House Bill hb1571

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    Florida House of Representatives - 2001                HB 1571

        By Representatives Lee and Mahon






  1                      A bill to be entitled

  2         An act relating to property and casualty

  3         insurance risk apportionment; amending s.

  4         627.351, F.S.; providing that nursing homes and

  5         assisted living facilities are immediately

  6         eligible for coverage in the Florida Property

  7         and Casualty Joint Underwriting Association;

  8         providing that rates used by the association

  9         are subject to s. 627.062, F.S.; eliminating

10         provisions tying the initial rates of the

11         association to rates contained in the Insurance

12         Services Office filing with the Department of

13         Insurance; providing an effective date.

14

15  Be It Enacted by the Legislature of the State of Florida:

16

17         Section 1.  Paragraphs (a) and (b) of subsection (5) of

18  section 627.351, Florida Statutes, are amended to read:

19         627.351  Insurance risk apportionment plans.--

20         (5)  PROPERTY AND CASUALTY INSURANCE RISK

21  APPORTIONMENT.--The department shall adopt by rule a joint

22  underwriting plan to equitably apportion among insurers

23  authorized in this state to write property insurance as

24  defined in s. 624.604 or casualty insurance as defined in s.

25  624.605, the underwriting of one or more classes of property

26  insurance or casualty insurance, except for the types of

27  insurance that are included within property insurance or

28  casualty insurance for which an equitable apportionment plan,

29  assigned risk plan, or joint underwriting plan is authorized

30  under s. 627.311 or subsection (1), subsection (2), subsection

31  (3), subsection (4), or subsection (6) and except for risks

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  1  eligible for flood insurance written through the federal flood

  2  insurance program to persons with risks eligible under

  3  subparagraph (a)1. and who are in good faith entitled to, but

  4  are unable to, obtain such property or casualty insurance

  5  coverage, including excess coverage, through the voluntary

  6  market. For purposes of this subsection, an adequate level of

  7  coverage means that coverage which is required by state law or

  8  by responsible or prudent business practices. The Joint

  9  Underwriting Association shall not be required to provide

10  coverage for any type of risk for which there are no insurers

11  providing similar coverage in this state. The department may

12  designate one or more participating insurers who agree to

13  provide policyholder and claims service, including the

14  issuance of policies, on behalf of the participating insurers.

15         (a)  The plan shall provide:

16         1.  A means of establishing eligibility of a risk for

17  obtaining insurance through the plan, which provides that:

18         a.  A risk shall be eligible for such property

19  insurance or casualty insurance as is required by Florida law

20  if the insurance is unavailable in the voluntary market,

21  including the market assistance program and the surplus lines

22  market.

23         b.  A commercial risk not eligible under

24  sub-subparagraph a. shall be eligible for property or casualty

25  insurance if:

26         (I)  The insurance is unavailable in the voluntary

27  market, including the market assistance plan and the surplus

28  lines market;

29         (II)  Failure to secure the insurance would

30  substantially impair the ability of the entity to conduct its

31  affairs; and

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  1         (III)  The risk is not determined by the Risk

  2  Underwriting Committee to be uninsurable.

  3         c.  In the event the Federal Government terminates the

  4  Federal Crime Insurance Program established under 44 C.F.R.

  5  ss. 80-83, Florida commercial and residential risks previously

  6  insured under the federal program shall be eligible under the

  7  plan.

  8         d.(I)  In the event a risk is eligible under this

  9  paragraph and in the event the market assistance plan receives

10  a minimum of 100 applications for coverage within a 3-month

11  period, or 200 applications for coverage within a 1-year

12  period or less, for a given class of risk contained in the

13  classification system defined in the plan of operation of the

14  Joint Underwriting Association, and unless the market

15  assistance plan provides a quotation for at least 80 percent

16  of such applicants, such classification shall immediately be

17  eligible for coverage in the Joint Underwriting Association.

18         (II)  Any market assistance plan application which is

19  rejected because an individual risk is so hazardous as to be

20  practically uninsurable, considering whether the likelihood of

21  a loss for such a risk is substantially higher than for other

22  risks of the same class due to individual risk

23  characteristics, prior loss experience, unwillingness to

24  cooperate with a prior insurer, physical characteristics and

25  physical location shall not be included in the minimum

26  percentage calculation provided above. In the event that there

27  is any legal or administrative challenge to a determination by

28  the department that the conditions of this subparagraph have

29  been met for eligibility for coverage in the Joint

30  Underwriting Association for a given classification, any

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  1  eligible risk may obtain coverage during the pendency of any

  2  such challenge.

  3         e.  In order to qualify as a quotation for the purpose

  4  of meeting the minimum percentage calculation in this

  5  subparagraph, the quoted premium must meet the following

  6  criteria:

  7         (I)  In the case of an admitted carrier, the quoted

  8  premium must not exceed the premium available for a given

  9  classification currently in use by the Joint Underwriting

10  Association or the premium developed by using the rates and

11  rating plans on file with the department by the quoting

12  insurer, whichever is greater.

13         (II)  In the case of an authorized surplus lines

14  insurer, the quoted premium must not exceed the premium

15  available for a given classification currently in use by the

16  Joint Underwriting Association by more than 25 percent, after

17  consideration of any individual risk surcharge or credit.

18         f.  Any agent who falsely certifies the unavailability

19  of coverage as provided by sub-subparagraphs a. and b., is

20  subject to the penalties provided in s. 626.611.

