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Thursday, February 22, 2024

Florida Begins New Period with Main Property Insurance coverage Reforms


For the fourth time since 2019, the Florida Legislature has enacted property insurance coverage reforms aimed in direction of stabilizing a beleaguered insurance coverage market. The invoice, S.B. 2-A, creates a reinsurance help program, establishes extra oversight for insurers with excessive volumes of hurricane claims, and reforms many points of the claims course of, together with the timing for paying and adjusting claims. The reforms additional eradicate one-way lawyer charge awards to policyholders and ban assignment-of-benefits agreements.  On this article, we’ll give attention to the adjustments to the declare adjustment course of and protection and unhealthy religion litigation.

Within the first spherical of property insurance coverage reforms in 2019, the Legislature established a pre-suit discover course of and two-way lawyer’s charge shifting in project of advantages (AOB) litigation towards admitted carriers. Within the second spherical of property insurance coverage reforms, the Legislature established a process requiring pre-suit discover for policyholders. The second spherical of reforms additionally set stricter time limitations for giving discover of claims. Within the third spherical of property insurance coverage reforms, the Florida Legislature took a extra direct shot on the downside and eradicated statutory lawyer charge shifting in fits introduced by assignees, created a statutory presumption towards lawyer’s charge multipliers, and established a requirement that claimants show a breach of contract as a way to prevail on a declare for statutory unhealthy religion towards a property insurer.  The brand new fourth spherical of reforms is mentioned intimately beneath.

No Statutory Legal professional’s Payment Shifting in Property Insurance coverage Litigation

The prior reforms tried to curb frivolous and extreme litigation by establishing a pre-suit discover course of and a sliding scale for lawyer’s charge awards based mostly on success within the lawsuit. However even with a diminished prospect for an award of lawyer’s charges, policyholders nonetheless had the leverage of uneven litigation. Giving a litigation benefit to 1 social gathering encourages extra litigation.

The Florida Legislature has now eradicated the statutory lawyer’s charge shifting in residential and industrial property lawsuits for each admitted and surplus traces carriers, including the next language to each Sections 627.428 and 626.9373: “In a swimsuit arising underneath a residential or industrial property insurance coverage coverage, there isn’t a proper to lawyer charges underneath this part.” The fee-shifting statutes stay in impact for different varieties of insurance coverage, and there may be nonetheless potential that policyholders get better lawyer’s charges by sanctions motions or proposals for settlement.

Adjustment of Claims

The brand new reforms scale back the time for insurers to problem undisputed funds. Part 626.9541, unfair strategies of competitors and unfair or misleading acts or practices, has been amended to cut back the time for which undisputed funds needs to be made. Undisputed funds should now be paid inside 60 days, down from 90 days, except fee of the undisputed advantages is prevented by elements past the management of the insurer as outlined in Part 627.70131(5).

The Florida Legislature additionally made additional amendments to Part 627.70131, which can take impact on March 1, 2023. Adjustments embody:

  • Lowering the time from 14 calendar days to 7 calendar days for insurers to assessment and acknowledge receipt of communications, except fee is made inside that point or except the failure to acknowledge is attributable to elements past the management of the insurer.
  • Lowering the time from 14 days to 7 days after the insurer obtained proof-of-loss statements for the insurer to start such investigation as is fairly crucial, except in any other case supplied by the coverage or by legislation, or except the failure to start such investigation is attributable to elements past the management of the insurer.
  • Lowering the time from 45 days to 30 days after receiving proof-of-loss statements for the insurer to conduct a bodily inspection of the property.
  • Allowing insurers to make use of digital strategies to analyze losses. Such digital strategies could embody any technique that gives the insurer with clear, colour photos or video documenting the loss, together with, however not restricted to, digital images or video recordings of the loss, video conferencing between the adjuster and the policyholder which incorporates video recording of the loss, and video recordings or images of the loss utilizing a drone, driverless automobile, or different machine that may transfer independently or by distant management. The insurer additionally could enable the policyholder to make use of such strategies to help within the investigation of the loss. An insurer could void the insurance coverage coverage if the policyholder or another particular person on the course of the policyholder, with intent to injure, defraud, or deceive any insurer, commits insurance coverage fraud by offering false, incomplete, or deceptive info regarding any reality or factor materials to a declare utilizing digital strategies. Using digital strategies to analyze the loss doesn’t prohibit an insurer from assigning a licensed adjuster to bodily examine the property.
  • Requiring the insurer to ship the policyholder a replica of any detailed estimate of loss inside 7 days after the estimate is written by the insurer’s adjuster, eradicating the requirement that the policyholder first request a replica of the estimate.

