.11 for claims, supplemental claims, or |
712 | reopened claims timely filed under this section. |
713 | Section 11. Section 627.062, Florida Statutes, is amended |
714 | to read: |
715 | 627.062 Rate standards.- |
716 | (1) The rates for all classes of insurance to which the |
717 | provisions of this part are applicable may shall not be |
718 | excessive, inadequate, or unfairly discriminatory. |
719 | (2) As to all such classes of insurance: |
720 | (a) Insurers or rating organizations shall establish and |
721 | use rates, rating schedules, or rating manuals that to allow the |
722 | insurer a reasonable rate of return on the such classes of |
723 | insurance written in this state. A copy of rates, rating |
724 | schedules, rating manuals, premium credits or discount |
725 | schedules, and surcharge schedules, and changes thereto, must |
726 | shall be filed with the office under one of the following |
727 | procedures except as provided in subparagraph 3.: |
728 | 1. If the filing is made at least 90 days before the |
729 | proposed effective date and the filing is not implemented during |
730 | the office's review of the filing and any proceeding and |
731 | judicial review, then such filing is shall be considered a "file |
732 | and use" filing. In such case, the office shall finalize its |
733 | review by issuance of a notice of intent to approve or a notice |
734 | of intent to disapprove within 90 days after receipt of the |
735 | filing. The notice of intent to approve and the notice of intent |
736 | to disapprove constitute agency action for purposes of the |
737 | Administrative Procedure Act. Requests for supporting |
738 | information, requests for mathematical or mechanical |
739 | corrections, or notification to the insurer by the office of its |
740 | preliminary findings does shall not toll the 90-day period |
741 | during any such proceedings and subsequent judicial review. The |
742 | rate shall be deemed approved if the office does not issue a |
743 | notice of intent to approve or a notice of intent to disapprove |
744 | within 90 days after receipt of the filing. |
745 | 2. If the filing is not made in accordance with the |
746 | provisions of subparagraph 1., such filing must shall be made as |
747 | soon as practicable, but within no later than 30 days after the |
748 | effective date, and is shall be considered a "use and file" |
749 | filing. An insurer making a "use and file" filing is potentially |
750 | subject to an order by the office to return to policyholders |
751 | those portions of rates found to be excessive, as provided in |
752 | paragraph (h). |
753 | 3. For all property insurance filings made or submitted |
754 | after January 25, 2007, but before May 1, 2012 December 31, |
755 | 2010, an insurer seeking a rate that is greater than the rate |
756 | most recently approved by the office shall make a "file and use" |
757 | filing. For purposes of this subparagraph, motor vehicle |
758 | collision and comprehensive coverages are not considered to be |
759 | property coverages. |
760 | (b) Upon receiving a rate filing, the office shall review |
761 | the rate filing to determine if a rate is excessive, inadequate, |
762 | or unfairly discriminatory. In making that determination, the |
763 | office shall, in accordance with generally accepted and |
764 | reasonable actuarial techniques, consider the following factors: |
765 | 1. Past and prospective loss experience within and without |
766 | this state. |
767 | 2. Past and prospective expenses. |
768 | 3. The degree of competition among insurers for the risk |
769 | insured. |
770 | 4. Investment income reasonably expected by the insurer, |
771 | consistent with the insurer's investment practices, from |
772 | investable premiums anticipated in the filing, plus any other |
773 | expected income from currently invested assets representing the |
774 | amount expected on unearned premium reserves and loss reserves. |
775 | The commission may adopt rules using reasonable techniques of |
776 | actuarial science and economics to specify the manner in which |
777 | insurers shall calculate investment income attributable to such |
778 | classes of insurance written in this state and the manner in |
779 | which such investment income is shall be used to calculate |
780 | insurance rates. Such manner must shall contemplate allowances |
781 | for an underwriting profit factor and full consideration of |
782 | investment income which produce a reasonable rate of return; |
783 | however, investment income from invested surplus may not be |
784 | considered. |
785 | 5. The reasonableness of the judgment reflected in the |
786 | filing. |
787 | 6. Dividends, savings, or unabsorbed premium deposits |
788 | allowed or returned to Florida policyholders, members, or |
789 | subscribers. |
790 | 7. The adequacy of loss reserves. |
791 | 8. The cost of reinsurance. The office may shall not |
792 | disapprove a rate as excessive solely due to the insurer having |
793 | obtained catastrophic reinsurance to cover the insurer's |
794 | estimated 250-year probable maximum loss or any lower level of |
795 | loss. |
796 | 9. Trend factors, including trends in actual losses per |
797 | insured unit for the insurer making the filing. |
798 | 10. Conflagration and catastrophe hazards, if applicable. |
799 | 11. Projected hurricane losses, if applicable, which must |
800 | be estimated using a model or method found to be acceptable or |
801 | reliable by the Florida Commission on Hurricane Loss Projection |
802 | Methodology, and as further provided in s. 627.0628. |
803 | 12. A reasonable margin for underwriting profit and |
804 | contingencies. |
805 | 13. The cost of medical services, if applicable. |
806 | 14. Other relevant factors that affect which impact upon |
807 | the frequency or severity of claims or upon expenses. |
808 | (c) In the case of fire insurance rates, consideration |
809 | must shall be given to the availability of water supplies and |
810 | the experience of the fire insurance business during a period of |
811 | not less than the most recent 5-year period for which such |
812 | experience is available. |
813 | (d) If conflagration or catastrophe hazards are considered |
814 | given consideration by an insurer in its rates or rating plan, |
815 | including surcharges and discounts, the insurer shall establish |
816 | a reserve for that portion of the premium allocated to such |
817 | hazard and shall maintain the premium in a catastrophe reserve. |
818 | Any Removal of such premiums from the reserve for purposes other |
819 | than paying claims associated with a catastrophe or purchasing |
820 | reinsurance for catastrophes must be approved by shall be |
821 | subject to approval of the office. Any ceding commission |
822 | received by an insurer purchasing reinsurance for catastrophes |
823 | must shall be placed in the catastrophe reserve. |
824 | (e) After consideration of the rate factors provided in |
825 | paragraphs (b), (c), and (d), the office may find a rate may be |
826 | found by the office to be excessive, inadequate, or unfairly |
827 | discriminatory based upon the following standards: |
828 | 1. Rates shall be deemed excessive if they are likely to |
829 | produce a profit from Florida business which that is |
830 | unreasonably high in relation to the risk involved in the class |
831 | of business or if expenses are unreasonably high in relation to |
832 | services rendered. |
833 | 2. Rates shall be deemed excessive if, among other things, |
834 | the rate structure established by a stock insurance company |
835 | provides for replenishment of surpluses from premiums, if when |
836 | the replenishment is attributable to investment losses. |
837 | 3. Rates shall be deemed inadequate if they are clearly |
838 | insufficient, together with the investment income attributable |
839 | to them, to sustain projected losses and expenses in the class |
840 | of business to which they apply. |
841 | 4. A rating plan, including discounts, credits, or |
842 | surcharges, shall be deemed unfairly discriminatory if it fails |
843 | to clearly and equitably reflect consideration of the |
844 | policyholder's participation in a risk management program |
845 | adopted pursuant to s. 627.0625. |
846 | 5. A rate shall be deemed inadequate as to the premium |
847 | charged to a risk or group of risks if discounts or credits are |
848 | allowed which exceed a reasonable reflection of expense savings |
849 | and reasonably expected loss experience from the risk or group |
850 | of risks. |
851 | 6. A rate shall be deemed unfairly discriminatory as to a |
852 | risk or group of risks if the application of premium discounts, |
853 | credits, or surcharges among such risks does not bear a |
854 | reasonable relationship to the expected loss and expense |
855 | experience among the various risks. |
856 | (f) In reviewing a rate filing, the office may require the |
857 | insurer to provide, at the insurer's expense, all information |
858 | necessary to evaluate the condition of the company and the |
859 | reasonableness of the filing according to the criteria |
860 | enumerated in this section. |
861 | (g) The office may at any time review a rate, rating |
862 | schedule, rating manual, or rate change; the pertinent records |
863 | of the insurer; and market conditions. If the office finds on a |
864 | preliminary basis that a rate may be excessive, inadequate, or |
865 | unfairly discriminatory, the office shall initiate proceedings |
866 | to disapprove the rate and shall so notify the insurer. However, |
867 | the office may not disapprove as excessive any rate for which it |
868 | has given final approval or which has been deemed approved for a |
869 | period of 1 year after the effective date of the filing unless |
870 | the office finds that a material misrepresentation or material |
871 | error was made by the insurer or was contained in the filing. |
872 | Upon being so notified, the insurer or rating organization |
873 | shall, within 60 days, file with the office all information that |
874 | which, in the belief of the insurer or organization, proves the |
875 | reasonableness, adequacy, and fairness of the rate or rate |
876 | change. The office shall issue a notice of intent to approve or |
877 | a notice of intent to disapprove pursuant to the procedures of |
878 | paragraph (a) within 90 days after receipt of the insurer's |
879 | initial response. In such instances and in any administrative |
880 | proceeding relating to the legality of the rate, the insurer or |
881 | rating organization shall carry the burden of proof by a |
882 | preponderance of the evidence to show that the rate is not |
883 | excessive, inadequate, or unfairly discriminatory. After the |
884 | office notifies an insurer that a rate may be excessive, |
885 | inadequate, or unfairly discriminatory, unless the office |
886 | withdraws the notification, the insurer may shall not alter the |
887 | rate except to conform to with the office's notice until the |
888 | earlier of 120 days after the date the notification was provided |
889 | or 180 days after the date of implementing the implementation of |
890 | the rate. The office may, subject to chapter 120, may disapprove |
891 | without the 60-day notification any rate increase filed by an |
892 | insurer within the prohibited time period or during the time |
893 | that the legality of the increased rate is being contested. |
894 | (h) If In the event the office finds that a rate or rate |
895 | change is excessive, inadequate, or unfairly discriminatory, the |
896 | office shall issue an order of disapproval specifying that a new |
897 | rate or rate schedule, which responds to the findings of the |
898 | office, be filed by the insurer. The office shall further order, |
899 | for any "use and file" filing made in accordance with |
900 | subparagraph (a)2., that premiums charged each policyholder |
901 | constituting the portion of the rate above that which was |
902 | actuarially justified be returned to the such policyholder in |
903 | the form of a credit or refund. If the office finds that an |
904 | insurer's rate or rate change is inadequate, the new rate or |
905 | rate schedule filed with the office in response to such a |
906 | finding is shall be applicable only to new or renewal business |
907 | of the insurer written on or after the effective date of the |
908 | responsive filing. |
909 | (i) Except as otherwise specifically provided in this |
910 | chapter, the office may shall not, directly or indirectly: |
911 | 1. Prohibit any insurer, including any residual market |
912 | plan or joint underwriting association, from paying acquisition |
913 | costs based on the full amount of premium, as defined in s. |
914 | 627.403, applicable to any policy, or prohibit any such insurer |
915 | from including the full amount of acquisition costs in a rate |
916 | filing; or. |
917 | 2. Impede, abridge, or otherwise compromise an insurer's |
918 | right to acquire policyholders, advertise, or appoint agents, |
919 | including the calculation, manner, or amount of such agent |
