CS for CS for SB 2012 Second Engrossed

20082012e2

A bill to be entitled

An act relating to insurance; amending s. 624.46226, F.S.;

revising provisions authorizing public housing authorities

to form self-insurance funds; specifying requirements;

providing a definition; providing construction relating to

self-insurance funds; providing for application of certain

provisions of law to premiums, contributions, and

assessments of public authority's self-insurance funds;

specifying an alternative tax rate; providing for

application of certain provisions of law to public

authority's self-insurance funds not meeting certain

requirements; amending s. 624.501, F.S.; providing for

filing fees for an application for reinstatement of a

suspended license; amending s. 626.015, F.S.; redefining

the term "adjuster" to include a public adjuster

apprentice; amending s. 626.221, F.S.; providing that

certain company employee adjusters and independent

adjusters seeking reinstatement of a suspended license are

not required to take an examination; amending s. 626.241,

F.S.; requiring that the Department of Financial Services

create an examination for applicants seeking licensure as

a public adjuster and a separate examination for

applicants seeking licensure as a company employee

adjuster or independent adjuster; providing that an

examination on worker's compensation insurance or health

insurance may not be required for public adjusters;

amending s. 626.641, F.S.; providing that a suspended

license may not be reinstated unless the individual

seeking reinstatement files an application for

reinstatement which is subsequently approved by the

department; prohibiting the department from approving such

an application under certain circumstances; amending s.

626.854, F.S.; prohibiting a public adjuster from

soliciting or entering into a contract with any insured or

claimant under an insurance policy for a specified period

after the occurrence of an event that may be the subject

of a claim; providing an exception; providing that a

public adjuster's contract to adjust a claim may be

canceled by the client without penalty within a specified

period after the execution of the contract; requiring that

a public adjuster disclose to a client his or her right to

cancel a contract by specified means; providing an

exception during a state of emergency; specifying an

unfair and deceptive insurance trade practice; prohibiting

a public adjuster, apprentice, or his or her agent from

giving or offering a monetary loan or an article in excess

of a specified value to a client or prospective client;

prohibiting a public adjuster from basing any charge, fee,

payment, commission, or compensation relating to a

supplemental claim on the corresponding previous

settlement or claim payment; prohibiting a public adjuster

from charging, agreeing to, or accepting a fee, payment,

commission, or any compensation in excess of certain

amounts; providing application; requiring public adjusters

to provide claimants or insureds a written estimate of

certain losses relating to claims for payment of insurance

proceeds; requiring adjusters to retain estimates for a

specified time and make estimates available to claimants,

insureds, and the department; creating s. 626.8541, F.S.;

defining the term "public adjuster apprentice"; amending

s. 626.865, F.S.; providing qualifications that an

applicant must possess before the issuance of a license by

the department; requiring that certain persons applying

for a license after the completion of a period of

suspension, termination, cancellation, revocation, or

expiration must pass the examination required for

licensure as a public adjuster; creating s. 626.8651,

F.S.; providing requirements for licensure as a public

adjuster apprentice; requiring that the department approve

an application under certain circumstances; requiring that

all license fees be paid before the department issues a

license; requiring the applicant to file a bond in a

specified amount in favor of the department; providing for

termination of the bond; requiring that the apprentice's

work be supervised by a licensed adjuster in good

standing; authorizing the department to adopt rules

governing employment requirements; providing that the

supervising adjuster is responsible for the acts of the

apprentice; providing a period of effectiveness for an

apprentice license; providing that an individual licensed

as an apprentice may file an application for licensure as

a public adjuster after a specified period of employment

as an apprentice; requiring that a sworn affidavit

containing certain information accompany such application;

prohibiting an apprentice from performing any functions

for which a license is required after the expiration of

his or her license for apprenticeship without first

obtaining a license to work as a public adjuster; limiting

the authority of a public adjuster apprentice; amending s.

626.869, F.S.; providing that an examination on worker's

compensation insurance or health insurance may not be

required for public adjusters; providing for continuing

education for company employee adjusters, independent

adjusters, and public adjusters; providing for the

satisfaction of continuing education requirements for

nonresident adjusters; amending s. 626.8698, F.S.;

providing disciplinary guidelines for public adjusters and

public adjuster apprentices; amending s. 626.870, F.S.;

providing requirements for the reinstatement of a

100

suspended license, an appointment, or eligibility;

101

providing for the notification of approval of an

102

application for reinstatement; amending s. 626.8732, F.S.;

103

revising requirements for licensure as a nonresident

104

public adjuster; providing exceptions to such

105

requirements; requiring that an applicant for licensure as

106

a nonresident public adjuster provide certain information

107

with his or her application; requiring that the department

108

verify the nonresident applicant's licensing status;

109

creating s. 626.8796, F.S.; requiring that all contracts

110

for services by a public adjuster be in writing and

111

contain a specified statement regarding fraud; creating s.

112

626.8797, F.S.; requiring that proof of loss statements

113

contain a specified statement regarding fraud; amending s.

114

624.443, F.S.; authorizing the Office of Insurance

115

Regulation to waive the requirement that each multiple-

116

employer welfare arrangement maintain its principal place

117

of business in this state if the arrangement meets certain

118

specified conditions and has a minimum specified fund

119

balance at the time of licensure; amending s. 395.106,

120

F.S.; expanding authority for certain hospitals to form an

121

alliance for certain purposes; authorizing reinsurance

122

companies to issue coverage to certain self-insuring

123

alliances under certain circumstances; providing for

124

considering certain alliances as insurers for certain

125

purposes; providing for alliance reinsurance contracts to

126

receive the same tax treatment as reinsurance contracts

127

issued to insurance companies; providing an exception;

128

amending s. 627.351, F.S.; clarifying the right of certain

129

parties to discover underwriting and claims file records;

130

authorizing the corporation to release such records as it

131

deems necessary; amending s. 627.94073, F.S.; revising

132

provisions requiring that insurers notify policyholders of

133

the right to designate a secondary addressee to receive a

134

notice of termination of long-term care insurance

135

policies; requiring that a canceled long-term care policy

136

be reinstated if the policyholder failed to pay the

137

premium due to an extended confinement in a hospital,

138

skilled nursing facility, or assisted living facility;

139

providing for application; amending s. 626.9543, F.S.;

140

extending the period within which certain insurers must

141

permit claims from a Holocaust victim or from a

142

beneficiary, descendent, or heir of such a victim;

143

extending the period within which certain actions brought

144

by such a victim, descendent, or heir seeking proceeds of

145

certain insurance policies may not be dismissed; amending

146

s. 627.736, F.S.; revising the schedule of maximum charges

147

on which an insurer may base a limited reimbursement for

148

certain medical services, supplies, and care for injured

149

persons covered by personal injury protection; specifying

150

a minimum amount for the applicable fee schedule or

151

payment limitation under Medicare for such reimbursements;

152

providing legislative intent relating to certain Uniform

153

Commercial Code insurance products; authorizing title

154

insurers to petition for a rate deviation for certain

155

insurance products under certain circumstances; providing

156

criteria for the Office of Insurance Regulation; amending

157

s. 215.555, F.S.; extending for an additional year the

158

offer of reimbursement coverage for specified insurers;

159

revising the qualifying criteria for such insurers;

160

revising provisions to conform; amending s. 626.221, F.S.;

161

expanding the list of applicants eligible for exemption

162

from certain examination requirements; amending s.

163

626.2815, F.S.; expanding application of certain

164

continuing education requirements; providing limited

165

exceptions to compliance with continuing education

166

requirements as a condition precedent to certain

167

appointments; providing an exception to certain

168

examination monitoring requirements; providing exception

169

requirements; amending s. 626.381, F.S.; authorizing

170

appointing entities to require appointees to attend

171

certain training and education programs for certain

172

purposes; providing an exception; limiting an appointing

173

entity's appointment authority; prohibiting appointments

174

to be contingent upon an appointee's attendance at certain

175

courses; requiring Citizens Property Insurance Corporation

176

to electronically report certain claims data and histories

177

to certain consumer reporting agencies; providing

178

effective dates.

