Bill Text: FL S0258 | 2015 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Property and Casualty Insurance
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Introduced - Dead) 2015-04-22 - Laid on Table, companion bill(s) passed, see CS/CS/CS/HB 165 (Ch. 2015-135), CS/HB 273 (Ch. 2015-170) [S0258 Detail]
Download: Florida-2015-S0258-Comm_Sub.html
Bill Title: Property and Casualty Insurance
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Introduced - Dead) 2015-04-22 - Laid on Table, companion bill(s) passed, see CS/CS/CS/HB 165 (Ch. 2015-135), CS/HB 273 (Ch. 2015-170) [S0258 Detail]
Download: Florida-2015-S0258-Comm_Sub.html
Florida Senate - 2015 CS for SB 258 By the Committee on Banking and Insurance; and Senator Brandes 597-01652-15 2015258c1 1 A bill to be entitled 2 An act relating to property and casualty insurance; 3 amending s. 627.0628, F.S.; increasing the length of 4 time during which an insurer is not required to adhere 5 to certain models found by the Commission on Hurricane 6 Loss Projection Methodology to be accurate or reliable 7 in determining probable maximum loss levels with 8 respect to certain rate filings; amending s. 627.0651, 9 F.S.; revising provisions for the making and use of 10 rates for motor vehicle insurance; amending s. 11 627.3518, F.S.; conforming a cross-reference; amending 12 s. 627.4133, F.S.; increasing the amount of prior 13 notice required with respect to the nonrenewal, 14 cancellation, or termination of certain insurance 15 policies; deleting certain provisions that require 16 extended periods of prior notice with respect to the 17 nonrenewal, cancellation, or termination of certain 18 insurance policies; prohibiting the cancellation of 19 certain policies that have been in effect for a 20 specified amount of time except under certain 21 circumstances; amending s. 627.421, F.S.; authorizing 22 a policyholder of personal lines insurance to 23 affirmatively elect delivery of policy documents by 24 electronic means; amending s. 627.7074, F.S.; revising 25 notification requirements for participation in the 26 neutral evaluation program; amending s. 627.736, F.S.; 27 revising the applicability of certain Medicare fee 28 schedules or payment limitations; defining the term 29 “service year”; amending s. 627.744, F.S.; revising 30 the preinsurance inspection requirements for private 31 passenger motor vehicles; repealing s. 631.65, F.S., 32 relating to prohibited advertisement or solicitation; 33 providing an effective date. 34 35 Be It Enacted by the Legislature of the State of Florida: 36 37 Section 1. Paragraph (d) of subsection (3) of section 38 627.0628, Florida Statutes, is amended to read: 39 627.0628 Florida Commission on Hurricane Loss Projection 40 Methodology; public records exemption; public meetings 41 exemption.— 42 (3) ADOPTION AND EFFECT OF STANDARDS AND GUIDELINES.— 43 (d) With respect to a rate filing under s. 627.062, an 44 insurer shall employ and may not modify or adjust actuarial 45 methods, principles, standards, models, or output ranges found 46 by the commission to be accurate or reliable in determining 47 hurricane loss factors for use in a rate filing under s. 48 627.062. An insurer shall employ and may not modify or adjust 49 models found by the commission to be accurate or reliable in 50 determining probable maximum loss levels pursuant to paragraph 51 (b) with respect to a rate filing under s. 627.062 made more 52 than 18060days after the commission has made such findings. 53 This paragraph does not prohibit an insurer from using a 54 straight average of model results or output ranges for the 55 purposes of a rate filing for personal lines residential flood 56 insurance coverage under s. 627.062. 57 Section 2. Subsection (8) of section 627.0651, Florida 58 Statutes, is amended to read: 59 627.0651 Making and use of rates for motor vehicle 60 insurance.— 61 (8) Rates are not unfairly discriminatory if averaged 62 broadly among members of a group; nor are rates unfairly 63 discriminatory even though they are lower than rates for 64 nonmembers of the group. However, such rates are unfairly 65 discriminatory if they are not actuarially measurable and 66 credible and sufficiently related to actual or expected loss and 67 expense experience of the group so as to ensureassurethat 68 nonmembers of the group are not unfairly discriminated against. 69 Use of a single United States Postal Service zip code as a 70 rating territory shall be deemed unfairly discriminatory unless 71 filed pursuant to paragraph (1)(a) and such territory 72 incorporates sufficient actual or expected loss and loss 73 adjustment expense experience so as to be actuarially measurable 74 and credible. 