21         g.  Notwithstanding sub-subparagraph d., nursing homes

22  licensed under part II of chapter 400 and assisted living

23  facilities licensed under part III of chapter 400 are

24  immediately eligible for coverage in the Joint Underwriting

25  Association.

26         2.  A means for the equitable apportionment of profits

27  or losses and expenses among participating insurers.

28         3.  Rules for the classification of risks and rates

29  which reflect the past and prospective loss experience.

30         4.  A rating plan which reasonably reflects the prior

31  claims experience of the insureds. Such rating plan shall

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  1  include at least two levels of rates for risks that have

  2  favorable loss experience and risks that have unfavorable loss

  3  experience, as established by the plan.

  4         5.  Reasonable limits to available amounts of

  5  insurance. Such limits may not be less than the amounts of

  6  insurance required of eligible risks by Florida law.

  7         6.  Risk management requirements for insurance where

  8  such requirements are reasonable and are expected to reduce

  9  losses.

10         7.  Deductibles as may be necessary to meet the needs

11  of insureds.

12         8.  Policy forms which are consistent with the forms in

13  use by the majority of the insurers providing coverage in the

14  voluntary market for the coverage requested by the applicant.

15         9.  A means to remove risks from the plan once such

16  risks no longer meet the eligibility requirements of this

17  paragraph. For this purpose, the plan shall include the

18  following requirements: At each 6-month interval after the

19  activation of any class of insureds, the board of governors or

20  its designated committee shall review the number of

21  applications to the market assistance plan for that class. If,

22  based on these latest numbers, at least 90 percent of such

23  applications have been provided a quotation, the Joint

24  Underwriting Association shall cease underwriting new

25  applications for such class within 30 days, and notification

26  of this decision shall be sent to the Insurance Commissioner,

27  the major agents' associations, and the board of directors of

28  the market assistance plan. A quotation for the purpose of

29  this subparagraph shall meet the same criteria for a quotation

30  as provided in sub-subparagraph d. All policies which were

31  previously written for that class shall continue in force

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  1  until their normal expiration date, at which time, subject to

  2  the required timely notification of nonrenewal by the Joint

  3  Underwriting Association, the insured may then elect to

  4  reapply to the Joint Underwriting Association according to the

  5  requirements of eligibility. If, upon reapplication, those

  6  previously insured Joint Underwriting Association risks meet

  7  the eligibility requirements, the Joint Underwriting

  8  Association shall provide the coverage requested.

  9         10.  A means for providing credits to insurers against

10  any deficit assessment levied pursuant to paragraph (c), for

11  risks voluntarily written through the market assistance plan

12  by such insurers.

13         11.  That the Joint Underwriting Association shall

14  operate subject to the supervision and approval of a board of

15  governors consisting of 13 individuals appointed by the

16  Insurance Commissioner, and shall have an executive or

17  underwriting committee. At least four of the members shall be

18  representatives of insurance trade associations as follows:

19  one member from the American Insurance Association, one member

20  from the Alliance of American Insurers, one member from the

21  National Association of Independent Insurers, and one member

22  from an unaffiliated insurer writing coverage on a national

23  basis. Two representatives shall be from two of the statewide

24  agents' associations. Each board member shall be appointed to

25  serve for 2-year terms beginning on a date designated by the

26  plan and shall serve at the pleasure of the commissioner.

27  Members may be reappointed for subsequent terms.

28         (b)  Rates used by the Joint Underwriting Association

29  must shall be actuarially sound and are subject to s. 627.062.

30  To the extent applicable, the rate standards set forth in s.

31  627.062 shall be considered by the department in establishing

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  1  rates to be used by the joint underwriting plan. The initial

  2  rate level shall be determined using the rates, rules, rating

  3  plans, and classifications contained in the most current

  4  Insurance Services Office (ISO) filing with the department or

  5  the filing of other licensed rating organizations with an

  6  additional increment of 25 percent of premium. For any type of

  7  coverage or classification which lends itself to manual rating

  8  for which the Insurance Services Office or another licensed

  9  rating organization does not file or publish a rate, the Joint

10  Underwriting Association shall file and use an initial rate

11  based on the average current market rate. The initial rate

12  level for the rate plan shall also be subject to an experience

13  and schedule rating plan which may produce a maximum of 25

14  percent debits or credits. For any risk which does not lend

15  itself to manual rating and for which no rate has been

16  promulgated under the rate plan, the board shall develop and

17  file with the commissioner, subject to his or her approval,

18  appropriate criteria and factors for rating the individual

19  risk. Such criteria and factors shall include, but not be

20  limited to, loss rating plans, composite rating plans, and

21  unique and unusual risk rating plans. The initial rates

22  required under this paragraph shall be adjusted in conformity

23  with future filings by the Insurance Services Office with the

24  department and shall remain in effect until such time as the

25  Joint Underwriting Association has sufficient data as to

26  independently justify an actuarially sound change in such

27  rates.

28         Section 2.  This act shall take effect October 1, 2001.

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  2                       LEGISLATIVE SUMMARY

  3
      Revises provisions relating to insurance coverage for
  4    nursing homes and assisted living facilities. Provides
      that such facilities are immediately eligible for
  5    coverage in the Florida Property and Casualty Joint
      Underwriting Association. Provides that the rates used by
  6    the association are subject to certain rate standards.
      Eliminates requirements that the initial rates of the
  7    association be tied to certain Insurance Services Office
      filings.
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