Senate Bill sb0010Ac1

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    Florida Senate - 2004                           CS for SB 10-A

    By the Committee on General Government Appropriations; and
    Senators Garcia and Lynn




    601-609-05

  1                      A bill to be entitled

  2         An act relating to hurricane deductibles;

  3         providing for the Department of Financial

  4         Services to reimburse policyholders of

  5         residential property insurance for multiple

  6         deductibles applied by insurers for two or more

  7         hurricanes; providing legislative findings and

  8         intent; establishing criteria for eligibility

  9         for reimbursement; requiring applications to be

10         submitted to the department and to include

11         certain information; limiting the maximum

12         amount of reimbursement; limiting total

13         reimbursement to the amount appropriated for

14         this purpose; requiring payment to be made in a

15         specified order of priority and providing for

16         pro rata reimbursement; requiring insurers to

17         provide the department with certain information

18         related to the claim for reimbursement, subject

19         to the policyholder's authorization;

20         authorizing the department to contract with a

21         third party for investigation or adjustment of

22         a claim for reimbursement; requiring insurers

23         to mail notice to certain policyholders of the

24         reimbursement procedures; providing for

25         emergency rules; providing that an application

26         for reimbursement constitutes an insurance

27         claim for purposes of determining insurance

28         fraud; prohibiting insurers from changing their

29         method of waiving or applying deductibles due

30         to the provisions of the law providing for

31         reimbursement to policyholders; requiring the

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1         Office of Insurance Regulation to collect data

 2         from insurers regarding the application of

 3         multiple deductibles; providing legislative

 4         intent that reimbursements made to

 5         policyholders be considered disaster-relief

 6         assistance for purposes of the Internal Revenue

 7         Code; amending s. 627.701, F.S.; requiring that

 8         hurricane deductibles of residential property

 9         insurance policies be applied on an annual

10         basis to all hurricane losses that occur during

11         a calendar year; allowing insurers to apply an

12         alternative deductible to subsequent hurricane

13         losses after the annual deductible is met;

14         providing the method by which the hurricane

15         deductible is to be calculated if a hurricane

16         deductible is changed for a new or renewal

17         policy; allowing insurers to require

18         policyholders to report hurricane losses or to

19         maintain receipts or records in order to apply

20         hurricane losses to a subsequent hurricane

21         claim; providing appropriations; requiring the

22         State Board of Administration to increase

23         future premiums to the Florida Hurricane

24         Catastrophe Fund; providing an effective date.

25  

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

27  

28         Section 1.  Legislative findings and intent.--The

29  Legislature finds that the four hurricanes striking Florida in

30  2004 resulted in at least 30,000 residential property

31  insurance policyholders experiencing damage from two or more

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1  hurricanes for which insurers have applied the hurricane

 2  deductible to each hurricane claim. The fact that

 3  policyholders have separate hurricane deductibles can result

 4  in significant out-of-pocket expense and financial hardship to

 5  policyholders. Although insurers are required by law to notify

 6  policyholders that the hurricane deductible can result in a

 7  large out-of-pocket expense, it was not anticipated that a

 8  policyholder would have damage from two or more hurricanes in

 9  the same year and be forced to meet two or more deductibles in

10  this circumstance. The Legislature further finds that the

11  public health, safety, and welfare demand that residential

12  structures damaged or destroyed in a catastrophe be repaired

13  or reconstructed as soon as possible and that application of

14  multiple deductibles delays or prevents such reconstruction,

15  hinders the economic recovery of the state and its residents,

16  and endangers the public health, safety, and welfare.

17  Therefore, state action to establish a program to reimburse

18  policyholders for the financial loss suffered due to the

19  application of multiple hurricane deductibles constitutes a

20  valid and necessary public and governmental purpose. The

21  Legislature intends to establish a program to reimburse

22  policyholders for such losses, up to specified limits.

23         Section 2.  Reimbursement for multiple hurricane

24  deductibles.--

25         (1)  As used in this section, the term "residential

26  property insurance" means residential coverage as described in

27  section 627.4025(1), Florida Statutes.

28         (2)  The Department of Financial Services shall

29  reimburse policyholders of residential property insurance

30  whose property was damaged by two or more hurricanes in 2004

31  and whose insurer applied more than one hurricane deductible

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1  to the insurance claims. The reimbursement shall be the amount

 2  of the claim that was not paid due to application of the

 3  second or subsequent deductible, as further limited by this

 4  section.