75 Section 3. Subsection (9) of section 627.3518, Florida 76 Statutes, is amended to read: 77 627.3518 Citizens Property Insurance Corporation 78 policyholder eligibility clearinghouse program.—The purpose of 79 this section is to provide a framework for the corporation to 80 implement a clearinghouse program by January 1, 2014. 81 (9) The 45-day notice of nonrenewal requirement set forth 82 in s. 627.4133(2)(b)5.s. 627.4133(2)(b)5.b.applies when a 83 policy is nonrenewed by the corporation because the risk has 84 received an offer of coverage pursuant to this section which 85 renders the risk ineligible for coverage by the corporation. 86 Section 4. Paragraph (b) of subsection (2) of section 87 627.4133, Florida Statutes, is amended to read: 88 627.4133 Notice of cancellation, nonrenewal, or renewal 89 premium.— 90 (2) With respect to any personal lines or commercial 91 residential property insurance policy, including, but not 92 limited to, any homeowner, mobile home owner, farmowner, 93 condominium association, condominium unit owner, apartment 94 building, or other policy covering a residential structure or 95 its contents: 96 (b) The insurer shall give the first-named insured written 97 notice of nonrenewal, cancellation, or termination at least 120 98100days before the effective date of the nonrenewal, 99 cancellation, or termination.However, the insurer shall give at100least 100 days’ written notice, or written notice by June 1,101whichever is earlier, for any nonrenewal, cancellation, or102termination that would be effective between June 1 and November10330.The notice must include the reason for the nonrenewal, 104 cancellation, or termination, except that: 1051. The insurer shall give the first-named insured written106notice of nonrenewal, cancellation, or termination at least 120107days before the effective date of the nonrenewal, cancellation,108or termination for a first-named insured whose residential109structure has been insured by that insurer or an affiliated110insurer for at least 5 years before the date of the written111notice.112 1.2.If cancellation is for nonpayment of premium, at least 113 10 days’ written notice of cancellation accompanied by the 114 reason therefor must be given. As used in this subparagraph, the 115 term “nonpayment of premium” means failure of the named insured 116 to discharge when due her or his obligations for paying the 117 premium on a policy or an installment of such premium, whether 118 the premium is payable directly to the insurer or its agent or 119 indirectly under a premium finance plan or extension of credit, 120 or failure to maintain membership in an organization if such 121 membership is a condition precedent to insurance coverage. The 122 term also means the failure of a financial institution to honor 123 an insurance applicant’s check after delivery to a licensed 124 agent for payment of a premium even if the agent has previously 125 delivered or transferred the premium to the insurer. If a 126 dishonored check represents the initial premium payment, the 127 contract and all contractual obligations are void ab initio 128 unless the nonpayment is cured within the earlier of 5 days 129 after actual notice by certified mail is received by the 130 applicant or 15 days after notice is sent to the applicant by 131 certified mail or registered mail. If the contract is void, any 132 premium received by the insurer from a third party must be 133 refunded to that party in full. 134 2.3.If cancellation or termination occurs during the first 135 90 days the insurance is in force and the insurance is canceled 136 or terminated for reasons other than nonpayment of premium, at 137 least 20 days’ written notice of cancellation or termination 138 accompanied by the reason therefor must be given unless there 139 has been a material misstatement or misrepresentation or a 140 failure to comply with the underwriting requirements established 141 by the insurer. 142 3. After the policy has been in effect for 90 days, the 143 policy may not be canceled by the insurer unless there has been 144 a material misstatement, a nonpayment of premium, a failure to 145 comply, within 90 days after the date of effectuation of 146 coverage, with the underwriting requirements established by the 147 insurer before the effectuation of coverage, or a substantial 148 change in the risk covered by the policy or unless the 149 cancellation is for all insureds under such policies for a given 150 class of insureds. This subparagraph does not apply to 151 individually rated risks that have a policy term of less than 90 152 days. 153 4. After a policy or contract has been in effect for more 154 than 90 days, the insurer may not cancel or terminate the policy 155 or contract based on credit information available in public 156 records. 