179

180

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

181

182

Section 1. Section 624.443, Florida Statutes, is amended to

183

read:

184

624.443 Place of business; maintenance of records.--Each

185

arrangement shall have and maintain its principal place of

186

business in this state and shall therein make available to the

187

office complete records of its assets, transactions, and affairs

188

in accordance with such methods and systems as are customary for,

189

or suitable to, the kind or kinds of business transacted. The

190

office may waive this requirement if an arrangement has been

191

operating in another state for at least 25 years, has been

192

licensed in such state for at least 10 years, and has a minimum

193

fund balance of $25 million at the time of licensure.

194

Section 2. Subsection (1) of section 395.106, Florida

195

Statutes, is amended, and subsection (5) is added to that

196

section, to read:

197

395.106 Risk pooling by certain hospitals and hospital

198

systems.--

199

(1) Notwithstanding any other provision of law, any two or

200

more hospitals licensed in this state and located in this state

201

may form an alliance for the purpose of pooling and spreading

202

liabilities of its members relative to property exposure,

203

implementing self-insurance coverage for its members, or securing

204

such property insurance coverage for the benefit of its members,

205

provided an alliance that is created:

206

(a) Has annual premiums in excess of $3 million.

207

(b) Maintains a continuing program of premium calculation

208

and evaluation and reserve evaluation to protect the financial

209

stability of the alliance in an amount and manner determined by

210

consultants using catastrophic (CAT) modeling criteria or other

211

risk-estimating methodologies, including those used by qualified

212

and independent actuaries.

213

214

financial statement based upon generally accepted accounting

215

principles and audited by an independent certified public

216

accountant within 6 months after the end of the fiscal year.

217

(d) Has a governing body comprised entirely of member

218

entities whose representatives on such governing body are

219

specified by the organizational documents of the alliance.

220

(5) Reinsurance companies complying with s. 624.610 may

221

issue coverage directly to an alliance self-insuring its

222

liabilities under this section. An alliance purchasing

223

reinsurance shall be considered an insurer for the sole purpose

224

of entering into such reinsurance contracts. Contracts of

225

reinsurance issued to an alliance under this section shall

226

receive the same tax treatment as reinsurance contracts issued to

227

insurance companies. However, the purchase of reinsurance

228

coverage by an alliance self-insuring pursuant to this section

229

shall not be construed as authorizing an alliance to otherwise

230

act as an insurer.

231

Section 3. Paragraph (w) of subsection (6) of section

232

627.351, Florida Statutes, is amended to read:

233

627.351 Insurance risk apportionment plans.--

234

(6) CITIZENS PROPERTY INSURANCE CORPORATION.--

235

(w)1. The following records of the corporation are

236

confidential and exempt from the provisions of s. 119.07(1) and

237

s. 24(a), Art. I of the State Constitution:

238

a. Underwriting files, except that a policyholder or an

239

applicant shall have access to his or her own underwriting files.

240

Confidential and exempt underwriting file records may also be

241

released to other governmental agencies upon written request and

242

demonstration of need; such records held by the receiving agency

243

remain confidential and exempt as provided herein.

244

b. Claims files, until termination of all litigation and

245

settlement of all claims arising out of the same incident,

246

although portions of the claims files may remain exempt, as

247

otherwise provided by law. Confidential and exempt claims file

248

records may be released to other governmental agencies upon

249

written request and demonstration of need; such records held by

250

the receiving agency remain confidential and exempt as provided

251

for herein.

252

c. Records obtained or generated by an internal auditor

253

pursuant to a routine audit, until the audit is completed, or if

254

the audit is conducted as part of an investigation, until the

255

investigation is closed or ceases to be active. An investigation

256

is considered "active" while the investigation is being conducted

257

with a reasonable, good faith belief that it could lead to the

258

filing of administrative, civil, or criminal proceedings.

259

d. Matters reasonably encompassed in privileged attorney-

260

client communications.

261

e. Proprietary information licensed to the corporation

262

under contract and the contract provides for the confidentiality

263

of such proprietary information.

264

f. All information relating to the medical condition or

265

medical status of a corporation employee which is not relevant to

266

the employee's capacity to perform his or her duties, except as

267

otherwise provided in this paragraph. Information that which is

268

exempt shall include, but is not limited to, information relating

269

to workers' compensation, insurance benefits, and retirement or

270

disability benefits.

271

g. Upon an employee's entrance into the employee assistance

272

program, a program to assist any employee who has a behavioral or

273

medical disorder, substance abuse problem, or emotional

274

difficulty which affects the employee's job performance, all

275

records relative to that participation shall be confidential and

276

exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I

277

of the State Constitution, except as otherwise provided in s.

278

112.0455(11).

279

h. Information relating to negotiations for financing,

280

reinsurance, depopulation, or contractual services, until the

281

conclusion of the negotiations.

282

i. Minutes of closed meetings regarding underwriting files,

283

and minutes of closed meetings regarding an open claims file

284

until termination of all litigation and settlement of all claims

285

with regard to that claim, except that information otherwise

286

confidential or exempt by law shall will be redacted.

287

2. If When an authorized insurer is considering

288

underwriting a risk insured by the corporation, relevant

289

underwriting files and confidential claims files may be released

290

to the insurer provided the insurer agrees in writing, notarized

291

and under oath, to maintain the confidentiality of such files. If

292

When a file is transferred to an insurer that file is no longer a

293

public record because it is not held by an agency subject to the

294

provisions of the public records law. Underwriting files and

295

confidential claims files may also be released to staff of and

296

the board of governors of the market assistance plan established

297

pursuant to s. 627.3515, who must retain the confidentiality of

298

such files, except such files may be released to authorized

299

insurers that are considering assuming the risks to which the

300

files apply, provided the insurer agrees in writing, notarized

301

and under oath, to maintain the confidentiality of such files.

302

Finally, the corporation or the board or staff of the market

303

assistance plan may make the following information obtained from

304

underwriting files and confidential claims files available to

305

licensed general lines insurance agents: name, address, and

306

telephone number of the residential property owner or insured;

307

location of the risk; rating information; loss history; and

308

policy type. The receiving licensed general lines insurance agent

309

must retain the confidentiality of the information received.

310

3. A policyholder who has filed suit against the

311

corporation has the right to discover the contents of his or her

312

own claims file to the same extent that discovery of such

313

contents would be available from a private insurer in litigation

314

as provided by the Florida Rules of Civil Procedure, the Florida

315

Evidence Code, and other applicable law. Pursuant to subpoena, a

316

third party has the right to discover the contents of an

317

insured's or applicant's underwriting or claims file to the same

318

extent that discovery of such contents would be available from a

319

private insurer by subpoena as provided by the Florida Rules of

320

Civil Procedure, the Florida Evidence Code, and other applicable

321

law, and subject to any confidentiality protections requested by

322

the corporation and agreed to by the seeking party or ordered by

323

the court. The corporation may release confidential underwriting

324

and claims file contents and information as it deems necessary

325

and appropriate to underwrite or service insurance policies and

326

claims, subject to any confidentiality protections deemed

327

necessary and appropriate by the corporation.

328

4.2. Portions of meetings of the corporation are exempt

329

from the provisions of s. 286.011 and s. 24(b), Art. I of the

330

State Constitution wherein confidential underwriting files or

331

confidential open claims files are discussed. All portions of

332

corporation meetings which are closed to the public shall be

333

recorded by a court reporter. The court reporter shall record the

334

times of commencement and termination of the meeting, all

335

discussion and proceedings, the names of all persons present at

336

any time, and the names of all persons speaking. No portion of

337

any closed meeting shall be off the record. Subject to the

338

provisions hereof and s. 119.07(1)(e)-(g), the court reporter's

339

notes of any closed meeting shall be retained by the corporation

340

for a minimum of 5 years. A copy of the transcript, less any

341

exempt matters, of any closed meeting wherein claims are

342

discussed shall become public as to individual claims after

343

settlement of the claim.

