Florida Senate - 2026                                    SB 1240
       
       
        
       By Senator Davis
       
       
       
       
       
       5-01562-26                                            20261240__
    1                        A bill to be entitled                      
    2         An act relating to insurance regulation; amending s.
    3         627.4025, F.S.; making clarifying changes regarding
    4         the definition of residential coverage; amending s.
    5         627.418, F.S.; prohibiting insurers from imposing or
    6         enforcing certain policy conditions or requirements;
    7         providing an exception; specifying that such
    8         conditions or requirements are void; requiring
    9         insurers to make certain disclosures and allow the
   10         insured to cancel the policy under certain
   11         circumstances; amending s. 627.426, F.S.; revising the
   12         conditions under which liability insurers may deny
   13         coverage based on a particular coverage defense;
   14         amending s. 627.70131, F.S.; revising the timeframe in
   15         which insurers must pay or deny claims; revising
   16         requirements for the explanation for the payment,
   17         denial, or partial payment; specifying that insurers
   18         have an obligation to pay a specified amount under
   19         certain circumstances; authorizing the Department of
   20         Financial Services to enforce such obligation; making
   21         a clarifying change regarding interest payments;
   22         providing an effective date.
   23          
   24  Be It Enacted by the Legislature of the State of Florida:
   25  
   26         Section 1. Subsection (1) of section 627.4025, Florida
   27  Statutes, is amended to read:
   28         627.4025 Residential coverage and hurricane coverage
   29  defined.—
   30         (1) Residential coverage includes both personal lines and
   31  commercial lines coverage. Personal lines residential coverage
   32  includes residential coverage, which consists of the type of
   33  coverage provided by homeowner, mobile home owner, dwelling,
   34  tenant, condominium unit owner, cooperative unit owner, and
   35  similar personal lines residential policies., and Commercial
   36  lines residential coverage includes, which consists of the type
   37  of coverage provided by condominium association, cooperative
   38  association, apartment building, and similar commercial lines
   39  residential policies, including policies covering the common
   40  elements of a homeowners association. Residential coverage for
   41  personal lines and commercial lines as set forth in this section
   42  includes policies that provide coverage for particular perils
   43  such as windstorm and hurricane or coverage for insurer
   44  insolvency or deductibles.
   45         Section 2. Subsection (3) is added to section 627.418,
   46  Florida Statutes, to read:
   47         627.418 Validity of noncomplying contracts.—
   48         (3) An insurer may not impose or enforce any policy
   49  condition or requirement that is not authorized by this
   50  insurance code unless the condition or requirement has been
   51  submitted to and approved by the office. Any such unauthorized
   52  condition or requirement is void and unenforceable. If a policy
   53  contains any condition or requirement not authorized by this
   54  insurance code but approved by the office, the insurer must
   55  clearly disclose such provision to the insured at the time of
   56  issuance along with necessary definitions to understand the
   57  provisions of the policy and the steps required for compliance
   58  with the provisions of the policy, using plain language, and
   59  must allow the insured to cancel the policy within 10 days after
   60  receipt at no cost. The disclosure must include the following
   61  notice, printed in bold type:
   62  
   63         IMPORTANT NOTICE: SOME PROVISIONS IN THIS POLICY ARE
   64         NOT ESTABLISHED BY FLORIDA STATUTES. FAILURE TO MEET
   65         THESE CONTRACTUAL REQUIREMENTS MAY AFFECT YOUR
   66         COVERAGE OR RESULT IN CLAIM DELAY OR DENIAL. YOU HAVE
   67         RIGHTS UNDER FLORIDA LAW. YOU MAY CANCEL THIS POLICY
   68         WITHIN 10 DAYS AFTER RECEIPT AT NO COST.
   69         Section 3. Subsection (2) of section 627.426, Florida
   70  Statutes, is amended to read:
   71         627.426 Claims administration.—
   72         (2) A liability insurer may shall not be permitted to deny
   73  coverage based on a particular coverage defense unless all of
   74  the following conditions are met:
   75         (a)1. Within 30 days after the liability insurer knew or
   76  should have known of the coverage defense, written notice of
   77  reservation of rights to assert a coverage defense is given to
   78  the named insured by United States postal proof of mailing,
   79  registered or certified mail, or other mailing using the
   80  Intelligent Mail barcode or other similar tracking method used
   81  or approved by the United States Postal Service sent to the last