1575. The requirement for providing written notice by June 1158of any nonrenewal that would be effective between June 1 and159November 30 does not apply to the following situations, but the160insurer remains subject to the requirement to provide such161notice at least 100 days before the effective date of162nonrenewal:163a. A policy that is nonrenewed due to a revision in the164coverage for sinkhole losses and catastrophic ground cover165collapse pursuant to s. 627.706.166 5.b.A policy that is nonrenewed by Citizens Property 167 Insurance Corporation, pursuant to s. 627.351(6), for a policy 168 that has been assumed by an authorized insurer offering 169 replacement coverage to the policyholder is exempt from the 170 notice requirements of paragraph (a) and this paragraph. In such 171 cases, the corporation must give the named insured written 172 notice of nonrenewal at least 45 days before the effective date 173 of the nonrenewal. 174 175After the policy has been in effect for 90 days, the policy may176not be canceled by the insurer unless there has been a material177misstatement, a nonpayment of premium, a failure to comply with178underwriting requirements established by the insurer within 90179days after the date of effectuation of coverage, a substantial180change in the risk covered by the policy, or the cancellation is181for all insureds under such policies for a given class of182insureds. This paragraph does not apply to individually rated183risks that have a policy term of less than 90 days.184 6. Notwithstanding any other provision of law, an insurer 185 may cancel or nonrenew a property insurance policy after at 186 least 45 days’ notice if the office finds that the early 187 cancellation of some or all of the insurer’s policies is 188 necessary to protect the best interests of the public or 189 policyholders and the office approves the insurer’s plan for 190 early cancellation or nonrenewal of some or all of its policies. 191 The office may base such finding upon the financial condition of 192 the insurer, lack of adequate reinsurance coverage for hurricane 193 risk, or other relevant factors. The office may condition its 194 finding on the consent of the insurer to be placed under 195 administrative supervision pursuant to s. 624.81 or to the 196 appointment of a receiver under chapter 631. 197 7. A policy covering both a home and a motor vehicle may be 198 nonrenewed for any reason applicable to the property or motor 199 vehicle insurance after providing 90 days’ notice. 200 Section 5. Subsection (1) of section 627.421, Florida 201 Statutes, is amended to read: 202 627.421 Delivery of policy.— 203 (1) Subject to the insurer’s requirement as to payment of 204 premium, every policy shall be mailed, delivered, or 205 electronically transmitted to the insured or to the person 206 entitled thereto not later than 60 days after the effectuation 207 of coverage. Notwithstanding any other provision of law, an 208 insurer may allow a policyholder of personal lines insurance to 209 affirmatively elect delivery of the policy documents, including, 210 but not limited to, policies, endorsements, notices, or 211 documents, by electronic means in lieu of delivery by mail. 212 Electronic transmission of a policy for commercial risks, 213 including, but not limited to, workers’ compensation and 214 employers’ liability, commercial automobile liability, 215 commercial automobile physical damage, commercial lines 216 residential property, commercial nonresidential property, 217 farmowners insurance, and the types of commercial lines risks 218 set forth in s. 627.062(3)(d), constitutesshall constitute219 delivery to the insured or to the person entitled to delivery,220 unless the insured or the person entitled to delivery 221 communicates to the insurer in writing or electronically that he 222 or she does not agree to delivery by electronic means. 223 Electronic transmission shall include a notice to the insured or 224 to the person entitled to delivery of a policy of his or her 225 right to receive the policy via United States mail rather than 226 via electronic transmission. A paper copy of the policy shall be 227 provided to the insured or to the person entitled to delivery at 228 his or her request. 229 Section 6. Subsection (3) of section 627.7074, Florida 230 Statutes, is amended to read: 231 627.7074 Alternative procedure for resolution of disputed 232 sinkhole insurance claims.