344

Section 4. Section 624.46226, Florida Statutes, is amended

345

to read:

346

624.46226 Public housing authorities self-insurance funds;

347

exemption for taxation and assessments.--

348

(1) Notwithstanding any other provision of law, any two or

349

more public housing authorities in the state as defined in

350

chapter 421 may form also create a self-insurance fund for the

351

purpose of pooling and spreading liabilities of its members as to

352

any one or combination of casualty risk or self-insuring real or

353

personal property risk of every kind and every interest in such

354

property against loss or damage from any hazard or cause and

355

against any loss consequential to such loss or damage, provided

356

the self-insurance fund that is created: all the provisions of s.

357

624.4622 are met.

358

(a) Has annual normal premiums in excess of $5 million.

359

(b) Uses a qualified actuary to determine rates using

360

accepted actuarial principles and annually submits to the office

361

a certification by the actuary that the rates are actuarially

362

sound and are not inadequate, as defined in s. 627.062.

363

364

and loss adjustment expenses and annually submits to the office a

365

certification by the actuary that the loss and loss adjustment

366

expense reserves are adequate. If the actuary determines that

367

reserves are not adequate, the fund shall file with the office a

368

remedial plan for increasing the reserves or otherwise addressing

369

the financial condition of the fund, subject to a determination

370

by the office that the fund will operate on an actuarially sound

371

basis and the fund does not pose a significant risk of

372

insolvency.

373

(d) Maintains a continuing program of excess insurance

374

coverage and reserve evaluation to protect the financial

375

stability of the fund in an amount and manner determined by a

376

qualified and independent actuary. At a minimum, this program

377

must:

378

1. Purchase excess insurance from authorized insurance

379

carriers or eligible surplus lines insurers.

380

2. Retain a per-loss occurrence that does not exceed

381

$350,000.

382

(e) Submits to the office annually an audited fiscal year-

383

end financial statement by an independent certified public

384

accountant within 6 months after the end of the fiscal year.

385

(f) Has a governing body which is comprised entirely of

386

commissioners of public housing authorities that are members of

387

the public housing authority self-insurance fund or persons

388

appointed by the commissioners of public housing authorities that

389

are members of the public housing authority self-insurance fund.

390

(g) Uses knowledgeable persons or business entities to

391

administer or service the fund in the areas of claims

392

administration, claims adjusting, underwriting, risk management,

393

loss control, policy administration, financial audit, and legal

394

areas. Such persons must meet all applicable requirements of law

395

for state licensure and must have at least 5 years' experience

396

with commercial self-insurance funds formed under s. 624.462,

397

self-insurance funds formed under s. 624.4622, or domestic

398

insurers.

399

(h) Submits to the office copies of contracts used for its

400

members that clearly establish the liability of each member for

401

the obligations of the fund.

402

(i) Annually submits to the office a certification by the

403

governing body of the fund that, to the best of its knowledge,

404

the requirements of this section are met.

405

(2) As used in this section, the term "qualified actuary"

406

means an actuary that is a member of the Casualty Actuarial

407

Society or the American Academy of Actuaries.

408

(3) A public housing authority's self-insurance fund that

409

meets the requirements of this section is not:

410

(a) An insurer for purposes of participation in or coverage

411

by any insurance guaranty association established by chapter 631;

412

413

(b) Subject to s. 624.4621 and is not required to file any

414

report with the department under s. 440.38(2)(b) that is uniquely

415

required of group self-insurer funds qualified under s. 624.4621.

416

(4) Premiums, contributions, and assessments received by a

417

public housing authority's self-insurance fund are subject to ss.

418

624.509(1) and (2) and 624.5092, except that the tax rate shall

419

be 1.6 percent of the gross amount of such premiums,

420

contributions, and assessments.

421

(5) If any of the requirements of subsection (1) are not

422

met, a public housing authority's self-insurance fund is subject

423

to the requirements of s. 624.4621 if the fund provides only

424

workers' compensation coverage or is subject to the requirements

425

of ss. 624.460-624.488 if the fund provides coverage for other

426

property, casualty, or surety risks.

427

(6)(2) Any public housing authority in the state as defined

428

in chapter 421 that is a member of a self-insurance fund pursuant

429

to this section shall be exempt from the assessments imposed

430

under ss. 215.555, 627.351 and 631.57.

431

Section 5. Effective January 1, 2009, subsection (5) of

432

section 624.501, Florida Statutes, is amended to read:

433

624.501 Filing, license, appointment, and miscellaneous

434

fees.--The department, commission, or office, as appropriate,

435

shall collect in advance, and persons so served shall pay to it

436

in advance, fees, licenses, and miscellaneous charges as follows:

437

(5) All insurance representatives, application for license,

438

application for reinstatement of suspended license, each filing,

439

filing fee....$50.00

440

Section 6. Effective January 1, 2009, subsection (1) of

441

section 626.015, Florida Statutes, is amended to read:

442

626.015 Definitions.--As used in this part:

443

(1) "Adjuster" means a public adjuster as defined in s.

444

626.854, public adjuster apprentice as defined in s. 626.8541,

445

independent adjuster as defined in s. 626.855, or company

446

employee adjuster as defined in s. 626.856.

447

Section 7. Effective January 1, 2009, paragraphs (c), (e),

448

and (f) of subsection (2) of section 626.221, Florida Statutes,

449

are amended to read:

450

626.221 Examination requirement; exemptions.--

451

(2) However, no such examination shall be necessary in any

452

of the following cases:

453

454

reinstatement of license or appointment as an agent, customer

455

representative, company employee adjuster, or independent

456

adjuster whose license has been suspended within 4 years prior to

457

the date of application or written request for reinstatement.

458

(e) A person who has been licensed and appointed as an a

459

public adjuster, independent adjuster, or company employee

460

adjuster as to all property, casualty, and surety insurances, may

461

be licensed and appointed as a company employee adjuster or,

462

independent, or public adjuster, as to these kinds of insurance,

463

without additional written examination if an application for

464

licensure is filed with the department within 48 months following

465

the date of cancellation or expiration of the prior appointment.

466

(f) A person who has been licensed as a company employee

467

adjuster or independent an adjuster for motor vehicle, property

468

and casualty, workers' compensation, and health insurance may be

469

licensed as such an adjuster without additional written

470

examination if his or her application for licensure is filed with

471

the department within 48 months after cancellation or expiration

472

of the prior license.

473

Section 8. Effective January 1, 2009, subsection (6) of

474

section 626.241, Florida Statutes, is amended to read:

475

626.241 Scope of examination.--

476

(6) In order to reflect the differences between adjusting

477

claims for an insurer and adjusting claims for an insured, the

478

department shall create an examination for applicants seeking

479

licensure as a public adjuster and a separate examination for

480

applicants seeking licensure as a company employee adjuster or

481

independent adjuster. Examinations given applicants for license

482

as an all-lines adjuster shall cover adjusting in all lines of

483

insurance, other than life and annuity; or, in accordance with

484

the application for the license, the examination may be limited

485

to adjusting in:

486

(a) Automobile physical damage insurance;

487

(b) Property and casualty insurance;

488

489

(d) Health insurance.

490

491

No examination on worker's compensation insurance or health

492

insurance shall be required for public adjusters.

493

Section 9. Effective January 1, 2009, subsection (1) of

494

section 626.641, Florida Statutes, is amended to read:

495

626.641 Duration of suspension or revocation.--

496

(1) The department shall, in its order suspending a license

497

or appointment or in its order suspending the eligibility of a

498

person to hold or apply for such license or appointment, specify

499

the period during which the suspension is to be in effect; but

500

such period shall not exceed 2 years. The license, appointment,

501

or eligibility shall remain suspended during the period so

502

specified, subject, however, to any rescission or modification of

503

the order by the department, or modification or reversal thereof

504

by the court, prior to expiration of the suspension period. A

505

license, appointment, or eligibility that which has been

506

suspended shall not be reinstated except upon the filing and

507

approval of an application for request for such reinstatement

508

and, in the case of a second suspension, completion of continuing

509

education courses prescribed and approved by the department; but

510

the department shall not approve an application for grant such

511

reinstatement if it finds that the circumstance or circumstances

512

for which the license, appointment, or eligibility was suspended

513

still exist or are likely to recur. In addition, an application a

514

request for reinstatement is subject to denial and subject to a

515

waiting period prior to approval on the same grounds that apply

516

to applications for licensure pursuant to ss. 626.207, 626.611,

517

and 626.621, and 626.8698.