920 | commissions, if any, in property and casualty insurance. |
921 | (j) With respect to residential property insurance rate |
922 | filings, the rate filing must account for mitigation measures |
923 | undertaken by policyholders to reduce hurricane losses. |
924 | (k)1. A residential property An insurer may make a |
925 | separate filing limited solely to an adjustment of its rates for |
926 | reinsurance, the cost of financing products used as a |
927 | replacement for reinsurance, or financing costs incurred in the |
928 | purchase of reinsurance, or financing products to replace or |
929 | finance the payment of the amount covered by the Temporary |
930 | Increase in Coverage Limits (TICL) portion of the Florida |
931 | Hurricane Catastrophe Fund including replacement reinsurance for |
932 | the TICL reductions made pursuant to s. 215.555(17)(e); the |
933 | actual cost paid due to the application of the TICL premium |
934 | factor pursuant to s. 215.555(17)(f); and the actual cost paid |
935 | due to the application of the cash build-up factor pursuant to |
936 | s. 215.555(5)(b) if the insurer: |
937 | a. Elects to purchase financing products such as a |
938 | liquidity instrument or line of credit, in which case the cost |
939 | included in the filing for the liquidity instrument or line of |
940 | credit may not result in a premium increase exceeding 3 percent |
941 | for any individual policyholder. All costs contained in the |
942 | filing may not result in an overall premium increase of more |
943 | than 15 10 percent for any individual policyholder. |
944 | b. Includes in the filing a copy of all of its |
945 | reinsurance, liquidity instrument, or line of credit contracts; |
946 | proof of the billing or payment for the contracts; and the |
947 | calculation upon which the proposed rate change is based |
948 | demonstrating demonstrates that the costs meet the criteria of |
949 | this section and are not loaded for expenses or profit for the |
950 | insurer making the filing. |
951 | c. Includes no other changes to its rates in the filing. |
952 | d. Has not implemented a rate increase within the 6 months |
953 | immediately preceding the filing. |
954 | e. Does not file for a rate increase under any other |
955 | paragraph within 6 months after making a filing under this |
956 | paragraph. |
957 | 2.f. An insurer that purchases reinsurance or financing |
958 | products from an affiliated company may make a separate filing |
959 | in compliance with this paragraph does so only if the costs for |
960 | such reinsurance or financing products are charged at or below |
961 | charges made for comparable coverage by nonaffiliated reinsurers |
962 | or financial entities making such coverage or financing products |
963 | available in this state. |
964 | 3.2. An insurer may only make only one filing per in any |
965 | 12-month period under this paragraph. |
966 | 4.3. An insurer that elects to implement a rate change |
967 | under this paragraph must file its rate filing with the office |
968 | at least 45 days before the effective date of the rate change. |
969 | After an insurer submits a complete filing that meets all of the |
970 | requirements of this paragraph, the office has 45 days after the |
971 | date of the filing to review the rate filing and determine if |
972 | the rate is excessive, inadequate, or unfairly discriminatory. |
973 |
|
974 | The provisions of This subsection does shall not apply to |
975 | workers' compensation, and employer's liability insurance, and |
976 | to motor vehicle insurance. |
977 | (3)(a) For individual risks that are not rated in |
978 | accordance with the insurer's rates, rating schedules, rating |
979 | manuals, and underwriting rules filed with the office and that |
980 | which have been submitted to the insurer for individual rating, |
981 | the insurer must maintain documentation on each risk subject to |
982 | individual risk rating. The documentation must identify the |
983 | named insured and specify the characteristics and classification |
984 | of the risk supporting the reason for the risk being |
985 | individually risk rated, including any modifications to existing |
986 | approved forms to be used on the risk. The insurer must maintain |
987 | these records for a period of at least 5 years after the |
988 | effective date of the policy. |
989 | (b) Individual risk rates and modifications to existing |
990 | approved forms are not subject to this part or part II, except |
991 | for paragraph (a) and ss. 627.402, 627.403, 627.4035, 627.404, |
992 | 627.405, 627.406, 627.407, 627.4085, 627.409, 627.4132, |
993 | 627.4133, 627.415, 627.416, 627.417, 627.419, 627.425, 627.426, |
994 | 627.4265, 627.427, and 627.428, but are subject to all other |
995 | applicable provisions of this code and rules adopted thereunder. |
996 | (c) This subsection does not apply to private passenger |
997 | motor vehicle insurance. |
998 | (d)1. The following categories or kinds of insurance and |
999 | types of commercial lines risks are not subject to paragraph |
1000 | (2)(a) or paragraph (2)(f): |
1001 | a. Excess or umbrella. |
1002 | b. Surety and fidelity. |
1003 | c. Boiler and machinery and leakage and fire extinguishing |
1004 | equipment. |
1005 | d. Errors and omissions. |
1006 | e. Directors and officers, employment practices, and |
1007 | management liability. |
1008 | f. Intellectual property and patent infringement |
1009 | liability. |
1010 | g. Advertising injury and Internet liability insurance. |
1011 | h. Property risks rated under a highly protected risks |
1012 | rating plan. |
1013 | i. Any other commercial lines categories or kinds of |
1014 | insurance or types of commercial lines risks that the office |
1015 | determines should not be subject to paragraph (2)(a) or |
1016 | paragraph (2)(f) because of the existence of a competitive |
1017 | market for such insurance, similarity of such insurance to other |
1018 | categories or kinds of insurance not subject to paragraph (2)(a) |
1019 | or paragraph (2)(f), or to improve the general operational |
1020 | efficiency of the office. |
1021 | 2. Insurers or rating organizations shall establish and |
1022 | use rates, rating schedules, or rating manuals to allow the |
1023 | insurer a reasonable rate of return on insurance and risks |
1024 | described in subparagraph 1. which are written in this state. |
1025 | 3. An insurer must notify the office of any changes to |
1026 | rates for insurance and risks described in subparagraph 1. |
1027 | within no later than 30 days after the effective date of the |
1028 | change. The notice must include the name of the insurer, the |
1029 | type or kind of insurance subject to rate change, total premium |
1030 | written during the immediately preceding year by the insurer for |
1031 | the type or kind of insurance subject to the rate change, and |
1032 | the average statewide percentage change in rates. Underwriting |
1033 | files, premiums, losses, and expense statistics with regard to |
1034 | such insurance and risks described in subparagraph 1. written by |
1035 | an insurer must shall be maintained by the insurer and subject |
1036 | to examination by the office. Upon examination, the office |
1037 | shall, in accordance with generally accepted and reasonable |
1038 | actuarial techniques, shall consider the rate factors in |
1039 | paragraphs (2)(b), (c), and (d) and the standards in paragraph |
1040 | (2)(e) to determine if the rate is excessive, inadequate, or |
1041 | unfairly discriminatory. |
1042 | 4. A rating organization must notify the office of any |
1043 | changes to loss cost for insurance and risks described in |
1044 | subparagraph 1. within no later than 30 days after the effective |
1045 | date of the change. The notice must include the name of the |
1046 | rating organization, the type or kind of insurance subject to a |
1047 | loss cost change, loss costs during the immediately preceding |
1048 | year for the type or kind of insurance subject to the loss cost |
1049 | change, and the average statewide percentage change in loss |
1050 | cost. Loss and exposure statistics with regard to risks |
1051 | applicable to loss costs for a rating organization not subject |
1052 | to paragraph (2)(a) or paragraph (2)(f) must shall be maintained |
1053 | by the rating organization and are subject to examination by the |
1054 | office. Upon examination, the office shall, in accordance with |
1055 | generally accepted and reasonable actuarial techniques, shall |
1056 | consider the rate factors in paragraphs (2)(b)-(d) and the |
1057 | standards in paragraph (2)(e) to determine if the rate is |
1058 | excessive, inadequate, or unfairly discriminatory. |
1059 | 5. In reviewing a rate, the office may require the insurer |
1060 | to provide, at the insurer's expense, all information necessary |
1061 | to evaluate the condition of the company and the reasonableness |
1062 | of the rate according to the applicable criteria described in |
1063 | this section. |
1064 | (4) The establishment of any rate, rating classification, |
1065 | rating plan or schedule, or variation thereof in violation of |
1066 | part IX of chapter 626 is also in violation of this section. In |
1067 | order to enhance the ability of consumers to compare premiums |
1068 | and to increase the accuracy and usefulness of rate-comparison |
1069 | information provided by the office to the public, the office |
1070 | shall develop a proposed standard rating territory plan to be |
1071 | used by all authorized property and casualty insurers for |
1072 | residential property insurance. In adopting the proposed plan, |
1073 | the office may consider geographical characteristics relevant to |
1074 | risk, county lines, major roadways, existing rating territories |
1075 | used by a significant segment of the market, and other relevant |
1076 | factors. Such plan shall be submitted to the President of the |
1077 | Senate and the Speaker of the House of Representatives by |
1078 | January 15, 2006. The plan may not be implemented unless |
1079 | authorized by further act of the Legislature. |
1080 | (5) With respect to a rate filing involving coverage of |
1081 | the type for which the insurer is required to pay a |
1082 | reimbursement premium to the Florida Hurricane Catastrophe Fund, |
1083 | the insurer may fully recoup in its property insurance premiums |
1084 | any reimbursement premiums paid to the Florida Hurricane |
1085 | Catastrophe fund, together with reasonable costs of other |
1086 | reinsurance; however, but except as otherwise provided in this |
1087 | section, the insurer may not recoup reinsurance costs that |
1088 | duplicate coverage provided by the Florida Hurricane Catastrophe |
1089 | fund. An insurer may not recoup more than 1 year of |
1090 | reimbursement premium at a time. Any under-recoupment from the |
1091 | prior year may be added to the following year's reimbursement |
1092 | premium, and any over-recoupment must shall be subtracted from |
1093 | the following year's reimbursement premium. |
1094 | (6)(a) If an insurer requests an administrative hearing |
1095 | pursuant to s. 120.57 related to a rate filing under this |
1096 | section, the director of the Division of Administrative Hearings |
1097 | shall expedite the hearing and assign an administrative law |
1098 | judge who shall commence the hearing within 30 days after the |
1099 | receipt of the formal request and shall enter a recommended |
1100 | order within 30 days after the hearing or within 30 days after |
1101 | receipt of the hearing transcript by the administrative law |
1102 | judge, whichever is later. Each party shall have be allowed 10 |
1103 | days in which to submit written exceptions to the recommended |
1104 | order. The office shall enter a final order within 30 days after |
1105 | the entry of the recommended order. The provisions of this |
1106 | paragraph may be waived upon stipulation of all parties. |
1107 | (b) Upon entry of a final order, the insurer may request a |
1108 | expedited appellate review pursuant to the Florida Rules of |
1109 | Appellate Procedure. It is the intent of the Legislature that |
1110 | the First District Court of Appeal grant an insurer's request |
1111 | for an expedited appellate review. |
1112 | (7)(a) The provisions of this subsection apply only with |
1113 | respect to rates for medical malpractice insurance and shall |
1114 | control to the extent of any conflict with other provisions of |
1115 | this section. |
1116 | (a)(b) Any portion of a judgment entered or settlement |
1117 | paid as a result of a statutory or common-law bad faith action |
1118 | and any portion of a judgment entered which awards punitive |
1119 | damages against an insurer may not be included in the insurer's |
1120 | rate base, and shall not be used to justify a rate or rate |
1121 | change. Any common-law bad faith action identified as such, any |
1122 | portion of a settlement entered as a result of a statutory or |
1123 | common-law action, or any portion of a settlement wherein an |
1124 | insurer agrees to pay specific punitive damages may not be used |
