Senate Bill sb2080

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    Florida Senate - 2003                                  SB 2080

    By Senator Peaden





    2-948-03                                           See HB 1129

  1                      A bill to be entitled

  2         An act relating to insurance; amending s.

  3         501.212, F.S.; deleting an exclusion from

  4         application of deceptive and unfair trade

  5         practices provisions to the Department of

  6         Insurance; creating s. 624.156, F.S.; providing

  7         that certain consumer protection laws apply to

  8         the business of insurance; amending s. 627.041,

  9         F.S.; revising definitions; amending s.

10         627.062, F.S.; specifying nonapplication to

11         professional medical malpractice insurance;

12         amending s. 627.314, F.S.; revising certain

13         authorized actions multiple insurers may engage

14         in together; prohibiting certain conduct on the

15         part of insurers; amending s. 627.357, F.S.;

16         deleting a prohibition against forming a

17         medical malpractice self-insurance fund;

18         amending s. 627.4147, F.S.; revising certain

19         notification criteria; providing for

20         application of a discount or surcharge or

21         alternative method based on loss experience in

22         determining the premium paid by a health care

23         provider; providing requirements; providing a

24         limitation; amending s. 627.912, F.S.;

25         increases the limit on a fine; requiring

26         provision of certain financial information to

27         the Office of Insurance Regulation; authorizing

28         an administrative fine for failure to comply;

29         requiring the director of the office to prepare

30         and submit to the Governor and Legislature an

31         annual report; creating s. 627.41491, F.S.;

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         requiring the Office of Insurance Regulation to

 2         provide health care providers with a full

 3         disclosure of certain rate comparison

 4         information each year; creating s. 627.41493,

 5         F.S.; requiring a medical malpractice insurance

 6         rate rollback; providing for subsequent

 7         increases under certain circumstances;

 8         requiring approval for use of certain medical

 9         malpractice insurance rates; creating s.

10         627.41495, F.S.; providing for consumer

11         participation in review of medical malpractice

12         rate changes; providing for public inspection;

13         providing for adoption of rules by the Office

14         of Insurance Regulation; creating s. 627.41497,

15         F.S.; requiring certain medical malpractice

16         insurance rates to be set by the director of

17         the Office of Insurance Regulation; providing

18         for approval of rate filings; requiring

19         insurers to apply for certain rates, schedules,

20         and manuals; providing procedures for

21         application and review; providing review

22         criteria; providing approval standards;

23         authorizing the office to require certain

24         additional information for review; requiring

25         adoption of certain rules; providing for

26         reports of certain information; requiring the

27         office to retain such reports for a time

28         certain; requiring medical malpractice insurers

29         to file certain information with the office;

30         authorizing the office to review rates,

31         schedules, manuals, or rate changes at any time

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         for certain purposes; providing procedures;

 2         requiring the office to issue orders for

 3         setting new rates; prohibiting the office from

 4         prohibiting insurers from paying certain

 5         acquisition costs for certain purposes;

 6         providing application; excluding certain

 7         judgment or settlement amounts, taxable costs,

 8         and attorney's fees from inclusion in an

 9         insurer's rate base; authorizing the Office of

10         Insurance Regulation to adopt rules; providing

11         an effective date.

12  

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

14  

15         Section 1.  Subsection (4) of section 501.212, Florida

16  Statutes, is amended to read:

17         501.212  Application.--This part does not apply to:

18         (4)  Any person or activity regulated under laws

19  administered by the Department of Insurance or Banks and

20  savings and loan associations regulated by the Department of

21  Banking and Finance or banks or savings and loan associations

22  regulated by federal agencies.

23         Section 2.  Section 624.156, Florida Statutes, is

24  created to read:

25         624.156  Applicability of consumer protection laws to

26  the business of insurance.--

27         (1)  Notwithstanding any provision of law to the

28  contrary, the business of insurance shall be subject to the

29  laws of this state applicable to any other business,

30  including, but not limited to, the Florida Civil Rights Act of

31  1992 set forth in part I of chapter 760, the Florida Antitrust

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  Act of 1980 set forth in chapter 542, the Florida Deceptive

 2  and Unfair Trade Practices Act set forth in part II of chapter

 3  501, and the consumer protection provisions contained in

 4  chapter 540.  The protections afforded consumers by chapters

 5  501, 540, 542, and 760 shall apply to insurance consumers.

 6         (2)  Nothing in this section shall be construed to

 7  prohibit:

 8         (a)  Any agreement to collect, compile, and disseminate

 9  historical data on paid claims or reserves for reported

10  claims, provided such data is contemporaneously transmitted to

11  the Office of Insurance Regulation and made available for

12  public inspection.

