No. SB 1240
Filed under Insurance.
Insurance Regulation; Making clarifying changes regarding the definition of residential coverage; prohibiting insurers from imposing or enforcing certain policy conditions or requirements; revising the conditions under which liability insurers may deny coverage based on a particular coverage defense; revising the timeframe in which insurers must pay or deny claims, etc.
Plain English Summary
AI-GENERATEDInsurers must now pay or deny a property insurance claim within 30 days of receiving notice, half the current 60-day window. Missing 90 days entirely creates an uncontestable duty to pay the claim in full, with interest doubled as a penalty.
Insurers can no longer include a policy condition Florida's insurance code does not authorize, unless regulators approved it first. An approved add-on condition must still be clearly disclosed in plain language, with a right to cancel within 10 days at no cost.
When a liability insurer reserves the right to later deny coverage, its notice must now spell out the factual issue, explain in plain language why coverage may be affected, and describe what information is still needed and what happens next.
That reservation-of-rights notice can no longer be used to stall a claim: it may not delay or suspend payment of a covered loss or push back any statutory deadline for paying or denying the claim.
AIAn insurer now has only 30 days after receiving notice of a property insurance claim to pay or deny it, half the current deadline, unless the delay is caused by factors genuinely beyond the insurer's control.
AIIf an insurer still has not paid the full amount owed 90 days after notice of the claim, it has an uncontestable obligation to pay it in full, plus interest, plus an additional equal interest penalty, and the department can enforce that obligation directly.
AIAn insurer's written explanation for paying, denying, or partly denying a claim must now apply the policy to the actual facts of the claim; simply reciting policy language back to the policyholder is not allowed.
AIAn insurer may not put a policy condition or requirement into a contract unless the insurance code itself authorizes it or the Office of Insurance Regulation approved it in advance; an unauthorized, unapproved condition is void and unenforceable.
AIWhen a liability insurer reserves the right to later deny coverage, the notice must now state the factual issue, explain in plain language how it could affect coverage, and describe what more is needed and the expected timeline.
AIOnce an insurer sends a coverage-defense reservation-of-rights notice, it cannot use that notice to delay or suspend payment of a covered loss, or to push back any statutory deadline for paying or denying the claim.
AIIf a policy does contain a condition not in the insurance code but approved by the office, the insurer must disclose it in plain language at issuance and let the insured cancel the policy within 10 days at no cost.