Bill Text: FL S0846 | 2012 | Regular Session | Introduced


Bill Title: Property Insurance

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2012-03-09 - Died in Banking and Insurance [S0846 Detail]

Download: Florida-2012-S0846-Introduced.html
       Florida Senate - 2012                                     SB 846
       
       
       
       By Senator Fasano
       
       
       
       
       11-00308-12                                            2012846__
    1                        A bill to be entitled                      
    2         An act relating to property insurance; amending s.
    3         627.70131, F.S.; defining the term “claim-related
    4         document”; requiring an insurer to disclose to a
    5         claimant certain information relating to policy
    6         coverage, that the claimant may request and obtain all
    7         claim-related documents, and whether there are any
    8         time requirements that would result in an insurer
    9         denying a claim; creating s. 627.70133, F.S.;
   10         incorporating provisions transferred from s.
   11         627.70131, F.S., relating to the payment of claims;
   12         creating s. 627.70191, F.S.; providing for the
   13         extension of the period of coverage for additional
   14         living expenses resulting from a state of emergency;
   15         amending s. 627.062, F.S.; conforming a cross
   16         reference; providing an effective date.
   17  
   18  Be It Enacted by the Legislature of the State of Florida:
   19  
   20         Section 1. Section 627.70131, Florida Statutes, is amended
   21  to read:
   22         627.70131 Insurer’s duty to acknowledge Communications
   23  regarding claims; required notices; investigation.—
   24         (1) As used in this section, the term:
   25         (a) “Agent” means any person to whom an insurer has granted
   26  authority or responsibility for receiving or making
   27  communications with respect to claims on behalf of the insurer.
   28         (b) “Claim-related documents” means all documents,
   29  instructions, and telephone numbers that relate to the
   30  evaluation of claims for damages, including repair and
   31  replacement estimates and bids, appraisals, scopes of loss,
   32  drawings, plans, reports, third-party findings on the amount of
   33  loss, covered damages, cost of repairs, and all other valuation,
   34  measurement, and loss adjustment calculations of the amount of
   35  loss, covered damage, and cost of repairs. The term does not
   36  include attorney work products or documents subject to an
   37  attorney-client privilege, documents that indicate fraud by the
   38  insured, or documents that contain medically privileged
   39  information.
   40         (c) “Insurer” means a residential property insurer.
   41         (2)(1)(a) Upon an insurer’s receiving a communication with
   42  respect to a claim, the insurer shall, within 14 calendar days,
   43  review and acknowledge receipt of such communication unless
   44  payment is made within that period of time or unless the failure
   45  to acknowledge the claim is caused by factors beyond the control
   46  of the insurer which reasonably prevent such acknowledgment. If
   47  the acknowledgment is not in writing, a notation notification
   48  indicating acknowledgment of the communication must shall be
   49  made in the insurer’s claim file and dated. A communication made
   50  to or by an agent of an insurer with respect to a claim
   51  constitutes shall constitute communication to or by the insurer.
   52         (b) As used in this subsection, the term “agent” means any
   53  person to whom an insurer has granted authority or
   54  responsibility to receive or make such communications with
   55  respect to claims on behalf of the insurer.
   56         (c) This subsection does shall not apply to claimants
   57  represented by counsel beyond those communications that are
   58  necessary to provide claim-related documents forms and
   59  instructions.
   60         (3)(2)Such Acknowledgment of a communication must shall be
   61  responsive to the communication.
   62         (a) The insurer must disclose to a claimant all benefits,
   63  coverage, time limits, or other provisions of an insurance
   64  policy issued by that insurer which may apply to the claim
   65  presented by the claimant. If additional benefits might
   66  reasonably be payable upon receipt of additional proofs of
   67  claim, the insurer shall immediately communicate this fact to
   68  the insured and cooperate with and assist the insured in
   69  determining the extent of the insurer’s additional liability.
   70         (b) If the communication constitutes a notification of a
   71  claim, unless the acknowledgment reasonably advises the claimant
   72  that the claim appears not to be covered by the insurer, the
   73  acknowledgment must inform the claimant that, upon request, he
   74  or she may obtain copies of all claim-related documents. Within
   75  15 calendar days after receiving such request, the insurer shall
   76  provide the insured with copies of all claim-related documents
   77  shall provide necessary claim forms, and instructions, including
   78  an appropriate telephone number. This paragraph does not alter
   79  discovery rights in matters that are subject to litigation.
   80         (4) Except where a claim has been settled by payment, an
   81  insurer must provide written notice of any statute of limitation
   82  or other time requirement upon which the insurer may rely to
   83  deny a claim.
   84         (a) Such notice must be given to the claimant at least 60
   85  days before the expiration date. However, if the notice of claim
   86  is first received by the insurer within that 60 days, notice of
   87  the expiration date must be given to the claimant immediately.
   88         (b) With respect to a first party claimant in a matter
   89  involving an uninsured motorist, notice must be given at least
   90  30 days before the expiration date. However, if the notice of
   91  claim is first received by the insurer within that 30 days,
   92  notice of the expiration date must be given to the claimant
   93  immediately.
   94         (c) This subsection does not apply to a claimant who is
   95  represented by counsel on the claim matter.
   96         (5)(3) Unless otherwise provided by the policy of insurance
   97  or by law, within 10 working days after an insurer receives
