| 1 | A bill to be entitled |
| 2 | An act relating to property loss appraisals; amending |
| 3 | s. 627.351, F.S.; requiring Citizens Property |
| 4 | Insurance Corporation's plan of operation to provide |
| 5 | for the adoption of policy forms that require |
| 6 | compliance with certain conditions and procedures |
| 7 | relating to the participation of umpires and |
| 8 | appraisers in the loss appraisal process under certain |
| 9 | circumstances; providing that either party may submit |
| 10 | a written demand to enter into the process of |
| 11 | appraisal when the insured and the corporation fail to |
| 12 | mutually agree to the actual cash value, the amount of |
| 13 | loss, or the cost of repair or replacement of property |
| 14 | for which a claim has been filed; providing an |
| 15 | exception upon which the corporation may refuse to |
| 16 | accept such demand; providing that the corporation |
| 17 | waives the right to demand an appraisal under certain |
| 18 | circumstances; requiring each party to select a |
| 19 | competent and independent appraiser and to notify the |
| 20 | opposing party within a specified period; requiring |
| 21 | the appraisers to select an appraisal umpire; |
| 22 | authorizing either party to file a petition, in a |
| 23 | county or circuit court in the jurisdiction in which |
| 24 | the covered property is located, to designate an |
| 25 | appraisal umpire if the appraisers cannot agree on the |
| 26 | selection of an umpire; providing that appraisal |
| 27 | proceedings are informal unless the corporation and |
| 28 | the insured agree otherwise; defining and providing |
| 29 | the scope of the term "informal" for purposes of |
| 30 | appraisal proceedings; requiring each appraiser to |
| 31 | submit a written report to the other appraiser; |
| 32 | requiring that any differences in findings between the |
| 33 | appraisers that cannot be resolved by the appraisers |
| 34 | themselves within a specified period be submitted to |
| 35 | the umpire for review; providing an exception; |
| 36 | requiring the umpire to submit his or her conclusions |
| 37 | regarding any unresolved differences in the findings |
| 38 | of the appraisers within a specified period; providing |
| 39 | that if either appraiser agrees with the conclusions |
| 40 | of the umpire, an itemized written appraisal award |
| 41 | signed by the umpire and appraiser shall be filed with |
| 42 | the corporation and shall determine the amount of the |
| 43 | loss; providing that the appraisal award is binding |
| 44 | upon the corporation and the insured; providing for |
| 45 | compensation of the appraisers and the umpire; |
| 46 | providing applicability of the Florida Arbitration |
| 47 | Code to residential or commercial residential property |
| 48 | insurance loss appraisal proceedings and specified |
| 49 | procedural matters; prohibiting the appraisal process |
| 50 | from addressing issues involving coverage or lack |
| 51 | thereof under an insurance contract; authorizing the |
| 52 | umpire and appraisers to consider causation issues |
| 53 | when necessary to determine the amount of loss; |
| 54 | providing an effective date. |
| 55 |
|
| 56 | Be It Enacted by the Legislature of the State of Florida: |
| 57 |
|
| 58 | Section 1. Paragraph (c) of subsection (6) of section |
| 59 | 627.351, Florida Statutes, is amended to read: |
| 60 | 627.351 Insurance risk apportionment plans.- |
| 61 | (6) CITIZENS PROPERTY INSURANCE CORPORATION.- |
| 62 | (c) The corporation's plan of operation: |
| 63 | 1. Must provide for adoption of residential property and |
| 64 | casualty insurance policy forms and commercial residential and |
| 65 | nonresidential property insurance forms, which must be approved |
| 66 | by the office before use. The corporation shall adopt the |
| 67 | following policy forms: |
| 68 | a. Standard personal lines policy forms that are |
| 69 | comprehensive multiperil policies providing full coverage of a |
| 70 | residential property equivalent to the coverage provided in the |
| 71 | private insurance market under an HO-3, HO-4, or HO-6 policy. |
| 72 | b. Basic personal lines policy forms that are policies |
| 73 | similar to an HO-8 policy or a dwelling fire policy that provide |
| 74 | coverage meeting the requirements of the secondary mortgage |
| 75 | market, but which is more limited than the coverage under a |
| 76 | standard policy. |
| 77 | c. Commercial lines residential and nonresidential policy |
| 78 | forms that are generally similar to the basic perils of full |
| 79 | coverage obtainable for commercial residential structures and |
| 80 | commercial nonresidential structures in the admitted voluntary |
| 81 | market. |
| 82 | d. Personal lines and commercial lines residential |
| 83 | property insurance forms that cover the peril of wind only. The |
| 84 | forms are applicable only to residential properties located in |
| 85 | areas eligible for coverage under the coastal account referred |
| 86 | to in sub-subparagraph (b)2.a. |
| 87 | e. Commercial lines nonresidential property insurance |
| 88 | forms that cover the peril of wind only. The forms are |
| 89 | applicable only to nonresidential properties located in areas |
| 90 | eligible for coverage under the coastal account referred to in |
| 91 | sub-subparagraph (b)2.a. |
| 92 | f. When the only issue remaining between an insured and |