518

Section 10. Effective October 1, 2008, subsections (5)

519

through (12) are added to section 626.854, Florida Statutes, to

520

read:

521

626.854 "Public adjuster" defined; prohibitions.--The

522

Legislature finds that it is necessary for the protection of the

523

public to regulate public insurance adjusters and to prevent the

524

unauthorized practice of law.

525

(5) A public adjuster may not directly or indirectly

526

through any other person or entity solicit an insured or claimant

527

by any means except on Monday through Saturday of each week and

528

only between the hours of 8 a.m. and 8 p.m. on those days.

529

(6) A public adjuster may not directly or indirectly

530

through any other person or entity initiate contact or engage in

531

face-to-face or telephonic solicitation or enter into a contract

532

with any insured or claimant under an insurance policy until at

533

least 48 hours after the occurrence of an event that may be the

534

subject of a claim under the insurance policy unless contact is

535

initiated by the insured or claimant.

536

(7) An insured or claimant may cancel a public adjuster's

537

contract to adjust a claim without penalty or obligation within 3

538

business days after the date on which the contract is executed or

539

within 3 business days after the date on which the insured or

540

claimant has notified the insurer of the claim, by phone or in

541

writing, whichever is later. The public adjuster's contract shall

542

disclose to the insured or claimant his or her right to cancel

543

the contract and advise the insured or claimant that notice of

544

cancellation must be submitted in writing and sent by certified

545

mail, return receipt requested, or other form of mailing which

546

provides proof thereof, to the public adjuster at the address

547

specified in the contract; provided, during any state of

548

emergency as declared by the Governor and for a period of 1 year

549

after the date of loss, the insured or claimant shall have 5

550

business days after the date on which the contract is executed to

551

cancel a public adjuster's contract.

552

(8) It is an unfair and deceptive insurance trade practice

553

pursuant to s. 626.9541 for a public adjuster or any other person

554

to circulate or disseminate any advertisement, announcement, or

555

statement containing any assertion, representation, or statement

556

with respect to the business of insurance which is untrue,

557

deceptive, or misleading.

558

(9) A public adjuster, a public adjuster apprentice, or any

559

person or entity acting on behalf of a public adjuster or public

560

adjuster apprentice may not give or offer to give a monetary loan

561

or advance to a client or prospective client.

562

(10) A public adjuster, public adjuster apprentice, or any

563

individual or entity acting on behalf of a public adjuster or

564

public adjuster apprentice may not give or offer to give,

565

directly or indirectly, any article of merchandise having a value

566

in excess of $25 to any individual for the purpose of advertising

567

or as an inducement to entering into a contract with a public

568

adjuster.

569

(11)(a) If a public adjuster enters into a contract with an

570

insured or claimant to reopen a claim or to file a supplemental

571

claim that seeks additional payments for a claim that has been

572

previously paid in part or in full or settled by the insurer, the

573

public adjuster may not charge, agree to, or accept any

574

compensation, payment, commission, fee, or other thing of value

575

based on a previous settlement or previous claim payments by the

576

insurer for the same cause of loss. The charge, compensation,

577

payment, commission, fee, or other thing of value may be based

578

only on the claim payments or settlement obtained through the

579

work of the public adjuster after entering into the contract with

580

the insured or claimant. The contracts described in this

581

paragraph are not subject to the limitations in paragraph (b).

582

(b) A public adjuster may not charge, agree to, or accept

583

any compensation, payment, commission, fee, or other thing of

584

value in excess of:

585

1. Ten percent of the amount of insurance claim payments by

586

the insurer for claims based on events that are the subject of a

587

declaration of a state of emergency by the Governor. This

588

provision applies to claims made during the period of 1 year

589

after the declaration of emergency.

590

2. Twenty percent of the amount of all other insurance

591

claim payments.

592

(12) Each public adjuster shall provide to the claimant or

593

insured a written estimate of the loss to assist in the

594

submission of a proof of loss or any other claim for payment of

595

insurance proceeds. The public adjuster shall retain such written

596

estimate for at least 5 years and shall make such estimate

597

available to the claimant or insured and the department upon

598

request.

599

600

The provisions of subsections (5)-(12) apply only to residential

601

property insurance policies and condominium association policies

602

as defined in s. 718.111(11).

603

Section 11. Effective January 1, 2009, section 626.8541,

604

Florida Statutes, is created to read:

605

626.8541 Public adjuster apprentice.--

606

(1) A "public adjuster apprentice" is any person who is not

607

a licensed public adjuster, who is employed by or has a contract

608

with a licensed and appointed public adjuster in good standing

609

with the department or a public adjusting firm that employs at

610

least one licensed and appointed public adjuster in good standing

611

with the department to assist a public adjuster in conducting

612

business under the license, and who satisfies the requirements of

613

s. 626.8651.

614

(2) A public adjuster apprentice must work with a licensed

615

and appointed public adjuster for a period of 12 months as set

616

forth in this section, and who otherwise is in full compliance

617

with this chapter, prior to being eligible for appointment as a

618

licensed public adjuster.

619

Section 12. Effective January 1, 2009, paragraph (e) of

620

subsection (1) of section 626.865, Florida Statutes, is amended,

621

and subsection (3) is added to that section, to read:

622

626.865 Public adjuster's qualifications, bond.--

623

(1) The department shall issue a license to an applicant

624

for a public adjuster's license upon determining that the

625

applicant has paid the applicable fees specified in s. 624.501

626

and possesses the following qualifications:

627

(e) Has passed the any required written examination.

628

(3) The department may not issue a license as a public

629

adjuster to any individual who has not passed the examination for

630

a public adjuster's license. Any individual who is applying for

631

reinstatement of a license after completion of a period of

632

suspension and any individual who is applying for a new license

633

after termination, cancellation, revocation, or expiration of a

634

prior license as a public adjuster must pass the examination

635

required for licensure as a public adjuster after approval of the

636

application for reinstatement or for a new license regardless of

637

whether the applicant passed an examination prior to issuance of

638

the license that was suspended, terminated, canceled, revoked, or

639

expired.

640

Section 13. Effective January 1, 2009, section 626.8651,

641

Florida Statutes, is created to read:

642

626.8651 Public adjuster apprentice license;

643

qualifications.--

644

(1) The department shall issue a license as a public

645

adjuster apprentice to an applicant who is:

646

(a) A natural person at least 18 years of age.

647

(b) A United States citizen or legal alien who possesses

648

work authorization from the United States Bureau of Citizenship

649

and Immigration Services and is a resident of this state.

650

651

reasonably ensure that the applicant will conduct business as a

652

public adjuster apprentice fairly and in good faith and without

653

detriment to the public.

654

(2) All applicable license fees, as prescribed in s.

655

624.501, must be paid in full before issuance of the license.

656

(3) At the time of application for license as a public

657

adjuster apprentice, the applicant shall file with the department

658

a bond executed and issued by a surety insurer authorized to

659

transact such business in this state in the amount of $50,000,

660

conditioned upon the faithful performance of his or her duties as

661

a public adjuster apprentice under the license for which the

662

applicant has applied, and thereafter maintain the bond

663

unimpaired throughout the existence of the license and for at

664

least 1 year after termination of the license. The bond shall be

665

in favor of the department and shall specifically authorize

666

recovery by the department of the damages sustained in case the

667

licensee commits fraud or unfair practices in connection with his

668

or her business as a public adjuster apprentice. The aggregate

669

liability of the surety for all such damages may not exceed the

670

amount of the bond, and the bond may not be terminated by the

671

issuing insurer unless written notice of at least 30 days is

672

given to the licensee and filed with the department.

673

(4) A public adjuster apprentice shall complete at a

674

minimum 100 hours of employment per month for 12 months of

675

employment under the supervision of a licensed and appointed all-

676

lines public adjuster in order to qualify for licensure as a

677

public adjuster. The department may adopt rules that establish

678

standards for such employment requirements.