 5         (3)  To be eligible for reimbursement, a policyholder

 6  must meet the criteria of subsection (2) and must:

 7         (a)  Apply to the department by March 1, 2005, on a

 8  form provided by the department. The form must identify the

 9  amount of the claims paid by the insurer, per hurricane, the

10  amount of the deductible which was applied to each claim; and

11  such additional information as the department requires to

12  verify the claim for reimbursement, including documentation

13  from the insurer. The applicant must submit documentation from

14  the insurer that the insurance claim was not paid, either in

15  full or in part, due to application of the deductible.

16         (b)  Have incurred damage in excess of the full amount

17  of a single hurricane deductible.

18         (c)  Meet a $100 deductible for a second and each

19  subsequent hurricane claim in addition to the amount of the

20  deductible which must be met under paragraph (b).

21         (d)  Provide written authorization for the department

22  to obtain from the policyholder's insurer information related

23  to the claim for reimbursement.

24         (4)(a)  Reimbursement may be provided only for damages

25  that would have been paid under the policy but for application

26  of the deductible. The maximum reimbursement shall be limited

27  to the amount of the policyholder's loss in excess of one full

28  deductible, but not more than $10,000 per policy for damage

29  caused by two hurricanes and not more than $20,000 per policy

30  for damage caused by three or more hurricanes, except as

31  otherwise provided in this subsection.

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    Florida Senate - 2004                           CS for SB 10-A
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 1         (b)  For a policy issued to a condominium association,

 2  the maximum reimbursement shall be limited to an amount equal

 3  to $3,000 multiplied by the number of condominium units or the

 4  maximum amount specified in paragraph (a) or paragraph (c),

 5  whichever is greater. Reimbursement may not be paid to a

 6  condominium association for loss amounts for which the

 7  condominium association has assessed unit owners and for which

 8  the unit owners have insurance coverage for the assessment.

 9         (c)  If more than one residential structure is insured

10  under the policy and a separate hurricane deductible applies

11  to each, the maximum reimbursement shall be limited to $10,000

12  per structure for multiple hurricane claims for that

13  structure.

14         (d)  Reimbursement may not be paid for loss amounts for

15  which the policyholder has received a grant from the Federal

16  Emergency Management Agency, or any other federal, state,

17  county, or municipal agency or program.

18         (5)  The total amount of funds paid to policyholders

19  pursuant to this section is limited to the amount appropriated

20  for this purpose. Payments shall be made to eligible

21  applicants in the following order of priority:

22         (a)  The department shall first reimburse policyholders

23  who received claims payments from their insurer for two or

24  more hurricanes for which each payment was reduced by the full

25  amount of the deductible.

26         (b)  After reimbursing all policyholders who meet the

27  criterion of paragraph (a), the department shall reimburse all

28  other eligible policyholders. If the amount appropriated for

29  this purpose is not adequate to pay all other eligible

30  policyholders up to the maximum reimbursement amounts, the

31  department shall provide reimbursement pro rata so that each

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    Florida Senate - 2004                           CS for SB 10-A
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 1  policyholder receives an equal percentage of the amount of the

 2  reimbursement claim that is approved.

 3         (6)  The insurer issuing the policy to the applicant

 4  for reimbursement shall provide to the department, upon

 5  request, such information in the applicant's claim file as

 6  will assist the department in determining the validity and

 7  reasonableness of the claim, subject to the policyholder's

 8  authorization to release such information. The department may

 9  further investigate or adjust the claim as it determines is

10  necessary and may contract with third parties for this

11  purpose.

12         (7)  Insurers shall mail notice to those residential

13  property insurance policyholders who filed claims with the

14  insurer for two or more hurricanes in 2004 and to whom the

15  insurer applied more than one hurricane deductible, whether

16  there was a claims payment or not. The notice shall be on a

17  form provided by the department which informs the policyholder

18  of the reimbursement program established by this section and

19  the procedures for seeking reimbursement, including the

20  application form provided by the department. The notice shall

21  be mailed in such manner and within such time as specified by

22  the department. For subsequent claims, the insurer shall

23  provide the notice at the time that the insurer notifies the

24  policyholder of the application of the second deductible.

