By Timothy J. Meenan, NAIFA-Florida Lobbyist
- Upon receiving communication with respect to a claim, an insurer must provide the Homeowner Claims Bill of Rights within 10 days, rather than the current 14.
- Upon receiving proof of loss statements, an insurer must begin its reasonably necessary investigation within 7 working days, rather than the current 10.
- After receiving proof of loss, upon written request, the insurer must provide confirmation that the claim is covered in full, partially covered, denied, or being investigated, within 20 days rather than the current 30.
- Upon initial notice of claim, an insurer must pay or deny the claim, or part of the claim within 60 days, rather than the current 90.
- Gives or receives referral fees or other items of value as an inducement for business that is paid by property insurance proceeds;
- Interprets insurance coverages or duties of the policy, unless the licensee is separately licensed as an adjuster under part VI of ch. 626, F.S.; and
- Fails to give an insured a detailed estimate of the cost of services and materials provided in connection with a property insurance claim before executing the contract authorizing the work.
On January 19, the House Insurance and Banking Subcommittee passed a Committee Substitute for HB 221 by Representative Trujillo, to reverse the current trend of policyholders with health insurance being billed by out-of-network health providers for covered benefits that are received at an in-network hospital. The Senate companion, SB 1442 by Senator Garcia will be heard by the Health Policy Committee on February 1.
- The amount negotiated with an in-network provider in the same community;
- The usual and customary reimbursement received by a provider for the same service in the community where the service was provided;
- The amount that would be paid under Medicare.
- The foreign insurer holds a valid certificate to transact individual health insurance in its domicile state.
- Individual health insurance offered for sale under these provisions must comply with all laws of the domicile state and is offered for sale in the domicile state.
- The foreign insurer files an annual report that includes the state of domicile, the number of individual health insurance products sold in Florida, a list of the Florida counties in which the foreign insurer sold individual health insurance, the number of individuals covered, and the total premium collected on individual health insurance sold in this Florida.
- The coverage must include additional living expenses.
- Any loss that is repaired or replaced must be adjusted on a replacement cost basis.
- That a surplus lines agent can export sinkhole insurance to surplus lines insurer without the “diligent effort” to seek coverage from authorized insurers.
- An insurer providing sinkhole coverage must notify OIR at least 30 days before writing the insurance, and file a plan of operation and financial projections or revisions to the plan.
- Citizens cannot issue or renew personal lines residential property insurance for sinkhole coverage after July 1, 2018, but will provide coverage for catastrophic ground cover collapse.