Part 627.70131(4) has been amended to require insurers to keep up sure information, together with dates of:

  • Any claim-related communication made between the insurer and the policyholder or the policyholder’s consultant;
  • The insurer’s receipt of the policyholder’s proof of loss assertion;
  • Any claim-related request for info made by the insurer to the policyholder or the policyholder’s consultant;
  • Any claim-related inspections of the property made by the insurer, together with bodily inspections and inspections made by digital means;
  • Any detailed estimate of the quantity of the loss generated by the insurer’s adjuster;
  • The start and finish of any tolling interval supplied for in subsection (8) of Part 627.70131; and
  • The insurer’s fee or denial of the declare.

“Components past the management of the insurer” means:

  • The Workplace of Insurance coverage Regulation issued an order discovering that every one or sure residential property insurers are moderately unable to fulfill the time necessities of the statute in specified areas and ordering that such insurer or insurers could have extra time as specified by the Workplace.
  • Actions by the policyholder or the policyholder’s consultant which represent fraud, lack of cooperation, or intentional misrepresentation concerning the declare for which advantages are owed when such actions moderately forestall the insurer from complying with any requirement of this part.

This definition of “elements past the management of the insurer” is essential as a result of it is usually used within the part requiring well timed fee of claims. The reformed statute now requires protection determinations inside 60 days:

 (7)(a) Inside 60 days after an insurer receives discover of an preliminary, reopened, or supplemental property insurance coverage declare from a policyholder, the insurer shall pay or deny such declare or a portion of the declare except the failure to pay is attributable to elements past the management of the insurer…. Any fee of an preliminary or supplemental declare or portion of such declare made 60 days after the insurer receives discover of the declare, or made after the expiration of any extra timeframe supplied to pay or deny a declare or a portion of a declare made pursuant to an order of the workplace discovering elements past the management of the insurer, whichever is later, bears curiosity ….

Accordingly, the exception to the curiosity fee requirement has been restricted to situations the place the Workplace of Insurance coverage Regulation decided that there are elements past the management of the insurer. An insurer can not make that willpower. Nevertheless, the time necessities of Part 627.70131 are tolled if a policyholder or a policyholder’s consultant fail to offer materials claims info requested by the insurer inside 10 days after the request, if the request is made no less than 15 days earlier than the insurer is required to pay or deny the declare.

The time necessities are additionally tolled throughout any statutory mediation continuing of any various dispute decision continuing supplied for underneath the coverage.

Deadlines for Discover of Claims

The Florida Legislature has once more amended Part 627.70132, which is relevant to each admitted insurers and surplus traces insurers and applies to claims arising from any peril. The amended statute reduces the time to report a declare or reopened declare from 2 years after the date of loss to 1 yr. The time to report a supplemental declare is lowered from 3 years after the date of loss to 18 months.

Pre-Swimsuit Discover Course of

The components of Part 627.70152 pertaining to lawyer’s charges have been eliminated. The pre-suit discover and determination course of have in any other case been left intact.

Assignments of Advantages

On the finish of 2022, assignments of advantages to service suppliers shall be prohibited:

Besides as supplied in subsection (11), a policyholder could not assign, in complete or partly, any post-loss insurance coverage profit underneath any residential property insurance coverage coverage or underneath any industrial property insurance coverage coverage as that time period is outlined in s. 627.0625(1), issued on or after January 1, 2023. An try and assign post-loss property insurance coverage advantages underneath such a coverage is void, invalid, and unenforceable.

This prohibition will apply to admitted carriers solely.

Breach of Contract Crucial for Dangerous Religion

Florida Statutes Part 624.155 permits claimants to file unhealthy religion claims underneath first-party property insurance coverage insurance policies. Earlier than a claimant can file a nasty religion swimsuit, the existence of protection and the extent of damages, the quantity of loss, have to be decided. Over the previous decade, quite a few Florida courts have held that an appraisal award is a adequate willpower of protection and quantity of loss to allow a nasty religion swimsuit. Due to this fact, even when an insurer correctly issued fee underneath the phrases of the coverage, and had not been discovered to have breached any a part of the coverage, it might nonetheless face a nasty religion swimsuit if an appraisal award resulted in any extra fee to the insured. Consequently, value determinations have turn out to be a preferred instrument for unhealthy religion setups.