1125 | to justify a rate or rate change. The portion of the taxable |
1126 | costs and attorney's fees which is identified as being related |
1127 | to the bad faith and punitive damages in these judgments and |
1128 | settlements may not be included in the insurer's rate base and |
1129 | used may not be utilized to justify a rate or rate change. |
1130 | (b)(c) Upon reviewing a rate filing and determining |
1131 | whether the rate is excessive, inadequate, or unfairly |
1132 | discriminatory, the office shall consider, in accordance with |
1133 | generally accepted and reasonable actuarial techniques, past and |
1134 | present prospective loss experience, either using loss |
1135 | experience solely for this state or giving greater credibility |
1136 | to this state's loss data after applying actuarially sound |
1137 | methods of assigning credibility to such data. |
1138 | (c)(d) Rates shall be deemed excessive if, among other |
1139 | standards established by this section, the rate structure |
1140 | provides for replenishment of reserves or surpluses from |
1141 | premiums when the replenishment is attributable to investment |
1142 | losses. |
1143 | (d)(e) The insurer must apply a discount or surcharge |
1144 | based on the health care provider's loss experience or shall |
1145 | establish an alternative method giving due consideration to the |
1146 | provider's loss experience. The insurer must include in the |
1147 | filing a copy of the surcharge or discount schedule or a |
1148 | description of the alternative method used, and must provide a |
1149 | copy of such schedule or description, as approved by the office, |
1150 | to policyholders at the time of renewal and to prospective |
1151 | policyholders at the time of application for coverage. |
1152 | (e)(f) Each medical malpractice insurer must make a rate |
1153 | filing under this section, sworn to by at least two executive |
1154 | officers of the insurer, at least once each calendar year. |
1155 | (8)(a)1. No later than 60 days after the effective date of |
1156 | medical malpractice legislation enacted during the 2003 Special |
1157 | Session D of the Florida Legislature, the office shall calculate |
1158 | a presumed factor that reflects the impact that the changes |
1159 | contained in such legislation will have on rates for medical |
1160 | malpractice insurance and shall issue a notice informing all |
1161 | insurers writing medical malpractice coverage of such presumed |
1162 | factor. In determining the presumed factor, the office shall use |
1163 | generally accepted actuarial techniques and standards provided |
1164 | in this section in determining the expected impact on losses, |
1165 | expenses, and investment income of the insurer. To the extent |
1166 | that the operation of a provision of medical malpractice |
1167 | legislation enacted during the 2003 Special Session D of the |
1168 | Florida Legislature is stayed pending a constitutional |
1169 | challenge, the impact of that provision shall not be included in |
1170 | the calculation of a presumed factor under this subparagraph. |
1171 | 2. No later than 60 days after the office issues its |
1172 | notice of the presumed rate change factor under subparagraph 1., |
1173 | each insurer writing medical malpractice coverage in this state |
1174 | shall submit to the office a rate filing for medical malpractice |
1175 | insurance, which will take effect no later than January 1, 2004, |
1176 | and apply retroactively to policies issued or renewed on or |
1177 | after the effective date of medical malpractice legislation |
1178 | enacted during the 2003 Special Session D of the Florida |
1179 | Legislature. Except as authorized under paragraph (b), the |
1180 | filing shall reflect an overall rate reduction at least as great |
1181 | as the presumed factor determined under subparagraph 1. With |
1182 | respect to policies issued on or after the effective date of |
1183 | such legislation and prior to the effective date of the rate |
1184 | filing required by this subsection, the office shall order the |
1185 | insurer to make a refund of the amount that was charged in |
1186 | excess of the rate that is approved. |
1187 | (b) Any insurer or rating organization that contends that |
1188 | the rate provided for in paragraph (a) is excessive, inadequate, |
1189 | or unfairly discriminatory shall separately state in its filing |
1190 | the rate it contends is appropriate and shall state with |
1191 | specificity the factors or data that it contends should be |
1192 | considered in order to produce such appropriate rate. The |
1193 | insurer or rating organization shall be permitted to use all of |
1194 | the generally accepted actuarial techniques provided in this |
1195 | section in making any filing pursuant to this subsection. The |
1196 | office shall review each such exception and approve or |
1197 | disapprove it prior to use. It shall be the insurer's burden to |
1198 | actuarially justify any deviations from the rates required to be |
1199 | filed under paragraph (a). The insurer making a filing under |
1200 | this paragraph shall include in the filing the expected impact |
1201 | of medical malpractice legislation enacted during the 2003 |
1202 | Special Session D of the Florida Legislature on losses, |
1203 | expenses, and rates. |
1204 | (c) If any provision of medical malpractice legislation |
1205 | enacted during the 2003 Special Session D of the Florida |
1206 | Legislature is held invalid by a court of competent |
1207 | jurisdiction, the office shall permit an adjustment of all |
1208 | medical malpractice rates filed under this section to reflect |
1209 | the impact of such holding on such rates so as to ensure that |
1210 | the rates are not excessive, inadequate, or unfairly |
1211 | discriminatory. |
1212 | (d) Rates approved on or before July 1, 2003, for medical |
1213 | malpractice insurance shall remain in effect until the effective |
1214 | date of a new rate filing approved under this subsection. |
1215 | (e) The calculation and notice by the office of the |
1216 | presumed factor pursuant to paragraph (a) is not an order or |
1217 | rule that is subject to chapter 120. If the office enters into a |
1218 | contract with an independent consultant to assist the office in |
1219 | calculating the presumed factor, such contract shall not be |
1220 | subject to the competitive solicitation requirements of s. |
1221 | 287.057. |
1222 | (8)(9)(a) The chief executive officer or chief financial |
1223 | officer of a property insurer and the chief actuary of a |
1224 | property insurer must certify under oath and subject to the |
1225 | penalty of perjury, on a form approved by the commission, the |
1226 | following information, which must accompany a rate filing: |
1227 | 1. The signing officer and actuary have reviewed the rate |
1228 | filing; |
1229 | 2. Based on the signing officer's and actuary's knowledge, |
1230 | the rate filing does not contain any untrue statement of a |
1231 | material fact or omit to state a material fact necessary in |
1232 | order to make the statements made, in light of the circumstances |
1233 | under which such statements were made, not misleading; |
1234 | 3. Based on the signing officer's and actuary's knowledge, |
1235 | the information and other factors described in paragraph (2)(b), |
1236 | including, but not limited to, investment income, fairly present |
1237 | in all material respects the basis of the rate filing for the |
1238 | periods presented in the filing; and |
1239 | 4. Based on the signing officer's and actuary's knowledge, |
1240 | the rate filing reflects all premium savings that are reasonably |
1241 | expected to result from legislative enactments and are in |
1242 | accordance with generally accepted and reasonable actuarial |
1243 | techniques. |
1244 | (b) A signing officer or actuary who knowingly makes |
1245 | making a false certification under this subsection commits a |
1246 | violation of s. 626.9541(1)(e) and is subject to the penalties |
1247 | under s. 626.9521. |
1248 | (c) Failure to provide such certification by the officer |
1249 | and actuary shall result in the rate filing being disapproved |
1250 | without prejudice to be refiled. |
1251 | (d) The certification made pursuant to paragraph (a) is |
1252 | not rendered false if, after making the subject rate filing, the |
1253 | insurer provides the office with additional or supplementary |
1254 | information pursuant to a formal or informal request from the |
1255 | office. However, the actuary primarily responsible for preparing |
1256 | and submitting the additional or supplementary information shall |
1257 | certify the information consistent with the certification |
1258 | required in paragraph (a) and the penalties in paragraph (b), |
1259 | except that the chief executive officer or chief financial |
1260 | officer or chief actuary is not required to certify to the |
1261 | additional or supplementary information. |
1262 | (e)(d) The commission may adopt rules and forms pursuant |
1263 | to ss. 120.536(1) and 120.54 to administer this subsection. |
1264 | (9)(10) The burden is on the office to establish that |
1265 | rates are excessive for personal lines residential coverage with |
1266 | a dwelling replacement cost of $1 million or more or for a |
1267 | single condominium unit with a combined dwelling and contents |
1268 | replacement cost of $1 million or more. Upon request of the |
1269 | office, the insurer shall provide to the office such loss and |
1270 | expense information as the office reasonably needs to meet this |
1271 | burden. |
1272 | (10)(11) Any interest paid pursuant to s. 627.70131(5) may |
1273 | not be included in the insurer's rate base and may not be used |
1274 | to justify a rate or rate change. |
1275 | Section 12. Paragraph (b) of subsection (3) of section |
1276 | 627.06281, Florida Statutes, is amended to read: |
1277 | 627.06281 Public hurricane loss projection model; |
1278 | reporting of data by insurers.- |
1279 | (3) |
1280 | (b) The fees charged for private sector access and use of |
1281 | the model shall be the reasonable costs associated with the |
1282 | operation and maintenance of the model. Such fees do not apply |
1283 | to access and use of the model by the office. By January 1, |
1284 | 2009, the office shall establish by rule a fee schedule for |
1285 | access to and the use of the model. The fee schedule must be |
1286 | reasonably calculated to cover only the actual costs of |
1287 | providing access to and the use of the model. |
1288 | Section 13. Subsections (1) and (5) and paragraph (b) of |
1289 | subsection (8) of section 627.0629, Florida Statutes, are |
1290 | amended to read: |
1291 | 627.0629 Residential property insurance; rate filings.- |
1292 | (1)(a) It is the intent of the Legislature that insurers |
1293 | must provide savings to consumers who install or implement |
1294 | windstorm damage mitigation techniques, alterations, or |
1295 | solutions to their properties to prevent windstorm losses. A |
1296 | rate filing for residential property insurance must include |
1297 | actuarially reasonable discounts, credits, or other rate |
1298 | differentials, or appropriate reductions in deductibles, for |
1299 | properties on which fixtures or construction techniques |
1300 | demonstrated to reduce the amount of loss in a windstorm have |
1301 | been installed or implemented. The fixtures or construction |
1302 | techniques must shall include, but not be limited to, fixtures |
1303 | or construction techniques that which enhance roof strength, |
1304 | roof covering performance, roof-to-wall strength, wall-to-floor- |
1305 | to-foundation strength, opening protection, and window, door, |
1306 | and skylight strength. Credits, discounts, or other rate |
1307 | differentials, or appropriate reductions in deductibles, for |
1308 | fixtures and construction techniques that which meet the minimum |
1309 | requirements of the Florida Building Code must be included in |
1310 | the rate filing. All insurance companies must make a rate filing |
1311 | which includes the credits, discounts, or other rate |
1312 | differentials or reductions in deductibles by February 28, 2003. |
1313 | By July 1, 2007, the office shall reevaluate the discounts, |
1314 | credits, other rate differentials, and appropriate reductions in |
1315 | deductibles for fixtures and construction techniques that meet |
1316 | the minimum requirements of the Florida Building Code, based |
1317 | upon actual experience or any other loss relativity studies |
1318 | available to the office. The office shall determine the |
1319 | discounts, credits, other rate differentials, and appropriate |
1320 | reductions in deductibles that reflect the full actuarial value |
1321 | of such revaluation, which may be used by insurers in rate |
1322 | filings. |
1323 | (b) By February 1, 2011, the Office of Insurance |
1324 | Regulation, in consultation with the Department of Financial |
1325 | Services and the Department of Community Affairs, shall develop |
1326 | and make publicly available a proposed method for insurers to |