| 93 | the corporation on a residential or commercial residential |
| 94 | property is the actual cash value, the amount of loss, or the |
| 95 | cost of repair or replacement of property for which a claim has |
| 96 | been filed, residential and commercial residential property |
| 97 | insurance forms that apply to the umpires and appraisers who |
| 98 | participate in the appraisal process and that require compliance |
| 99 | with the following conditions and procedures: |
| 100 | (I) Either party may submit a written demand to enter into |
| 101 | the process of appraisal. |
| 102 | (II) The corporation may refuse to accept the demand only |
| 103 | if the insured materially fails to comply with the proof-of-loss |
| 104 | obligations of the insured as set forth in the policy |
| 105 | conditions. |
| 106 | (III) The corporation is deemed to have waived its right |
| 107 | to demand an appraisal if it fails to invoke an appraisal within |
| 108 | 30 days after the insured substantially complies with the proof- |
| 109 | of-loss obligation as set forth in the policy conditions. |
| 110 | (IV) Each party shall select a competent appraiser and |
| 111 | notify the other party of the appraiser selected within 20 days |
| 112 | after the date of the demand for an appraisal. The appraisers |
| 113 | shall select a competent, independent, and impartial umpire. If |
| 114 | the appraisers are unable to agree on an umpire within 15 days, |
| 115 | the insured or the corporation may file a petition with a county |
| 116 | or circuit court in the jurisdiction in which the covered |
| 117 | property is located to designate a property insurance appraisal |
| 118 | umpire for the appraisal. |
| 119 | (V) Appraisal proceedings are informal unless the insured |
| 120 | and the corporation mutually agree otherwise. As used in this |
| 121 | sub-sub-subparagraph, the term "informal" means that formal |
| 122 | discovery is not conducted, including depositions, |
| 123 | interrogatories, requests for admission, or other forms of |
| 124 | formal civil discovery; formal rules of evidence are not |
| 125 | applied; and a court reporter is not used for the proceedings. |
| 126 | However, either appraiser may rely on experts in reaching the |
| 127 | value of loss. |
| 128 | (VI) Within 60 days after being appointed, each appraiser |
| 129 | shall appraise the loss and submit a written report to the other |
| 130 | appraiser that separately states the cost of the loss, the |
| 131 | actual cash value, or the cost to repair or replace each item. |
| 132 | Within 30 days after submitting the reports, the appraisers |
| 133 | shall attempt to resolve any differences in the appraisals and |
| 134 | reach a mutual agreement on all matters. If the appraisers are |
| 135 | unable to agree, they shall, within 5 days after the end of the |
| 136 | 30-day period, submit the differences in their findings in |
| 137 | writing to the umpire. However, the appraisers have an |
| 138 | additional 60 days after appointment to appraise the loss and |
| 139 | submit a written report if the loss is covered under a |
| 140 | commercial property insurance policy and the insured structure |
| 141 | is 10,000 square feet or more or is covered under a residential |
| 142 | or commercial residential insurance policy and the claim is |
| 143 | based on and made subsequent to a hurricane designated by the |
| 144 | National Hurricane Center or an emergency declared by the |
| 145 | Governor. |
| 146 | (VII) The umpire shall review any differences in |
| 147 | appraisals submitted by the appraisers and determine the amount |
| 148 | of the loss for each item submitted. Within 10 days after |
| 149 | receipt of any differences in appraisals, the umpire shall |
| 150 | submit his or her conclusions in writing to each appraiser. |
| 151 | (VIII) If either appraiser agrees with the conclusions of |
| 152 | the umpire, an itemized written appraisal award signed by the |
| 153 | umpire and the appraiser shall be filed with the corporation and |
| 154 | shall determine the amount of the loss. |
| 155 | (IX) The appraisal award is binding on the corporation and |
| 156 | the insured with regard to the amount of the loss. If the |
| 157 | insurance policy so provides, the corporation may assert that |
| 158 | there is no coverage under the policy for the loss as a whole or |
| 159 | that there has been a violation of the policy conditions with |
| 160 | respect to fraud, lack of notice, or failure to cooperate. |
| 161 | (X) Each appraiser shall be paid by the party who selects |
| 162 | the appraiser, and the expenses of the appraisal and fees of the |
| 163 | umpire shall be paid by the parties equally, except that if the |
| 164 | final determination of the amount of the loss exceeds the |
| 165 | corporation's preappraisal estimate of the loss communicated to |
| 166 | the insured in writing by 50 percent or more, the corporation |
| 167 | shall pay all expenses, including any fees and expenses charged |
| 168 | by the insured's appraiser and all fees and expenses of the |
| 169 | umpire. This sub-sub-subparagraph does not affect an insured's |
| 170 | claim for attorney fees under s. 627.428. |
| 171 | (XI) The Florida Arbitration Code does not apply to |
| 172 | residential and commercial residential property insurance loss |
| 173 | appraisal proceedings, except for those provisions of the code |