The Florida Legislature tried to repair this problem in its third spherical of reforms, however the language within the new Part 624.1551 was too obscure as to what it means to determine a breach of contract. The Legislature has now changed Part 624.1551 with extra exact circumstances for asserting a nasty religion declare towards a property insurer:

624.1551 Civil treatment actions towards property insurers.—

However any provision of s. 624.155 on the contrary, in any declare for extracontractual damages underneath s. 624.155(1)(b), no motion shall lie till a named or omnibus insured or a named beneficiary has established by an antagonistic adjudication by a courtroom of legislation that the property insurer breached the insurance coverage contract and a remaining judgment or decree has been rendered towards the insurer. Acceptance of a suggestion of judgment underneath s. 768.79 or the fee of an appraisal award doesn’t represent an antagonistic adjudication underneath this part. The distinction between an insurer’s appraiser’s remaining estimate and the appraisal award could also be proof of unhealthy religion underneath s. 624.155(1)(b), however will not be deemed an antagonistic adjudication underneath this part and doesn’t, by itself, give rise to a explanation for motion.

With this modification, the Legislature has ended the “appraisal to unhealthy religion” setup, and made clear a easy, affordable proposition—an insurer that has abided by the phrases of the insurance coverage coverage mustn’t must defend a nasty religion swimsuit.

Provides of Judgment

The Florida Legislature amended Part 768.79, the provide of judgment statute, to allow the making of joint gives which can be conditioned on mutual acceptance. This modification eliminates the “spousal loophole,” which permits spousal co-plaintiffs, and different carefully associated policyholders, to keep away from gives of judgment conditioned on their joint acceptance.

Submission of Claims to Appraisal as a Basic Enterprise Apply

The invoice amends Part 624.418, which gives grounds for the suspension or revocation of an insurer’s certification of authority, to incorporate situations the place an insurer, as a part of a normal enterprise follow, with out trigger, compels insureds to take part in appraisal as a way to safe full fee of their claims. Appraisal is a mechanism for resolving real disputes over the quantity of loss for a given declare, and the choice to invoke appraisal needs to be made based mostly upon the info and circumstances of a selected declare. This modification to Part 624.418 ought to alleviate issues about appraisal getting used as a way for avoiding unhealthy religion legal responsibility because of the breach of contract requirement added to Part 624.1551.

Flood Insurance coverage is Inspired

The Legislature amended the warning language required in house owner’s insurance coverage insurance policies that don’t present flood protection. As a substitute of advising owners that they “can also want to contemplate” flood protection, the brand new disclaimer will advise policyholders that they “ought to take into account” flood protection.

Necessary Binding Arbitration Endorsements Approved

The brand new legislation creates Part 627.70154, which codifies that insurers can problem non-compulsory obligatory binding arbitration endorsements. The policyholder should signal a type electing binding arbitration, and the premium for the coverage should embody an actuarially sound low cost for the obligatory binding arbitration endorsement. However, insurers should additionally provide the policyholder a coverage that doesn’t require participation in obligatory binding arbitration.

Efficient Dates

These statutory reforms turned efficient upon being signed into legislation by Governor DeSantis on December 16, 2022, which suggests the adjustments apply to insurance policies issued after that point. The amendments to Part 627.70131 take impact on March 1, 2023. As a result of the previous legal guidelines will apply to insurance policies which have already been issued, we anticipate a excessive quantity of litigation on older claims, and of claims for injury from Hurricane Ian and Hurricane Nicole. Following the third spherical of reforms, we noticed an uptick of litigation from assignees hoping to litigate underneath the older, extra favorable legal guidelines.

Assignments of advantages shall be prohibited on January 1, 2023, however this prohibition will possible solely apply to admitted carriers. 

Closing Ideas

These reforms characterize probably the most important adjustments to Florida’s present Insurance coverage Code since its inception in 1982. Particularly, the elimination of lawyer’s charge awards has been on the radar of the Workplace of Insurance coverage Regulation for plenty of years now. These insurance coverage reforms profit each policyholders and insurers. Policyholders will obtain faster declare selections and funds, and insurers ought to finally see fewer abusive lawsuits. The Florida Legislature is encouraging immediate and open adjustment of claims, whereas discouraging attorneys and contractors from abusing the insurance coverage declare course of. We consider these reforms may have a optimistic affect on the insurance coverage market in Florida, however it should take no less than a couple of years earlier than we see the true affect of this laws on the quantity of property insurance coverage litigation.  

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