Florida Senate - 2015 CS for CS for SB 1250
By the Committees on Transportation; and Banking and Insurance;
and Senator Montford
596-04182-15 20151250c2
1 A bill to be entitled
2 An act relating to motor vehicle insurance; amending
3 s. 627.311, F.S.; authorizing a joint underwriting
4 plan and the Florida Automobile Joint Underwriting
5 Association to cancel certain insurance policies
6 within a specified period under certain circumstances;
7 prohibiting an insured from canceling certain
8 insurance policies within a specified period;
9 providing exceptions; amending s. 627.727, F.S.;
10 authorizing insurers to electronically provide a form
11 to reject, or to select lower coverage amounts of,
12 uninsured motorist vehicle coverage to a named
13 insured; authorizing the named insured to sign the
14 form electronically; specifying requirements for the
15 format, storage, and preservation of an electronically
16 signed form; amending s. 627.736, F.S.; revising the
17 period during which the applicable fee schedule or
18 payment limitation under Medicare applies with respect
19 to certain personal injury protection insurance
20 coverage; defining the term “service year”; deleting
21 an obsolete date; amending s. 627.744, F.S.; revising
22 the exemption from the preinsurance inspection
23 requirements for private passenger motor vehicles to
24 include certain leased vehicles; revising the list of
25 documents that an insurer may require for purposes of
26 the exemption; prohibiting the physical damage
27 coverage on a motor vehicle from being suspended
28 during the term of a policy due to the insurer’s
29 option not to require certain documents; authorizing a
30 payment of a claim to be conditioned if the insurer
31 requires a document under certain circumstances;
32 providing an effective date.
33
34 Be It Enacted by the Legislature of the State of Florida:
35
36 Section 1. Paragraph (m) is added to subsection (3) of
37 section 627.311, Florida Statutes, to read:
38 627.311 Joint underwriters and joint reinsurers; public
39 records and public meetings exemptions.—
40 (3) The office may, after consultation with insurers
41 licensed to write automobile insurance in this state, approve a
42 joint underwriting plan for purposes of equitable apportionment
43 or sharing among insurers of automobile liability insurance and
44 other motor vehicle insurance, as an alternate to the plan
45 required in s. 627.351(1). All insurers authorized to write
46 automobile insurance in this state shall subscribe to the plan
47 and participate therein. The plan shall be subject to continuous
48 review by the office which may at any time disapprove the entire
49 plan or any part thereof if it determines that conditions have
50 changed since prior approval and that in view of the purposes of
51 the plan changes are warranted. Any disapproval by the office
52 shall be subject to the provisions of chapter 120. The Florida
53 Automobile Joint Underwriting Association is created under the
54 plan. The plan and the association:
55 (m) May cancel personal lines or commercial policies issued
56 by the plan within the first 60 days after the effective date of
57 the policy or binder for nonpayment of premium if the reason for
58 cancellation is the issuance of a check for the premium which is
59 dishonored for any reason or any other type of premium payment
60 which is rejected or deemed invalid. An insured may not cancel a
61 policy or binder within the first 90 days, or within a lesser
62 period as required by the plan, after the effective date of the
63 policy or binder, except:
64 1. Upon total destruction of the insured motor vehicle;
65 2. Upon transfer of ownership of the insured motor vehicle;
66 or
67 3. After purchase of another policy or binder covering the
68 motor vehicle that was covered under the policy being canceled.
69 Section 2. Subsection (1) of section 627.727, Florida
70 Statutes, is amended to read:
71 627.727 Motor vehicle insurance; uninsured and underinsured
72 vehicle coverage; insolvent insurer protection.—
73 (1) A No motor vehicle liability insurance policy that
74 which provides bodily injury liability coverage may not shall be
75 delivered or issued for delivery in this state with respect to a
76 any specifically insured or identified motor vehicle registered
77 or principally garaged in this state unless uninsured motor
78 vehicle coverage is provided therein or supplemental thereto for
79 the protection of persons insured by the policy thereunder who
80 are legally entitled to recover damages from owners or operators
81 of uninsured motor vehicles because of bodily injury, sickness,
82 or disease, including death, resulting therefrom. However, the
83 coverage required under this section is not applicable if when,
84 or to the extent that, an insured named in the policy makes a
85 written rejection of the coverage on behalf of all insureds
86 under the policy. If When a motor vehicle is leased for a period
87 of 1 year or longer and the lessor of the such vehicle, by the
88 terms of the lease contract, provides liability coverage on the
89 leased vehicle, the lessee of the such vehicle has shall have
90 the sole privilege to reject uninsured motorist coverage or to
91 select lower limits than the bodily injury liability limits,
92 regardless of whether the lessor is qualified as a self-insurer
93 pursuant to s. 324.171. Unless an insured, or lessee having the
94 privilege of rejecting uninsured motorist coverage, requests
95 such coverage or requests higher uninsured motorist limits in
96 writing, the coverage or the such higher uninsured motorist
97 limits are need not required to be provided in or supplemental
98 to any other policy that which renews, extends, changes,
99 supersedes, or replaces an existing policy with the same bodily
100 injury liability limits when an insured or lessee had rejected
101 the coverage. If When an insured or lessee has initially
102 selected limits of uninsured motorist coverage lower than her or
103 his bodily injury liability limits, higher limits of uninsured
