Department Communication
The Communications Director manages the Department of Communications. The CFO and Insurance Commissioner are proponents of transparency for its citizens. Managing communications and making them public (as appropriate) enforces the transparency process.
The Newsroom on the floir.com website makes the Director available, provides access to OIR actions, and ensures related news is current. Citizens are invited to follow them on social media and sign up for the weekly newsletter Dollars & Sense. [Source: OIR Press Release]
Guaranty Association
Florida Insurance Guaranty Association (FIGA) is part of a non-profit, state-based, statutorily-created system that pays certain outstanding claims of insolvent insurance companies. By paying these claims, guaranty associations protect policyholders and claimants. Guaranty associations are active in every state, the District of Columbia, Puerto Rico and the Virgin Islands.
Guaranty associations ease the burden on policyholders and claimants of the insolvent insurer by immediately stepping in to assume responsibility for most policy claims following liquidation. They provide two important benefits: prompt payment of covered claims and payment of the full value of covered claims up to the limits set by the policy or state law. [Chapter 631]
Coverage applies to direct life insurance, health insurance, annuity contracts, and supplemental contracts issued by those licensed to transact insurance in Florida. Coverage is provided to:
- Those who are the beneficiaries, assignees, or payees of covered persons
- Those who are owners of policies or contracts and who are residents of Florida
- Residents of other states if the insurer is domiciled in Florida, the insurers were not licensed in the states in which the individuals reside, and such other states have associations similar to FIGA
- A payee under a structured settlement annuity (or beneficiary if the payee is deceased) with a coverage limit of $300,000, if the payee is a resident of Florida
For purposes of administration and assessment, the association maintains three accounts: the health insurance account, the life insurance account, and the annuity account. Borrowing between accounts for payment of claims is authorized at the discretion of the board of directors, provided that the amounts are restored to the appropriate accounts not less than annually. [§631.715(2)(a)]
There is a nonprofit legal entity known as the Florida HMO Consumer Assistance Plan. All HMOs must remain members of the plan as a condition of their authority to transact business in Florida. The plan comes under the immediate supervision of the department and is subject to the applicable laws of Florida. [§631.811 and §631.828]
New Florida Law Updates
Waives the prelicensing education requirement for active military members, veterans, and their spouses who are currently in good standing with the military or have been honorably discharged. These individuals are also exempt from license application fees if they are currently in good standing or have been honorably discharged within 24 months of application.
Effective July 1, 2018 [Sec. 626.171, 732, 7851, 8311, 8417, 927 F.S.]
Modifies Florida’s unfair trade practices law regarding advertising and promotional gifts. Insurers and agents may give insureds, prospective insureds, and others merchandise, gift cards, event tickets, or other items valued at $100 or less per individual in any calendar year. For title insurance agents and agencies, a $25 limit applies. Insurers and agents may also make charitable contributions on behalf of insureds or prospective insureds of up to $100 per individual in any calendar year.
Effective July 1, 2018 [Sec. 626.9541 F.S.]
Provides for substantial changes in the way insurance benefits may be assigned to third parties. Key provisions:
- Defines “assignment agreement” and establishes requirements for execution, validity, and effect
- Transfers certain pre-lawsuit duties under the insurance contract to the assignee
- Requires each insurer to report data on claims paid under assignment agreements by January 30, 2022, and each year thereafter
- Revises the state’s one-way attorney fee statute to incorporate an attorney fee structure
- Requires service providers to give an insurer and the consumer prior written notice of at least 10 business days before filing suit on a claim
Takes Effect: July 1, 2019
Requires authorized insurers to provide insureds a loss run statement within 15 days after receipt of the insured’s written request. No fees can be charged for providing this information once annually. A loss run statement contains: policy number, period of coverage, number of claims, paid losses on all claims, and date of each loss. The loss run statement must cover the past five years or the complete claims history if less than five years.
