THE BILL ITSELF
HB 459
Property Insurance Claims
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A bill to be entitled
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An act relating to property insurance claims; amending
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s. 627.7015, F.S.; establishing a mandatory procedure
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for resolution of disputed property insurance claims;
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deleting obsolete provisions; revising legislative
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intent and purpose; requiring certain entities to
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administer a specified law in a certain manner;
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requiring insurers, at specified times, to notify
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policyholders of the mandatory procedure; requiring
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the Department of Financial Services to prepare a
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consumer information pamphlet to be provided to
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policyholders at specified times; authorizing a
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policyholder or an insurer to file a petition with the
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Division of Administrative Hearings to resolve certain
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claims; specifying requirements for the filing and
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service of such petition; requiring the department to
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inform policyholders of the location of the Division
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of Administrative Hearings and the division's website
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address; specifying that the parties to the claim must
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bear the cost of certain conferences; requiring an
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administrative law judge to review the petition upon
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receiving it; requiring the administrative law judge
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to dismiss petitions that do not contain specified
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information; requiring that the petition include a
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certain certification; specifying that dismissal of a
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petition or a portion of a petition is without
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prejudice and does not require a hearing; specifying
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that motions to dismiss must be handled in a specified
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manner; requiring the insurer to pay the requested
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claim or file a response to the petition within a
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specified timeframe; specifying filing and content
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requirements for the insurer's response to the
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petition; requiring the administrative law judge to
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conduct proceedings in a specified manner; providing
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an exception; requiring the administrative law judge
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to make a final determination of total coverage amount
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within a specified timeframe; requiring such amount to
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be paid in a specified manner; revising the definition
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of the term "claim"; repealing ss. 627.70151,
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627.70152, 627.70153, and 627.70154, F.S., relating to
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appraisal clauses in property insurance contracts,
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suits arising under a property insurance policy,
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consolidation of residential property insurance
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actions, and mandatory binding arbitration of property
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insurance policies, respectively; amending ss.
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627.351, 627.70131, and 627.7074, F.S.; conforming
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provisions to changes made by the act; providing an
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effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Section 627.7015, Florida Statutes, is amended
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to read:
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627.7015 Mandatory Alternative procedure for resolution of
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disputed property insurance claims.—
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(1) This section sets forth a nonadversarial alternative
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dispute resolution procedure for an a mediated claim resolution
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conference prompted by the need for effective, fair, and timely
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resolution handling of disputed property insurance claims. There
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is a particular need for a mandatory an informal, nonthreatening
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forum, available at the election of either party, for helping
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parties who elect this procedure to resolve their claims
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disputes regarding because most homeowner and commercial
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residential insurance policies obligate policyholders to
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participate in a potentially expensive and time-consuming
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adversarial appraisal process before litigation. The procedure
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set forth in this section is designed to bring the parties
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together to ensure the efficient delivery of the coverage
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offered under the policy, helping to restore an owner's property
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and livelihood to normalcy after a disaster or loss while
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maintaining reasonable costs to the insurer for a mediated
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claims settlement conference without any of the trappings or
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drawbacks of an adversarial process. Before participating in
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resorting to these procedures, policyholders and insurers are
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encouraged to resolve claims as quickly and fairly as possible.
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The department, the office, and the Division of Administrative
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Hearings shall administer this section in a manner that
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facilitates the self-execution of the system and the process of
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ensuring a prompt and cost-effective delivery of payments to
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insureds This section is available with respect to claims under
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personal lines and commercial residential policies before
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commencing the appraisal process , or before commencing
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litigation. Mediation may be requested only by the policyholder,
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as a first-party claimant, a third-party, as an assignee of the
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policy benefits, or the insurer. However, an insurer is not
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required to participate in any mediation requested by a third-
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party assignee of the policy benefits. If requested by the
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policyholder, Participation by legal counsel is permitted but is
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not required. Expert testimony may be used in the procedure,
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regardless of whether legal counsel is participating. Mediation
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under this section is also available to litigants referred to
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the department by a county court or circuit court. This section
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does not apply to commercial coverages, to private passenger
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motor vehicle insurance coverages, or to disputes relating to
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liability coverages in policies of property insurance.
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(2) At the time of issuance and renewal of a policy or at
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the time a first-party claim within the scope of this section is
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filed by the policyholder, the insurer shall notify the
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policyholder of the mandatory procedure its right to participate
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in the mediation program under this section. A claim becomes
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eligible for mediation after the insurer complies with s.
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627.70131(7) or elects to reinspect pursuant to s.
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627.70152(4)(a)3. If the insurer has not complied with s.
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627.70131(7) or elected to reinspect pursuant to s.
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627.70152(4)(a)3. within 90 days after notice of the loss, the
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insurer may not require mediation under this section. This
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subsection does not impair the right of an insurance company to
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request mediation after a determination of coverage pursuant to
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this section or require appraisal or another method of
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alternative dispute resolution pursuant to s. 627.70152(4)(b).