1327 | establish discounts, credits, or other rate differentials for |
1328 | hurricane mitigation measures which directly correlate to the |
1329 | numerical rating assigned to a structure pursuant to the uniform |
1330 | home grading scale adopted by the Financial Services Commission |
1331 | pursuant to s. 215.55865, including any proposed changes to the |
1332 | uniform home grading scale. By October 1, 2011, the commission |
1333 | shall adopt rules requiring insurers to make rate filings for |
1334 | residential property insurance which revise insurers' discounts, |
1335 | credits, or other rate differentials for hurricane mitigation |
1336 | measures so that such rate differentials correlate directly to |
1337 | the uniform home grading scale. The rules may include such |
1338 | changes to the uniform home grading scale as the commission |
1339 | determines are necessary, and may specify the minimum required |
1340 | discounts, credits, or other rate differentials. Such rate |
1341 | differentials must be consistent with generally accepted |
1342 | actuarial principles and wind-loss mitigation studies. The rules |
1343 | shall allow a period of at least 2 years after the effective |
1344 | date of the revised mitigation discounts, credits, or other rate |
1345 | differentials for a property owner to obtain an inspection or |
1346 | otherwise qualify for the revised credit, during which time the |
1347 | insurer shall continue to apply the mitigation credit that was |
1348 | applied immediately prior to the effective date of the revised |
1349 | credit. Discounts, credits, and other rate differentials |
1350 | established for rate filings under this paragraph shall |
1351 | supersede, after adoption, the discounts, credits, and other |
1352 | rate differentials included in rate filings under paragraph (a). |
1353 | (5) In order to provide an appropriate transition period, |
1354 | an insurer may, in its sole discretion, implement an approved |
1355 | rate filing for residential property insurance over a period of |
1356 | years. Such An insurer electing to phase in its rate filing must |
1357 | provide an informational notice to the office setting out its |
1358 | schedule for implementation of the phased-in rate filing. The An |
1359 | insurer may include in its rate the actual cost of private |
1360 | market reinsurance that corresponds to available coverage of the |
1361 | Temporary Increase in Coverage Limits, TICL, from the Florida |
1362 | Hurricane Catastrophe Fund. The insurer may also include the |
1363 | cost of reinsurance to replace the TICL reduction implemented |
1364 | pursuant to s. 215.555(17)(d)9. However, this cost for |
1365 | reinsurance may not include any expense or profit load or result |
1366 | in a total annual base rate increase in excess of 10 percent. |
1367 | (8) EVALUATION OF RESIDENTIAL PROPERTY STRUCTURAL |
1368 | SOUNDNESS.- |
1369 | (b) To the extent that funds are provided for this purpose |
1370 | in the General Appropriations Act, the Legislature hereby |
1371 | authorizes the establishment of a program to be administered by |
1372 | the Citizens Property Insurance Corporation for homeowners |
1373 | insured in the high-risk account is authorized. |
1374 | Section 14. Paragraph (b) of subsection (2) of section |
1375 | 627.4133, Florida Statutes, is amended to read: |
1376 | 627.4133 Notice of cancellation, nonrenewal, or renewal |
1377 | premium.- |
1378 | (2) With respect to any personal lines or commercial |
1379 | residential property insurance policy, including, but not |
1380 | limited to, any homeowner's, mobile home owner's, farmowner's, |
1381 | condominium association, condominium unit owner's, apartment |
1382 | building, or other policy covering a residential structure or |
1383 | its contents: |
1384 | (b) The insurer shall give the named insured written |
1385 | notice of nonrenewal, cancellation, or termination at least 100 |
1386 | days before prior to the effective date of the nonrenewal, |
1387 | cancellation, or termination. However, the insurer shall give at |
1388 | least 100 days' written notice, or written notice by June 1, |
1389 | whichever is earlier, for any nonrenewal, cancellation, or |
1390 | termination that would be effective between June 1 and November |
1391 | 30. The notice must include the reason or reasons for the |
1392 | nonrenewal, cancellation, or termination, except that: |
1393 | 1. The insurer shall give the named insured written notice |
1394 | of nonrenewal, cancellation, or termination at least 120 180 |
1395 | days prior to the effective date of the nonrenewal, |
1396 | cancellation, or termination for a named insured whose |
1397 | residential structure has been insured by that insurer or an |
1398 | affiliated insurer for at least a 5-year period immediately |
1399 | prior to the date of the written notice. |
1400 | 2. If When cancellation is for nonpayment of premium, at |
1401 | least 10 days' written notice of cancellation accompanied by the |
1402 | reason therefor must shall be given. As used in this |
1403 | subparagraph, the term "nonpayment of premium" means failure of |
1404 | the named insured to discharge when due any of her or his |
1405 | obligations in connection with the payment of premiums on a |
1406 | policy or any installment of such premium, whether the premium |
1407 | is payable directly to the insurer or its agent or indirectly |
1408 | under any premium finance plan or extension of credit, or |
1409 | failure to maintain membership in an organization if such |
1410 | membership is a condition precedent to insurance coverage. The |
1411 | term "Nonpayment of premium" also means the failure of a |
1412 | financial institution to honor an insurance applicant's check |
1413 | after delivery to a licensed agent for payment of a premium, |
1414 | even if the agent has previously delivered or transferred the |
1415 | premium to the insurer. If a dishonored check represents the |
1416 | initial premium payment, the contract and all contractual |
1417 | obligations are shall be void ab initio unless the nonpayment is |
1418 | cured within the earlier of 5 days after actual notice by |
1419 | certified mail is received by the applicant or 15 days after |
1420 | notice is sent to the applicant by certified mail or registered |
1421 | mail, and if the contract is void, any premium received by the |
1422 | insurer from a third party must shall be refunded to that party |
1423 | in full. |
1424 | 3. If When such cancellation or termination occurs during |
1425 | the first 90 days during which the insurance is in force and the |
1426 | insurance is canceled or terminated for reasons other than |
1427 | nonpayment of premium, at least 20 days' written notice of |
1428 | cancellation or termination accompanied by the reason therefor |
1429 | must shall be given unless except where there has been a |
1430 | material misstatement or misrepresentation or failure to comply |
1431 | with the underwriting requirements established by the insurer. |
1432 | 4. The requirement for providing written notice of |
1433 | nonrenewal by June 1 of any nonrenewal that would be effective |
1434 | between June 1 and November 30 does not apply to the following |
1435 | situations, but the insurer remains subject to the requirement |
1436 | to provide such notice at least 100 days before prior to the |
1437 | effective date of nonrenewal: |
1438 | a. A policy that is nonrenewed due to a revision in the |
1439 | coverage for sinkhole losses and catastrophic ground cover |
1440 | collapse pursuant to s. 627.706, as amended by s. 30, chapter |
1441 | 2007-1, Laws of Florida. |
1442 | b. A policy that is nonrenewed by Citizens Property |
1443 | Insurance Corporation, pursuant to s. 627.351(6), for a policy |
1444 | that has been assumed by an authorized insurer offering |
1445 | replacement or renewal coverage to the policyholder. |
1446 |
|
1447 | After the policy has been in effect for 90 days, the policy may |
1448 | shall not be canceled by the insurer unless except when there |
1449 | has been a material misstatement, a nonpayment of premium, a |
1450 | failure to comply with underwriting requirements established by |
1451 | the insurer within 90 days after of the date of effectuation of |
1452 | coverage, or a substantial change in the risk covered by the |
1453 | policy or if when the cancellation is for all insureds under |
1454 | such policies for a given class of insureds. This paragraph does |
1455 | not apply to individually rated risks having a policy term of |
1456 | less than 90 days. |
1457 | 5. Notwithstanding any other provision of law, an insurer |
1458 | may cancel or nonrenew a property insurance policy after at |
1459 | least 45 days' notice if the office finds that the early |
1460 | cancellation of some or all of the insurer's policies is |
1461 | necessary to protect the best interests of the public or |
1462 | policyholders and the office approves the insurer's plan for |
1463 | early cancellation or nonrenewal of some or all of its policies. |
1464 | The office may base such finding upon the financial condition of |
1465 | the insurer, lack of adequate reinsurance coverage for hurricane |
1466 | risk, or other relevant factors. The office may condition its |
1467 | finding on the consent of the insurer to be placed under |
1468 | administrative supervision pursuant to s. 624.81 or to the |
1469 | appointment of a receiver under chapter 631. |
1470 | Section 15. Section 627.43141, Florida Statutes, is |
1471 | created to read: |
1472 | 627.43141 Notice of change in policy terms.- |
1473 | (1) As used in this section, the term: |
1474 | (a) "Change in policy terms" means the modification, |
1475 | addition, or deletion of any term, coverage, duty, or condition |
1476 | from the previous policy. The correction of typographical or |
1477 | scrivener's errors or the application of mandated legislative |
1478 | changes is not a change in policy terms. |
1479 | (b) "Policy" means a written contract of personal lines |
1480 | property and casualty insurance or a written agreement for |
1481 | insurance, or the certificate of such insurance, by whatever |
1482 | name called, and includes all clauses, riders, endorsements, and |
1483 | papers that are a part of such policy. The term does not include |
1484 | a binder as defined in s. 627.420 unless the duration of the |
1485 | binder period exceeds 60 days. |
1486 | (c) "Renewal" means the issuance and delivery by an |
1487 | insurer of a policy superseding at the end of the policy period |
1488 | a policy previously issued and delivered by the same insurer or |
1489 | the issuance and delivery of a certificate or notice extending |
1490 | the term of a policy beyond its policy period or term. Any |
1491 | policy that has a policy period or term of less than 6 months or |
1492 | that does not have a fixed expiration date shall, for purposes |
1493 | of this section, be considered as written for successive policy |
1494 | periods or terms of 6 months. |
1495 | (2) A renewal policy may contain a change in policy terms. |
1496 | If a renewal policy does contains such change, the insurer must |
1497 | give the named insured written notice of the change, which must |
1498 | be enclosed along with the written notice of renewal premium |
1499 | required by ss. 627.4133 and 627.728. Such notice shall be |
1500 | entitled "Notice of Change in Policy Terms." |
1501 | (3) Although not required, proof of mailing or registered |
1502 | mailing through the United States Postal Service of the Notice |
1503 | of Change in Policy Terms to the named insured at the address |
1504 | shown in the policy is sufficient proof of notice. |
1505 | (4) Receipt of the premium payment for the renewal policy |
1506 | by the insurer is deemed to be acceptance of the new policy |
1507 | terms by the named insured. |
1508 | (5) If an insurer fails to provide the notice required in |
1509 | subsection (2), the original policy terms remain in effect until |
1510 | the next renewal and the proper service of the notice, or until |
1511 | the effective date of replacement coverage obtained by the named |
1512 | insured, whichever occurs first. |
1513 | (6) The intent of this section is to: |
1514 | (a) Allow an insurer to make a change in policy terms |
1515 | without nonrenewing those policyholders that the insurer wishes |
1516 | to continue insuring. |
1517 | (b) Alleviate concern and confusion to the policyholder |
1518 | caused by the required policy nonrenewal for the limited issue |
1519 | if an insurer intends to renew the insurance policy, but the new |
1520 | policy contains a change in policy terms. |
1521 | (c) Encourage policyholders to discuss their coverages |
1522 | with their insurance agents. |
1523 | Section 16. Section 627.7011, Florida Statutes, is amended |
1524 | to read: |
1525 | 627.7011 Homeowners' policies; offer of replacement cost |
1526 | coverage and law and ordinance coverage.- |
1527 | (1) Before Prior to issuing or renewing a homeowner's |
1528 | insurance policy on or after October 1, 2005, or prior to the |
