HOUSE AMENDMENT Bill No. HB 25A
1	CHAMBER ACTION
2	Senate House
3	.
4	.
5	.
6
7
8
9
10
11
12	Representatives Brown, Berfield, Clarke, Goodlette, and Ross
13	offered the following:
14
15	Amendment (with directory and title amendments)
16	Remove line(s) 4827-4900, and insert:
17	440.525 Examination and investigation of carriers and
18	claims-handling entities.--
19	(1) The department may examine, or investigate anyeach
20	carrier, third-party administrator, servicing agent, or other
21	claims-handling entity as often as is warranted to ensure that
22	it iscarriers are fulfilling itstheir obligations under this
23	chapterthe law. The examination may cover any period of the
24	carrier's operations since the last previous examination.
25	(2) An examination may cover any period of the carrier's,
26	third-party administrator's, servicing agent's, or other claims-
27	handling entity's operations since the last previous
28	examination. An investigation based upon a reasonable belief by
29	the department that a material violation of this chapter has
30	occurred may cover any time period, but may not predate the last
31	examination by more than 5 years. The department may by rule
32	establish procedures, standards, and protocols for examinations
33	and investigations. If the department finds any violation of
34	this chapter, it may impose administrative penalties pursuant to
35	this chapter. If the department finds any self-insurer in
36	violation of this chapter, it may take action pursuant s.
37	440.38(3). Examinations or investigations by the department may
38	address, but are not limited to addressing, patterns or
39	practices of unreasonable delay in claims handling; timeliness
40	and accuracy of payments and reports under ss. 440.13, 440.16,
41	and 440.185; or patterns or practices of harassment, coercion,
42	or intimidation of claimants. The department may also specify by
43	rule the documentation to be maintained for each claim file.
44	(3) As to any examination or investigation conducted under
45	this chapter, the department shall have the power to conduct
46	onsite inspections of claims records and documentation of a
47	carrier, third-party administrator, servicing agent, or other
48	claims-handling entity, and conduct interviews, both sworn and
49	unsworn, of claims-handling personnel. Carriers, third-party
50	administrators, servicing agents, and other claims-handling
51	entities shall make all claims records, documentation,
52	communication, and correspondence available to department
53	personnel during regular business hours. If any person fails to
54	comply with a request for production of records or documents or
55	fails to produce an employee for interview, the department may
56	compel production or attendance by subpoena. The results of an
57	examination or investigation shall be provided to the carrier,
58	third-party administrator, servicing agent, or other claims-
59	handling entity in a written report setting forth the basis for
60	any violations that are asserted. Such report is agency action
61	for purposes of chapter 120, and the aggrieved party may request
62	a proceeding under s. 120.57 with regard to the findings and
63	conclusion of the report.
64	(4) If the department finds that violations of this
65	chapter have occurred, the department may impose an
66	administrative penalty upon the offending entity or entities.
67	For each offending entity, such penalties shall not exceed
68	$2,500 for each pattern or practice constituting nonwillful
69	violation and shall not exceed an aggregate amount of $10,000
70	for all nonwillful violations arising out of the same action. If
71	the department finds a pattern of practice that constitutes a
72	willful violation, the department may impose an administrative
73	penalty upon each offending entity not to exceed $20,000 for
74	each willful pattern or practice. Such fines shall not exceed
75	$100,000 for all willful violations arising out of the same
76	action. No penalty assessed under this section may be recouped
77	by any carrier in the rate base, the premium, or any rate
78	filing. Any administrative penalty imposed under this section
79	for a nonwillful violation shall not duplicate an administrative
80	penalty imposed under another provision of this chapter or the
81	Insurance Code. The department may adopt rules to implement this
82	section. The department shall adopt penalty guidelines by rule
83	to set penalties under this chapter.
84
85
86	================= T I T L E A M E N D M E N T =================
87	Remove line(s) 86-89, and insert:
88	to conduct examinations and investigations of claims-handing
89	entities; providing penalties; providing for rules; amending s.
90	627.162,