13         (b)  Participation in any joint arrangement established

14  by law or the Office of Insurance Regulation to assure

15  availability of insurance.

16         (c)  Any agent or broker, representing one or more

17  insurers, from obtaining from any insurer such agent or broker

18  represents information relative to the premium for any policy

19  or risk to be underwritten by that insurer.

20         (d)  Any agent or broker from disclosing to an insurer

21  the agent or broker represents any quoted rate or charge

22  offered by another insurer represented by that agent or broker

23  for the purpose of negotiating a lower rate, charge, or term

24  from the insurer to whom the disclosure is made.

25         (e)  Any agents, brokers, or insurers from using, or

26  participating with multiple insurers or reinsurers for

27  underwriting, a single risk or group of risks.

28         Section 3.  Subsections (3) and (4) of section 627.041,

29  Florida Statutes, are amended to read:

30         627.041  Definitions.--As used in this part:

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         (3)  "Rating organization" means every person, other

 2  than an authorized insurer, whether located within or outside

 3  this state, who has as his or her object or purpose the

 4  collecting, compiling, and disseminating historical data on

 5  paid claims or reserves for reported claims making of rates,

 6  rating plans, or rating systems. Two or more authorized

 7  insurers that act in concert for the purpose of collecting,

 8  compiling, and disseminating historical data on paid claims or

 9  reserves for reported claims making rates, rating plans, or

10  rating systems, and that do not operate within the specific

11  authorizations contained in ss. 627.311, 627.314(2), (4), and

12  627.351, shall be deemed to be a rating organization. No

13  single insurer shall be deemed to be a rating organization.

14         (4)  "Advisory organization" means every group,

15  association, or other organization of insurers, whether

16  located within or outside this state, which prepares policy

17  forms or makes underwriting rules incident to but not

18  including the making of rates, rating plans, or rating systems

19  or which collects and furnishes to authorized insurers or

20  rating organizations loss or expense statistics or other

21  statistical information and data and acts in an advisory, as

22  distinguished from a ratemaking, capacity.

23         Section 4.  Subsection (7) is added to section 627.062,

24  Florida Statutes, to read:

25         627.062  Rate standards.--

26         (7)  This section shall not apply to professional

27  medical malpractice insurance.

28         Section 5.  Section 627.314, Florida Statutes, is

29  amended to read:

30         627.314  Concerted action by two or more insurers.--

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         (1)  Subject to and in compliance with the provisions

 2  of this part authorizing insurers to be members or subscribers

 3  of rating or advisory organizations or to engage in joint

 4  underwriting or joint reinsurance, two or more insurers may

 5  act in concert with each other and with others with respect to

 6  any matters pertaining to:

 7         (a)  Collecting, compiling, and disseminating

 8  historical data on paid claims or reserve for reported claims

 9  The making of rates or rating systems except for private

10  passenger automobile insurance rates;

11         (b)  The preparation or making of insurance policy or

12  bond forms, underwriting rules, surveys, inspections, and

13  investigations;

14         (c)  The furnishing of loss or expense statistics or

15  other information and data; or

16         (c)(d)  The carrying on of research.

17         (2)  With respect to any matters pertaining to the

18  making of rates or rating systems; the preparation or making

19  of insurance policy or bond forms, underwriting rules,

20  surveys, inspections, and investigations; the furnishing of

21  loss or expense statistics or other information and data; or

22  the carrying on of research, two or more authorized insurers

23  having a common ownership or operating in the state under

24  common management or control are hereby authorized to act in

25  concert between or among themselves the same as if they

26  constituted a single insurer. To the extent that such matters

27  relate to cosurety bonds, two or more authorized insurers

28  executing such bonds are hereby authorized to act in concert

29  between or among themselves the same as if they constituted a

30  single insurer.

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         (3)(a)  Members and subscribers of rating or advisory

 2  organizations may use the rates, rating systems, underwriting

 3  rules, or policy or bond forms of such organizations, either

 4  consistently or intermittently; but, except as provided in

 5  subsection (2) and ss. 627.311 and 627.351, they shall not

 6  agree with each other or rating organizations or others to

 7  adhere thereto.

 8         (b)  The fact that two or more authorized insurers,

 9  whether or not members or subscribers of a rating or advisory

10  organization, use, either consistently or intermittently, the

11  rates or rating systems made or adopted by a rating

12  organization or the underwriting rules or policy or bond forms

13  prepared by a rating or advisory organization shall not be

14  sufficient in itself to support a finding that an agreement to

15  so adhere exists, and may be used only for the purpose of

16  supplementing or explaining direct evidence of the existence

17  of any such agreement.

18         (b)(c)  This subsection does not apply as to workers'

19  compensation and employer's liability insurances.