| 174 | regarding proceedings to compel and stay arbitration in s. |
| 175 | 682.03; procedures for correcting, vacating, or modifying an |
| 176 | award in ss. 682.10, 682.13, and 682.14; procedures for entry of |
| 177 | judgment on the award in s. 682.15; and procedures regarding |
| 178 | confirmation of an award in s. 682.12. |
| 179 | (XII) The appraisal process may not address issues |
| 180 | involving whether the loss or damage is covered under the terms |
| 181 | of the insurance contract. However, the appraisers and the |
| 182 | umpire may consider causation issues, if necessary, to determine |
| 183 | the amount of loss. |
| 184 |
|
| 185 | f. The corporation may adopt variations of the policy forms |
| 186 | listed in sub-subparagraphs a.-e. which contain more restrictive |
| 187 | coverage. |
| 188 | 2. Must provide that the corporation adopt a program in |
| 189 | which the corporation and authorized insurers enter into quota |
| 190 | share primary insurance agreements for hurricane coverage, as |
| 191 | defined in s. 627.4025(2)(a), for eligible risks, and adopt |
| 192 | property insurance forms for eligible risks which cover the |
| 193 | peril of wind only. |
| 194 | a. As used in this subsection, the term: |
| 195 | (I) "Quota share primary insurance" means an arrangement |
| 196 | in which the primary hurricane coverage of an eligible risk is |
| 197 | provided in specified percentages by the corporation and an |
| 198 | authorized insurer. The corporation and authorized insurer are |
| 199 | each solely responsible for a specified percentage of hurricane |
| 200 | coverage of an eligible risk as set forth in a quota share |
| 201 | primary insurance agreement between the corporation and an |
| 202 | authorized insurer and the insurance contract. The |
| 203 | responsibility of the corporation or authorized insurer to pay |
| 204 | its specified percentage of hurricane losses of an eligible |
| 205 | risk, as set forth in the agreement, may not be altered by the |
| 206 | inability of the other party to pay its specified percentage of |
| 207 | losses. Eligible risks that are provided hurricane coverage |
| 208 | through a quota share primary insurance arrangement must be |
| 209 | provided policy forms that set forth the obligations of the |
| 210 | corporation and authorized insurer under the arrangement, |
| 211 | clearly specify the percentages of quota share primary insurance |
| 212 | provided by the corporation and authorized insurer, and |
| 213 | conspicuously and clearly state that the authorized insurer and |
| 214 | the corporation may not be held responsible beyond their |
| 215 | specified percentage of coverage of hurricane losses. |
| 216 | (II) "Eligible risks" means personal lines residential and |
| 217 | commercial lines residential risks that meet the underwriting |
| 218 | criteria of the corporation and are located in areas that were |
| 219 | eligible for coverage by the Florida Windstorm Underwriting |
| 220 | Association on January 1, 2002. |
| 221 | b. The corporation may enter into quota share primary |
| 222 | insurance agreements with authorized insurers at corporation |
| 223 | coverage levels of 90 percent and 50 percent. |
| 224 | c. If the corporation determines that additional coverage |
| 225 | levels are necessary to maximize participation in quota share |
| 226 | primary insurance agreements by authorized insurers, the |
| 227 | corporation may establish additional coverage levels. However, |
| 228 | the corporation's quota share primary insurance coverage level |
| 229 | may not exceed 90 percent. |
| 230 | d. Any quota share primary insurance agreement entered |
| 231 | into between an authorized insurer and the corporation must |
| 232 | provide for a uniform specified percentage of coverage of |
| 233 | hurricane losses, by county or territory as set forth by the |
| 234 | corporation board, for all eligible risks of the authorized |
| 235 | insurer covered under the agreement. |
| 236 | e. Any quota share primary insurance agreement entered |
| 237 | into between an authorized insurer and the corporation is |
| 238 | subject to review and approval by the office. However, such |
| 239 | agreement shall be authorized only as to insurance contracts |
| 240 | entered into between an authorized insurer and an insured who is |
| 241 | already insured by the corporation for wind coverage. |
| 242 | f. For all eligible risks covered under quota share |
| 243 | primary insurance agreements, the exposure and coverage levels |
| 244 | for both the corporation and authorized insurers shall be |
| 245 | reported by the corporation to the Florida Hurricane Catastrophe |
| 246 | Fund. For all policies of eligible risks covered under such |
| 247 | agreements, the corporation and the authorized insurer must |
| 248 | maintain complete and accurate records for the purpose of |
| 249 | exposure and loss reimbursement audits as required by fund |
| 250 | rules. The corporation and the authorized insurer shall each |
| 251 | maintain duplicate copies of policy declaration pages and |
| 252 | supporting claims documents. |
| 253 | g. The corporation board shall establish in its plan of |
| 254 | operation standards for quota share agreements which ensure that |
| 255 | there is no discriminatory application among insurers as to the |
| 256 | terms of the agreements, pricing of the agreements, incentive |