679

(5) A supervising public adjuster shall be responsible and

680

accountable for the acts of a public adjuster apprentice which

681

are related to transacting business as a public adjuster

682

apprentice.

683

(6) An apprentice license is effective for 18 months unless

684

the license expires due to lack of maintaining an appointment; is

685

surrendered by the licensee; is terminated, suspended, or revoked

686

by the department; or is canceled by the department upon issuance

687

of a public adjuster license. The department may not issue a

688

public adjuster apprentice license to any individual who has held

689

such a license in this state within 2 years after expiration,

690

surrender, termination, revocation, or cancellation of the

691

license.

692

(7) After completing the requirements for employment as a

693

public adjuster apprentice, the licensee may file an application

694

for a public adjuster license. The applicant and supervising

695

public adjuster or public adjusting firm must each file a sworn

696

affidavit, on a form prescribed by the department, verifying that

697

the employment of the public adjuster apprentice meets the

698

requirements of this section.

699

(8) In no event shall a public adjuster apprentice licensed

700

under this section perform any of the functions for which a

701

public adjuster's license is required after expiration of the

702

public adjuster apprentice license without having obtained a

703

public adjuster license.

704

(9) A public adjuster apprentice has the same authority as

705

the licensed public adjuster or public adjusting firm that

706

employs the apprentice except that an apprentice may not execute

707

contracts for the services of a public adjuster or public

708

adjusting firm and may not solicit contracts for the services

709

except under the direct supervision and guidance of the

710

supervisory public adjuster. An individual may not be, act as, or

711

hold himself or herself out to be a public adjuster apprentice

712

unless the individual is licensed and holds a current appointment

713

by a licensed public all-lines adjuster or a public adjusting

714

firm that employs a licensed all-lines public adjuster.

715

Section 14. Effective October 1, 2008, subsections (1) and

716

(4) of section 626.869, Florida Statutes, are amended to read:

717

626.869 License, adjusters; continuing education.--

718

(1) An applicant for a license as an adjuster may qualify

719

and his or her license when issued may cover adjusting in any one

720

of the following classes of insurance:

721

(a) All lines of insurance except life and annuities.

722

(b) Motor vehicle physical damage insurance.

723

724

(d) Workers' compensation insurance.

725

(e) Health insurance.

726

727

No examination on worker's compensation insurance or health

728

insurance shall be required for public adjusters.

729

(4)(a) Any individual holding a license as a company

730

employee adjuster or independent adjuster for 24 consecutive

731

months or longer must, beginning in his or her birth month and

732

every 2 years thereafter, have completed 24 hours of courses, 2

733

hours of which relate to ethics, in subjects designed to inform

734

the licensee regarding the current insurance laws of this state,

735

so as to enable him or her to engage in business as an insurance

736

adjuster fairly and without injury to the public and to adjust

737

all claims in accordance with the policy or contract and the laws

738

of this state.

739

(b) Any individual holding a license as a public adjuster

740

for 24 consecutive months or longer, beginning in their birth

741

month and every 2 years thereafter, must have completed 24 hours

742

of courses, 2 hours of which relate to ethics, in subjects

743

designed to inform the licensee regarding the current laws of

744

this state pertaining to all lines of insurance other than life

745

and annuities, the current laws of this state pertaining to the

746

duties and responsibilities of public adjusters as set forth in

747

this part, and the current rules of the department applicable to

748

public adjusters and standard or representative policy forms used

749

by insurers, other than forms for life insurance and annuities,

750

so as to enable him or her to engage in business as an adjuster

751

fairly and without injury to the public and to adjust all claims

752

in accordance with the policy or contract and laws of this state.

753

In order to receive credit for continuing education courses,

754

public adjusters must take courses that are specifically designed

755

for public adjusters and approved by the department, provided,

756

however, no continuing education course shall be required for

757

public adjusters for worker's compensation insurance or health

758

insurance.

759

760

and administer the continuing education requirements of this

761

subsection. For good cause shown, the department may grant an

762

extension of time during which the requirements imposed by this

763

section may be completed, but such extension of time may not

764

exceed 1 year.

765

(d) A nonresident public adjuster must complete the

766

continuing education requirements provided by this section;

767

provided, a nonresident public adjuster may meet the requirements

768

of this section if the continuing education requirements of the

769

nonresident public adjuster's home state are determined to be

770

substantially comparable to the requirements of this state's

771

continuing education requirements and if the resident's state

772

recognizes reciprocity with this state's continuing education

773

requirements. A nonresident public adjuster whose home state does

774

not have such continuing education requirements for adjusters,

775

and who is not licensed as a nonresident adjuster in a state that

776

has continuing education requirements and reciprocates with this

777

state, must meet the continuing education requirements of this

778

section.

779

Section 15. Effective October 1, 2008, section 626.8698,

780

Florida Statutes, is amended to read:

781

626.8698 Disciplinary guidelines for public adjusters and

782

public adjuster apprentices.--The department may deny, suspend,

783

or revoke the license of a public adjuster or public adjuster

784

apprentice, and administer a fine not to exceed $5,000 per act,

785

for any of the following:

786

(1) Violating any provision of this chapter or a rule or

787

order of the department;

788

(2) Receiving payment or anything of value as a result of

789

an unfair or deceptive practice;

790

(3) Receiving or accepting any fee, kickback, or other

791

thing of value pursuant to any agreement or understanding, oral

792

or otherwise; entering into a split-fee arrangement with another

793

person who is not a public adjuster; or being otherwise paid or

794

accepting payment for services that have not been performed;

795

(4) Violating s. 316.066 or s. 817.234;

796

(5) Soliciting or otherwise taking advantage of a person

797

who is vulnerable, emotional, or otherwise upset as the result of

798

a trauma, accident, or other similar occurrence; or

799

(6) Violating any ethical rule of the department.

800

Section 16. Effective January 1, 2009, subsection (4) is

801

added to section 626.870, Florida Statutes, to read:

802

626.870 Application for license.--

803

(4) A license, an appointment, or eligibility that has been

804

suspended may not be reinstated except upon the filing and

805

approval of an application for reinstatement in accordance with

806

s. 626.641. In addition, for reinstatement of a public adjuster's

807

license, appointment, or eligibility, the individual must pass

808

the public adjuster licensing examination. An application for

809

reinstatement must be accompanied by any applicable examination

810

fee. Successful completion of the examination does not entitle

811

the applicant to have a license reinstated. The application is

812

subject to denial pursuant to ss. 626.207, 626.611, 626.621, and

813

626.8698. If the department approves an application for

814

reinstatement, the applicant shall be notified that the license

815

will be reinstated upon payment by the applicant of the

816

reinstatement fee contained in s. 624.501(15).

817

Section 17. Effective January 1, 2009, paragraphs (b) and

818

(e) of subsection (1) and paragraphs (b) and (c) of subsection

819

(2) of section 626.8732, Florida Statutes, are amended, and

820

subsection (6) is added to that section, to read:

821

626.8732 Nonresident public adjuster's qualifications,

822

bond.--

823

(1) The department shall, upon application therefor, issue

824

a license to an applicant for a nonresident public adjuster's

825

license upon determining that the applicant has paid the

826

applicable license fees required under s. 624.501 and:

827

(b) Has passed to the satisfaction of the department a

828

written Florida public adjuster's examination of the scope

829

prescribed in s. 626.241(6); however, the requirement for such an

830

examination does not apply to any of the following:

831

1. An applicant who is licensed as a resident public

832

adjuster in his or her state of residence, when that state

833

requires the passing of a written examination in order to obtain

834

the license and a reciprocal agreement with the appropriate

835

official of that state has been entered into by the department;

836

837

2. An applicant who is licensed as a nonresident public

838

adjuster in a state other than his or her state of residence when

839

the state of licensure requires the passing of a written

840

examination in order to obtain the license and a reciprocal

841

agreement with the appropriate official of the state of licensure

842

has been entered into by the department.