1529 | first renewal of a homeowner's insurance policy on or after |
1530 | October 1, 2005, the insurer must offer each of the following: |
1531 | (a) A policy or endorsement providing that any loss that |
1532 | which is repaired or replaced will be adjusted on the basis of |
1533 | replacement costs to the dwelling not exceeding policy limits as |
1534 | to the dwelling, rather than actual cash value, but not |
1535 | including costs necessary to meet applicable laws and ordinances |
1536 | regulating the construction, use, or repair of any property or |
1537 | requiring the tearing down of any property, including the costs |
1538 | of removing debris. |
1539 | (b) A policy or endorsement providing that, subject to |
1540 | other policy provisions, any loss that which is repaired or |
1541 | replaced at any location will be adjusted on the basis of |
1542 | replacement costs to the dwelling not exceeding policy limits as |
1543 | to the dwelling, rather than actual cash value, and also |
1544 | including costs necessary to meet applicable laws and ordinances |
1545 | regulating the construction, use, or repair of any property or |
1546 | requiring the tearing down of any property, including the costs |
1547 | of removing debris.; However, such additional costs necessary to |
1548 | meet applicable laws and ordinances may be limited to either 25 |
1549 | percent or 50 percent of the dwelling limit, as selected by the |
1550 | policyholder, and such coverage applies shall apply only to |
1551 | repairs of the damaged portion of the structure unless the total |
1552 | damage to the structure exceeds 50 percent of the replacement |
1553 | cost of the structure. |
1554 |
|
1555 | An insurer is not required to make the offers required by this |
1556 | subsection with respect to the issuance or renewal of a |
1557 | homeowner's policy that contains the provisions specified in |
1558 | paragraph (b) for law and ordinance coverage limited to 25 |
1559 | percent of the dwelling limit, except that the insurer must |
1560 | offer the law and ordinance coverage limited to 50 percent of |
1561 | the dwelling limit. This subsection does not prohibit the offer |
1562 | of a guaranteed replacement cost policy. |
1563 | (2) Unless the insurer obtains the policyholder's written |
1564 | refusal of the policies or endorsements specified in subsection |
1565 | (1), any policy covering the dwelling is deemed to include the |
1566 | law and ordinance coverage limited to 25 percent of the dwelling |
1567 | limit. The rejection or selection of alternative coverage shall |
1568 | be made on a form approved by the office. The form must shall |
1569 | fully advise the applicant of the nature of the coverage being |
1570 | rejected. If this form is signed by a named insured, it is will |
1571 | be conclusively presumed that there was an informed, knowing |
1572 | rejection of the coverage or election of the alternative |
1573 | coverage on behalf of all insureds. Unless the policyholder |
1574 | requests in writing the coverage specified in this section, it |
1575 | need not be provided in or supplemental to any other policy that |
1576 | renews, insures, extends, changes, supersedes, or replaces an |
1577 | existing policy if when the policyholder has rejected the |
1578 | coverage specified in this section or has selected alternative |
1579 | coverage. The insurer must provide the such policyholder with |
1580 | notice of the availability of such coverage in a form approved |
1581 | by the office at least once every 3 years. The failure to |
1582 | provide such notice constitutes a violation of this code, but |
1583 | does not affect the coverage provided under the policy. |
1584 | (3)(a) In the event of a loss for which a dwelling is |
1585 | insured on the basis of replacement costs, the insurer initially |
1586 | must pay at least the actual cash value of the insured loss, |
1587 | less any applicable deductible. An insured shall subsequently |
1588 | enter into a contract for the performance of building and |
1589 | structural repairs. The insurer shall pay any remaining amounts |
1590 | incurred to perform such repairs as the work is performed. With |
1591 | the exception of incidental expenses to mitigate further damage, |
1592 | the insurer or any contractor or subcontractor may not require |
1593 | the policyholder to advance payment for such repairs or |
1594 | expenses. The insurer may waive the requirement for a contract |
1595 | as provided in this paragraph. An insured shall have a period of |
1596 | 1 year after the date the insurer pays actual cash value to make |
1597 | a claim for replacement cost. If a total loss of a dwelling |
1598 | occurs, the insurer shall pay the replacement cost coverage |
1599 | without reservation or holdback of any depreciation in value, |
1600 | pursuant to s. 627.702. |
1601 | (b) In the event of a loss for which a dwelling or |
1602 | personal property is insured on the basis of replacement costs, |
1603 | the insurer shall pay the replacement cost without reservation |
1604 | or holdback of any depreciation in value, whether or not the |
1605 | insured replaces or repairs the dwelling or property. |
1606 | (4) A Any homeowner's insurance policy issued or renewed |
1607 | on or after October 1, 2005, must include in bold type no |
1608 | smaller than 18 points the following statement: |
1609 |
|
1610 | "LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE |
1611 | THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO |
1612 | CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE |
1613 | NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS |
1614 | COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE |
1615 | DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT." |
1616 |
|
1617 | The intent of this subsection is to encourage policyholders to |
1618 | purchase sufficient coverage to protect them in case events |
1619 | excluded from the standard homeowners policy, such as law and |
1620 | ordinance enforcement and flood, combine with covered events to |
1621 | produce damage or loss to the insured property. The intent is |
1622 | also to encourage policyholders to discuss these issues with |
1623 | their insurance agent. |
1624 | (5) Nothing in This section does not: shall be construed |
1625 | to |
1626 | (a) Apply to policies not considered to be "homeowners' |
1627 | policies," as that term is commonly understood in the insurance |
1628 | industry. This section specifically does not |
1629 | (b) Apply to mobile home policies. Nothing in this section |
1630 | (c) Limit shall be construed as limiting the ability of an |
1631 | any insurer to reject or nonrenew any insured or applicant on |
1632 | the grounds that the structure does not meet underwriting |
1633 | criteria applicable to replacement cost or law and ordinance |
1634 | policies or for other lawful reasons. |
1635 | (d)(6) This section does not Prohibit an insurer from |
1636 | limiting its liability under a policy or endorsement providing |
1637 | that loss will be adjusted on the basis of replacement costs to |
1638 | the lesser of: |
1639 | 1.(a) The limit of liability shown on the policy |
1640 | declarations page; |
1641 | 2.(b) The reasonable and necessary cost to repair the |
1642 | damaged, destroyed, or stolen covered property; or |
1643 | 3.(c) The reasonable and necessary cost to replace the |
1644 | damaged, destroyed, or stolen covered property. |
1645 | (e)(7) This section does not Prohibit an insurer from |
1646 | exercising its right to repair damaged property in compliance |
1647 | with its policy and s. 627.702(7). |
1648 | Section 17. Paragraph (a) of subsection (5) of section |
1649 | 627.70131, Florida Statutes, is amended to read: |
1650 | 627.70131 Insurer's duty to acknowledge communications |
1651 | regarding claims; investigation.- |
1652 | (5)(a) Within 90 days after an insurer receives notice of |
1653 | an initial, reopened, or supplemental a property insurance claim |
1654 | from a policyholder, the insurer shall pay or deny such claim or |
1655 | a portion of the claim unless the failure to pay such claim or a |
1656 | portion of the claim is caused by factors beyond the control of |
1657 | the insurer which reasonably prevent such payment. Any payment |
1658 | of an initial or supplemental a claim or portion of such a claim |
1659 | made paid 90 days after the insurer receives notice of the |
1660 | claim, or made paid more than 15 days after there are no longer |
1661 | factors beyond the control of the insurer which reasonably |
1662 | prevented such payment, whichever is later, bears shall bear |
1663 | interest at the rate set forth in s. 55.03. Interest begins to |
1664 | accrue from the date the insurer receives notice of the claim. |
1665 | The provisions of this subsection may not be waived, voided, or |
1666 | nullified by the terms of the insurance policy. If there is a |
1667 | right to prejudgment interest, the insured shall select whether |
1668 | to receive prejudgment interest or interest under this |
1669 | subsection. Interest is payable when the claim or portion of the |
1670 | claim is paid. Failure to comply with this subsection |
1671 | constitutes a violation of this code. However, failure to comply |
1672 | with this subsection does shall not form the sole basis for a |
1673 | private cause of action. |
1674 | Section 18. The Legislature finds and declares: |
1675 | (1) There is a compelling state interest in maintaining a |
1676 | viable and orderly private-sector market for property insurance |
1677 | in this state. The lack of a viable and orderly property market |
1678 | reduces the availability of property insurance coverage to state |
1679 | residents, increases the cost of property insurance, and |
1680 | increases the state's reliance on a residual property insurance |
1681 | market and its potential for imposing assessments on |
1682 | policyholders throughout the state. |
1683 | (2) In 2005, the Legislature revised ss. 627.706-627.7074, |
1684 | Florida Statutes, to adopt certain geological or technical |
1685 | terms; to increase reliance on objective, scientific testing |
1686 | requirements; and generally to reduce the number of sinkhole |
1687 | claims and related disputes arising under prior law. The |
1688 | Legislature determined that since the enactment of these |
1689 | statutory revisions, both private-sector insurers and Citizens |
1690 | Property Insurance Corporation have, nevertheless, continued to |
1691 | experience high claims frequency and severity for sinkhole |
1692 | insurance claims. In addition, many properties remain unrepaired |
1693 | even after loss payments, which reduces the local property tax |
1694 | base and adversely affects the real estate market. Therefore, |
1695 | the Legislature finds that losses associated with sinkhole |
1696 | claims adversely affect the public health, safety, and welfare |
1697 | of this state and its citizens. |
1698 | (3) Pursuant to sections 19 through 23 of this act, |
1699 | technical or scientific definitions adopted in the 2005 |
1700 | legislation are clarified to implement and advance the |
1701 | Legislature's intended reduction of sinkhole claims and |
1702 | disputes. Certain other revisions to ss. 627.706-627.7074, |
1703 | Florida Statutes, are enacted to advance legislative intent to |
1704 | rely on scientific or technical determinations relating to |
1705 | sinkholes and sinkhole claims, reduce the number and cost of |
1706 | disputes relating to sinkhole claims, and ensure that repairs |
1707 | are made commensurate with the scientific and technical |
1708 | determinations and insurance claims payments. |
1709 | Section 19. Section 627.706, Florida Statutes, is amended |
1710 | to read: |
1711 | 627.706 Sinkhole insurance; catastrophic ground cover |
1712 | collapse; definitions.- |
1713 | (1)(a) Every insurer authorized to transact property |
1714 | insurance in this state must shall provide coverage for a |
1715 | catastrophic ground cover collapse. |
1716 | (b) The insurer and shall make available, for an |
1717 | appropriate additional premium, coverage for sinkhole losses on |
1718 | any structure, including the contents of personal property |
1719 | contained therein, to the extent provided in the form to which |
1720 | the coverage attaches. The insurer may require an inspection of |
1721 | the property before issuance of sinkhole loss coverage. A policy |
1722 | for residential property insurance may include a deductible |
1723 | amount applicable to sinkhole losses equal to 1 percent, 2 |
1724 | percent, 5 percent, or 10 percent of the policy dwelling limits, |
1725 | with appropriate premium discounts offered with each deductible |
1726 | amount. |
1727 | (c) The insurer may restrict catastrophic ground cover |
1728 | collapse and sinkhole loss coverage to the principal building, |
1729 | as defined in the applicable policy. |
1730 | (2) As used in ss. 627.706-627.7074, and as used in |
1731 | connection with any policy providing coverage for a catastrophic |
1732 | ground cover collapse or for sinkhole losses, the term: |