20         (4)  Licensed rating organizations and authorized

21  insurers are authorized to exchange information and experience

22  data with rating organizations and insurers in this and other

23  states and may consult with them with respect to ratemaking

24  and the application of rating systems.

25         (4)(5)  Upon compliance with the provisions of this

26  part applicable thereto, any rating organization or advisory

27  organization, and any group, association, or other

28  organization of authorized insurers which engages in joint

29  underwriting or joint reinsurance through such organization or

30  by standing agreement among the members thereof, may conduct

31  operations in this state. As respects insurance risks or

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  operations in this state, no insurer shall be a member or

 2  subscriber of any such organization, group, or association

 3  that has not complied with the provisions of this part

 4  applicable to it.

 5         (5)(6)  Notwithstanding any other provisions of this

 6  part, insurers shall not participate directly or indirectly in

 7  the deliberations or decisions of rating organizations on

 8  private passenger automobile insurance. However, such rating

 9  organizations shall, upon request of individual insurers, be

10  required to furnish at reasonable cost the rate indications

11  resulting from the loss and expense statistics gathered by

12  them. Individual insurers may modify the indications to

13  reflect their individual experience in determining their own

14  rates. Such rates shall be filed with the department for

15  public inspection whenever requested and shall be available

16  for public announcement only by the press, department, or

17  insurer.

18         Section 6.  Subsection (10) of section 627.357, Florida

19  Statutes, is amended to read:

20         627.357  Medical malpractice self-insurance.--

21         (10)  A self-insurance fund may not be formed under

22  this section after October 1, 1992.

23         Section 7.  Section 627.4147, Florida Statutes, is

24  amended to read:

25         627.4147  Medical malpractice insurance contracts.--

26         (1)  In addition to any other requirements imposed by

27  law, each self-insurance policy as authorized under s. 627.357

28  or insurance policy providing coverage for claims arising out

29  of the rendering of, or the failure to render, medical care or

30  services, including those of the Florida Medical Malpractice

31  Joint Underwriting Association, shall include:

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         (a)  A clause requiring the insured to cooperate fully

 2  in the review process prescribed under s. 766.106 if a notice

 3  of intent to file a claim for medical malpractice is made

 4  against the insured.

 5         (b)1.  Except as provided in subparagraph 2., a clause

 6  authorizing the insurer or self-insurer to determine, to make,

 7  and to conclude, without the permission of the insured, any

 8  offer of admission of liability and for arbitration pursuant

 9  to s. 766.106, settlement offer, or offer of judgment, if the

10  offer is within the policy limits. It is against public policy

11  for any insurance or self-insurance policy to contain a clause

12  giving the insured the exclusive right to veto any offer for

13  admission of liability and for arbitration made pursuant to s.

14  766.106, settlement offer, or offer of judgment, when such

15  offer is within the policy limits. However, any offer of

16  admission of liability, settlement offer, or offer of judgment

17  made by an insurer or self-insurer shall be made in good faith

18  and in the best interests of the insured.

19         2.a.  With respect to dentists licensed under chapter

20  466, a clause clearly stating whether or not the insured has

21  the exclusive right to veto any offer of admission of

22  liability and for arbitration pursuant to s. 766.106,

23  settlement offer, or offer of judgment if the offer is within

24  policy limits. An insurer or self-insurer shall not make or

25  conclude, without the permission of the insured, any offer of

26  admission of liability and for arbitration pursuant to s.

27  766.106, settlement offer, or offer of judgment, if such offer

28  is outside the policy limits. However, any offer for admission

29  of liability and for arbitration made under s. 766.106,

30  settlement offer, or offer of judgment made by an insurer or

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  self-insurer shall be made in good faith and in the best

 2  interest of the insured.

 3         b.  If the policy contains a clause stating the insured

 4  does not have the exclusive right to veto any offer or

 5  admission of liability and for arbitration made pursuant to s.

 6  766.106, settlement offer or offer of judgment, the insurer or

 7  self-insurer shall provide to the insured or the insured's

 8  legal representative by certified mail, return receipt

 9  requested, a copy of the final offer of admission of liability

10  and for arbitration made pursuant to s. 766.106, settlement

11  offer or offer of judgment and at the same time such offer is

12  provided to the claimant. A copy of any final agreement

13  reached between the insurer and claimant shall also be

14  provided to the insurer or his or her legal representative by

15  certified mail, return receipt requested not more than 10 days

16  after affecting such agreement.