| 257 | provisions if any, and consideration paid for servicing policies |
| 258 | or adjusting claims. |
| 259 | h. The quota share primary insurance agreement between the |
| 260 | corporation and an authorized insurer must set forth the |
| 261 | specific terms under which coverage is provided, including, but |
| 262 | not limited to, the sale and servicing of policies issued under |
| 263 | the agreement by the insurance agent of the authorized insurer |
| 264 | producing the business, the reporting of information concerning |
| 265 | eligible risks, the payment of premium to the corporation, and |
| 266 | arrangements for the adjustment and payment of hurricane claims |
| 267 | incurred on eligible risks by the claims adjuster and personnel |
| 268 | of the authorized insurer. Entering into a quota sharing |
| 269 | insurance agreement between the corporation and an authorized |
| 270 | insurer is voluntary and at the discretion of the authorized |
| 271 | insurer. |
| 272 | 3.a. May provide that the corporation may employ or |
| 273 | otherwise contract with individuals or other entities to provide |
| 274 | administrative or professional services that may be appropriate |
| 275 | to effectuate the plan. The corporation may borrow funds by |
| 276 | issuing bonds or by incurring other indebtedness, and shall have |
| 277 | other powers reasonably necessary to effectuate the requirements |
| 278 | of this subsection, including, without limitation, the power to |
| 279 | issue bonds and incur other indebtedness in order to refinance |
| 280 | outstanding bonds or other indebtedness. The corporation may |
| 281 | seek judicial validation of its bonds or other indebtedness |
| 282 | under chapter 75. The corporation may issue bonds or incur other |
| 283 | indebtedness, or have bonds issued on its behalf by a unit of |
| 284 | local government pursuant to subparagraph (q)2. in the absence |
| 285 | of a hurricane or other weather-related event, upon a |
| 286 | determination by the corporation, subject to approval by the |
| 287 | office, that such action would enable it to efficiently meet the |
| 288 | financial obligations of the corporation and that such |
| 289 | financings are reasonably necessary to effectuate the |
| 290 | requirements of this subsection. The corporation may take all |
| 291 | actions needed to facilitate tax-free status for such bonds or |
| 292 | indebtedness, including formation of trusts or other affiliated |
| 293 | entities. The corporation may pledge assessments, projected |
| 294 | recoveries from the Florida Hurricane Catastrophe Fund, other |
| 295 | reinsurance recoverables, market equalization and other |
| 296 | surcharges, and other funds available to the corporation as |
| 297 | security for bonds or other indebtedness. In recognition of s. |
| 298 | 10, Art. I of the State Constitution, prohibiting the impairment |
| 299 | of obligations of contracts, it is the intent of the Legislature |
| 300 | that no action be taken whose purpose is to impair any bond |
| 301 | indenture or financing agreement or any revenue source committed |
| 302 | by contract to such bond or other indebtedness. |
| 303 | b. To ensure that the corporation is operating in an |
| 304 | efficient and economic manner while providing quality service to |
| 305 | policyholders, applicants, and agents, the board shall |
| 306 | commission an independent third-party consultant having |
| 307 | expertise in insurance company management or insurance company |
| 308 | management consulting to prepare a report and make |
| 309 | recommendations on the relative costs and benefits of |
| 310 | outsourcing various policy issuance and service functions to |
| 311 | private servicing carriers or entities performing similar |
| 312 | functions in the private market for a fee, rather than |
| 313 | performing such functions in-house. In making such |
| 314 | recommendations, the consultant shall consider how other |
| 315 | residual markets, both in this state and around the country, |
| 316 | outsource appropriate functions or use servicing carriers to |
| 317 | better match expenses with revenues that fluctuate based on a |
| 318 | widely varying policy count. The report must be completed by |
| 319 | July 1, 2012. Upon receiving the report, the board shall develop |
| 320 | a plan to implement the report and submit the plan for review, |
| 321 | modification, and approval to the Financial Services Commission. |
| 322 | Upon the commission's approval of the plan, the board shall |
| 323 | begin implementing the plan by January 1, 2013. |
| 324 | 4. Must require that the corporation operate subject to |
| 325 | the supervision and approval of a board of governors consisting |
| 326 | of eight individuals who are residents of this state, from |
| 327 | different geographical areas of this state. |
| 328 | a. The Governor, the Chief Financial Officer, the |
| 329 | President of the Senate, and the Speaker of the House of |
| 330 | Representatives shall each appoint two members of the board. At |
| 331 | least one of the two members appointed by each appointing |
| 332 | officer must have demonstrated expertise in insurance and is |
| 333 | deemed to be within the scope of the exemption provided in s. |
| 334 | 112.313(7)(b). The Chief Financial Officer shall designate one |
| 335 | of the appointees as chair. All board members serve at the |
