Insurers Must Give Commercial, Residential Property First-Party Claimants Notice of Right to Participate In Florida Mediation Program, Proposed Rules Say
Nov 7, 2013
The Florida Department of Financial Services (“DFS”) Division of Consumer Services advised today, November 7, 2013, that proposed amendments to Rule 69J-166.002, “Mediation of Commercial Residential Property Insurance Claims” and Rule 69J-166.031, “Mediation of Residential Property Insurance Claims,” would update subparagraphs (4)(a)1. of both Rules to conform with changes made by Chapter 2012-151, Laws of Florida, and the opinion of the Third District Court of Appeal in Fernando Subirats v. Fidelity National Property, 106 So. 3d 997 (Fla. 3rd DCA 2013).
To view today’s Notice of Proposed Rule, click here.
If requested by November 28 (21 days of the date of the Notice), a hearing will be scheduled for December 3, 2013 in Tallahassee (Room 142, Larson Building, 200 E. Gaines St.).
The revisions provide that an insurer must give a policyholder notice of his or her right to participate in the appropriate mediation program prescribed by the Rules at the time the policyholder files a first-party claim. The proposed amendments also substitute the word “policyholder” for “insured” in the Rules.
Both Rule 69J-166.002 and 69J-166.031 implement Section 627.7015, F.S. The mediation programs (“programs”) they establish are prompted by what has been determined to be a critical need for effective, fair and timely handling of both commercial residential and residential property claims.
The programs are available to all first-party claimants and insurers prior to commencing the appraisal process set forth in their policies or commencing litigation. They are also available to litigants referred to the DFS from Circuit or County court. For claims that have not previously been mediated under any DFS mediation program, the procedures described in these Rules are available to all commercial residential or residential property claims for property located in the State of Florida. These Rules do not apply to commercial insurance, private passenger motor vehicle insurance, or to liability coverage contained in property insurance policies, nor do they apply to policies issued under the National Flood Insurance Program. Before resorting to these procedures, policyholders and insurers are encouraged to resolve claims as quickly and fairly as possible.
The full texts of the proposed Rules are below
69J-166.002 Mediation of Commercial Residential Property Insurance Claims.
(1) through (3) No change.
(4) Claim Settlement.
(a) Notification of the right to mediate.
1. At the time Within five days of the insurer receiving a first-party claim which falls within the scope of this rule is filed by the policyholder, the insurer shall notify the policyholder insured of their right to participate in this program. An insurer is not required to send a notice of the right to mediate disputed claims when no payment has been made on a claim because the insurer concludes the amount of covered damages is less than the policyholder’s insured’s deductible.
(4)(a)2. through 4. No change.
(4)(b) through (c) No change.
(5) through (12) No change.
Rulemaking Authority 624.308(1), 626.9611, 627.7015(4) FS. Law Implemented 624.307(1), (2), (4), (5), 626.9541(1)(a), (e), (i), (u), 626.9561, 626.9581(1), 626.9641(1)(g), 627.7015 FS. History-New 8-30-09, Amended __________.
69J-166.031 Mediation of Residential Property Insurance Claims.
(1) through (3) No change.
(4) Claim Settlement.
(a) Notification of the right to mediate.
1. At the time Within five days of the insured filing a first-party claim which falls within the scope of this rule is filed by the policyholder, the insurer shall notify the policyholder insured of their right to participate in this program. An insurer is not required to send a notice of the right to mediate claims when no payment has been made for a covered loss because the insurer concludes the amount of covered loss is less than the policyholder’s insured’s deductible.
(4)(a)2. through 4. No change.
(4)(b) through (c) No change.
(5) through (12) No change.
Rulemaking Authority 624.308(1), 626.9611, 627.7015(4) FS. Law Implemented 624.307(1), (2), (4), (5), 626.9541(1)(a), (e), (i), (u), 626.9561, 626.9581(1), 626.9641(1)(g), 627.7015 FS. History-New 8-18-94, Amended 5-1-96, 4-6-00, Formerly 4-166.031, 69B-166.031, Amended 9-24-09,__________.
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