17         (c)  A clause requiring the insurer or self-insurer to

18  notify the insured no less than 90 60 days prior to the

19  effective date of a rate increase or cancellation of the

20  policy or contract and, in the event of a determination by the

21  insurer or self-insurer not to renew the policy or contract,

22  to notify the insured no less than 90 60 days prior to the end

23  of the policy or contract period. If cancellation or

24  nonrenewal is due to nonpayment or loss of license, 10 days'

25  notice is required.

26         (2)  In determining the premium paid by any health care

27  provider, a medical malpractice insurer shall apply a discount

28  or surcharge based on the provider's loss experience,

29  including state disciplinary action, or shall establish an

30  alternative method giving due consideration to the provider s

31  loss experience. The insurer shall include a schedule of all

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  such discounts and surcharges or a description of such

 2  alternative method in all filings the insurer makes with the

 3  director of the Office of Insurance Regulation. Such schedule

 4  or description of alternative method shall also be provided to

 5  policyholders or prospective policyholders. No medical

 6  malpractice liability insurer may use any rate or charge any

 7  premium unless the insurer has filed such schedule or

 8  alternative method with the director and the director has

 9  approved such schedule or alternative method. Each insurer

10  covered by this section may require the insured to be a member

11  in good standing, i.e., not subject to expulsion or

12  suspension, of a duly recognized state or local professional

13  society of health care providers which maintains a medical

14  review committee. No professional society shall expel or

15  suspend a member solely because he or she participates in a

16  health maintenance organization licensed under part I of

17  chapter 641.

18         (3)  This section shall apply to all policies issued or

19  renewed after July 1, 2003 October 1, 1985.

20         Section 8.  Section 627.912, Florida Statutes, is

21  amended to read:

22         627.912  Professional liability claims and actions;

23  reports by insurers; annual reports.--

24         (1)  Each self-insurer authorized under s. 627.357 and

25  each insurer or joint underwriting association providing

26  professional liability insurance to a practitioner of medicine

27  licensed under chapter 458, to a practitioner of osteopathic

28  medicine licensed under chapter 459, to a podiatric physician

29  licensed under chapter 461, to a dentist licensed under

30  chapter 466, to a hospital licensed under chapter 395, to a

31  crisis stabilization unit licensed under part IV of chapter

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  394, to a health maintenance organization certificated under

 2  part I of chapter 641, to clinics included in chapter 390, to

 3  an ambulatory surgical center as defined in s. 395.002, or to

 4  a member of The Florida Bar shall report in duplicate to the

 5  Department of Insurance any claim or action for damages for

 6  personal injuries claimed to have been caused by error,

 7  omission, or negligence in the performance of such insured's

 8  professional services or based on a claimed performance of

 9  professional services without consent, if the claim resulted

10  in:

11         (a)  A final judgment in any amount.

12         (b)  A settlement in any amount.

13  

14  Reports shall be filed with the department and, if the insured

15  party is licensed under chapter 458, chapter 459, chapter 461,

16  or chapter 466, with the Department of Health, no later than

17  30 days following the occurrence of any event listed in

18  paragraph (a) or paragraph (b). The Department of Health shall

19  review each report and determine whether any of the incidents

20  that resulted in the claim potentially involved conduct by the

21  licensee that is subject to disciplinary action, in which case

22  the provisions of s. 456.073 shall apply. The Department of

23  Health, as part of the annual report required by s. 456.026,

24  shall publish annual statistics, without identifying

25  licensees, on the reports it receives, including final action

26  taken on such reports by the Department of Health or the

27  appropriate regulatory board.

28         (2)  The reports required by subsection (1) shall

29  contain:

30         (a)  The name, address, and specialty coverage of the

31  insured.

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         (b)  The insured's policy number.

 2         (c)  The date of the occurrence which created the

 3  claim.

 4         (d)  The date the claim was reported to the insurer or

 5  self-insurer.

 6         (e)  The name and address of the injured person. This

 7  information is confidential and exempt from the provisions of

 8  s. 119.07(1), and must not be disclosed by the department

 9  without the injured person's consent, except for disclosure by

10  the department to the Department of Health. This information

11  may be used by the department for purposes of identifying

12  multiple or duplicate claims arising out of the same

13  occurrence.

14         (f)  The date of suit, if filed.

15         (g)  The injured person's age and sex.

16         (h)  The total number and names of all defendants

17  involved in the claim.

18         (i)  The date and amount of judgment or settlement, if

19  any, including the itemization of the verdict, together with a

20  copy of the settlement or judgment.

21         (j)  In the case of a settlement, such information as

22  the department may require with regard to the injured person's

23  incurred and anticipated medical expense, wage loss, and other

24  expenses.

25         (k)  The loss adjustment expense paid to defense

26  counsel, and all other allocated loss adjustment expense paid.

27         (l)  The date and reason for final disposition, if no

28  judgment or settlement.