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The department shall prepare a consumer information pamphlet for
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distribution to be provided to policyholders at the time of
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issuance and renewal of the policy and upon the Governor's
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declaration of a state of emergency within the policyholder's
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county persons participating in mediation.
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(3) A policyholder or an insurer may, for any claim that
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is ripe, due, and owing, file a petition with the Division of
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Administrative Hearings to resolve claims which meets the
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requirements of this section. A party represented by an attorney
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shall file by electronic means. A party not represented by an
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attorney may file by certified mail or by electronic means. The
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department shall inform policyholders of the location of the
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Division of Administrative Hearings and the division's website
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address for purposes of filing a petition for resolving a claim.
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The policyholder shall also serve, by certified mail or
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electronic means, copies of the petition to resolve claims on
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the insurer. The costs of the procedure mediation must be
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reasonable, and the parties insurer must bear all of the cost of
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conducting mediation conferences, except as otherwise provided
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in this section. If a policyholder fails to appear at the
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conference, the conference must be rescheduled upon the
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policyholder's payment of the costs of a rescheduled conference.
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If the insurer fails to appear at the conference, the insurer
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must pay the policyholder's actual cash expenses incurred in
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attending the conference if the insurer's failure to attend was
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not due to a good cause acceptable to the department. An insurer
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will be deemed to have failed to appear if the insurer's
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representative lacks authority to settle the full value of the
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claim. The insurer shall incur an additional fee for a
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rescheduled conference necessitated by the insurer's failure to
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appear at a scheduled conference. The fees assessed by the
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department must include a charge necessary to defray the
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expenses of the department related to its duties under this
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section and must be deposited in the Insurance Regulatory Trust
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Fund. The department may suspend the insurer's authority to
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appoint licensees if the insurer does not timely pay the
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required fees.
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(4) Upon receipt of the petition, an administrative law
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judge shall review it and shall dismiss any petition or any
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portion of such petition which does not on its face specifically
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identify or itemize all of the following information:
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(a) The policyholder's name, address, telephone number,
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and social security number.
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(b) The insurer's name, address, and telephone number.
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(c) A detailed description of the loss or damage for which
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the claim has been filed, including the date it occurred.
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(d) The alleged acts or omissions of the insurer giving
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rise to the dispute, including, if applicable, a denial of
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coverage.
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(e) An estimate of damages, if known, and the amount that
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is disputed by the insurer.
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(f) A specific explanation of any other disputed issue
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that the administrative law judge will be called to rule upon
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The department shall adopt by rule a property insurance
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mediation program to be administered by the department or its
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designee. The department may also adopt special rules which are
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applicable in cases of an emergency within the state. The rules
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shall be modeled after practices and procedures set forth in
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mediation rules of procedure adopted by the Supreme Court. The
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rules shall provide for:
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(a) Reasonable requirement for processing and scheduling
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of requests for mediation.
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(b) Qualifications , denial of application, suspension ,
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revocation of approval, and other penalties for mediators as
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provided in s. 627.745 and the Florida Rules for Certified and
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Court-Appointed Mediators.
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(c) Provisions governing who may attend mediation
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conferences.
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(d) Selection of mediators.
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(e) Criteria for the conduct of mediation conferences.
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(f) Right to legal counsel.
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(5) The petition must include a certification by the
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policyholder or, if the policyholder is represented by counsel,
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the policyholder's attorney stating that the policyholder or
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attorney, as applicable, has made a good faith effort to resolve
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the dispute with the insurer and that the policyholder or
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attorney was unable to resolve the dispute with the insurer All
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statements made and documents produced at a mediation conference
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shall be deemed to be settlement negotiations in anticipation of
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litigation within the scope of s. 90.408. All parties to the
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mediation must negotiate in good faith and must have the
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authority to immediately settle the claim. Mediators are deemed
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to be agents of the department and shall have the immunity from
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suit provided in s. 44.107.
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(6)(a) The dismissal of any petition or portion of such a
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petition under this section is without prejudice and does not
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require a hearing Mediation is nonbinding; however, if a written
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settlement is reached, the policyholder has 3 business days
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within which the policyholder may rescind the settlement unless
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the policyholder has cashed or deposited any check or draft
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disbursed to the policyholder for the disputed matters as a
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result of the conference. If a settlement agreement is reached
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and is not rescinded, it is binding and acts as a release of all
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specific claims that were presented in that mediation
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conference.
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(b) At the conclusion of the mediation, the mediator shall
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provide a written report of the results of mediation, including
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any settlement amount, to the insurer, the policyholder, and the
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policyholder's representative if the policyholder is represented
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at the mediation.
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(7) All motions to dismiss must be handled as specified in
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s. 440.192(5) If the insurer fails to comply with subsection (2)
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by failing to notify a policyholder of its right to participate
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in the mediation program under this section or if the insurer
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requests the mediation, and the mediation results are rejected
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by either party, the policyholder is not required to submit to
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or participate in any contractual loss appraisal process of the
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property loss damage as a precondition to legal action for
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breach of contract against the insurer for its failure to pay
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the policyholder's claims covered by the policy.