843

(e) Has been licensed and employed as a public adjuster in

844

the applicant's state of residence on a continual basis for the

845

past 3 years, or, if the applicant's state of residence does not

846

issue licenses to individuals who act as public adjusters, the

847

applicant has been licensed and employed as a resident insurance

848

company or independent adjuster, insurance agent, insurance

849

broker, or other insurance representative in his or her state of

850

residence or any other state on a continual basis for the past 3

851

years. This paragraph does not apply to individuals who are

852

licensed to transact only life insurance and annuity business had

853

sufficient experience, training, or instruction concerning the

854

adjusting of damages or losses under insurance contracts, other

855

than life and annuity contracts; is sufficiently informed as to

856

the terms and effects of the provisions of those types of

857

insurance contracts; and possesses adequate knowledge of the laws

858

of this state relating to such contracts as to enable and qualify

859

him or her to engage in the business of insurance adjuster fairly

860

and without injury to the public or any member thereof with whom

861

he or she may have business as a public adjuster.

862

(2) The applicant shall furnish the following with his or

863

her application:

864

(b) If currently licensed as a resident public adjuster in

865

the applicant's state of residence, a certificate or letter of

866

authorization from the licensing authority of the applicant's

867

state of residence, stating that the applicant holds a current or

868

comparable license to act as a public adjuster and has held the

869

license continuously for the past 3 years. The certificate or

870

letter of authorization must be signed by the insurance

871

commissioner or his or her deputy or the appropriate licensing

872

official and must disclose whether the adjuster has ever had any

873

license or eligibility to hold any license declined, denied,

874

suspended, revoked, or placed on probation or whether an

875

administrative fine or penalty has been levied against the

876

adjuster and, if so, the reason for the action.

877

878

licensure as a public adjuster and the applicant has been

879

licensed as a resident insurance adjuster, agent, broker, or

880

other insurance representative in his or her state of residence

881

or any other state within the past 3 years, a certificate or

882

letter of authorization from the licensing authority stating that

883

the applicant holds or has held a license to act as such an

884

insurance adjuster, agent, or other insurance representative and

885

has held the license continuously for the past 3 years. The

886

certificate or letter of authorization must be signed by the

887

insurance commissioner or his or her deputy or the appropriate

888

licensing official and must disclose whether or not the adjuster,

889

agent, or other insurance representative has ever had any license

890

or eligibility to hold any license declined, denied, suspended,

891

revoked, or placed on probation or whether an administrative fine

892

or penalty has been levied against the adjuster and, if so, the

893

reason for the action.

894

(6) If available, the department shall verify the

895

nonresident applicant's licensing status through the producer

896

database maintained by the National Association of Insurance

897

Commissioners or its affiliates or subsidiaries.

898

Section 18. Effective October 1, 2008, section 626.8796,

899

Florida Statutes, is created to read:

900

626.8796 Public adjuster contracts; fraud statement.--All

901

contracts for public adjuster services must be in writing and

902

must prominently display the following statement on the contract:

903

"Pursuant to s. 817.234, Florida Statutes, any person who, with

904

the intent to injure, defraud, or deceive any insurer or insured,

905

prepares, presents, or causes to be presented a proof of loss or

906

estimate of cost or repair of damaged property in support of a

907

claim under an insurance policy knowing that the proof of loss or

908

estimate of claim or repairs contains any false, incomplete, or

909

misleading information concerning any fact or thing material to

910

the claim commits a felony of the third degree, punishable as

911

provided in s. 775.082, s. 775.803, or s. 775.084, Florida

912

Statutes."

913

Section 19. Effective October 1, 2008, section 626.8797,

914

Florida Statutes, is created to read:

915

626.8797 Proof of loss; fraud statement.--All proof of loss

916

statements must prominently display the following statement:

917

"Pursuant to s. 817.234, Florida Statutes, any person who, with

918

the intent to injure, defraud, or deceive any insurer or insured,

919

prepares, presents, or causes to be presented a proof of loss or

920

estimate of cost or repair of damaged property in support of a

921

claim under an insurance policy knowing that the proof of loss or

922

estimate of claim or repairs contains any false, incomplete, or

923

misleading information concerning any fact or thing material to

924

the claim commits a felony of the third degree, punishable as

925

provided in s. 775.082, s. 775.803, or s. 775.084, Florida

926

Statutes."

927

Section 20. Effective January 1, 2009, and applicable to

928

policies issued or renewed on or after that date, section

929

627.94073, Florida Statutes, is amended to read:

930

627.94073 Notice of cancellation; grace period.--

931

(1) A long-term care policy shall provide that the insured

932

is entitled to a grace period of not less than 30 days, within

933

which payment of any premium after the first may be made. The

934

insurer may require payment of an interest charge not in excess

935

of 8 percent per year for the number of days elapsing before the

936

payment of the premium, during which period the policy shall

937

continue in force. If the policy becomes a claim during the grace

938

period before the overdue premium is paid, the amount of such

939

premium or premiums with interest not in excess of 8 percent per

940

year may be deducted in any settlement under the policy.

941

(2) A long-term care policy may not be canceled for

942

nonpayment of premium unless, after expiration of the grace

943

period in subsection (1), and at least 30 days prior to the

944

effective date of such cancellation, the insurer has mailed a

945

notification of possible lapse in coverage to the policyholder

946

and to a specified secondary addressee if such addressee has been

947

designated in writing by name and address by the policyholder.

948

For policies issued or renewed on or after October 1, 1996, the

949

insurer shall notify the policyholder, at least once annually

950

every 2 years, of the right to designate a secondary addressee.

951

The applicant has the right to designate at least one person who

952

is to receive the notice of termination, in addition to the

953

insured. Designation shall not constitute acceptance of any

954

liability on the third party for services provided to the

955

insured. The form used for the written designation must provide

956

space clearly designated for listing at least one person. The

957

form must also inform the policyholder to update any change made

958

to the address of the secondary addressee. The designation shall

959

include each person's full name and home address. In the case of

960

an applicant who elects not to designate an additional person,

961

the waiver shall state: "Protection against unintended lapse.--I

962

understand that I have the right to designate at least one person

963

other than myself to receive notice of lapse or termination of

964

this long-term care or limited benefit insurance policy for

965

nonpayment of premium. I understand that notice will not be given

966

until 30 days after a premium is due and unpaid. I elect NOT to

967

designate any person to receive such notice." Notice of possible

968

lapse in coverage due to nonpayment of premium shall be given by

969

United States Postal Service proof of mailing or certified or

970

registered mail to the policyholder and secondary designee at the

971

address shown in the policy or the last known address provided to

972

the insurer. first class United States mail, postage prepaid, and

973

Notice may not be given until 30 days after a premium is due and

974

unpaid. Notice shall be deemed to have been given as of 5 days

975

after the date of mailing.

976

(3) If a policy is canceled due to nonpayment of premium,

977

the policyholder is shall be entitled to have the policy

978

reinstated if, within a period of not less than 5 months after

979

the date of cancellation, the policyholder or any secondary

980

addressee designated pursuant to subsection (2) demonstrates that

981

the failure to pay the premium when due was unintentional and due

982

to the policyholder's cognitive impairment, or loss of functional

983

capacity, or continuous confinement in a hospital, skilled

984

nursing facility, or assisted living facility for a period in

985

excess of 60 days of the policyholder. Policy reinstatement shall

986

be subject to payment of overdue premiums. The standard of proof

987

of cognitive impairment or loss of functional capacity shall not

988

be more stringent than the benefit eligibility criteria for

989

cognitive impairment or the loss of functional capacity, if any,

990

contained in the policy and certificate. The insurer may require

991

payment of an interest charge not in excess of 8 percent per year

992

for the number of days elapsing before the payment of the

993

premium, during which period the policy shall continue in force

994

if the demonstration of cognitive impairment is made. If the

995

policy becomes a claim during the 180-day period before the

996

overdue premium is paid, the amount of the premium or premiums

997

with interest not in excess of 8 percent per year may be deducted

998

in any settlement under the policy.

999

(4) When the policyholder or certificateholder pays premium

1000

for a long-term care insurance policy or certificate policy

1001

through a payroll or pension deduction plan, the requirements in

1002

subsection (2) need not be met until 60 days after the

1003

policyholder or certificateholder is no longer on such a payment

1004

plan. The application or enrollment form for such policies or

1005

certificates shall clearly indicate the payment plan selected by

1006

the applicant.