29         (m)  A summary of the occurrence which created the

30  claim, which shall include:

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         1.  The name of the institution, if any, and the

 2  location within the institution at which the injury occurred.

 3         2.  The final diagnosis for which treatment was sought

 4  or rendered, including the patient's actual condition.

 5         3.  A description of the misdiagnosis made, if any, of

 6  the patient's actual condition.

 7         4.  The operation, diagnostic, or treatment procedure

 8  causing the injury.

 9         5.  A description of the principal injury giving rise

10  to the claim.

11         6.  The safety management steps that have been taken by

12  the insured to make similar occurrences or injuries less

13  likely in the future.

14         (n)  Any other information required by the department

15  to analyze and evaluate the nature, causes, location, cost,

16  and damages involved in professional liability cases.

17         (3)  Upon request by the Department of Health, the

18  department shall provide the Department of Health with any

19  information received under this section related to persons

20  licensed under chapter 458, chapter 459, chapter 461, or

21  chapter 466. For purposes of safety management, the department

22  shall annually provide the Department of Health with copies of

23  the reports in cases resulting in an indemnity being paid to

24  the claimants.

25         (4)  There shall be no liability on the part of, and no

26  cause of action of any nature shall arise against, any insurer

27  reporting hereunder or its agents or employees or the

28  department or its employees for any action taken by them under

29  this section. The department may impose a fine of $250 per day

30  per case, but not to exceed a total of $10,000 $1,000 per

31  case, against an insurer that violates the requirements of

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  this section. This subsection applies to claims accruing on or

 2  after October 1, 1997.

 3         (5)  Any self-insurance program established under s.

 4  1004.24 shall report in duplicate to the Department of

 5  Insurance any claim or action for damages for personal

 6  injuries claimed to have been caused by error, omission, or

 7  negligence in the performance of professional services

 8  provided by the state university board of trustees through an

 9  employee or agent of the state university board of trustees,

10  including practitioners of medicine licensed under chapter

11  458, practitioners of osteopathic medicine licensed under

12  chapter 459, podiatric physicians licensed under chapter 461,

13  and dentists licensed under chapter 466, or based on a claimed

14  performance of professional services without consent if the

15  claim resulted in a final judgment in any amount, or a

16  settlement in any amount. The reports required by this

17  subsection shall contain the information required by

18  subsection (3) and the name, address, and specialty of the

19  employee or agent of the state university board of trustees

20  whose performance or professional services is alleged in the

21  claim or action to have caused personal injury.

22         (6)  Each entity required to report closed claims for

23  the classification of insurance set forth in subsection (1)

24  shall also provide to the Office of Insurance Regulation the

25  following financial information, specific to this state and

26  countrywide, if applicable, for the prior calendar year:

27         (a)  Direct premiums written.

28         (b)  Direct premiums earned.

29         (c)  Incurred loss and loss expense developed according

30  to the formula A + B - C + D - E + F + G - H, for which A

31  equals the dollar amount of losses paid, B equals the reserves

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  for reported claims at the end of the current year, C equals

 2  the reserves for reported claims at the end of the previous

 3  year, D equals the reserves for incurred but not reported

 4  claims at the end of the current year, E equals the reserves

 5  for incurred but not reported claims at the end of the

 6  previous year, F equals loss adjustment expenses paid, G

 7  equals the reserves for loss adjustment expenses at the end of

 8  the current year, and H equals the reserves for loss

 9  adjustment expenses at the end of the previous year.

10         (d)  Incurred expenses allocated separately to

11  commissions, other acquisition costs, general expenses, taxes,

12  licenses, and fees, using appropriate estimates when

13  necessary.

14         (e)  Policyholder dividends.

15         (f)  Underwriting gain or loss.

16         (g)  Net investment income, including net realized

17  capital gains and losses, using appropriate estimates where

18  necessary.

19         (h)  Federal income taxes.

20         (i)  Net income.

21         (7)  The director of the Office of Insurance Regulation

22  may levy an administrative fine of $1,000 per day against any

23  insurer failing to comply with the reporting requirements of

24  this section.

25         (8)  The director of the Office of Insurance Regulation

26  shall prepare an annual report no later than July 1 that

27  summarizes the information submitted pursuant to this section.

28  Such summary shall be prepared on an aggregate basis. A copy

29  of the report shall be delivered to the Governor, the

30  President of the Senate, and the Speaker of the House of

31  Representatives. The first report submitted pursuant to this

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  subsection shall be delivered on or before October 1, 2003,

 2  for the calendar year 2002. Subsequent reports shall be filed

 3  on or before March 1 for each prior year.