Effective Date: 1/1/2021
- Prohibits the DFS and OIR from disseminating aggregated information if it contains trade secret information that can be individually extrapolated
- Requires authorized insurers to file the name and email address of the person who will receive civil remedy notices
- Changes the statute of limitations tolling period for statutory bad faith actions from 65 days after mailing to 60 days after the insurer receives the notice from the DFS
Effective Date: July 1, 2020
- Establishes the Division of Public Assistance Fraud (DPAF) as a criminal justice agency
- Changes the mandatory CE update course from a 5-hour course to a 4-hour course every two years, effective for compliance periods ending January 1, 2022 or later
- Prohibits a person from requiring an insurance agent or agency to provide the replacement cost estimator or other proprietary underwriting information as a condition to extending credit secured by real property
Effective Date: July 1, 2021
- Requires entities licensed by DFS or OIR to respond to document requests from the DFS Division of Consumer Services
- Revises the prohibition against unlicensed activity to include knowingly aiding or abetting an unlicensed person — a third-degree felony
- Authorizes DFS to suspend or revoke the license of an agent that makes a consumer’s personal financial or medical information available to the public
- Prohibits in-person or telephone solicitation with a prospective customer after 9 p.m. or before 8 a.m., unless the customer requests otherwise
- Prohibits the sale of industrial life insurance policies, effective July 1, 2021
- Requires insurance agencies whose name contains the word “Medicare” or “Medicaid” to delete those words from the agency name no later than June 30, 2023
Effective Date: Upon becoming law (06/16/2021, unless otherwise noted)
- Requires all sales telephone calls, text messages, and direct-to-voicemail transmissions to have the receiving consumer’s prior express written consent if the call will be made using an automated machine
- Prohibits telephone sellers from calling consumers outside of the hours between 8 a.m. and 8 p.m. in the consumer’s time zone
- Prohibits contact with consumers on the same subject matter more than three times in a 24-hour period
Effective Date: July 1, 2021
Reduces from 5 years to 3 years the claims history that must be included within a loss run statement. Requires admitted and non-admitted personal lines insurers to provide loss run statements within 15 days of an insured’s request after first providing information on how to obtain a loss run statement from a consumer reporting agency. Excludes admitted and non-admitted life insurers from the requirement.
Effective June 24, 2022
Adopts the NAIC Suitability in Annuity Transactions Model Regulation (2020), broadening the scope of requirements for sales or recommendations of annuities. The bill places a duty on insurers and agents to act in the best interest of consumers, emphasizing care, disclosure, conflict of interest, and recordkeeping. Introduces training requirements for agents involved in annuity sales.
See bill text for effective dates
- Investigations: Expands authority of the Division of Investigative and Forensic Services (DIFS) to initiate investigations when there is reason to believe a violation of Florida or federal criminal law has occurred
- Anti-Fraud Reward Program: Expands the list of insurance fraud violations for which DFS can offer rewards of up to $25,000, and eliminates the requirement for a conviction to award a reward
- Insurer Insolvency: Provides DFS with authority in receivership proceedings to transfer an insolvent insurer’s book of business to a solvent assuming insurer
Codifies FUFIPA into ch. 738, F.S., replacing FUPIA as the law governing the allocation of trust and estate receipts and disbursements. Key provisions: allows for total-return investing under the “modern portfolio theory,” provides for conversion of an existing trust into a unitrust, and provides a governing law provision to reduce jurisdictional disputes.
Effective Date: January 1, 2025
Creates a new section of law authorizing Nonprofit Agricultural Organizations (Farm Bureaus) to establish medical benefit plans that are exempt from state insurance laws, as is permitted in several other states.
Effective Date: July 1, 2025 [Statutes Affected: 624.4032]
Reduces from 30 months to 12 months the timeframe for a health insurer or HMO to submit claims for overpayment to a licensed psychologist, aligning psychologists with the same 12-month look-back period applicable to other health care providers.
Effective Date: July 1, 2025 [Statutes Affected: 627.6131, 641.3155]
Removes the definition of “diligent effort” for surplus lines insurance and removes all existing eligibility criteria for surplus lines exporting, including the diligent effort requirement, layering allowances, and documentation standards. The only provisions retained are updates to the disclosure form required for surplus lines placements — specifically adding that surplus lines insurers’ policy rates and forms are not approved by any Florida regulatory agency.
Effective July 1, 2025
Pertinent Federal Law Review
Each state’s insurance director manages most insurance issues and products at the state level. There are, however, instances in which the state and federal governments work together — for example, Medicaid is a state and federally funded program.
The Federal Insurance Office (FIO) was created by the Dodd-Frank Wall Street Reform and Consumer Protection Act (DFA), which has allowed states the same freedoms as before creation of the FIO. The fall of the economy played a significant role in Title V of the DFA. The FIO’s authorities extend to all lines of insurance except health and LTC insurances (except those lines of insurance included with life or annuity components).
Although the FIO states authority extends to all lines except health, the Affordable Care Act represents substantial federal input into health insurance regulation. The Act runs on a rolling calendar, resulting in yearly changes to applicable rules.
This bill requires the Securities and Exchange Commission (SEC) to create a new form for the registration of index-linked annuities to ensure that a purchaser can make a knowledgeable decision. The bill defines a registered index-linked annuity as an annuity that:
- Is deemed a security that must be registered with the SEC
- Is issued by an insurance company subject to state supervision
- Has returns based on the performance of a specified benchmark index or rate
- May be subject to a market value adjustment if amounts are withdrawn early
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