25         (8)  The department may adopt rules to implement this

26  section. It is the Legislature's intent that the department

27  implement this section as soon as possible in order to provide

28  immediate relief to affected policyholders. Therefore, the

29  department may adopt such rules pursuant to the emergency rule

30  procedures of section 120.54(4), Florida Statutes.

31  

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1         (9)  An application for reimbursement shall be

 2  considered an insurance claim for purposes of determining

 3  whether a person has committed insurance fraud pursuant to

 4  section 817.234, Florida Statutes. The Department of Financial

 5  Services and the department's Division of Insurance Fraud

 6  shall have the powers to investigate and enforce such actions

 7  provided in section 626.989, Florida Statutes.

 8         (10)  It is a violation of the Florida Insurance Code

 9  for an insurer to change its method of determining whether to

10  waive or apply multiple hurricane deductibles to multiple

11  claims due to the provisions of this section.

12         (11)  The Office of Insurance Regulation shall collect

13  data from residential property insurers regarding the number

14  of claims that were filed by policyholders for two or more

15  hurricanes for the 2004 hurricane season, and the number of

16  those claims for which the insurer applied two or more

17  deductibles, including the dollar amount of those claims, and

18  such additional related information as the department may

19  require.

20         (12)  It is the intent of the Legislature that

21  reimbursements made to policyholders under this section shall

22  be considered disaster-relief assistance within the meaning of

23  section 139 of the Internal Revenue Code.

24         Section 3.  Present subsections (5) through (8) of

25  section 627.701, Florida Statutes, are renumbered subsections

26  (6) through (9), respectively, and a new subsection (5) is

27  added to that section to read:

28         627.701  Liability of insureds; coinsurance;

29  deductibles.--

30         (5)  The hurricane deductible of any residential

31  property insurance policy shall be applied as follows:

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1         (a)  The hurricane deductible shall apply on an annual

 2  basis to all covered hurricane losses that occur during a

 3  calendar year for losses that are covered under one or more

 4  policies issued by the same insurer or an insurer in the same

 5  insurer group.

 6         (b)  If a hurricane deductible applies separately to

 7  any structure insured under a single policy, the requirements

 8  of this subsection apply with respect to the deductible for

 9  such structure.

10         (c)  If there was a hurricane loss for a prior

11  hurricane or hurricanes during the calendar year, the insurer

12  may apply a deductible to a subsequent hurricane which is the

13  greater of the remaining amount of the hurricane deductible or

14  the amount of the deductible which applies to perils other

15  than a hurricane. Insurers may require policyholders to report

16  hurricane losses that are below the hurricane deductible or to

17  maintain receipts or other records of such hurricane losses in

18  order to apply such losses to subsequent hurricane claims.

19         (d)  If there are hurricane losses in a calendar year

20  on more than one policy issued by the same insurer or an

21  insurer in the same insurer group, the hurricane deductible

22  shall be the highest amount stated in any one of the policies.

23  If a policyholder who had a hurricane loss under a prior

24  policy is provided or offered a lower hurricane deductible

25  under a new or renewal policy, the insurer must notify the

26  policyholder, in writing, at the time the lower hurricane

27  deductible is provided or offered that the lower hurricane

28  deductible will not apply until January 1 of the following

29  calendar year.

30  

31  

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    Florida Senate - 2004                           CS for SB 10-A
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 1  This subsection applies to policies issued or renewed on or

 2  after May 1, 2005.

 3         Section 4.  (1)  Notwithstanding section 215.555,

 4  Florida Statutes, the State Board of Administration is

 5  directed to transfer, no later than January 15, 2005, $20

 6  million from the Florida Hurricane Catastrophe Fund cash

 7  balance to the Insurance Regulatory Trust Fund within the

 8  Department of Financial Services to provide funding for the

 9  reimbursements authorized in subsection (3).

10         (2)  Notwithstanding section 215.555, Florida Statutes,

11  the State Board of Administration is directed to transfer up

12  to $130 million from the Florida Hurricane Catastrophe Fund

13  cash balance to the Insurance Regulatory Trust Fund in the

14  Department of Financial Services to provide funding for the

15  reimbursements authorized in subsection (3). The Chief

16  Financial Officer shall periodically certify to the State

17  Board of Administration an amount to be transferred from the

18  funds appropriated in this subsection based on the documented

19  expenditure need for reimbursement payments submitted to the

20  Department of Financial Services. The amount of each transfer

21  may not exceed the documented need. The Chief Financial

22  Officer shall provide a copy of each certification to the

23  Executive Office of the Governor and the chair and vice chair

24  of the Legislative Budget Commission. The State Board of

25  Administration shall provide notice of each transfer to the

26  Executive Office of the Governor and the chair and vice chair

27  of the Legislative Budget Commission at least 3 working days

28  before such transfer.