 4         Section 9.  Section 627.41491, Florida Statutes, is

 5  created to read:

 6         627.41491  Full disclosure of insurance

 7  information.--The Office of Insurance Regulation shall provide

 8  health care providers with a comparison of the rate in effect

 9  for each medical malpractice insurer and self-insurer and the

10  Florida Medical Malpractice Joint Underwriting Association.

11  Such rate comparison chart shall be made available to the

12  public through the Internet and other commonly used means of

13  distribution no later than July 1 of each year.

14         Section 10.  Section 627.41493, Florida Statutes, is

15  created to read:

16         627.41493  Insurance rate rollback.--

17         (1)  For any coverage for medical malpractice insurance

18  subject to this chapter issued or renewed on or after July 1,

19  2003, every insurer shall reduce its charges to levels that

20  are at least 20 percent less than the charges for the same

21  coverage that were in effect on January 1, 2001.

22         (2)  Between July 1, 2003, and July 1, 2004, rates and

23  premiums reduced pursuant to subsection (1) may only be

24  increased if the director of the Office of Insurance

25  Regulation finds, after a hearing, that an insurer or

26  self-insurer or the Florida Medical Malpractice Joint

27  Underwriting Association is substantially threatened with

28  insolvency.

29         (3)  Commencing July 1, 2003, insurance rates for

30  medical malpractice subject to this chapter must be approved

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  by the director of the Office of Insurance Regulation prior to

 2  being used.

 3         (4)  Any separate affiliate of an insurer is subject to

 4  the provisions of this section.

 5         Section 11.  Section 627.41495, Florida Statutes, is

 6  created to read:

 7         627.41495  Consumer participation in rate review.--

 8         (1)  Upon the filing of a proposed rate change by a

 9  medical malpractice insurer, self-insurer, or risk retention

10  group, the director of the Office of Insurance Regulation

11  shall require the insurer, self-insurer, or risk retention

12  group to give notice to the public and to the insureds or

13  associations of insureds of the insurer, self-insurer, or risk

14  retention group making the filing.

15         (2)  The rate filing shall be available for public

16  inspection. If any insureds or associations of insureds of the

17  insurer, self-insurer, or risk retention group filing the

18  proposed rate change request the director of the Office of

19  Insurance Regulation to hold a hearing within 30 days after

20  the mailing of the notification of the proposed rate changes

21  to the insureds, the director shall hold a hearing within 30

22  days after such request. Any consumer may participate in such

23  hearing, and the office shall adopt rules governing such

24  participation.

25         Section 12.  Section 627.41497, Florida Statutes, is

26  created to read:

27         627.41497  Medical malpractice rate standards; prior

28  approval of rates.--

29         (1)  In addition to any other requirements imposed by

30  law, the rates for each self-insurance policy as authorized

31  under s. 627.357 or insurance policy providing coverage for

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  claims arising out of the rendering of, or the failure to

 2  render, medical care or services shall be set by the director

 3  of the Office of Insurance Regulation and shall not be

 4  excessive, inadequate, or unfairly discriminatory.

 5         (2)  As to all rate filings subject to approval in

 6  accordance with this section:

 7         (a)  Insurers or rating organizations shall apply for

 8  rates, rating schedules, or rating manuals to allow the

 9  insurer a reasonable rate of return on such classes of

10  insurance written in this state. A copy of rates, rating

11  schedules, rating manuals, premium credits, or discount

12  schedules and surcharge schedules, and changes to such rates,

13  schedules, manuals, and credits, shall be filed with the

14  Office of Insurance Regulation. The filing shall be made at

15  least 180 days before the proposed effective date and shall

16  not be implemented during the review of the filing by the

17  Office of Insurance Regulation, any proceeding, or judicial

18  review.

19         (b)  Upon receiving a rate filing and within a

20  reasonable time after such receipt, the Office of Insurance

21  Regulation shall review the rate filing and set a rate or rate

22  schedule that is not excessive, inadequate, or unfairly

23  discriminatory. In making such determination, the office

24  shall, in accordance with generally accepted and reasonable

25  actuarial techniques, use the following factors:

26         1.  Past and prospective loss experience within and

27  without this state and the insurer's or self-insurer's past

28  and prospective loss experience within this state, if

29  applicable. A medical malpractice insurer shall consider past

30  and prospective loss experience and catastrophic hazards, if

31  any, solely within this state. However, if there is

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  insufficient experience within this state upon which a rate

 2  can be based, the insurer may consider experiences within any

 3  other state or states that have a similar cost of claim and

 4  frequency of claim experience as this state and, if

 5  insufficient experience is available, the insurer may use

 6  nationwide experience. The insurer, in its rate filing or in

 7  its records, shall expressly show the rate experience it is

 8  using. In considering experience outside this state, as much

 9  weight as possible shall be given to state experience.