   98  proof of loss statements, the insurer shall begin such
   99  investigation as is reasonably necessary unless the failure to
  100  begin such investigation is caused by factors beyond the control
  101  of the insurer which reasonably prevent the commencement of such
  102  investigation.
  103         (6) If, within a 6-month period, the company assigns a
  104  third or subsequent adjuster to be primarily responsible for a
  105  claim, the insurer shall provide the insured with a written
  106  status report in a timely manner. The status report must include
  107  a summary of any decisions or actions that are substantially
  108  related to the disposition of a claim, including, but not
  109  limited to, the amount of losses to structures or contents, the
  110  retention or consultation of design or construction
  111  professionals, the amount of coverage for losses to structures
  112  or contents, and all items of dispute.
  113         (4) For purposes of this section, the term “insurer” means
  114  any residential property insurer.
  115         (5)(a) Within 90 days after an insurer receives notice of
  116  an initial, reopened, or supplemental property insurance claim
  117  from a policyholder, the insurer shall pay or deny such claim or
  118  a portion of the claim unless the failure to pay is caused by
  119  factors beyond the control of the insurer which reasonably
  120  prevent such payment. Any payment of an initial or supplemental
  121  claim or portion of such claim made 90 days after the insurer
  122  receives notice of the claim, or made more than 15 days after
  123  there are no longer factors beyond the control of the insurer
  124  which reasonably prevented such payment, whichever is later,
  125  bears interest at the rate set forth in s. 55.03. Interest
  126  begins to accrue from the date the insurer receives notice of
  127  the claim. The provisions of this subsection may not be waived,
  128  voided, or nullified by the terms of the insurance policy. If
  129  there is a right to prejudgment interest, the insured shall
  130  select whether to receive prejudgment interest or interest under
  131  this subsection. Interest is payable when the claim or portion
  132  of the claim is paid. Failure to comply with this subsection
  133  constitutes a violation of this code. However, failure to comply
  134  with this subsection does not form the sole basis for a private
  135  cause of action.
  136         (b) Notwithstanding subsection (4), for purposes of this
  137  subsection, the term “claim” means any of the following:
  138         1. A claim under an insurance policy providing residential
  139  coverage as defined in s. 627.4025(1);
  140         2. A claim for structural or contents coverage under a
  141  commercial property insurance policy if the insured structure is
  142  10,000 square feet or less; or
  143         3. A claim for contents coverage under a commercial tenants
  144  policy if the insured premises is 10,000 square feet or less.
  145         (c) This subsection shall not apply to claims under an
  146  insurance policy covering nonresidential commercial structures
  147  or contents in more than one state.
  148         Section 2. Section 627.70133, Florida Statutes, is created
  149  to read:
  150         627.70133Payment of claims.—
  151         (1) As used in this section, the term “claim” means:
  152         (a) A claim under an insurance policy providing residential
  153  coverage as described in s. 627.4025(1);
  154         (b) A claim for structural or contents coverage under a
  155  commercial property insurance policy if the insured structure is
  156  10,000 square feet or less; or
  157         (c) A claim for contents coverage under a commercial
  158  tenants policy if the insured premises is 10,000 square feet or
  159  less.
  160         (2) Within 90 days after an insurer receives notice of an
  161  initial, reopened, or supplemental property insurance claim from
  162  a policyholder, the insurer shall pay or deny such claim or a
  163  portion of the claim unless the failure to pay is caused by
  164  factors beyond the control of the insurer which reasonably
  165  prevent such payment. Payment of an initial or supplemental
  166  claim or portion of such claim made 90 days after the insurer
  167  receives notice of the claim, or more than 15 days after there
  168  are no longer factors beyond the control of the insurer which
  169  reasonably prevented such payment, whichever occurs later, bears
  170  interest at the rate set forth in s. 55.03. Interest begins to
  171  accrue from the date the insurer receives notice of the claim.
  172  If there is a right to prejudgment interest, the insured shall
  173  select whether to receive prejudgment interest or interest under
  174  this subsection. Interest is payable when the claim or portion
  175  of the claim is paid.
  176         (3) The provisions of this section may not be waived,
  177  voided, or nullified by the terms of the insurance policy.
  178  Failure to comply with this section constitutes a violation of
  179  this code. However, failure to comply with this section does not
  180  form the sole basis for a private cause of action.
  181         (4) This section does not apply to claims under an
  182  insurance policy covering nonresidential commercial structures
  183  or contents in more than one state.
  184         Section 3. Section 627.70191, Florida Statutes, is created
  185  to read:
  186         627.70191Coverage for living expenses relating to a state
  187  of emergency.—In the event of a covered loss relating to a state
  188  of emergency that has been declared under s. 252.36, the period
  189  of coverage for additional living expenses shall be extended to
  190  24 months. However, any extension of time required under this
  191  section which is beyond the period provided in the policy does
  192  not increase the amount of the policy limit for additional
  193  living expenses which is in force at the time of the loss.
  194         Section 4. Subsection (10) of section 627.062, Florida
  195  Statutes, is amended to read:
  196         627.062 Rate standards.—
  197         (10) Any interest paid pursuant to s. 627.70133
  198  627.70131(5) may not be included in the insurer’s rate base and
  199  may not be used to justify a rate or rate change.
  200         Section 5. This act shall take effect July 1, 2012.

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