| 336 | pleasure of the appointing officer. All members of the board are |
| 337 | subject to removal at will by the officers who appointed them. |
| 338 | All board members, including the chair, must be appointed to |
| 339 | serve for 3-year terms beginning annually on a date designated |
| 340 | by the plan. However, for the first term beginning on or after |
| 341 | July 1, 2009, each appointing officer shall appoint one member |
| 342 | of the board for a 2-year term and one member for a 3-year term. |
| 343 | A board vacancy shall be filled for the unexpired term by the |
| 344 | appointing officer. The Chief Financial Officer shall appoint a |
| 345 | technical advisory group to provide information and advice to |
| 346 | the board in connection with the board's duties under this |
| 347 | subsection. The executive director and senior managers of the |
| 348 | corporation shall be engaged by the board and serve at the |
| 349 | pleasure of the board. Any executive director appointed on or |
| 350 | after July 1, 2006, is subject to confirmation by the Senate. |
| 351 | The executive director is responsible for employing other staff |
| 352 | as the corporation may require, subject to review and |
| 353 | concurrence by the board. |
| 354 | b. The board shall create a Market Accountability Advisory |
| 355 | Committee to assist the corporation in developing awareness of |
| 356 | its rates and its customer and agent service levels in |
| 357 | relationship to the voluntary market insurers writing similar |
| 358 | coverage. |
| 359 | (I) The members of the advisory committee consist of the |
| 360 | following 11 persons, one of whom must be elected chair by the |
| 361 | members of the committee: four representatives, one appointed by |
| 362 | the Florida Association of Insurance Agents, one by the Florida |
| 363 | Association of Insurance and Financial Advisors, one by the |
| 364 | Professional Insurance Agents of Florida, and one by the Latin |
| 365 | American Association of Insurance Agencies; three |
| 366 | representatives appointed by the insurers with the three highest |
| 367 | voluntary market share of residential property insurance |
| 368 | business in the state; one representative from the Office of |
| 369 | Insurance Regulation; one consumer appointed by the board who is |
| 370 | insured by the corporation at the time of appointment to the |
| 371 | committee; one representative appointed by the Florida |
| 372 | Association of Realtors; and one representative appointed by the |
| 373 | Florida Bankers Association. All members shall be appointed to |
| 374 | 3-year terms and may serve for consecutive terms. |
| 375 | (II) The committee shall report to the corporation at each |
| 376 | board meeting on insurance market issues which may include rates |
| 377 | and rate competition with the voluntary market; service, |
| 378 | including policy issuance, claims processing, and general |
| 379 | responsiveness to policyholders, applicants, and agents; and |
| 380 | matters relating to depopulation. |
| 381 | 5. Must provide a procedure for determining the |
| 382 | eligibility of a risk for coverage, as follows: |
| 383 | a. Subject to s. 627.3517, with respect to personal lines |
| 384 | residential risks, if the risk is offered coverage from an |
| 385 | authorized insurer at the insurer's approved rate under a |
| 386 | standard policy including wind coverage or, if consistent with |
| 387 | the insurer's underwriting rules as filed with the office, a |
| 388 | basic policy including wind coverage, for a new application to |
| 389 | the corporation for coverage, the risk is not eligible for any |
| 390 | policy issued by the corporation unless the premium for coverage |
| 391 | from the authorized insurer is more than 15 percent greater than |
| 392 | the premium for comparable coverage from the corporation. If the |
| 393 | risk is not able to obtain such offer, the risk is eligible for |
| 394 | a standard policy including wind coverage or a basic policy |
| 395 | including wind coverage issued by the corporation; however, if |
| 396 | the risk could not be insured under a standard policy including |
| 397 | wind coverage regardless of market conditions, the risk is |
| 398 | eligible for a basic policy including wind coverage unless |
| 399 | rejected under subparagraph 8. However, a policyholder of the |
| 400 | corporation or a policyholder removed from the corporation |
| 401 | through an assumption agreement until the end of the assumption |
| 402 | period remains eligible for coverage from the corporation |
| 403 | regardless of any offer of coverage from an authorized insurer |
| 404 | or surplus lines insurer. The corporation shall determine the |
| 405 | type of policy to be provided on the basis of objective |
| 406 | standards specified in the underwriting manual and based on |
| 407 | generally accepted underwriting practices. |
| 408 | (I) If the risk accepts an offer of coverage through the |
| 409 | market assistance plan or through a mechanism established by the |
| 410 | corporation before a policy is issued to the risk by the |
| 411 | corporation or during the first 30 days of coverage by the |
| 412 | corporation, and the producing agent who submitted the |
| 413 | application to the plan or to the corporation is not currently |
| 414 | appointed by the insurer, the insurer shall: |