   82  known address of the insured or by hand delivery. Such notice of
   83  reservation of rights must include all the following:
   84         a.A clear statement of the factual issue giving rise to
   85  the reservation of rights.
   86         b.An explanation, in plain language, of why the issue may
   87  affect coverage.
   88         c.A description of any additional information or
   89  documentation needed from the insured.
   90         d.A description of the next steps in the investigative
   91  process and the expected timeframes for completing those steps.
   92         e.If the insurer determines that fraud or
   93  misrepresentation may affect the claim, identification of the
   94  specific facts supporting that determination.
   95         2.A notice of reservation of rights given under this
   96  section may not be used to extend, delay, or suspend the payment
   97  of a covered loss or any statutory deadline for paying or
   98  denying a claim under this code.; and
   99         (b) Within 60 days after of compliance with paragraph (a)
  100  or receipt of a summons and complaint naming the insured as a
  101  defendant, whichever is later, but in no case later than 30 days
  102  before trial, the insurer:
  103         1. Gives written notice to the named insured by United
  104  States postal proof of mailing, registered or certified mail, or
  105  other mailing using the Intelligent Mail barcode or other
  106  similar tracking method used or approved by the United States
  107  Postal Service of its refusal to defend the insured;
  108         2. Obtains from the insured a nonwaiver agreement following
  109  full disclosure of the specific facts and policy provisions upon
  110  which the coverage defense is asserted and the duties,
  111  obligations, and liabilities of the insurer during and following
  112  the pendency of the subject litigation; or
  113         3. Retains independent counsel which is mutually agreeable
  114  to the parties. Reasonable fees for the counsel may be agreed
  115  upon between the parties or, if no agreement is reached, shall
  116  be set by the court.
  117         Section 4. Paragraph (a) of subsection (7) of section
  118  627.70131, Florida Statutes, is amended to read:
  119         627.70131 Insurer’s duty to acknowledge communications
  120  regarding claims; investigation.—
  121         (7)(a) Within 30 60 days after an insurer receives notice
  122  of an initial, reopened, or supplemental property insurance
  123  claim from a policyholder, the insurer shall pay or deny such
  124  claim or a portion of the claim unless the failure to pay or
  125  deny is caused by factors beyond the insurer’s control of the
  126  insurer. The insurer shall provide a clear, written reasonable
  127  explanation in writing to the policyholder which outlines the
  128  reasoning of the basis in the insurance policy, in relation to
  129  the facts or applicable law, for the payment, denial, or partial
  130  denial of the a claim, referencing relevant sections of the
  131  insurance policy, applicable facts, or laws. Such explanation
  132  may not be solely a recitation of policy provisions without
  133  application of those provisions to the facts of the claim. If
  134  the insurer’s claim payment is less than specified in any
  135  insurer’s detailed estimate of the amount of the loss, the
  136  insurer must provide a reasonable explanation in writing of the
  137  difference to the policyholder. Any payment for of an initial or
  138  supplemental claim or portion of such claim made 60 days after
  139  the insurer receives notice of the claim, or made after the
  140  expiration of any additional timeframe provided to pay or deny a
  141  claim or a portion of a claim made pursuant to an order of the
  142  office finding factors beyond the insurer’s control of the
  143  insurer, whichever is later, bears interest at the rate set
  144  forth in s. 55.03. Interest begins to accrue from the date the
  145  insurer receives notice of the claim. If the insurer fails to
  146  pay the full amount owed on the claim within 90 days after the
  147  insurer receives notice of the claim or within any extended
  148  timeframe authorized by order of the office, the insurer has an
  149  uncontestable obligation to pay the amount owed, together with
  150  interest as provided in this subsection and an additional equal
  151  interest penalty. The department may enforce such obligation.
  152  The provisions of this subsection may not be waived, voided, or
  153  nullified by the terms of the insurance policy. If there is a
  154  right to prejudgment interest, the insured must select whether
  155  to receive prejudgment interest or interest under this
  156  subsection. Interest is payable when the claim or portion of the
  157  claim is paid, even if the payment is contingent upon a release.
  158  Failure to comply with this subsection constitutes a violation
  159  of this code. However, failure to comply with this subsection
  160  does not form the sole basis for a private cause of action.
  161         Section 5. This act shall take effect July 1, 2026.