The not too long ago filed and quickly-to-be-heard proposed Florida insurance coverage legal guidelines famous in yesterday’s put up, Breaking News—Florida Senate Proposes New Insurance Legislation, finds Steve Badger on the whole settlement with this proposed unfair claims apply:
Altering or amending an insurance coverage adjuster’s report with out together with on the report or as an addendum to the report an in depth record of all adjustments made to the report and the id of the one who ordered every change. Any change that has the impact of decreasing the estimate of the loss should embody an in depth reason such change was made;
These proposed legal guidelines may be traced to the work of Washington Post journalist Brianna Sacks whose article I famous in Insurance Company Corrupt Claims Culture Exposed by Washington Post. My impression is that elements of the proposed laws tackle Florida’s insurance coverage firm executives skimming cash from the Florida insurance coverage firms, as reported by Tampa Bay Times journalist Lawrence Mower in Florida Insurance Company Execs Saw Big Payouts in Years Without Hurricanes.
I used to be on an American Policyholder Association Board of Advisors Zoom convention when Mathew Mulholland despatched me a hyperlink to Steve Badger’s earlier response to the Washington Post article:
My response to the 7 public adjusters, 5 policyholder attorneys, and a couple of roofing contractors who all despatched me a hyperlink to yesterday’s Washington Post article….
‘Yes, I saw it.’
I’ll say the identical factor I posted a number of weeks in the past when this problem was first reported…..
If these Florida insurance coverage firms have been altering the impartial adjusters’ factual observations of what they discovered to be broken after which utilizing these factual adjustments as the idea for the declare measure despatched to the insured, then, sure, that’s flawed. I can perceive the allegation such conduct could possibly be fraud.
But, if these insurance coverage firms have been solely making use of their coverage protection to the factual findings of the impartial adjusters, I’ve no drawback with an insurance coverage firm altering an IA’s estimate to be according to the protection offered by the relevant coverage. Of course, an insurance coverage firm solely owes for harm that’s coated by its coverage.
With that mentioned, making these adjustments and leaving the estimate on the impartial adjuster’s letterhead is just not a most popular apply. But I wouldn’t name it fraud.
The greatest apply could be to revise the impartial adjuster’s estimate to be according to the accessible protection and put the revised estimate on the insurance coverage firm’s letterhead. Then ship the insured each estimates, one displaying every thing that was discovered to be broken and one displaying what harm is definitely coated by the coverage.
I hold telling those who some insurance coverage protection attorneys have a coronary heart and sufficient braveness to state their opinion concerning the significance “good faith” claims practices. We ought to hear fastidiously to and perceive those that are working for the insurance coverage claims trade, even when we disagree. Many are moral and deeply care about making the insurance coverage product work for society.
A Bill Analysis and Fiscal Impact Statement was revealed yesterday, and it could be simpler for a lot of to learn for an understanding of what the proposed regulation does. It notes that the proposed regulation:
Prohibits approved and surplus strains insurers from cancelling a property insurance coverage coverage throughout any pending declare till after repairs are full;
Requires that Citizens cowl property with open claims which might be being dealt with by FIGA (Florida Insurance Guaranty Association);
Prohibits the Office of Insurance Regulation (OIR) from waiving its assessment of coverage types for 3 years for any insurer that has violated the Insurance Code;
Provides that the prohibition on making use of every other deductible below the coverage if a roof deductible is utilized encompasses every other loss to the property brought on by the identical coated peril.
Tolls the time interval for submitting a property insurance coverage declare throughout an insured’s lively responsibility navy service; and
Clarifies legislative intent that Chapter 2022-271, Laws of Florida, handed throughout Special Session A in December 2023, (SB 2-A [2022] on Property Insurance) shall not be construed to impair any proper below an insurance coverage contract in impact on or earlier than the efficient date of that chapter regulation (December 16, 2022).
Regarding claims dealing with practices, the proposed regulation:
Requires OIR to make sure legal responsibility insurers are complying with correct claims dealing with practices by following specified greatest practices
Creates a 60-day prompt-pay regulation for non-PIP motorized vehicle insurance coverage claims just like the immediate pay regulation for residential property insurance coverage claims;
Requires insurers to yearly submit their claims manuals to the OIR and attest that the handbook comports to traditional and customary trade claims dealing with practices; and
Strengthens the Unfair Insurance Trade Practices Act by:
o Prohibiting altering or amending an adjuster’s report with out together with an inventory of adjustments, who made the change, and a proof of a change that reduces protection; and
o Prohibiting fee of bonuses to officers and administrators whereas an insurer is impaired or bancrupt.
The first listening to of this invoice is tomorrow morning in Tallahassee.
Thought For The Day
Courage is resistance to worry, mastery of worry, not absence of worry.
—Mark Twain