1733 | (a) "Catastrophic ground cover collapse" means geological |
1734 | activity that results in all the following: |
1735 | 1. The abrupt collapse of the ground cover; |
1736 | 2. A depression in the ground cover clearly visible to the |
1737 | naked eye; |
1738 | 3. Structural damage to the covered building, including |
1739 | the foundation; and |
1740 | 4. The insured structure being condemned and ordered to be |
1741 | vacated by the governmental agency authorized by law to issue |
1742 | such an order for that structure. |
1743 |
|
1744 | Contents coverage applies if there is a loss resulting from a |
1745 | catastrophic ground cover collapse. Structural Damage consisting |
1746 | merely of the settling or cracking of a foundation, structure, |
1747 | or building does not constitute a loss resulting from a |
1748 | catastrophic ground cover collapse. |
1749 | (b) "Neutral evaluation" means the alternative dispute |
1750 | resolution provided in s. 627.7074. |
1751 | (c) "Neutral evaluator" means a professional engineer or a |
1752 | professional geologist who has completed a course of study in |
1753 | alternative dispute resolution designed or approved by the |
1754 | department for use in the neutral evaluation process and who is |
1755 | determined to be fair and impartial. |
1756 | (d)(e) "Professional engineer" means a person, as defined |
1757 | in s. 471.005, who has a bachelor's degree or higher in |
1758 | engineering and has successfully completed at least five courses |
1759 | in any combination of the following: geotechnical engineering, |
1760 | structural engineering, soil mechanics, foundations, or geology |
1761 | with a specialty in the geotechnical engineering field. A |
1762 | professional engineer must also have geotechnical experience and |
1763 | expertise in the identification of sinkhole activity as well as |
1764 | other potential causes of structural damage to the structure. |
1765 | (e)(f) "Professional geologist" means a person, as defined |
1766 | in by s. 492.102, who has a bachelor's degree or higher in |
1767 | geology or related earth science and with expertise in the |
1768 | geology of Florida. A professional geologist must have |
1769 | geological experience and expertise in the identification of |
1770 | sinkhole activity as well as other potential geologic causes of |
1771 | structural damage to the structure. |
1772 | (f)(b) "Sinkhole" means a landform created by subsidence |
1773 | of soil, sediment, or rock as underlying strata are dissolved by |
1774 | groundwater. A sinkhole forms may form by collapse into |
1775 | subterranean voids created by dissolution of limestone or |
1776 | dolostone or by subsidence as these strata are dissolved. |
1777 | (g)(c) "Sinkhole loss" means structural damage to the |
1778 | covered building, including the foundation, caused by sinkhole |
1779 | activity. Contents coverage and additional living expenses shall |
1780 | apply only if there is structural damage to the covered building |
1781 | caused by sinkhole activity. |
1782 | (h)(d) "Sinkhole activity" means settlement or systematic |
1783 | weakening of the earth supporting such property only if the when |
1784 | such settlement or systematic weakening results from |
1785 | contemporaneous movement or raveling of soils, sediments, or |
1786 | rock materials into subterranean voids created by the effect of |
1787 | water on a limestone or similar rock formation. |
1788 | (i) "Structural damage" means a covered building has |
1789 | experienced: |
1790 | 1. Foundation displacement in excess of acceptable |
1791 | variances or deflections as defined in ACI 117-90 or the Florida |
1792 | Building Code and damage in the primary structural members or |
1793 | primary structural systems that prevents them from supporting |
1794 | the loads and forces they were designed to support as defined in |
1795 | the Florida Building Code; |
1796 | 2. Damage that results in stresses in a primary structural |
1797 | member greater than one and one-third the nominal strength |
1798 | allowed under the Florida Building Code for new buildings of |
1799 | similar structure, purpose, or location; |
1800 | 3. Listing, leaning, or buckling of the exterior load |
1801 | bearing walls or other vertical primary structural members to |
1802 | such an extent that a plumb line passing through the center of |
1803 | gravity does not fall inside the middle one-third of the base as |
1804 | defined within the Florida Building Code; |
1805 | 4. Damage that results in the building, or any portion |
1806 | thereof, being likely to imminently collapse partially or |
1807 | completely because of the movement or instability of the ground |
1808 | within the influence zone of the supporting ground within the |
1809 | sheer plane necessary for the purpose of supporting such |
1810 | building as defined within the Florida Building Code; or |
1811 | 5. Damage that qualifies as "substantial structural |
1812 | damage" as defined in the Florida Building Code. |
1813 | (3) On or before June 1, 2007, Every insurer authorized to |
1814 | transact property insurance in this state shall make a proper |
1815 | filing with the office for the purpose of extending the |
1816 | appropriate forms of property insurance to include coverage for |
1817 | catastrophic ground cover collapse or for sinkhole losses. |
1818 | coverage for catastrophic ground cover collapse may not go into |
1819 | effect until the effective date provided for in the filing |
1820 | approved by the office. |
1821 | (3)(4) Insurers offering policies that exclude coverage |
1822 | for sinkhole losses must shall inform policyholders in bold type |
1823 | of not less than 14 points as follows: "YOUR POLICY PROVIDES |
1824 | COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS |
1825 | IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, |
1826 | YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU |
1827 | MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN |
1828 | ADDITIONAL PREMIUM." |
1829 | (4)(5) An insurer offering sinkhole coverage to |
1830 | policyholders before or after the adoption of s. 30, chapter |
1831 | 2007-1, Laws of Florida, may nonrenew the policies of |
1832 | policyholders maintaining sinkhole coverage in Pasco County or |
1833 | Hernando County, at the option of the insurer, and provide an |
1834 | offer of coverage that to such policyholders which includes |
1835 | catastrophic ground cover collapse and excludes sinkhole |
1836 | coverage. Insurers acting in accordance with this subsection are |
1837 | subject to the following requirements: |
1838 | (a) Policyholders must be notified that a nonrenewal is |
1839 | for purposes of removing sinkhole coverage, and that the |
1840 | policyholder is still being offered a policy that provides |
1841 | coverage for catastrophic ground cover collapse. |
1842 | (b) Policyholders must be provided an actuarially |
1843 | reasonable premium credit or discount for the removal of |
1844 | sinkhole coverage and provision of only catastrophic ground |
1845 | cover collapse. |
1846 | (c) Subject to the provisions of this subsection and the |
1847 | insurer's approved underwriting or insurability guidelines, the |
1848 | insurer shall provide each policyholder with the opportunity to |
1849 | purchase an endorsement to his or her policy providing sinkhole |
1850 | coverage and may require an inspection of the property before |
1851 | issuance of a sinkhole coverage endorsement. |
1852 | (d) Section 624.4305 does not apply to nonrenewal notices |
1853 | issued pursuant to this subsection. |
1854 | (5) Any claim, including, but not limited to, initial, |
1855 | supplemental, and reopened claims under an insurance policy that |
1856 | provides sinkhole coverage is barred unless notice of the claim |
1857 | was given to the insurer in accordance with the terms of the |
1858 | policy within 4 years after the policyholder knew or reasonably |
1859 | should have known about the sinkhole loss. |
1860 | Section 20. Section 627.7065, Florida Statutes, is |
1861 | repealed. |
1862 | Section 21. Section 627.707, Florida Statutes, is amended |
1863 | to read: |
1864 | 627.707 Standards for Investigation of sinkhole claims by |
1865 | insurers; insurer payment; nonrenewals.-Upon receipt of a claim |
1866 | for a sinkhole loss to a covered building, an insurer must meet |
1867 | the following standards in investigating a claim: |
1868 | (1) The insurer must inspect make an inspection of the |
1869 | policyholder's insured's premises to determine if there is |
1870 | structural has been physical damage that to the structure which |
1871 | may be the result of sinkhole activity. |
1872 | (2) If the insurer confirms that structural damage exists |
1873 | but is unable to identify a valid cause of such damage or |
1874 | discovers that such damage is consistent with sinkhole loss |
1875 | Following the insurer's initial inspection, the insurer shall |
1876 | engage a professional engineer or a professional geologist to |
1877 | conduct testing as provided in s. 627.7072 to determine the |
1878 | cause of the loss within a reasonable professional probability |
1879 | and issue a report as provided in s. 627.7073, only if sinkhole |
1880 | loss is covered under the policy. Except as provided in |
1881 | subsections (4) and (6), the fees and costs of the professional |
1882 | engineer or professional geologist shall be paid by the |
1883 | insurer.: |
1884 | (a) The insurer is unable to identify a valid cause of the |
1885 | damage or discovers damage to the structure which is consistent |
1886 | with sinkhole loss; or |
1887 | (b) The policyholder demands testing in accordance with |
1888 | this section or s. 627.7072. |
1889 | (3) Following the initial inspection of the policyholder's |
1890 | insured premises, the insurer shall provide written notice to |
1891 | the policyholder disclosing the following information: |
1892 | (a) What the insurer has determined to be the cause of |
1893 | damage, if the insurer has made such a determination. |
1894 | (b) A statement of the circumstances under which the |
1895 | insurer is required to engage a professional engineer or a |
1896 | professional geologist to verify or eliminate sinkhole loss and |
1897 | to engage a professional engineer to make recommendations |
1898 | regarding land and building stabilization and foundation repair. |
1899 | (c) A statement regarding the right of the policyholder to |
1900 | request testing by a professional engineer or a professional |
1901 | geologist, and the circumstances under which the policyholder |
1902 | may demand certain testing, and the circumstances under which |
1903 | the policyholder may incur costs associated with testing. |
1904 | (4)(a) If the insurer determines that there is no sinkhole |
1905 | loss, the insurer may deny the claim. |
1906 | (b) If coverage for sinkhole loss is available and If the |
1907 | insurer denies the claim, without performing testing under s. |
1908 | 627.7072, the policyholder may demand testing by the insurer |
1909 | under s. 627.7072. |
1910 | 1. The policyholder's demand for testing must be |
1911 | communicated to the insurer in writing within 60 days after the |
1912 | policyholder's receipt of the insurer's denial of the claim. |
1913 | 2. The policyholder shall pay 50 percent of the actual |
1914 | costs of the analyses and services provided under ss. 627.7072 |
1915 | and 627.7073 or $2,500, whichever is less. |
1916 | 3. The insurer shall reimburse the policyholder for the |
1917 | costs if the insurer obtains pursuant to s. 627.7073 written |
1918 | certification that there is sinkhole loss. |
1919 | (5)(a) Subject to paragraph (b), If a sinkhole loss is |
1920 | verified, the insurer shall pay to stabilize the land and |
1921 | building and repair the foundation in accordance with the |
1922 | recommendations of the professional engineer retained pursuant |
1923 | to subsection (2), as provided under s. 627.7073, and in |
1924 | consultation with notice to the policyholder, subject to the |
1925 | coverage and terms of the policy. The insurer shall pay for |
1926 | other repairs to the structure and contents in accordance with |
1927 | the terms of the policy. |
1928 | (a)(b) The insurer may limit its total claims payment to |
1929 | the actual cash value of the sinkhole loss, which does not |
1930 | include including underpinning or grouting or any other repair |
1931 | technique performed below the existing foundation of the |
1932 | building, until the policyholder enters into a contract for the |
1933 | performance of building stabilization or foundation repairs in |
1934 | accordance with the recommendations set forth in the insurer's |
1935 | report issued pursuant to s. 627.7073. |
1936 | (b) In order to prevent additional damage to the building |
1937 | or structure, the policyholder must enter into a contract for |
1938 | the performance of building stabilization or foundation repairs |
1939 | within 90 days after the insurance company confirms coverage for |
1940 | the sinkhole loss and notifies the policyholder of such |