29         (3)  The sum of $150 million is appropriated for the

30  period from the effective date of this act through September

31  30, 2005, from the Insurance Regulatory Trust Fund in the

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    Florida Senate - 2004                           CS for SB 10-A
    601-609-05




 1  Department of Financial Services in a special appropriation

 2  category "Hurricane Multiple Deductible Reimbursements" for

 3  reimbursement to residential property insurance policyholders

 4  for the expense of multiple hurricane deductibles, as provided

 5  in sections 1 and 2. Up to 1 percent of this appropriation may

 6  be used by the department for the administration of payments

 7  to such policyholders.

 8         (4)  All Florida Hurricane Catastrophe Fund moneys

 9  transferred to the Insurance Regulatory Trust Fund under this

10  act which remain unexpended on December 31, 2005, shall revert

11  to the Florida Hurricane Catastrophe Fund.

12         (5)  Beginning January 15, 2005, and monthly

13  thereafter, the Chief Financial Officer shall provide a report

14  to the Executive Office of the Governor and the chair and vice

15  chair of the Legislative Budget Commission containing

16  information regarding the reimbursement for multiple hurricane

17  deductibles. The report shall include, but is not limited to,

18  cumulative and monthly information on the number of

19  reimbursement claims submitted, the total amount requested for

20  reimbursement, the number of claims paid, and the amount paid

21  for reimbursement.

22         (6)  In order to maintain actuarially indicated

23  premiums as required by section 215.555, Florida Statutes, the

24  State Board of Administration shall increase future premiums

25  by the amount appropriated and transferred from the Florida

26  Hurricane Catastrophe Fund under this section, plus additional

27  amounts necessary to recover lost investment income, less any

28  refunds of unused cash to the Florida Hurricane Catastrophe

29  Fund. The increase in future premiums shall be divided over 5

30  years, in equal or approximately equal amounts, beginning with

31  the June 1, 2006, contract year.

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    Florida Senate - 2004                           CS for SB 10-A
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 1         (7)  All appropriations authorized by this act are

 2  nonrecurring and are intended to address needs caused by

 3  Hurricanes Charley, Frances, Ivan, and Jeanne.

 4         Section 5.  This act shall take effect upon becoming a

 5  law.

 6  

 7          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 8                         Senate Bill 10-A

 9                                 

10  
      -  Requires the applicant for reimbursement to submit
11       documentation from the insurer to the department that the
         insurance claim was not paid, in full or in part, due to
12       application of the deductible.

13    -  Clarifies that a condominium association is not eligible
         to be reimbursed for loss amounts for which the
14       condominium association has accessed unit owners and for
         which the unit owners have insurance coverage for the
15       assessment.

16    -  Clarifies that reimbursement payments may not be paid for
         amounts for which the policyholder has received a grant
17       from any federal, state, county, or municipal agency or
         program.
18  
      -  Clarifies that after "full deductible" claimants are paid
19       in full, the pro-rata share of reimbursement funds
         available to other qualified applicants in the event that
20       the appropriation is not sufficient to pay all claims in
         full is an equal percentage of the amount of the
21       reimbursement claim that is approved.

22    -  Clarifies it is a violation of the Insurance Code for an
         insurer to change its method of determining whether to
23       waive or apply multiple hurricane deductibles to multiple
         claims due to the provisions of this bill.  Requires the
24       Office of Insurance Regulation to collect data from
         residential property insurers regarding the number of
25       claims filed by policyholders for two or more claims for
         the 2004 hurricane season.
26  
      -  Changes the date from September 30, 2005, to December 31,
27       2005 for unexpended funds to revert to the Florida
         Hurricane Catastrophe Fund.
28  
      -  Changes the date from June 1, 2005 to June 1, 2006 for
29       when the five-year increase in premiums for the Florida
         Hurricane Catastrophe Fund begins.
30  
      -  Clarifies reimbursements made to policyholders are to be
31       considered disaster-relief assistance within the meaning
         of section 139 of the Internal Revenue Code.
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