10         2.  Past and prospective expenses.

11         3.  Investment income reasonably expected by the

12  insurer, consistent with the insurer's investment practices,

13  from investable premiums anticipated in the filing, plus any

14  other expected income from currently invested assets

15  representing the amount expected on unearned premium reserves,

16  loss reserves, and surplus. The Office of Insurance Regulation

17  may adopt rules using reasonable techniques of actuarial

18  science and economics to specify the manner in which insurers

19  shall calculate investment income attributable to such classes

20  of insurance written in this state and the manner in which

21  such investment income shall be used in the calculation of

22  insurance rates. The profit and contingency factor as

23  specified in the filing shall be used in computing excess

24  profits in conjunction with s. 627.215.

25         4.  The reasonableness of the judgment reflected in the

26  filing.

27         5.  Dividends, savings, or unabsorbed premium deposits

28  allowed or returned to policyholders, members, or subscribers

29  in this state.

30         6.  The adequacy of loss reserves.

31         7.  The cost of reinsurance.

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         8.  Trend factors, including trends in actual losses

 2  per insured unit for the insurer making the filing.

 3         9.  A reasonable margin for underwriting profit and

 4  contingencies.

 5         10.  The cost of medical services.

 6         11.  Other relevant factors that impact upon the

 7  frequency or severity of claims or upon expenses.

 8         (c)  After consideration of the rate factors provided

 9  in paragraph (b), the Office of Insurance Regulation shall

10  determine and set the appropriate rate, so long as the rate is

11  not excessive, inadequate, or unfairly discriminatory based

12  upon the following standards:

13         1.  Rates shall be deemed excessive if they are likely

14  to produce a profit from business in this state that is

15  unreasonably high in relation to the risk involved in the

16  class of business or if expenses are unreasonably high in

17  relation to services rendered.

18         2.  Rates shall be deemed excessive if, among other

19  things, the rate structure established by a stock insurance

20  company provides for replenishment of reserves or surpluses

21  from premiums when the replenishment is attributable to

22  investment losses, the rate is unreasonably high for the

23  insurance provided, or expenses are unreasonably high in

24  relation to services rendered.

25         3.  Rates shall be deemed inadequate if they are

26  clearly insufficient, together with the investment income

27  attributable to such rates, to sustain projected losses and

28  expenses in the class of business to which they apply and the

29  continued use of such rate endangers the solvency of the

30  insurer using the rate.

31  

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         4.  A rating plan, including discounts, credits, or

 2  surcharges, shall be deemed unfairly discriminatory if the

 3  plan fails to clearly and equitably reflect consideration of

 4  the policyholder's participation in a risk management program

 5  adopted pursuant to s. 627.0625 or the policyholder's

 6  individual claims history or unless price differentials fail

 7  to reflect equitably the differences in expected losses and

 8  experiences.

 9         5.  A rate shall be deemed inadequate as to the premium

10  charged to a risk or group of risks if discounts or credits

11  are allowed which exceed a reasonable reflection of expense

12  savings and reasonably expected loss experience from the risk

13  or group of risks.

14         6.  A rate shall be deemed unfairly discriminatory as

15  to a risk or group of risks if the application of premium

16  discounts, credits, or surcharges among such risks does not

17  bear a reasonable relationship to the expected loss and

18  expense experience among the various risks.

19         (d)  In reviewing a rate filing, the Office of

20  Insurance Regulation may require the insurer to provide at the

21  insurer's expense all information necessary to evaluate the

22  condition of the company and the reasonableness of the filing

23  according to the criteria enumerated in this section.

24         1.  The Office of Insurance Regulation shall adopt

25  rules that shall require each medical malpractice insurer to

26  record and report its loss and expense experience and such

27  other data, including reserves, as may be necessary to

28  determine whether rates comply with the standards set forth in

29  this section. Every medical malpractice insurer shall provide

30  such information in such form as the director of the office

31  may require.

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1         2.  The director shall require that the annual report

 2  and any such supplemental report that contains information of

 3  a company s loss and loss adjustment reserves be accompanied

 4  by an opinion signed and sworn to by a qualified and

 5  independent actuary verifying that, within the 9 months prior

 6  to the submission of the report, the actuary has conducted a

 7  review and analysis of the insurance company s loss and loss

 8  adjustment reserves and the reserves are computed in

 9  accordance with accepted loss reserving standards and are

10  fairly stated in accordance with sound loss reserving

11  principles.

12         3.  The director shall maintain for at least 10 years,

13  by carrier, all reports submitted by insurers pursuant to

14  rules adopted by the office under this section. The director

15  shall consider such reports in determining the appropriateness

16  of premium rates for medical malpractice insurance.