1941 | confirmation. This time period is tolled if either party invokes |
1942 | the neutral evaluation process and begins again 10 days after |
1943 | the conclusion of the neutral evaluation process. |
1944 | (c) After the policyholder enters into the contract for |
1945 | the performance of building stabilization or foundation repairs, |
1946 | the insurer shall pay the amounts necessary to begin and perform |
1947 | such repairs as the work is performed and the expenses are |
1948 | incurred. The insurer may not require the policyholder to |
1949 | advance payment for such repairs. If repair covered by a |
1950 | personal lines residential property insurance policy has begun |
1951 | and the professional engineer selected or approved by the |
1952 | insurer determines that the repair cannot be completed within |
1953 | the policy limits, the insurer must either complete the |
1954 | professional engineer's recommended repair or tender the policy |
1955 | limits to the policyholder without a reduction for the repair |
1956 | expenses incurred. |
1957 | (d) The stabilization and all other repairs to the |
1958 | structure and contents must be completed within 12 months after |
1959 | entering into the contract for repairs described in paragraph |
1960 | (b) unless: |
1961 | 1. There is a mutual agreement between the insurer and the |
1962 | policyholder; |
1963 | 2. The claim is involved with the neutral evaluation |
1964 | process; |
1965 | 3. The claim is in litigation; or |
1966 | 4. The claim is under appraisal or mediation. |
1967 | (e)(c) Upon the insurer's obtaining the written approval |
1968 | of the policyholder and any lienholder, the insurer may make |
1969 | payment directly to the persons selected by the policyholder to |
1970 | perform the land and building stabilization and foundation |
1971 | repairs. The decision by the insurer to make payment to such |
1972 | persons does not hold the insurer liable for the work performed. |
1973 | The policyholder may not accept a rebate from any person |
1974 | performing the repairs specified in this section. If a |
1975 | policyholder does receive a rebate, coverage is void and the |
1976 | policyholder must refund the amount of the rebate to the |
1977 | insurer. Any person making the repairs specified in this section |
1978 | who offers a rebate, or any policyholder who accepts a rebate |
1979 | for such repairs, commits insurance fraud, a felony of the third |
1980 | degree punishable as provided in s. 775.082, s. 775.083, or s. |
1981 | 775.084. |
1982 | (6) Except as provided in subsection (7), the fees and |
1983 | costs of the professional engineer or the professional geologist |
1984 | shall be paid by the insurer. |
1985 | (6)(7) If the insurer obtains, pursuant to s. 627.7073, |
1986 | written certification that there is no sinkhole loss or that the |
1987 | cause of the damage was not sinkhole activity, and if the |
1988 | policyholder has submitted the sinkhole claim without good faith |
1989 | grounds for submitting such claim, the policyholder shall |
1990 | reimburse the insurer for 50 percent of the actual costs of the |
1991 | analyses and services provided under ss. 627.7072 and 627.7073; |
1992 | however, a policyholder is not required to reimburse an insurer |
1993 | more than $2,500 with respect to any claim. A policyholder is |
1994 | required to pay reimbursement under this subsection only if the |
1995 | policyholder requested the analysis and services provided under |
1996 | ss. 627.7072 and 627.7073 and the insurer, before prior to |
1997 | ordering the analysis under s. 627.7072, informs the |
1998 | policyholder in writing of the policyholder's potential |
1999 | liability for reimbursement and gives the policyholder the |
2000 | opportunity to withdraw the claim. |
2001 | (7)(8) An No insurer may not shall nonrenew any policy of |
2002 | property insurance on the basis of filing of claims for sinkhole |
2003 | partial loss if caused by sinkhole damage or clay shrinkage as |
2004 | long as the total of such payments does not exceed the current |
2005 | policy limits of coverage for the policy in effect on the date |
2006 | of loss, for property damage to the covered building, as set |
2007 | forth on the declarations page, and provided the insured has |
2008 | repaired the structure in accordance with the engineering |
2009 | recommendations made pursuant to subsection (2) upon which any |
2010 | payment or policy proceeds were based. |
2011 | (8)(9) The insurer may engage a professional structural |
2012 | engineer to make recommendations as to the repair of the |
2013 | structure. |
2014 | Section 22. Section 627.7073, Florida Statutes, is amended |
2015 | to read: |
2016 | 627.7073 Sinkhole reports.- |
2017 | (1) Upon completion of testing as provided in s. 627.7072, |
2018 | the professional engineer or professional geologist shall issue |
2019 | a report and certification to the insurer and the policyholder |
2020 | as provided in this section. |
2021 | (a) Sinkhole loss is verified if, based upon tests |
2022 | performed in accordance with s. 627.7072, a professional |
2023 | engineer or a professional geologist issues a written report and |
2024 | certification stating: |
2025 | 1. That structural damage to the covered building has been |
2026 | identified within a reasonable professional probability. |
2027 | 2.1. That the cause of the actual physical and structural |
2028 | damage is sinkhole activity within a reasonable professional |
2029 | probability. |
2030 | 3.2. That the analyses conducted were of sufficient scope |
2031 | to identify sinkhole activity as the cause of damage within a |
2032 | reasonable professional probability. |
2033 | 4.3. A description of the tests performed. |
2034 | 5.4. A recommendation by the professional engineer of |
2035 | methods for stabilizing the land and building and for making |
2036 | repairs to the foundation. |
2037 | (b) If there is no structural damage or if sinkhole |
2038 | activity is eliminated as the cause of such damage to the |
2039 | covered building structure, the professional engineer or |
2040 | professional geologist shall issue a written report and |
2041 | certification to the policyholder and the insurer stating: |
2042 | 1. That there is no structural damage or the cause of such |
2043 | the damage is not sinkhole activity within a reasonable |
2044 | professional probability. |
2045 | 2. That the analyses and tests conducted were of |
2046 | sufficient scope to eliminate sinkhole activity as the cause of |
2047 | the structural damage within a reasonable professional |
2048 | probability. |
2049 | 3. A statement of the cause of the structural damage |
2050 | within a reasonable professional probability. |
2051 | 4. A description of the tests performed. |
2052 | (c) The respective findings, opinions, and recommendations |
2053 | of the professional engineer or professional geologist as to the |
2054 | cause of distress to the property and the findings, opinions, |
2055 | and recommendations of the professional engineer as to land and |
2056 | building stabilization and foundation repair shall be presumed |
2057 | correct. |
2058 | (2)(a) Any insurer that has paid a claim for a sinkhole |
2059 | loss shall file a copy of the report and certification, prepared |
2060 | pursuant to subsection (1), including the legal description of |
2061 | the real property and the name of the property owner, the |
2062 | neutral evaluator's report, if any, that indicates that sinkhole |
2063 | activity caused the damage claimed, a copy of the certification |
2064 | indicating that stabilization has been completed, if applicable, |
2065 | and the amount of the payment, with the county clerk of court, |
2066 | who shall record the report and certification. The insurer shall |
2067 | bear the cost of filing and recording one or more reports and |
2068 | certifications the report and certification. There shall be no |
2069 | cause of action or liability against an insurer for compliance |
2070 | with this section. |
2071 | (a) The recording of the report and certification does |
2072 | not: |
2073 | 1. Constitute a lien, encumbrance, or restriction on the |
2074 | title to the real property or constitute a defect in the title |
2075 | to the real property; |
2076 | 2. Create any cause of action or liability against any |
2077 | grantor of the real property for breach of any warranty of good |
2078 | title or warranty against encumbrances; or |
2079 | 3. Create any cause of action or liability against any |
2080 | title insurer that insures the title to the real property. |
2081 | (b) As a precondition to accepting payment for a sinkhole |
2082 | loss, the policyholder must file a copy of any report prepared |
2083 | on behalf or at the request of the policyholder regarding the |
2084 | insured property. The policyholder shall bear the cost of filing |
2085 | and recording such sinkhole report. The recording of the report |
2086 | does not: |
2087 | 1. Constitute a lien, encumbrance, or restriction on the |
2088 | title to the real property or constitute a defect in the title |
2089 | to the real property; |
2090 | 2. Create any cause of action or liability against any |
2091 | grantor of the real property for breach of any warranty of good |
2092 | title or warranty against encumbrances; or |
2093 | 3. Create any cause of action or liability against any |
2094 | title insurer that insures the title to the real property. |
2095 | (c)(b) The seller of real property upon which a sinkhole |
2096 | claim has been made by the seller and paid by the insurer must |
2097 | shall disclose to the buyer of such property that a claim has |
2098 | been paid and whether or not the full amount of the proceeds |
2099 | were used to repair the sinkhole damage. |
2100 | Section 23. Section 627.7074, Florida Statutes, is amended |
2101 | to read: |
2102 | 627.7074 Alternative procedure for resolution of disputed |
2103 | sinkhole insurance claims.- |
2104 | (1) As used in this section, the term: |
2105 | (a) "Neutral evaluation" means the alternative dispute |
2106 | resolution provided for in this section. |
2107 | (b) "Neutral evaluator" means a professional engineer or a |
2108 | professional geologist who has completed a course of study in |
2109 | alternative dispute resolution designed or approved by the |
2110 | department for use in the neutral evaluation process, who is |
2111 | determined to be fair and impartial. |
2112 | (1)(2)(a) The department shall: |
2113 | (a) Certify and maintain a list of persons who are neutral |
2114 | evaluators. |
2115 | (b) The department shall Prepare a consumer information |
2116 | pamphlet for distribution by insurers to policyholders which |
2117 | clearly describes the neutral evaluation process and includes |
2118 | information and forms necessary for the policyholder to request |
2119 | a neutral evaluation. |
2120 | (2) Neutral evaluation is available to either party if a |
2121 | sinkhole report has been issued pursuant to s. 627.7073. At a |
2122 | minimum, neutral evaluation must determine: |
2123 | (a) Causation; |
2124 | (b) All methods of stabilization and repair both above and |
2125 | below ground; |
2126 | (c) The costs for stabilization and all repairs; and |
2127 | (d) Information necessary to carry out subsection (12). |
2128 | (3) Following the receipt of the report provided under s. |
2129 | 627.7073 or the denial of a claim for a sinkhole loss, the |
2130 | insurer shall notify the policyholder of his or her right to |
2131 | participate in the neutral evaluation program under this |
2132 | section. Neutral evaluation supersedes the alternative dispute |
2133 | resolution process under s. 627.7015, but does not invalidate |
2134 | the appraisal clause of the insurance policy. The insurer shall |
2135 | provide to the policyholder the consumer information pamphlet |
2136 | prepared by the department pursuant to subsection (1) |
2137 | electronically or by United States mail paragraph (2)(b). |
2138 | (4) Neutral evaluation is nonbinding, but mandatory if |
2139 | requested by either party. A request for neutral evaluation may |
2140 | be filed with the department by the policyholder or the insurer |
2141 | on a form approved by the department. The request for neutral |
2142 | evaluation must state the reason for the request and must |
2143 | include an explanation of all the issues in dispute at the time |
2144 | of the request. Filing a request for neutral evaluation tolls |
2145 | the applicable time requirements for filing suit for a period of |
2146 | 60 days following the conclusion of the neutral evaluation |
2147 | process or the time prescribed in s. 95.11, whichever is later. |
2148 | (5) Neutral evaluation shall be conducted as an informal |
2149 | process in which formal rules of evidence and procedure need not |
2150 | be observed. A party to neutral evaluation is not required to |
2151 | attend neutral evaluation if a representative of the party |
2152 | attends and has the authority to make a binding decision on |
2153 | behalf of the party. All parties shall participate in the |
