Florida Senate - 2023 SB 1662 By Senator Grall 29-01239B-23 20231662__ Page 1 of 5 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1

An act relating to insurance claims; providing a short 2 title; amending s. 627.0651, F.S.; requiring the 3 Office of Insurance Regulation to consider the 4 recovery of funds under specified provisions in 5 reviewing rates; amending s. 817.234, F.S.; requiring 6 insurers to report the recovery of funds under 7 specified provisions; specifying that an insured’s 8 payment of a deductible or copayment is not a 9 condition of an insurer’s payment obligations; 10 providing an effective date. 11 12 Be It Enacted by the Legislature of the State of Florida: 13 14

Section 1. This act may be cited as the “Transparency in 15 Recoveries Act.” 16

Section 2. Paragraphs (

g) through (

l) of subsection (2) of 17

section 627.0651, Florida Statutes, are redesignated as 18 paragraphs (

h) through (m), respectively, a new paragraph (

g) is 19 added to that subsection, and paragraphs (

d) and (

e) of 20 subsection (14) of that

section are amended, to read: 21 627.0651 Making and use of rates for motor vehicle 22 insurance.— 23

(2) Upon receiving notice of a rate filing or rate change, 24 the office shall review the rate or rate change to determine if 25 the rate is excessive, inadequate, or unfairly discriminatory. 26 In making that determination, the office shall in accordance 27 with generally accepted and reasonable actuarial techniques 28 consider the following factors: 29

Florida Senate - 2023 SB 1662 29-01239B-23 20231662__ Page 2 of 5 CODING: Words stricken are deletions; words underlined are additions. (

g) Recovery of funds by judgment or settlement and 30 attorney fees and costs awarded or returned for payments 31 recovered as a result of claimed violations of s. 456.054,

part 32 X of

chapter 440,

part II of

chapter 501, s. 627.732, s. 33 627.736(17), s. 817.234, or s. 817.505 or repayment of claims 34 paid for pursuant to actions or allegations of common law fraud, 35 civil conspiracy, unjust enrichment, or unlawful conduct. 36 (14) 37 (

d) An insurer must notify the office of any changes to 38 rates for type of insurance described in this subsection no 39 later than 30 days after the effective date of the change. The 40 notice shall include the name of the insurer, the type or kind 41 of insurance subject to rate change, and the average statewide 42 percentage change in rates. Actuarial data with regard to rates 43 for risks described in this subsection shall be maintained by 44 the insurer for 2 years after the effective date of changes to 45 those rates and are subject to examination by the office.

The 46 office may require the insurer to incur the costs associated 47 with an examination. Upon examination, the office shall, in 48 accordance with generally accepted and reasonable actuarial 49 techniques, consider the factors in paragraphs (2)(a)-(m) 50 (2)(a)-(

l) and apply subsections (3)-(8) to determine if the 51 rate is excessive, inadequate, or unfairly discriminatory. 52 (

e) A rating organization must notify the office of any 53 changes to loss cost for the type of insurance described in this 54 subsection no later than 30 days after the effective date of the 55 change. The notice shall include the name of the rating 56 organization, the type or kind of insurance subject to a loss 57 cost change, loss costs during the immediately preceding year 58

Florida Senate - 2023 SB 1662 29-01239B-23 20231662__ Page 3 of 5 CODING: Words stricken are deletions; words underlined are additions. for the type or kind of insurance subject to the loss cost 59 change, and the average statewide percentage change in loss 60 cost. Actuarial data with regard to changes to loss cost for 61 risks not subject to subsection (1), subsection (2), or 62 subsection (9) shall be maintained by the rating organization 63 for 2 years after the effective date of the change and are 64 subject to examination by the office.

The office may require the 65 rating organization to incur the costs associated with an 66 examination. Upon examination, the office shall, in accordance 67 with generally accepted and reasonable actuarial techniques, 68 consider the rate factors in paragraphs (2)(a)-(m) (2)(a)-(l) 69 and apply subsections (3)-(8) to determine if the rate is 70 excessive, inadequate, or unfairly discriminatory. 71

Section 3. Paragraph (

c) is added to subsection (5) of 72

section 817.234, Florida Statutes, and subsection (7) of that 73

section is amended, to read: 74 817.234 False and fraudulent insurance claims.— 75 (5) 76 (

c) If an insurer damaged as a result of a violation of any 77 provision of this

section or s. 456.054,

part X of

chapter 440, 78

part II of

chapter 501, s. 627.732, s. 627.736(17), s. 817.234, 79 or s. 817.505 and the insurer obtains repayment or a refund of 80 claims paid pursuant to s. 627.736, the insurer shall report to 81 the department the amount of funds received as a result of a 82 claim, settlement, or judgment, inclusive of attorney fees and 83 costs, of such repayment of funds. 84 (7)(

a) It shall constitute a material omission and 85 insurance fraud, punishable as provided in subsection (11), for 86 any service provider, other than a hospital, to engage in a 87

Florida Senate - 2023 SB 1662 29-01239B-23 20231662__ Page 4 of 5 CODING: Words stricken are deletions; words underlined are additions. general business practice of billing amounts as its usual and 88 customary charge, if such provider has agreed with the insured 89 or intends to waive deductibles or copayments, or does not for 90 any other reason intend to collect the total amount of such 91 charge.

With respect to a determination as to whether a service 92 provider has engaged in such general business practice, 93 consideration shall be given to evidence of whether the 94 physician or other provider made a good faith attempt to collect 95 such deductible or copayment. This paragraph does not apply to 96 physicians or other providers who defer collection of waive 97 deductibles or copayments or reduce their bills as part of a 98 bodily injury settlement or verdict. Payment by an insured of a 99 deductible or copayment is not a condition of an insurer’s 100 payment obligations. 101 (

b) The provisions of this

section shall also apply as to 102 any insurer or adjusting firm or its agents or representatives 103 who, with intent, injure, defraud, or deceive any claimant with 104 regard to any claim. The claimant shall have the right to 105 recover the damages provided in this section. 106 (

c) An insurer, or any person acting at the direction of or 107 on behalf of an insurer, may not change an opinion in a mental 108 or physical report prepared under s. 627.736(7) or direct the 109 physician preparing the report to change such opinion; however, 110 this paragraph provision does not preclude the insurer from 111 calling to the attention of the physician errors of fact in the 112 report based upon information in the claim file. Any person who 113 violates this paragraph commits a felony of the third degree, 114 punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 115 (

d) A contractor, or a person acting on behalf of a 116

Florida Senate - 2023 SB 1662 29-01239B-23 20231662__ Page 5 of 5 CODING: Words stricken are deletions; words underlined are additions. contractor, may not knowingly or willfully and with intent to 117 injure, defraud, or deceive, pay, waive, or rebate all or

part 118 of an insurance deductible applicable to payment to the 119 contractor, or a person acting on behalf of a contractor, for 120 repairs to property covered by a property insurance policy. A 121 person who violates this paragraph commits a third degree felony 122 of the third degree, punishable as provided in s. 775.082, s. 123 775.083, or s. 775.084. 124

Section 4. This act shall take effect July 1, 2023. 125