— 233 (3) Following the receipt of the report provided under s. 234 627.7073 or the denial of a claim for a sinkhole loss, the 235 insurer shall notify the policyholder of his or her right to 236 participate in the neutral evaluation program under this section 237 if there is coverage available under the policy and the claim 238 was submitted within the timeframe provided in s. 627.706(5). 239 Neutral evaluation supersedes the alternative dispute resolution 240 process under s. 627.7015 but does not invalidate the appraisal 241 clause of the insurance policy. The insurer shall provide to the 242 policyholder the consumer information pamphlet prepared by the 243 department pursuant to subsection (1) electronically or by 244 United States mail. 245 Section 7. Paragraph (a) of subsection (5) of section 246 627.736, Florida Statutes, is amended to read: 247 627.736 Required personal injury protection benefits; 248 exclusions; priority; claims.— 249 (5) CHARGES FOR TREATMENT OF INJURED PERSONS.— 250 (a) A physician, hospital, clinic, or other person or 251 institution lawfully rendering treatment to an injured person 252 for a bodily injury covered by personal injury protection 253 insurance may charge the insurer and injured party only a 254 reasonable amount pursuant to this section for the services and 255 supplies rendered, and the insurer providing such coverage may 256 pay for such charges directly to such person or institution 257 lawfully rendering such treatment if the insured receiving such 258 treatment or his or her guardian has countersigned the properly 259 completed invoice, bill, or claim form approved by the office 260 upon which such charges are to be paid for as having actually 261 been rendered, to the best knowledge of the insured or his or 262 her guardian. However, such a charge may not exceed the amount 263 the person or institution customarily charges for like services 264 or supplies. In determining whether a charge for a particular 265 service, treatment, or otherwise is reasonable, consideration 266 may be given to evidence of usual and customary charges and 267 payments accepted by the provider involved in the dispute, 268 reimbursement levels in the community and various federal and 269 state medical fee schedules applicable to motor vehicle and 270 other insurance coverages, and other information relevant to the 271 reasonableness of the reimbursement for the service, treatment, 272 or supply. 273 1. The insurer may limit reimbursement to 80 percent of the 274 following schedule of maximum charges: 275 a. For emergency transport and treatment by providers 276 licensed under chapter 401, 200 percent of Medicare. 277 b. For emergency services and care provided by a hospital 278 licensed under chapter 395, 75 percent of the hospital’s usual 279 and customary charges. 280 c. For emergency services and care as defined by s. 395.002 281 provided in a facility licensed under chapter 395 rendered by a 282 physician or dentist, and related hospital inpatient services 283 rendered by a physician or dentist, the usual and customary 284 charges in the community. 285 d. For hospital inpatient services, other than emergency 286 services and care, 200 percent of the Medicare Part A 287 prospective payment applicable to the specific hospital 288 providing the inpatient services. 289 e. For hospital outpatient services, other than emergency 290 services and care, 200 percent of the Medicare Part A Ambulatory 291 Payment Classification for the specific hospital providing the 292 outpatient services. 293 f. For all other medical services, supplies, and care, 200 294 percent of the allowable amount under: 295 (I) The participating physicians fee schedule of Medicare 296 Part B, except as provided in sub-sub-subparagraphs (II) and 297 (III). 298 (II) Medicare Part B, in the case of services, supplies, 299 and care provided by ambulatory surgical centers and clinical 300 laboratories. 301 (III) The Durable Medical Equipment Prosthetics/Orthotics 302 and Supplies fee schedule of Medicare Part B, in the case of 303 durable medical equipment. 304 305 However, if such services, supplies, or care is not reimbursable 306 under Medicare Part B, as provided in this sub-subparagraph, the 307 insurer may limit reimbursement to 80 percent of the maximum 308 reimbursable allowance under workers’ compensation, as 309 determined under s. 440.13 and rules adopted thereunder which 310 are in effect at the time such services, supplies, or care is 311 provided. Services, supplies, or care that is not reimbursable 312 under Medicare or workers’ compensation is not required to be 313 reimbursed by the insurer. 