104 motorist coverage are need not required to be provided in or
105 supplemental to any other policy that which renews, extends,
106 changes, supersedes, or replaces an existing policy with the
107 same bodily injury liability limits unless an insured requests
108 higher uninsured motorist coverage in writing. The rejection or
109 selection of lower limits must shall be made on a form approved
110 by the office. The form must shall fully advise the named
111 insured applicant of the nature of the coverage and must shall
112 state that the coverage is equal to bodily injury liability
113 limits unless lower limits are requested or the coverage is
114 rejected. The heading of the form shall be in 12-point bold type
115 and shall state: “You are electing not to purchase certain
116 valuable coverage which protects you and your family or you are
117 purchasing uninsured motorist limits less than your bodily
118 injury liability limits when you sign this form. Please read
119 carefully.” If this form is signed by a named insured, it will
120 be conclusively presumed that there was an informed, knowing
121 rejection of coverage or election of lower limits on behalf of
122 all insureds. The form may be provided electronically to and may
123 be signed electronically by the named insured. The heading of a
124 form provided electronically must be in boldfaced type that is
125 larger than the surrounding text and in black type on a white
126 background or white type on a black background. An electronic
127 signature by the named insured must be affixed using technology
128 that stores and preserves the form, as viewed and signed by the
129 named insured, as an exact image and that creates a record of
130 any attempt to modify or tamper with the form after signature.
131 The insurer must shall notify the named insured at least
132 annually of her or his options as to the coverage required by
133 this section. Such notice must shall be part of, and attached
134 to, the notice of premium, must shall provide for a means to
135 allow the insured to request such coverage, and must shall be
136 given in a manner approved by the office. Receipt of this notice
137 does not constitute an affirmative waiver of the insured’s right
138 to uninsured motorist coverage where the insured has not signed
139 a selection or rejection form. The coverage described under this
140 section must shall be over and above, but may shall not
141 duplicate, the benefits available to an insured under any
142 workers’ compensation law, personal injury protection benefits,
143 disability benefits law, or similar law; under any automobile
144 medical expense coverage; under any motor vehicle liability
145 insurance coverage; or from the owner or operator of the
146 uninsured motor vehicle or any other person or organization
147 jointly or severally liable together with such owner or operator
148 for the accident; and such coverage must shall cover the
149 difference, if any, between the sum of such benefits and the
150 damages sustained, up to the maximum amount of such coverage
151 provided under this section. The amount of coverage available
152 under this section may shall not be reduced by a setoff against
153 any coverage, including liability insurance. Such coverage may
154 shall not inure directly or indirectly to the benefit of a any
155 workers’ compensation or disability benefits carrier or a any
156 person or organization qualifying as a self-insurer under a any
157 workers’ compensation or disability benefits law or similar law.
158 Section 3. Paragraph (a) of subsection (5) of section
159 627.736, Florida Statutes, is amended to read:
160 627.736 Required personal injury protection benefits;
161 exclusions; priority; claims.—
162 (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
163 (a) A physician, hospital, clinic, or other person or
164 institution lawfully rendering treatment to an injured person
165 for a bodily injury covered by personal injury protection
166 insurance may charge the insurer and injured party only a
167 reasonable amount pursuant to this section for the services and
168 supplies rendered, and the insurer providing such coverage may
169 pay for such charges directly to such person or institution
170 lawfully rendering such treatment if the insured receiving such
171 treatment or his or her guardian has countersigned the properly
172 completed invoice, bill, or claim form approved by the office
173 upon which such charges are to be paid for as having actually
174 been rendered, to the best knowledge of the insured or his or
175 her guardian. However, such a charge may not exceed the amount
176 the person or institution customarily charges for like services
177 or supplies. In determining whether a charge for a particular
178 service, treatment, or otherwise is reasonable, consideration
179 may be given to evidence of usual and customary charges and
180 payments accepted by the provider involved in the dispute,
181 reimbursement levels in the community and various federal and
182 state medical fee schedules applicable to motor vehicle and
183 other insurance coverages, and other information relevant to the
184 reasonableness of the reimbursement for the service, treatment,
185 or supply.
186 1. The insurer may limit reimbursement to 80 percent of the
187 following schedule of maximum charges:
188 a. For emergency transport and treatment by providers
189 licensed under chapter 401, 200 percent of Medicare.
190 b. For emergency services and care provided by a hospital
191 licensed under chapter 395, 75 percent of the hospital’s usual
192 and customary charges.
193 c. For emergency services and care as defined by s. 395.002
194 provided in a facility licensed under chapter 395 rendered by a
195 physician or dentist, and related hospital inpatient services
196 rendered by a physician or dentist, the usual and customary
197 charges in the community.
198 d. For hospital inpatient services, other than emergency
199 services and care, 200 percent of the Medicare Part A
200 prospective payment applicable to the specific hospital
201 providing the inpatient services.