| 415 | (A) Pay to the producing agent of record of the policy for |
| 416 | the first year, an amount that is the greater of the insurer's |
| 417 | usual and customary commission for the type of policy written or |
| 418 | a fee equal to the usual and customary commission of the |
| 419 | corporation; or |
| 420 | (B) Offer to allow the producing agent of record of the |
| 421 | policy to continue servicing the policy for at least 1 year and |
| 422 | offer to pay the agent the greater of the insurer's or the |
| 423 | corporation's usual and customary commission for the type of |
| 424 | policy written. |
| 425 |
|
| 426 | If the producing agent is unwilling or unable to accept |
| 427 | appointment, the new insurer shall pay the agent in accordance |
| 428 | with sub-sub-sub-subparagraph (A). |
| 429 | (II) If the corporation enters into a contractual |
| 430 | agreement for a take-out plan, the producing agent of record of |
| 431 | the corporation policy is entitled to retain any unearned |
| 432 | commission on the policy, and the insurer shall: |
| 433 | (A) Pay to the producing agent of record, for the first |
| 434 | year, an amount that is the greater of the insurer's usual and |
| 435 | customary commission for the type of policy written or a fee |
| 436 | equal to the usual and customary commission of the corporation; |
| 437 | or |
| 438 | (B) Offer to allow the producing agent of record to |
| 439 | continue servicing the policy for at least 1 year and offer to |
| 440 | pay the agent the greater of the insurer's or the corporation's |
| 441 | usual and customary commission for the type of policy written. |
| 442 |
|
| 443 | If the producing agent is unwilling or unable to accept |
| 444 | appointment, the new insurer shall pay the agent in accordance |
| 445 | with sub-sub-sub-subparagraph (A). |
| 446 | b. With respect to commercial lines residential risks, for |
| 447 | a new application to the corporation for coverage, if the risk |
| 448 | is offered coverage under a policy including wind coverage from |
| 449 | an authorized insurer at its approved rate, the risk is not |
| 450 | eligible for a policy issued by the corporation unless the |
| 451 | premium for coverage from the authorized insurer is more than 15 |
| 452 | percent greater than the premium for comparable coverage from |
| 453 | the corporation. If the risk is not able to obtain any such |
| 454 | offer, the risk is eligible for a policy including wind coverage |
| 455 | issued by the corporation. However, a policyholder of the |
| 456 | corporation or a policyholder removed from the corporation |
| 457 | through an assumption agreement until the end of the assumption |
| 458 | period remains eligible for coverage from the corporation |
| 459 | regardless of an offer of coverage from an authorized insurer or |
| 460 | surplus lines insurer. |
| 461 | (I) If the risk accepts an offer of coverage through the |
| 462 | market assistance plan or through a mechanism established by the |
| 463 | corporation before a policy is issued to the risk by the |
| 464 | corporation or during the first 30 days of coverage by the |
| 465 | corporation, and the producing agent who submitted the |
| 466 | application to the plan or the corporation is not currently |
| 467 | appointed by the insurer, the insurer shall: |
| 468 | (A) Pay to the producing agent of record of the policy, |
| 469 | for the first year, an amount that is the greater of the |
| 470 | insurer's usual and customary commission for the type of policy |
| 471 | written or a fee equal to the usual and customary commission of |
| 472 | the corporation; or |
| 473 | (B) Offer to allow the producing agent of record of the |
| 474 | policy to continue servicing the policy for at least 1 year and |
| 475 | offer to pay the agent the greater of the insurer's or the |
| 476 | corporation's usual and customary commission for the type of |
| 477 | policy written. |
| 478 |
|
| 479 | If the producing agent is unwilling or unable to accept |
| 480 | appointment, the new insurer shall pay the agent in accordance |
| 481 | with sub-sub-sub-subparagraph (A). |
| 482 | (II) If the corporation enters into a contractual |
| 483 | agreement for a take-out plan, the producing agent of record of |
| 484 | the corporation policy is entitled to retain any unearned |
| 485 | commission on the policy, and the insurer shall: |
| 486 | (A) Pay to the producing agent of record, for the first |
| 487 | year, an amount that is the greater of the insurer's usual and |
| 488 | customary commission for the type of policy written or a fee |
| 489 | equal to the usual and customary commission of the corporation; |
| 490 | or |
| 491 | (B) Offer to allow the producing agent of record to |
| 492 | continue servicing the policy for at least 1 year and offer to |
| 493 | pay the agent the greater of the insurer's or the corporation's |
| 494 | usual and customary commission for the type of policy written. |
| 495 |
|
| 496 | If the producing agent is unwilling or unable to accept |
| 497 | appointment, the new insurer shall pay the agent in accordance |
| 498 | with sub-sub-sub-subparagraph (A). |
| 499 | c. For purposes of determining comparable coverage under |
| 500 | sub-subparagraphs a. and b., the comparison must be based on |
| 501 | those forms and coverages that are reasonably comparable. The |
| 502 | corporation may rely on a determination of comparable coverage |