1007

Section 21. Paragraph (c) of subsection (5) and subsection

1008

(6) of section 626.9543, Florida Statutes, are amended to read:

1009

626.9543 Holocaust victims.--

1010

(5) PROOF OF A CLAIM.--Any insurer doing business in this

1011

state, in receipt of a claim from a Holocaust victim or from a

1012

beneficiary, descendant, or heir of a Holocaust victim, shall:

1013

1014

limitations or notice requirements imposed by any insurance

1015

policy issued, provided the claim is submitted on or before July

1016

1, 2018 within 10 years after the effective date of this section.

1017

(6) STATUTE OF LIMITATIONS.--Notwithstanding any law or

1018

agreement among the parties to an insurance policy to the

1019

contrary, any action brought by Holocaust victims or by a

1020

beneficiary, heir, or a descendant of a Holocaust victim seeking

1021

proceeds of an insurance policy issued or in effect between 1920

1022

and 1945, inclusive, shall not be dismissed for failure to comply

1023

with the applicable statute of limitations or laches provided the

1024

action is commenced on or before July 1, 2018 within 10 years

1025

after the effective date of this section.

1026

Section 22. Paragraph (a) of subsection (5) of section

1027

627.736, Florida Statutes, is amended to read:

1028

627.736 Required personal injury protection benefits;

1029

exclusions; priority; claims.--

1030

(5) CHARGES FOR TREATMENT OF INJURED PERSONS.--

1031

(a)1. Any physician, hospital, clinic, or other person or

1032

institution lawfully rendering treatment to an injured person for

1033

a bodily injury covered by personal injury protection insurance

1034

may charge the insurer and injured party only a reasonable amount

1035

pursuant to this section for the services and supplies rendered,

1036

and the insurer providing such coverage may pay for such charges

1037

directly to such person or institution lawfully rendering such

1038

treatment, if the insured receiving such treatment or his or her

1039

guardian has countersigned the properly completed invoice, bill,

1040

or claim form approved by the office upon which such charges are

1041

to be paid for as having actually been rendered, to the best

1042

knowledge of the insured or his or her guardian. In no event,

1043

however, may such a charge be in excess of the amount the person

1044

or institution customarily charges for like services or supplies.

1045

With respect to a determination of whether a charge for a

1046

particular service, treatment, or otherwise is reasonable,

1047

consideration may be given to evidence of usual and customary

1048

charges and payments accepted by the provider involved in the

1049

dispute, and reimbursement levels in the community and various

1050

federal and state medical fee schedules applicable to automobile

1051

and other insurance coverages, and other information relevant to

1052

the reasonableness of the reimbursement for the service,

1053

treatment, or supply.

1054

2. The insurer may limit reimbursement to 80 percent of the

1055

following schedule of maximum charges:

1056

a. For emergency transport and treatment by providers

1057

licensed under chapter 401, 200 percent of Medicare.

1058

b. For emergency services and care provided by a hospital

1059

licensed under chapter 395, 75 percent of the hospital's usual

1060

and customary charges.

1061

c. For emergency services and care as defined by s.

1062

395.002(10) provided in a facility licensed under chapter 395

1063

rendered by a physician or dentist, and related hospital

1064

inpatient services rendered by a physician or dentist, the usual

1065

and customary charges in the community.

1066

d. For hospital inpatient services, other than emergency

1067

services and care, 200 percent of the Medicare Part A prospective

1068

payment applicable to the specific hospital providing the

1069

inpatient services.

1070

e. For hospital outpatient services, other than emergency

1071

services and care, 200 percent of the Medicare Part A Ambulatory

1072

Payment Classification for the specific hospital providing the

1073

outpatient services.

1074

f. For all other medical services, supplies, and care, 200

1075

percent of the allowable amount under the participating

1076

physicians schedule of applicable Medicare Part B fee schedule.

1077

However, if such services, supplies, or care is not reimbursable

1078

under Medicare Part B, the insurer may limit reimbursement to 80

1079

percent of the maximum reimbursable allowance under workers'

1080

compensation, as determined under s. 440.13 and rules adopted

1081

thereunder which are in effect at the time such services,

1082

supplies, or care is provided. Services, supplies, or care that

1083

is not reimbursable under Medicare or workers' compensation is

1084

not required to be reimbursed by the insurer.

1085

3. For purposes of subparagraph 2., the applicable fee

1086

schedule or payment limitation under Medicare is the fee schedule

1087

or payment limitation in effect at the time the services,

1088

supplies, or care was rendered and for the area in which such

1089

services were rendered, except that it may not be less than the

1090

allowable amount under the participating physicians schedule

1091

applicable 2007 Medicare Part B for 2007 fee schedule for medical

1092

services, supplies, and care subject to Medicare Part B.

1093

4. Subparagraph 2. does not allow the insurer to apply any

1094

limitation on the number of treatments or other utilization

1095

limits that apply under Medicare or workers' compensation. An

1096

insurer that applies the allowable payment limitations of

1097

subparagraph 2. must reimburse a provider who lawfully provided

1098

care or treatment under the scope of his or her license,

1099

regardless of whether such provider would be entitled to

1100

reimbursement under Medicare due to restrictions or limitations

1101

on the types or discipline of health care providers who may be

1102

reimbursed for particular procedures or procedure codes.

1103

5. If an insurer limits payment as authorized by

1104

subparagraph 2., the person providing such services, supplies, or

1105

care may not bill or attempt to collect from the insured any

1106

amount in excess of such limits, except for amounts that are not

1107

covered by the insured's personal injury protection coverage due

1108

to the coinsurance amount or maximum policy limits.

1109

Section 23. The Legislature finds that the Uniform

1110

Commercial Code insurance product authorized by section 1 of

1111

Chapter 2005-153, Laws of Florida, will open new markets in this

1112

state and will result in generation of new revenue for the state.

1113

Accordingly, title insurers may petition for a rate deviation as

1114

provided by s. 627.783, Florida Statutes, for the uniform

1115

commercial code insurance product. In determining whether to

1116

approve such petition for a rate deviation for the uniform

1117

commercial code insurance product, the office shall be guided by

1118

standards for national rates for the product currently being

1119

offered in other states.

1120

Section 24. Paragraph (b) of subsection (4) of section

1121

215.555, Florida Statutes, is amended to read:

1122

215.555 Florida Hurricane Catastrophe Fund.--

1123

(4) REIMBURSEMENT CONTRACTS.--

1124

(b)1. The contract shall contain a promise by the board to

1125

reimburse the insurer for 45 percent, 75 percent, or 90 percent

1126

of its losses from each covered event in excess of the insurer's

1127

retention, plus 5 percent of the reimbursed losses to cover loss

1128

adjustment expenses.

1129

2. The insurer must elect one of the percentage coverage

1130

levels specified in this paragraph and may, upon renewal of a

1131

reimbursement contract, elect a lower percentage coverage level

1132

if no revenue bonds issued under subsection (6) after a covered

1133

event are outstanding, or elect a higher percentage coverage

1134

level, regardless of whether or not revenue bonds are

1135

outstanding. All members of an insurer group must elect the same

1136

percentage coverage level. Any joint underwriting association,

1137

risk apportionment plan, or other entity created under s. 627.351

1138

must elect the 90-percent coverage level.

1139

3. The contract shall provide that reimbursement amounts

1140

shall not be reduced by reinsurance paid or payable to the

1141

insurer from other sources.

1142

4. Notwithstanding any other provision contained in this

1143

section, the board shall make available to insurers that

1144

purchased coverage provided by this subparagraph in 2007 2006,

1145

insurers qualifying as limited apportionment companies under s.

1146

627.351(6)(c), and insurers that have been were approved to

1147

participate in 2006 or that are approved in 2007 for the

1148

Insurance Capital Build-Up Incentive Program pursuant to s.

1149

215.5595, a contract or contract addendum that provides an

1150

additional amount of reimbursement coverage of up to $10 million.

