Florida Bill Proposes Claim File Transparency

A proposed law finally helping Florida policyholders with claims has been proposed. Florida Senate Bill 1726 and House Bill 1287 would require claims documents, which many Florida insurance companies refuse to turn over. Insurers in most parts of the country who are acting in good faith turn these claims documents over all the time. Many Florida insurers do not.

The bills provide:

Section 627.41375, Florida Statutes, is created to read:

627.41375 Access by insureds to claim-related documents.—

(1) As used in this section, the term “claim-related documents” means every writing that relates to the evaluation of damages, including, but not limited to, repair and replacement estimates and bids, appraisals, scopes of loss, drawings, plans, reports, third-party findings on the amount of loss, covered damages, cost of repairs, and all other valuation, measurement, and loss adjustment calculations of the amount of loss, covered damage, and cost of repairs.

(2) Upon receipt of a claim, an insurer shall notify the insured or the party submitting the claim on behalf of the insured that the insured may obtain, upon request, copies of all claim-related documents.

(3) Within 15 calendar days after receiving a request from an insured, the insured’s agent, or the insured’s attorney for claim-related documents, the insurer shall provide the insured with copies of all claim-related documents; however, the insurer may withhold:

(a) Attorney work product documents;

(b) Privileged attorney-client documents;

(c) Documents that indicate fraud by the insured; or

(d) Documents that contain medically privileged information, provided that the insurer identify the documents being withheld.

(4) This section does not:

(a) Affect discovery rights in civil litigation or arbitration; or

(b) Limit the rights of an insured to any writing which the insured is otherwise entitled to receive under the terms of the insurance policy or applicable law.

(5) This section may be enforced by civil action, and the insured that prevails in such action is entitled to recover the insured’s reasonable attorney fees and costs.

Good faith in insurance claims handling mandates that adjusters from insurance companies operate with absolute transparency throughout the claims investigation and evaluation process. This involves openly sharing all relevant information, providing clear and timely communication, and ensuring that policyholders are fully and honestly informed about the progress and outcomes of their claims. Such transparency is essential to maintain trust, uphold ethical standards, and ensure that policyholders receive fair and just treatment in accordance with their policy terms and legal obligations of good faith claims treatment.

A big should out goes to Florida House member Hillary Cassel, who helped draft and promote this bill. It is somewhat similar to the law in California, which I sent to Hillary, suggesting Floridians need similar protection. To her credit, she took the idea and ran with it. If these bills become law, Florida insurers will be required to be much more transparent with their policyholders.

Policyholders should encourage their elected officials and Florida’s Insurance Consumer Advocate to pass this legislation. Every ethical insurance company looking out for their policyholder customers should support it, too.

Thought For The Day  

Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.

—Margaret Mead