NOTICE TO INDUSTRY:
Hurricane Preparedness and Claims Handling
The Office of Insurance Regulation (OIR) reminds all Property & Casualty (P&C) insurers of the importance of preparedness and compliance with all provisions of the Florida Insurance Code. The following highlights important regulatory requirements and best practices to ensure efficient and proper claims handling pursuant to Florida law.
Claims-Handling Manuals
OIR expects insurers to be prepared to implement their claims-handling manuals which meet the requirements of the Florida Insurance Code and meet minimum, usual and customary industry claims-handling practices. OIR will be monitoring for compliance and expects insurers to engage in early and meaningful conversation with policyholders ahead of a catastrophe event. More information regarding claims-handling manual attestations can be found here. Insurers should ensure that all staff are familiar with updates or revisions to claims-handling manuals and are ready to implement them in a timely manner. Insurers should be prepared to provide catastrophe claims data immediately proceeding an event.
Acknowledgment of Claim Communication & Timeframe for Payment of Claims
Pursuant to Senate Bill 2-A which amended section 627.70131, F.S., insurers are required to acknowledge receipt of a claim within seven calendar days. Insurers must then make a claim determination within 60 days of receiving notice of a claim, notwithstanding a delay caused by factors beyond the control of the insurer.
More information regarding Senate Bill 2-A can be found here
OIR’s Fine Authority
Insurers are reminded that failure to comply with Florida law can result in fines and other penalties, in accordance with s. 624.4211, F.S.. Violations may result in any of the following penalties:
- Revocation or suspension of a certificate of authority issued under this chapter, the office may, in lieu of such revocation or suspension, impose a fine upon the insurer.
- For nonwillful violations, OIR may issue fines up to $5,000 per violation, not to exceed an aggregate amount of $20,000 for all violations arising out of the same action.
- For knowing and willful violations of a lawful order or rule of the office or commission or a provision of this code, OIR may impose a fine upon the insurer up to $40,000 for each such violation, not to exceed an aggregate amount of $200,000 for violations arising out of the same action.
- For nonwillful and willful violations, if restitution is due, the insurer is required to make restitution to all affected persons, including interest from either the date of the violation or the date of inception of the affected person's policy, at the insurer's option.
Preparedness Measures
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Review and Update Contact Information: Ensure all contact information for policyholders is up to date to facilitate timely communication.
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Staff Training: Conduct periodic training for claims handling and customer service staff on disaster-specific protocols.
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Resource Allocation: Allocate additional resources to handle the increased volume of claims expected during a catastrophe situation.
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Communication Plan: Develop a communication plan to keep policyholders informed about the claims process and any changes as a result of the natural disaster.
About the OIR
The Florida Office of Insurance Regulation (OIR) has primary responsibility for regulation, compliance, and enforcement of statutes related to the business of insurance and the monitoring of industry markets. For more information about OIR, please visit www.floir.com or follow on X @FLOIR_comm.
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