2154 | evaluation in good faith. The neutral evaluator must be allowed |
2155 | reasonable access to the interior and exterior of insured |
2156 | structures to be evaluated or for which a claim has been made. |
2157 | Any reports initiated by the policyholder, or an agent of the |
2158 | policyholder, confirming a sinkhole loss or disputing another |
2159 | sinkhole report regarding insured structures must be provided to |
2160 | the neutral evaluator before the evaluator's physical inspection |
2161 | of the insured property. |
2162 | (6) The insurer shall pay the costs associated with the |
2163 | neutral evaluation. However, if a party chooses to hire a court |
2164 | reporter or stenographer to contemporaneously record and |
2165 | document the neutral evaluation, that party must bear such |
2166 | costs. |
2167 | (7) Upon receipt of a request for neutral evaluation, the |
2168 | department shall provide the parties a list of certified neutral |
2169 | evaluators. The parties shall mutually select a neutral |
2170 | evaluator from the list and promptly inform the department. If |
2171 | the parties cannot agree to a neutral evaluator within 10 |
2172 | business days, The department shall allow the parties to submit |
2173 | requests to disqualify evaluators on the list for cause. |
2174 | (a) The department shall disqualify neutral evaluators for |
2175 | cause based only on any of the following grounds: |
2176 | 1. A familial relationship exists between the neutral |
2177 | evaluator and either party or a representative of either party |
2178 | within the third degree. |
2179 | 2. The proposed neutral evaluator has, in a professional |
2180 | capacity, previously represented either party or a |
2181 | representative of either party, in the same or a substantially |
2182 | related matter. |
2183 | 3. The proposed neutral evaluator has, in a professional |
2184 | capacity, represented another person in the same or a |
2185 | substantially related matter and that person's interests are |
2186 | materially adverse to the interests of the parties. The term |
2187 | "substantially related matter" means participation by the |
2188 | neutral evaluator on the same claim, property, or adjacent |
2189 | property. |
2190 | 4. The proposed neutral evaluator has, within the |
2191 | preceding 5 years, worked as an employer or employee of any |
2192 | party to the case. |
2193 | (b) The parties shall appoint a neutral evaluator from the |
2194 | department list and promptly inform the department. If the |
2195 | parties cannot agree to a neutral evaluator within 14 days, the |
2196 | department shall appoint a neutral evaluator from the list of |
2197 | certified neutral evaluators. The department shall allow each |
2198 | party to disqualify two neutral evaluators without cause. Upon |
2199 | selection or appointment, the department shall promptly refer |
2200 | the request to the neutral evaluator. |
2201 | (c) Within 7 5 business days after the referral, the |
2202 | neutral evaluator shall notify the policyholder and the insurer |
2203 | of the date, time, and place of the neutral evaluation |
2204 | conference. The conference may be held by telephone, if feasible |
2205 | and desirable. The neutral evaluator shall hold the neutral |
2206 | evaluation conference shall be held within 90 45 days after the |
2207 | receipt of the request by the department. Failure of the neutral |
2208 | evaluator to hold the conference within 90 days does not |
2209 | invalidate either party's right to neutral evaluation or to a |
2210 | neutral evaluation conference held outside this timeframe. |
2211 | (8) The department shall adopt rules of procedure for the |
2212 | neutral evaluation process. |
2213 | (8)(9) For policyholders not represented by an attorney, a |
2214 | consumer affairs specialist of the department or an employee |
2215 | designated as the primary contact for consumers on issues |
2216 | relating to sinkholes under s. 20.121 shall be available for |
2217 | consultation to the extent that he or she may lawfully do so. |
2218 | (9)(10) Evidence of an offer to settle a claim during the |
2219 | neutral evaluation process, as well as any relevant conduct or |
2220 | statements made in negotiations concerning the offer to settle a |
2221 | claim, is inadmissible to prove liability or absence of |
2222 | liability for the claim or its value, except as provided in |
2223 | subsection (14) (13). |
2224 | (10)(11) Regardless of when noticed, any court proceeding |
2225 | related to the subject matter of the neutral evaluation shall be |
2226 | stayed pending completion of the neutral evaluation and for 5 |
2227 | days after the filing of the neutral evaluator's report with the |
2228 | court. |
2229 | (11) If, based upon his or her professional training and |
2230 | credentials, a neutral evaluator is qualified to determine only |
2231 | disputes relating to causation or method of repair, the |
2232 | department shall allow the neutral evaluator to enlist the |
2233 | assistance of another professional from the list of neutral |
2234 | evaluators not previously stricken, who, based upon his or her |
2235 | professional training and credentials, is able to provide an |
2236 | opinion as to other disputed issues. A professional who would be |
2237 | disqualified for any reason listed in subsection (7) must be |
2238 | disqualified. The neutral evaluator may also use the services of |
2239 | professional engineers and professional geologists who are not |
2240 | certified as neutral evaluators, as well as licensed building |
2241 | contractors, in order to ensure that all items in dispute are |
2242 | addressed and the neutral evaluation can be completed. Any |
2243 | professional engineer, professional geologist, or licensed |
2244 | building contractor retained may be disqualified for any of the |
2245 | reasons listed in subsection (7). |
2246 | (12) At For matters that are not resolved by the parties |
2247 | at the conclusion of the neutral evaluation, the neutral |
2248 | evaluator shall prepare a report describing all matters that are |
2249 | the subject of the neutral evaluation, including whether, |
2250 | stating that in his or her opinion the sinkhole loss has been |
2251 | verified or eliminated within a reasonable degree of |
2252 | professional probability and, if verified, whether the sinkhole |
2253 | activity caused structural damage to the covered building, and |
2254 | if so, the need for and estimated costs of stabilizing the land |
2255 | and any covered structures or buildings and other appropriate |
2256 | remediation or necessary building structural repairs due to the |
2257 | sinkhole loss. The evaluator's report shall be sent to all |
2258 | parties in attendance at the neutral evaluation and to the |
2259 | department, within 14 days after completing the neutral |
2260 | evaluation conference. |
2261 | (13) The recommendation of the neutral evaluator is not |
2262 | binding on any party, and the parties retain access to the |
2263 | court. The neutral evaluator's written recommendation is |
2264 | admissible in any subsequent action or proceeding relating to |
2265 | the claim or to the cause of action giving rise to the claim. |
2266 | (14) If the neutral evaluator first verifies the existence |
2267 | of a sinkhole that caused structural damage and, second, |
2268 | recommends the need for and estimates costs of stabilizing the |
2269 | land and any covered structures or buildings and other |
2270 | appropriate remediation or building structural repairs, which |
2271 | costs exceed the amount that the insurer has offered to pay the |
2272 | policyholder, the insurer is liable to the policyholder for up |
2273 | to $2,500 in attorney's fees for the attorney's participation in |
2274 | the neutral evaluation process. For purposes of this subsection, |
2275 | the term "offer to pay" means a written offer signed by the |
2276 | insurer or its legal representative and delivered to the |
2277 | policyholder within 10 days after the insurer receives notice |
2278 | that a request for neutral evaluation has been made under this |
2279 | section. |
2280 | (15) If the insurer timely agrees in writing to comply and |
2281 | timely complies with the recommendation of the neutral |
2282 | evaluator, but the policyholder declines to resolve the matter |
2283 | in accordance with the recommendation of the neutral evaluator |
2284 | pursuant to this section: |
2285 | (a) The insurer is not liable for extracontractual damages |
2286 | related to a claim for a sinkhole loss but only as related to |
2287 | the issues determined by the neutral evaluation process. This |
2288 | section does not affect or impair claims for extracontractual |
2289 | damages unrelated to the issues determined by the neutral |
2290 | evaluation process contained in this section; and |
2291 | (b) The insurer is not liable for attorney's fees under s. |
2292 | 627.428 or other provisions of the insurance code unless the |
2293 | policyholder obtains a judgment that is more favorable than the |
2294 | recommendation of the neutral evaluator. |
2295 | (16) Neutral evaluators are deemed to be agents of the |
2296 | department and have immunity from suit as provided in s. 44.107. |
2297 | (17) The department shall adopt rules of procedure for the |
2298 | neutral evaluation process. |
2299 | Section 24. Subsection (8) of section 627.711, Florida |
2300 | Statutes, is amended to read: |
2301 | 627.711 Notice of premium discounts for hurricane loss |
2302 | mitigation; uniform mitigation verification inspection form.- |
2303 | (8) At its expense, the insurer may require that any |
2304 | uniform mitigation verification form provided by a policyholder, |
2305 | policyholder's agent, an authorized mitigation inspector, or |
2306 | inspection company be independently verified by an inspector, an |
2307 | inspection company, or an independent third-party quality |
2308 | assurance provider which does possess a quality assurance |
2309 | program before prior to accepting the uniform mitigation |
2310 | verification form as valid. |
2311 | Section 25. Subsection (3) of section 631.54, Florida |
2312 | Statutes, is amended to read: |
2313 | 631.54 Definitions.-As used in this part: |
2314 | (3) "Covered claim" means an unpaid claim, including one |
2315 | of unearned premiums, which arises out of, and is within the |
2316 | coverage, and not in excess of, the applicable limits of an |
2317 | insurance policy to which this part applies, issued by an |
2318 | insurer, if such insurer becomes an insolvent insurer and the |
2319 | claimant or insured is a resident of this state at the time of |
2320 | the insured event or the property from which the claim arises is |
2321 | permanently located in this state. For entities other than |
2322 | individuals, the residence of a claimant, insured, or |
2323 | policyholder is the state in which the entity's principal place |
2324 | of business is located at the time of the insured event. The |
2325 | term does "Covered claim" shall not include: |
2326 | (a) Any amount due any reinsurer, insurer, insurance pool, |
2327 | or underwriting association, sought directly or indirectly |
2328 | through a third party, as subrogation, contribution, |
2329 | indemnification, or otherwise; or |
2330 | (b) Any claim that would otherwise be a covered claim |
2331 | under this part that has been rejected by any other state |
2332 | guaranty fund on the grounds that an insured's net worth is |
2333 | greater than that allowed under that state's guaranty law. |
2334 | Member insurers shall have no right of subrogation, |
2335 | contribution, indemnification, or otherwise, sought directly or |
2336 | indirectly through a third party, against the insured of any |
2337 | insolvent member; or |
2338 | (c) Any amount payable for a sinkhole loss other than |
2339 | testing deemed appropriate by the association or payable for the |
2340 | actual repair of the loss, except that the association may not |
2341 | pay for attorney's fees or public adjuster's fees in connection |
2342 | with a sinkhole loss or pay the policyholder. The association |
2343 | may pay for actual repairs to the property, but is not liable |
2344 | for amounts in excess of policy limits. |
2345 | Section 26. If any provision of this act, or the |
2346 | application thereof to any person or circumstance is held |
2347 | invalid, such invalidity shall not affect other provisions or |
2348 | applications of this act which can be given effect without the |
2349 | invalid provision or application. It is the express intent of |
2350 | the Legislature to enact multiple important, but independent, |
2351 | reforms to Florida law relating to sinkhole insurance coverage |
2352 | and related claims. The Legislature further intends that the |
2353 | multiple reforms in the act could and should be enforced if one |
2354 | or more provisions are held invalid. To this end, the provisions |
2355 | of this act are declared to be severable. |
2356 | Section 27. Except as otherwise expressly provided in this |
2357 | act, this act shall take effect upon becoming a law. |