1151

The premium to be charged for this additional reimbursement

1152

coverage shall be 50 percent of the additional reimbursement

1153

coverage provided, which shall include one prepaid reinstatement.

1154

The minimum retention level that an eligible participating

1155

insurer must retain associated with this additional coverage

1156

layer is 30 percent of the insurer's surplus as of December 31,

1157

2007 2006. This coverage shall be in addition to all other

1158

coverage that may be provided under this section. The coverage

1159

provided by the fund under this subparagraph shall be in addition

1160

to the claims-paying capacity as defined in subparagraph (c)1.,

1161

but only with respect to those insurers that select the

1162

additional coverage option and meet the requirements of this

1163

subparagraph. The claims-paying capacity with respect to all

1164

other participating insurers and limited apportionment companies

1165

that do not select the additional coverage option shall be

1166

limited to their reimbursement premium's proportionate share of

1167

the actual claims-paying capacity otherwise defined in

1168

subparagraph (c)1. and as provided for under the terms of the

1169

reimbursement contract. Coverage provided in the reimbursement

1170

contract shall will not be affected by the additional premiums

1171

paid by participating insurers exercising the additional coverage

1172

option allowed in this subparagraph. This subparagraph expires on

1173

May 31, 2009 2008.

1174

Section 25. Effective January 1, 2009, paragraph (j) of

1175

subsection (2) of section 626.221, Florida Statutes, is amended

1176

to read:

1177

626.221 Examination requirement; exemptions.--

1178

(2) However, no such examination shall be necessary in any

1179

of the following cases:

1180

(j) An applicant for license as a customer representative

1181

who has earned the designation of Accredited Advisor in Insurance

1182

(AAI) from the Insurance Institute of America, the designation of

1183

Certified Insurance Counselor (CIC) from the Society of Certified

1184

Insurance Service Counselors, the designation of Accredited

1185

Customer Service Representative (ACSR) from the Independent

1186

Insurance Agents of America, the designation of Certified

1187

Professional Service Representative (CPSR) from the National

1188

Foundation for Certified Professional Service Representatives,

1189

the designation of Certified Insurance Service Representative

1190

(CISR) from the Society of Certified Insurance Service

1191

Representatives. Also, an applicant for license as a customer

1192

representative who has earned an associate's degree or bachelor's

1193

degree from an accredited college or university with at least 9

1194

academic hours of property and casualty insurance curriculum, or

1195

the equivalent, or has earned the designation of Certified

1196

Customer Service Representative (CCSR) from the Florida

1197

Association of Insurance Agents, or the designation of Registered

1198

Customer Service Representative (RCSR) from a regionally

1199

accredited postsecondary institution in this state, or the

1200

designation of Professional Customer Service Representative

1201

(PCSR) from the Professional Career Institute, whose curriculum

1202

has been approved by the department and whose curriculum includes

1203

comprehensive analysis of basic property and casualty lines of

1204

insurance and testing at least equal to that of standard

1205

department testing for the customer representative license. The

1206

department shall adopt rules establishing standards for the

1207

approval of curriculum.

1208

Section 26. Subsection (2), paragraph (f) of subsection

1209

(3), and paragraph (j) of subsection (4) of section 626.2815,

1210

Florida Statutes, are amended to read:

1211

626.2815 Continuing education required; application;

1212

exceptions; requirements; penalties.--

1213

(2) Except as otherwise provided in this section, the

1214

provisions of this section apply to persons licensed to engage in

1215

the sale of insurance in this state for all lines of insurance

1216

for which an examination is required for licensing and to each

1217

insurer, employer, or appointing entity, including, but not

1218

limited to, those created or existing pursuant to s. 627.351. The

1219

provisions of this section shall not apply to any person holding

1220

a license for the sale of any line of insurance for which an

1221

examination is not required by the laws of this state, nor shall

1222

the provisions of this section apply to any limited license as

1223

the department may exempt by rule.

1224

(3)

1225

(f)1. Except as provided in subparagraph 2., compliance

1226

with continuing education requirements is a condition precedent

1227

to the issuance, continuation, reinstatement, or renewal of any

1228

appointment subject to this section.

1229

2.a. An appointing entity, except one that appoints

1230

individuals who are employees or exclusive independent

1231

contractors of the appointing entity, may not require, directly

1232

or indirectly, as a condition of such appointment or the

1233

continuation of such appointment, the taking of an approved

1234

course or program by any appointee or potential appointee that is

1235

not of the appointee's choosing.

1236

b. Any entity created or existing pursuant to s. 627.351

1237

may require employees to take training of any type relevant to

1238

their employment but may not require appointees who are not

1239

employees to take any approved course or program unless the

1240

course or program deals solely with the appointing entity's

1241

internal procedures or products or with subjects substantially

1242

unique to the appointing entity.

1243

(4) The following courses may be completed in order to meet

1244

the continuing education course requirements:

1245

(j) Any course, including courses relating to agency

1246

management or errors and omissions, developed or sponsored by any

1247

authorized insurer or recognized agents' association or insurance

1248

trade association or any independent study program of

1249

instruction, subject to approval by the department, qualifies for

1250

the equivalency of the number of classroom hours assigned thereto

1251

by the department. However, unless otherwise provided in this

1252

section, continuing education hours may not be credited toward

1253

meeting the requirements of this section unless the course is

1254

provided by classroom instruction or results in a monitored

1255

examination. A monitored examination is not required for:

1256

1. An independent study program of instruction that is

1257

presented through interactive, online technology that the

1258

department determines has sufficient internal testing to validate

1259

the student's full comprehension of the materials presented; or

1260

2. An independent study program of instruction presented on

1261

paper or in printed material that imposes a final closed book

1262

examination that meets the requirements of the department's rule

1263

for self-study courses. The examination may be taken without a

1264

proctor provided the student presents to the provider a sworn

1265

affidavit certifying that the student did not consult any written

1266

materials or receive outside assistance of any kind or from any

1267

person, directly or indirectly, while taking the examination. If

1268

the student is an employee of an agency or corporate entity, the

1269

student's supervisor or a manager or owner of the agency or

1270

corporate entity must also sign the sworn affidavit. If the

1271

student is self-employed, a sole proprietor, or a partner, or if

1272

the examination is administered online, the sworn affidavit must

1273

also be signed by a disinterested third party. The sworn

1274

affidavit must be received by the approved provider prior to

1275

reporting continuing education credits to the department.

1276

Section 27. Subsections (6) and (7) of section 626.381,

1277

Florida Statutes, are renumbered as subsections (8) and (9),

1278

respectively, and new subsections (6) and (7) are added to that

1279

section to read:

1280

626.381 Renewal, continuation, reinstatement, or

1281

termination of appointment.--

1282

(6) An appointing entity may require an appointee to attend

1283

training and education programs of the appointing entity in order

1284

for the appointee to receive a new appointment or maintain an

1285

existing appointment. However, an appointing entity may not

1286

require, directly or indirectly, any appointee to attend any

1287

training programs that are wholly or partially approved for

1288

general continuing education credit as provided in s. 626.2815.

1289

(7) Each appointing entity may appoint only those persons

1290

who have met the continuing education requirements of the license

1291

necessary for such appointment as provided in s. 626.2815.

1292

However, an appointing entity may not make or allow, directly or

1293

indirectly, the appointment of any appointee or potential

1294

appointee to be contingent, in whole or in part, on any

1295

appointee's attendance at any course that is approved, in whole

1296

or in part, for continuing education credit pursuant to s.

1297

626.2815.

1298

Section 28. Upon the request of a consumer reporting

1299

agency, as defined by the federal Fair Credit Reporting Act, 15

1300

U.S.C. 1681 et seq., which consumer reporting agency is on

1301

compliance with the confidentiality requirements of such act, the

1302

Citizens Property Insurance Corporation shall electronically

1303

report claims data and histories to such consumer reporting

1304

agency which maintains a database of similar data for use in

1305

connection with the underwriting of insurance involving a

1306

consumer.

1307

Section 29. Except as otherwise expressly provided in this

1308

act, this act shall take effect July 1, 2008.

CODING: Words stricken are deletions; words underlined are additions.