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(8) Within 14 days after receipt of the petition, the
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insurer shall pay the requested claim or file a response to the
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petition with the Division of Administrative Hearings. If the
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insurer files a response to the petition, the response must be
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filed by electronic means. Such response must specify all claims
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requested but not paid and explain the insurer's reason for
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nonpayment. The insurer shall provide copies of the response to
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the policyholder by certified mail or by electronic means. In
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ruling on the petition and response to the petition, the
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administrative law judge shall conduct proceedings in a manner
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consistent with the process outlined in s. 440.25, except that
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the administrative law judge shall make a determination within
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60 days after the filing of the policyholder's petition. After
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determining coverage, the administrative law judge shall make a
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final determination of the total coverage amount within 180 days
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after the filing of the petition, which must be paid to the
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policyholder or held in escrow on the policyholder's behalf
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until exhausted for covered claims The department may designate
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an entity or person to serve as administrator to carry out any
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of the provisions of this section and may take this action by
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means of a written contract or agreement.
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(9) For purposes of this section, the term "claim" refers
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to any dispute between an insurer and a policyholder relating to
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a material issue of fact other than a dispute:
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(a) With respect to which the insurer has a reasonable
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basis to suspect fraud;
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(b) When the insurer has determined, based on agreed-upon
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facts as to the cause of loss, there is no coverage under the
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policy;
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(c) With respect to which the insurer has a reasonable
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basis to believe that the policyholder has intentionally made a
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material misrepresentation of fact which is relevant to the
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claim, and the entire request for payment of a loss has been
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denied on the basis of the material misrepresentation;
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(d) With respect to which the amount in controversy is
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less than $500, unless the parties agree to mediate a dispute
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involving a lesser amount; or
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(e) With respect to a loss that does not comply with s.
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627.70132.
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Section 2. Section 627.70151, Florida Statutes, is
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repealed.
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Section 3. Section 627.70152, Florida Statutes, is
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repealed.
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Section 4. Section 627.70153, Florida Statutes, is
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repealed.
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Section 5. Section 627.70154, Florida Statutes, is
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repealed.
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Section 6. Paragraph (ll) of subsection (6) of section
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627.351, Florida Statutes, is amended to read:
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627.351 Insurance risk apportionment plans.—
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(6) CITIZENS PROPERTY INSURANCE CORPORATION.—
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(ll)1. In addition to any other method of alternative
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dispute resolution authorized by state law, the corporation may
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adopt policy forms that provide for the resolution of disputes
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regarding its claim determinations, including disputes regarding
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coverage for, or the scope and value of, a claim, in a
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proceeding before the Division of Administrative Hearings. Any
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such policies are not subject to s. 627.70154. All proceedings
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in the Division of Administrative Hearings pursuant to such
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policies are subject to ss. 57.105 and 768.79 as if filed in the
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courts of this state and are not considered chapter 120
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administrative proceedings. Rule 1.442, Florida Rules of Civil
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Procedure, applies to any offer served pursuant to s. 768.79,
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except that, notwithstanding any provision in Rule 1.442,
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Florida Rules of Civil Procedure, to the contrary, an offer
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shall not be served earlier than 10 days after filing the
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request for hearing with the Division of Administrative Hearings
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and shall not be served later than 10 days before the date set
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for the final hearing. The administrative law judge in such
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proceedings shall award attorney fees and other relief pursuant
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to ss. 57.105 and 768.79. The corporation may not seek, and the
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office may not approve, a maximum hourly rate for attorney fees.
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2. The corporation may contract with the division to
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conduct proceedings to resolve disputes regarding its claim
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determinations as may be provided for in the applicable policies
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of insurance. This subparagraph expires July 1, 2026.
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Section 7. Paragraph (a) of subsection (8) of section
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627.70131, Florida Statutes, is amended to read:
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627.70131 Insurer's duty to acknowledge communications
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regarding claims; investigation.—
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(8) The requirements of this section are tolled:
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(a) During the pendency of any proceedings mediation
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proceeding under s. 627.7015 or any alternative dispute
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resolution proceeding provided for in the insurance contract.
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The tolling period ends upon the end of the proceedings
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mediation or alternative dispute resolution proceeding.
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Section 8. Subsection (3) of section 627.7074, Florida
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Statutes, is amended to read:
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627.7074 Alternative procedure for resolution of disputed
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sinkhole insurance claims.—
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(3) If there is coverage available under the policy and
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the claim was submitted within the timeframe provided in s.
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627.706(5), following the receipt of the report provided under
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s. 627.7073 or the denial of a claim for a sinkhole loss, the
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insurer shall notify the policyholder of his or her right to
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participate in the neutral evaluation program under this
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section. Neutral evaluation supersedes the alternative dispute
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resolution process under s. 627.7015 but does not invalidate the
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appraisal clause of the insurance policy. The insurer shall
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provide to the policyholder the consumer information pamphlet
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prepared by the department pursuant to subsection (1)
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electronically or by United States mail.
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Section 9. This act shall take effect July 1, 2026.