314 2. For purposes of subparagraph 1., the applicable fee 315 schedule or payment limitation under Medicare is the fee 316 schedule or payment limitation in effect on March 1 of the 317 service year in which the services, supplies, or care is 318 rendered and for the area in which such services, supplies, or 319 care is rendered, and the applicable fee schedule or payment 320 limitation applies to services, supplies, or care rendered 321 duringthroughout the remainder ofthat service year, 322 notwithstanding any subsequent change made to the fee schedule 323 or payment limitation, except that it may not be less than the 324 allowable amount under the applicable schedule of Medicare Part 325 B for 2007 for medical services, supplies, and care subject to 326 Medicare Part B. As used in this subparagraph, the term “service 327 year” means the period from March 1 through the last day of 328 February of the following year. 329 3. Subparagraph 1. does not allow the insurer to apply any 330 limitation on the number of treatments or other utilization 331 limits that apply under Medicare or workers’ compensation. An 332 insurer that applies the allowable payment limitations of 333 subparagraph 1. must reimburse a provider who lawfully provided 334 care or treatment under the scope of his or her license, 335 regardless of whether such provider is entitled to reimbursement 336 under Medicare due to restrictions or limitations on the types 337 or discipline of health care providers who may be reimbursed for 338 particular procedures or procedure codes. However, subparagraph 339 1. does not prohibit an insurer from using the Medicare coding 340 policies and payment methodologies of the federal Centers for 341 Medicare and Medicaid Services, including applicable modifiers, 342 to determine the appropriate amount of reimbursement for medical 343 services, supplies, or care if the coding policy or payment 344 methodology does not constitute a utilization limit. 345 4. If an insurer limits payment as authorized by 346 subparagraph 1., the person providing such services, supplies, 347 or care may not bill or attempt to collect from the insured any 348 amount in excess of such limits, except for amounts that are not 349 covered by the insured’s personal injury protection coverage due 350 to the coinsurance amount or maximum policy limits. 351 5.Effective July 1, 2012,An insurer may limit payment as 352 authorized by this paragraph only if the insurance policy 353 includes a notice at the time of issuance or renewal that the 354 insurer may limit payment pursuant to the schedule of charges 355 specified in this paragraph. A policy form approved by the 356 office satisfies this requirement. If a provider submits a 357 charge for an amount less than the amount allowed under 358 subparagraph 1., the insurer may pay the amount of the charge 359 submitted. 360 Section 8. Paragraphs (a) and (b) of subsection (2) of 361 section 627.744, Florida Statutes, are amended to read: 362 627.744 Required preinsurance inspection of private 363 passenger motor vehicles.— 364 (2) This section does not apply: 365 (a) To a policy for a policyholder who has been insured for 366 2 years or longer, without interruption, under a private 367 passenger motor vehicle policy thatwhichprovides physical 368 damage coverage for any vehicle,if the agent of the insurer 369 verifies the previous coverage. 370 (b) To a new, unused motor vehicle purchased or leased from 371 a licensed motor vehicle dealer or leasing company., ifThe 372 insurer may requireis provided with: 373 1. A bill of sale,orbuyer’s order, or lease agreement 374 thatwhichcontains a full description of the motor vehicle,375including all options and accessories; or 376 2. A copy of the title or registration thatwhich377 establishes transfer of ownership from the dealer or leasing 378 company to the customer and a copy of the window stickeror the379dealer invoice showing the itemized options and equipment and380the total retail price of the vehicle. 381 382 For the purposes of this paragraph, the physical damage coverage 383 on the motor vehicle may not be suspended during the term of the 384 policy due to the applicant’s failure to provide or the 385 insurer’s option not to require therequireddocuments. However, 386 if the insurer requires a document under this paragraph at the 387 time the policy is issued, payment of a claim may beis388 conditioned upon the receipt by the insurer of the required 389 documents, and no physical damage loss occurring after the 390 effective date of the coverage may beispayable until the 391 documents are provided to the insurer. 392 Section 9. Section 631.65, Florida Statutes, is repealed. 393 Section 10. This act shall take effect July 1, 2015.