202 e. For hospital outpatient services, other than emergency
203 services and care, 200 percent of the Medicare Part A Ambulatory
204 Payment Classification for the specific hospital providing the
205 outpatient services.
206 f. For all other medical services, supplies, and care, 200
207 percent of the allowable amount under:
208 (I) The participating physicians fee schedule of Medicare
209 Part B, except as provided in sub-sub-subparagraphs (II) and
210 (III).
211 (II) Medicare Part B, in the case of services, supplies,
212 and care provided by ambulatory surgical centers and clinical
213 laboratories.
214 (III) The Durable Medical Equipment Prosthetics/Orthotics
215 and Supplies fee schedule of Medicare Part B, in the case of
216 durable medical equipment.
217
218 However, if such services, supplies, or care is not reimbursable
219 under Medicare Part B, as provided in this sub-subparagraph, the
220 insurer may limit reimbursement to 80 percent of the maximum
221 reimbursable allowance under workers’ compensation, as
222 determined under s. 440.13 and rules adopted thereunder which
223 are in effect at the time such services, supplies, or care is
224 provided. Services, supplies, or care that is not reimbursable
225 under Medicare or workers’ compensation is not required to be
226 reimbursed by the insurer.
227 2. For purposes of subparagraph 1., the applicable fee
228 schedule or payment limitation under Medicare is the fee
229 schedule or payment limitation in effect on March 1 of the
230 service year in which the services, supplies, or care is
231 rendered and for the area in which such services, supplies, or
232 care is rendered, and the applicable fee schedule or payment
233 limitation applies to services, supplies, or care rendered
234 during throughout the remainder of that service year,
235 notwithstanding any subsequent change made to the fee schedule
236 or payment limitation, except that it may not be less than the
237 allowable amount under the applicable schedule of Medicare Part
238 B for 2007 for medical services, supplies, and care subject to
239 Medicare Part B. For purposes of this subparagraph, the term
240 “service year” means the period from March 1 through the end of
241 February of the following year.
242 3. Subparagraph 1. does not allow the insurer to apply any
243 limitation on the number of treatments or other utilization
244 limits that apply under Medicare or workers’ compensation. An
245 insurer that applies the allowable payment limitations of
246 subparagraph 1. must reimburse a provider who lawfully provided
247 care or treatment under the scope of his or her license,
248 regardless of whether such provider is entitled to reimbursement
249 under Medicare due to restrictions or limitations on the types
250 or discipline of health care providers who may be reimbursed for
251 particular procedures or procedure codes. However, subparagraph
252 1. does not prohibit an insurer from using the Medicare coding
253 policies and payment methodologies of the federal Centers for
254 Medicare and Medicaid Services, including applicable modifiers,
255 to determine the appropriate amount of reimbursement for medical
256 services, supplies, or care if the coding policy or payment
257 methodology does not constitute a utilization limit.
258 4. If an insurer limits payment as authorized by
259 subparagraph 1., the person providing such services, supplies,
260 or care may not bill or attempt to collect from the insured any
261 amount in excess of such limits, except for amounts that are not
262 covered by the insured’s personal injury protection coverage due
263 to the coinsurance amount or maximum policy limits.
264 5. Effective July 1, 2012, An insurer may limit payment as
265 authorized by this paragraph only if the insurance policy
266 includes a notice at the time of issuance or renewal that the
267 insurer may limit payment pursuant to the schedule of charges
268 specified in this paragraph. A policy form approved by the
269 office satisfies this requirement. If a provider submits a
270 charge for an amount less than the amount allowed under
271 subparagraph 1., the insurer may pay the amount of the charge
272 submitted.
273 Section 4. Paragraphs (a) and (b) of subsection (2) of
274 section 627.744, Florida Statutes, are amended to read:
275 627.744 Required preinsurance inspection of private
276 passenger motor vehicles.—
277 (2) This section does not apply:
278 (a) To a policy for a policyholder who has been insured for
279 2 years or longer, without interruption, under a private
280 passenger motor vehicle policy that which provides physical
281 damage coverage for any vehicle, if the agent of the insurer
282 verifies the previous coverage.
283 (b) To a new, unused motor vehicle purchased or leased from
284 a licensed motor vehicle dealer or leasing company., if The
285 insurer may require is provided with:
286 1. A bill of sale, or buyer’s order, or lease agreement
287 that which contains a full description of the motor vehicle,
288 including all options and accessories; or
289 2. A copy of the title or registration that which
290 establishes transfer of ownership from the dealer or leasing
291 company to the customer and a copy of the window sticker or the
292 dealer invoice showing the itemized options and equipment and
293 the total retail price of the vehicle.
294
295 For the purposes of this paragraph, the physical damage coverage
296 on the motor vehicle may not be suspended during the term of the
297 policy due to the applicant’s failure to provide or the
298 insurer’s option not to require the required documents. However,
299 if the insurer requires a document under this paragraph at the
300 time the policy is issued, payment of a claim may be is
301 conditioned upon the receipt by the insurer of the required
302 documents, and no physical damage loss occurring after the
303 effective date of the coverage is payable until the documents
304 are provided to the insurer.
305 Section 5. This act shall take effect July 1, 2015.