| 503 | and premium made by the producing agent who submits the |
| 504 | application to the corporation, made in the agent's capacity as |
| 505 | the corporation's agent. A comparison may be made solely of the |
| 506 | premium with respect to the main building or structure only on |
| 507 | the following basis: the same coverage A or other building |
| 508 | limits; the same percentage hurricane deductible that applies on |
| 509 | an annual basis or that applies to each hurricane for commercial |
| 510 | residential property; the same percentage of ordinance and law |
| 511 | coverage, if the same limit is offered by both the corporation |
| 512 | and the authorized insurer; the same mitigation credits, to the |
| 513 | extent the same types of credits are offered both by the |
| 514 | corporation and the authorized insurer; the same method for loss |
| 515 | payment, such as replacement cost or actual cash value, if the |
| 516 | same method is offered both by the corporation and the |
| 517 | authorized insurer in accordance with underwriting rules; and |
| 518 | any other form or coverage that is reasonably comparable as |
| 519 | determined by the board. If an application is submitted to the |
| 520 | corporation for wind-only coverage in the coastal account, the |
| 521 | premium for the corporation's wind-only policy plus the premium |
| 522 | for the ex-wind policy that is offered by an authorized insurer |
| 523 | to the applicant must be compared to the premium for multiperil |
| 524 | coverage offered by an authorized insurer, subject to the |
| 525 | standards for comparison specified in this subparagraph. If the |
| 526 | corporation or the applicant requests from the authorized |
| 527 | insurer a breakdown of the premium of the offer by types of |
| 528 | coverage so that a comparison may be made by the corporation or |
| 529 | its agent and the authorized insurer refuses or is unable to |
| 530 | provide such information, the corporation may treat the offer as |
| 531 | not being an offer of coverage from an authorized insurer at the |
| 532 | insurer's approved rate. |
| 533 | 6. Must include rules for classifications of risks and |
| 534 | rates. |
| 535 | 7. Must provide that if premium and investment income for |
| 536 | an account attributable to a particular calendar year are in |
| 537 | excess of projected losses and expenses for the account |
| 538 | attributable to that year, such excess shall be held in surplus |
| 539 | in the account. Such surplus must be available to defray |
| 540 | deficits in that account as to future years and used for that |
| 541 | purpose before assessing assessable insurers and assessable |
| 542 | insureds as to any calendar year. |
| 543 | 8. Must provide objective criteria and procedures to be |
| 544 | uniformly applied to all applicants in determining whether an |
| 545 | individual risk is so hazardous as to be uninsurable. In making |
| 546 | this determination and in establishing the criteria and |
| 547 | procedures, the following must be considered: |
| 548 | a. Whether the likelihood of a loss for the individual |
| 549 | risk is substantially higher than for other risks of the same |
| 550 | class; and |
| 551 | b. Whether the uncertainty associated with the individual |
| 552 | risk is such that an appropriate premium cannot be determined. |
| 553 |
|
| 554 | The acceptance or rejection of a risk by the corporation shall |
| 555 | be construed as the private placement of insurance, and the |
| 556 | provisions of chapter 120 do not apply. |
| 557 | 9. Must provide that the corporation make its best efforts |
| 558 | to procure catastrophe reinsurance at reasonable rates, to cover |
| 559 | its projected 100-year probable maximum loss as determined by |
| 560 | the board of governors. |
| 561 | 10. The policies issued by the corporation must provide |
| 562 | that if the corporation or the market assistance plan obtains an |
| 563 | offer from an authorized insurer to cover the risk at its |
| 564 | approved rates, the risk is no longer eligible for renewal |
| 565 | through the corporation, except as otherwise provided in this |
| 566 | subsection. |
| 567 | 11. Corporation policies and applications must include a |
| 568 | notice that the corporation policy could, under this section, be |
| 569 | replaced with a policy issued by an authorized insurer which |
| 570 | does not provide coverage identical to the coverage provided by |
| 571 | the corporation. The notice must also specify that acceptance of |
| 572 | corporation coverage creates a conclusive presumption that the |
| 573 | applicant or policyholder is aware of this potential. |
| 574 | 12. May establish, subject to approval by the office, |
| 575 | different eligibility requirements and operational procedures |
| 576 | for any line or type of coverage for any specified county or |
| 577 | area if the board determines that such changes are justified due |
| 578 | to the voluntary market being sufficiently stable and |
| 579 | competitive in such area or for such line or type of coverage |
| 580 | and that consumers who, in good faith, are unable to obtain |
| 581 | insurance through the voluntary market through ordinary methods |
| 582 | continue to have access to coverage from the corporation. If |
| 583 | coverage is sought in connection with a real property transfer, |
| 584 | the requirements and procedures may not provide an effective |