17         4.  The director may examine and review the assignment

18  and assessment of risk for difference classifications for

19  different specialties or practices of medicine. The director

20  may hold a public hearing on any filing containing a risk

21  assignment for medical malpractice insurance to determine

22  whether such risk assignment is reasonable and may issue

23  orders concerning such risk assignment.

24         (3)  With respect to the filing of rate information:

25         (a)  Every medical malpractice insurer shall file with

26  the Office of Insurance Regulation every manual of

27  classifications, rules, and rates, every rating plan, and

28  every modification of any of the foregoing that the insurer

29  proposes to use in this state.

30         (b)  The expense provisions included in the rates to be

31  used by a medical malpractice insurer shall reflect the

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  operating methods of the insurer and, so far as it is credible

 2  and reasonable, the insurer's own actual and anticipated

 3  expense experience.

 4         (c)  The rates to be used by a medical malpractice

 5  insurer shall contain provisions for contingencies and an

 6  allowance permitting a reasonable rate of return. In

 7  determining a reasonable rate of return, consideration shall

 8  be given to all investment income reasonably attributable to

 9  medical malpractice insurance.

10         (d)  Every filing shall state the proposed effective

11  date of the filing, shall indicate the character and extent of

12  the coverage contemplated, and shall contain supporting

13  information. Such supporting information may include the

14  experience or judgment of the insurer making the filing, the

15  insurer's interpretation of any statistical data the insurer

16  relied upon, the experience of other insurers, and any other

17  factors the insurer deems relevant.

18         (4)  The Office of Insurance Regulation may at any time

19  review a rate, rating schedule, rating manual, or rate change,

20  the pertinent records of the insurer, and market conditions.

21  If the office finds on a preliminary basis that a rate may be

22  excessive, inadequate, or unfairly discriminatory, the office

23  shall initiate proceedings to set a new rate and shall so

24  notify the insurer. However, the office may not disapprove as

25  excessive any rate the office has set for a period of 1 year

26  after the effective date of the filing unless the office finds

27  that a material misrepresentation or material error was made

28  by the insurer or was contained in the filing. Upon being so

29  notified, the insurer or rating organization shall, within 60

30  days, file with the office all information which, in the

31  belief of the insurer or organization, proves the

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  reasonableness, adequacy, and fairness of the rate or rate

 2  change. The office shall determine and set an appropriate rate

 3  within a reasonable time after receipt of the insurer's

 4  initial response, pursuant to the procedures of paragraphs

 5  (2)(b)-(d). In such instances and in any administrative

 6  proceeding relating to the legality of any rate, the insurer

 7  or rating organization shall carry the burden of proof by a

 8  preponderance of the evidence to show that the rate is not

 9  excessive, inadequate, or unfairly discriminatory.

10         (5)  When the Office of Insurance Regulation sets a new

11  rate or rate schedule, the office shall issue an order

12  specifying the new rate or rate schedule and the findings of

13  the office. The order shall constitute agency action for

14  purposes of the Administrative Procedure Act.

15         (6)  Except as otherwise specifically provided in this

16  chapter, the Office of Insurance Regulation shall not prohibit

17  any insurer, including any residual market plan or joint

18  underwriting association, from paying acquisition costs based

19  on the full amount of premium, as defined in s. 627.403,

20  applicable to any policy or prohibit any such insurer from

21  including the full amount of acquisition costs in a rate

22  filing.

23         (7)  The establishment or variation of any rate, rating

24  classification, rating plan, or rating schedule in violation

25  of part IX of chapter 626 is also a violation of this section.

26         (8)  Any portion of a judgment entered as a result of a

27  statutory or common-law bad faith action and any portion of a

28  judgment entered that awards punitive damages against an

29  insurer shall not be included in the insurer's rate base and

30  shall not be used to justify a rate or rate change. Any

31  portion of a settlement entered as a result of a statutory or

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    Florida Senate - 2003                                  SB 2080
    2-948-03                                           See HB 1129




 1  common-law, bad-faith action identified as such and any

 2  portion of a settlement in which an insurer agrees to pay

 3  specific punitive damages shall not be used to justify a rate

 4  or rate change. The portion of the taxable costs and

 5  attorney's fees that is identified as being related to the

 6  bad-faith and punitive damages in such judgments and

 7  settlements shall not be included in the insurer's rate base

 8  and shall not be used to justify a rate or rate change.

 9         Section 13.  The Office of Insurance Regulation may

10  adopt rules to administer this act.

11         Section 14.  This act shall take effect upon becoming a

12  law.

13  

14  

15  

16  

17  

18  

19  

20  

21  

22  

23  

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25  

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31  

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