Florida § 627.4108 - Claims-handling manuals; submission; attestation.

§ 627.4108. Claims-handling manuals; submission; attestation.

(1) Each authorized residential property insurer conducting business in this state must create and use a claims-handling manual that provides guidelines and procedures and that complies with the requirements of this code and, at a minimum, comports to usual and customary industry claims-handling practices. Such manual must include guidelines and procedures for: (a) Initially receiving and acknowledging initial receipt of the claim and reviewing and evaluating the claim; (b) Communicating with policyholders, beginning with the receipt of the claim and continuing until closure of the claim; (c) Setting the claim reserve; (d) Investigating the claim, including conducting inspections of the property that is the subject of the claim; (e) Making preliminary estimates and estimates of the covered damages to the insured property and communicating such estimates to the policyholder; (f) The payment, partial payment, or denial of the claim and communicating such claim decision to the policyholder; (g) Closing claims; and (h) Any aspect of the claims-handling process which the office determines should be included in the claims-handling manual in order to: 1. Comply with the laws of this state or rules or orders of the office or department; 2. Ensure that the claims-handling manual, at a minimum, comports with usual and customary industry claims-handling guidelines; or 3. Protect policyholders of the insurer or the general public. (2) At any time, the office may request that a residential property insurer submit a physical or electronic copy of the insurer’s currently applicable, or otherwise specifically requested, claims-handling manuals. Upon receiving such a request, a residential property insurer must submit to the office within 5 business days: (a) A true and correct copy of each claims-handling manual requested; and (b) An attestation, on a form prescribed by the commission, that certifies: 1. That the insurer has provided a true and correct copy of each currently applicable, or otherwise specifically requested, claims-handling manual; and 2. The timeframe for which each submitted claims-handling manual was or is in effect. (3)(a) Annually, each authorized residential property insurer must certify and attest, on a form prescribed by the commission, that: 1. Each of the insurer’s current claims-handling manuals complies with the requirements of this code and comports to, at a minimum, usual and customary industry claims-handling practices; and 2. The insurer maintains adequate resources available to implement the requirements of each of its claims-handling manuals at all times, including during natural disasters and catastrophic events. (b) Such attestation must be submitted to the office: 1. On or before August 1, 2023; and 2. Annually thereafter, on or before May 1 of each calendar year. (4) The commission is authorized, and all conditions are deemed met, to adopt emergency rules under s. 120.54(4), for the purpose of implementing this section. Notwithstanding any other law, emergency rules adopted under this section are effective for 6 months after adoption and may be renewed during the pendency of procedures to adopt permanent rules addressing the subject of the emergency rules.