| 585 | date of coverage later than the date of the closing of the |
| 586 | transfer as established by the transferor, the transferee, and, |
| 587 | if applicable, the lender. |
| 588 | 13. Must provide that, with respect to the coastal |
| 589 | account, any assessable insurer with a surplus as to |
| 590 | policyholders of $25 million or less writing 25 percent or more |
| 591 | of its total countrywide property insurance premiums in this |
| 592 | state may petition the office, within the first 90 days of each |
| 593 | calendar year, to qualify as a limited apportionment company. A |
| 594 | regular assessment levied by the corporation on a limited |
| 595 | apportionment company for a deficit incurred by the corporation |
| 596 | for the coastal account may be paid to the corporation on a |
| 597 | monthly basis as the assessments are collected by the limited |
| 598 | apportionment company from its insureds pursuant to s. 627.3512, |
| 599 | but the regular assessment must be paid in full within 12 months |
| 600 | after being levied by the corporation. A limited apportionment |
| 601 | company shall collect from its policyholders any emergency |
| 602 | assessment imposed under sub-subparagraph (b)3.d. The plan must |
| 603 | provide that, if the office determines that any regular |
| 604 | assessment will result in an impairment of the surplus of a |
| 605 | limited apportionment company, the office may direct that all or |
| 606 | part of such assessment be deferred as provided in subparagraph |
| 607 | (q)4. However, an emergency assessment to be collected from |
| 608 | policyholders under sub-subparagraph (b)3.d. may not be limited |
| 609 | or deferred. |
| 610 | 14. Must provide that the corporation appoint as its |
| 611 | licensed agents only those agents who also hold an appointment |
| 612 | as defined in s. 626.015(3) with an insurer who at the time of |
| 613 | the agent's initial appointment by the corporation is authorized |
| 614 | to write and is actually writing personal lines residential |
| 615 | property coverage, commercial residential property coverage, or |
| 616 | commercial nonresidential property coverage within the state. |
| 617 | 15. Must provide a premium payment plan option to its |
| 618 | policyholders which, at a minimum, allows for quarterly and |
| 619 | semiannual payment of premiums. A monthly payment plan may, but |
| 620 | is not required to, be offered. |
| 621 | 16. Must limit coverage on mobile homes or manufactured |
| 622 | homes built before 1994 to actual cash value of the dwelling |
| 623 | rather than replacement costs of the dwelling. |
| 624 | 17. May provide such limits of coverage as the board |
| 625 | determines, consistent with the requirements of this subsection. |
| 626 | 18. May require commercial property to meet specified |
| 627 | hurricane mitigation construction features as a condition of |
| 628 | eligibility for coverage. |
| 629 | 19. Must provide that new or renewal policies issued by |
| 630 | the corporation on or after January 1, 2012, which cover |
| 631 | sinkhole loss do not include coverage for any loss to |
| 632 | appurtenant structures, driveways, sidewalks, decks, or patios |
| 633 | that are directly or indirectly caused by sinkhole activity. The |
| 634 | corporation shall exclude such coverage using a notice of |
| 635 | coverage change, which may be included with the policy renewal, |
| 636 | and not by issuance of a notice of nonrenewal of the excluded |
| 637 | coverage upon renewal of the current policy. |
| 638 | 20. As of January 1, 2012, must require that the agent |
| 639 | obtain from an applicant for coverage from the corporation an |
| 640 | acknowledgement signed by the applicant, which includes, at a |
| 641 | minimum, the following statement: |
| 642 | ACKNOWLEDGEMENT OF POTENTIAL SURCHARGE |
| 643 | AND ASSESSMENT LIABILITY: |
| 644 | 1. AS A POLICYHOLDER OF CITIZENS PROPERTY INSURANCE |
| 645 | CORPORATION, I UNDERSTAND THAT IF THE CORPORATION SUSTAINS A |
| 646 | DEFICIT AS A RESULT OF HURRICANE LOSSES OR FOR ANY OTHER REASON, |
| 647 | MY POLICY COULD BE SUBJECT TO SURCHARGES, WHICH WILL BE DUE AND |
| 648 | PAYABLE UPON RENEWAL, CANCELLATION, OR TERMINATION OF THE |
| 649 | POLICY, AND THAT THE SURCHARGES COULD BE AS HIGH AS 45 PERCENT |
| 650 | OF MY PREMIUM, OR A DIFFERENT AMOUNT AS IMPOSED BY THE FLORIDA |
| 651 | LEGISLATURE. |
| 652 | 2. I ALSO UNDERSTAND THAT I MAY BE SUBJECT TO EMERGENCY |
| 653 | ASSESSMENTS TO THE SAME EXTENT AS POLICYHOLDERS OF OTHER |
| 654 | INSURANCE COMPANIES, OR A DIFFERENT AMOUNT AS IMPOSED BY THE |
| 655 | FLORIDA LEGISLATURE. |
| 656 | 3. I ALSO UNDERSTAND THAT CITIZENS PROPERTY INSURANCE |
| 657 | CORPORATION IS NOT SUPPORTED BY THE FULL FAITH AND CREDIT OF THE |
| 658 | STATE OF FLORIDA. |
| 659 | a. The corporation shall maintain, in electronic format or |
| 660 | otherwise, a copy of the applicant's signed acknowledgement and |
| 661 | provide a copy of the statement to the policyholder as part of |
| 662 | the first renewal after the effective date of this subparagraph. |
| 663 | b. The signed acknowledgement form creates a conclusive |
| 664 | presumption that the policyholder understood and accepted his or |
| 665 | her potential surcharge and assessment liability as a |
| 666 | policyholder of the corporation. |
| 667 | Section 2. This act shall take effect July 1, 2012. |