Senate Bill 1428 (2025) — Consumer protection in insurance matters
SB 1428
Florida Bills
Florida Senate - 2025 SB 1428 By Senator DiCeglie 18-01081A-25 20251428__ Page 1 of 11 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1
An act relating to consumer protection in insurance 2 matters; amending s. 626.854, F.S.; requiring public 3 adjusters, public adjuster apprentices, and public 4 adjusting firms to provide a specified response within 5 a specified timeframe after receiving a request for 6 claim status from a claimant, an insured, or a 7 designated representative; requiring such adjusters, 8 apprentices, and firms to retain a copy of such 9 response; creating s. 627.4815, F.S.; defining terms; 10 requiring that universal life insurance policies 11 include a provision requiring a certain annual report; 12 specifying requirements for the annual report; 13 providing applicability; amending s. 627.6515, F.S.; 14 revising applicability relating to group health 15 insurance policies; creating s. 627.7293, F.S.; 16 requiring certain automobile insurers, under certain 17 circumstances, to provide a specified statement in a 18 certain manner; requiring the automobile insurer to 19 obtain express consent before submitting specified 20 claims; providing applicability; creating s. 627.7431, 21 F.S.; defining terms; requiring insurers to pay or 22 deny certain claims within a specified timeframe; 23 providing an exception; requiring insurers to provide 24 certain explanations to policyholders under certain 25 circumstances; specifying that certain payments bear 26 specified interest; specifying when the interest 27 begins to accrue; providing construction; requiring 28 the insured to select the manner of receiving 29
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 2 of 11 CODING: Words stricken are deletions; words underlined are additions. prejudgment interest under certain circumstances; 30 specifying that the failure to comply with certain 31 provisions does not form the basis of a private cause 32 of action; providing applicability; specifying that 33 certain requirements are tolled under certain 34 circumstances; providing an effective date. 35 36 Be It Enacted by the Legislature of the State of Florida: 37 38
Section 1. Subsection (24) is added to
section 626.854, 39 Florida Statutes, to read: 40 626.854 “Public adjuster” defined; prohibitions.—The 41 Legislature finds that it is necessary for the protection of the 42 public to regulate public insurance adjusters and to prevent the 43 unauthorized practice of law. 44
(24) A public adjuster, public adjuster apprentice, or 45 public adjusting firm must provide a specific response to a 46 written or electronic request for claim status from a claimant, 47 an insured, or the person’s designated representative within 14 48 days after receiving the request. The public adjuster, public 49 adjuster apprentice, or public adjusting firm must retain a copy 50 of its response for its records. 51
Section
Section 627.4815, Florida Statutes, is created 52 to read: 53 627.4815 Universal life policies.— 54
(1) As used in this section, the term: 55 (a) “Cash surrender value” means the net cash surrender 56 value plus any amounts outstanding as policy loans. 57 (b) “Fixed premium universal life insurance policy” means a 58
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 3 of 11 CODING: Words stricken are deletions; words underlined are additions. universal life insurance policy other than a flexible premium 59 universal life insurance policy. 60 (c) “Flexible premium universal life insurance policy” 61 means a universal life insurance policy that permits the 62 policyowner to vary, independently of each other, the amount or 63 timing of one or more premium payments or the amount of 64 insurance. 65 (d) “Net cash surrender value” means the maximum amount 66 payable to the policyowner upon surrender. 67 (e) “Policy value” means the value of any individual life 68 insurance policy, rider, group master policy, or individual 69 certificate.
The term includes separately identified interest 70 credits, except those related to dividend accumulations, premium 71 deposit funds, or other supplementary accounts, and mortality 72 and expense charges. 73 (f) “Universal life insurance policy” means any individual 74 life insurance policy, rider, group master policy, or individual 75 certificate that includes separately identified interest credits 76 and mortality and expense charges. A universal life insurance 77 policy may also include other types of credits and charges.
The 78 term does not apply to policies, riders, group master policies, 79 or individual certificates in connection with dividend 80 accumulations, premium deposit funds, or other supplementary 81 accounts. 82
(2) A universal life insurance policy issued in this state 83 must include a provision requiring the policyowner to receive, 84 at no cost, an annual report on the policy’s status. The report 85 must be sent within 3 months after the end of the reporting 86 period. The report must include all of the following: 87
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 4 of 11 CODING: Words stricken are deletions; words underlined are additions. (
a) The beginning and end of the current reporting period. 88 (
b) The policy value at the end of the previous reporting 89 period and at the end of the current reporting period. 90 (
c) The total amounts that have been credited or debited to 91 the policy value during the current reporting period, identified 92 by type. 93 (
d) The current death benefit at the end of the current 94 reporting period on each life covered by the policy. 95 (
e) The net cash surrender value of the policy as of the 96 end of the current reporting period. 97 (
f) The amount of outstanding loans, if any, as of the end 98 of the current reporting period. 99 (
g) For fixed premium policies, if, assuming guaranteed 100 interest, mortality and expense loads, and continued scheduled 101 premium payment, the policy’s net cash surrender value is such 102 that it would not maintain insurance in force until the end of 103 the next reporting period, a notice to that effect. 104 (
h) For flexible premium policies, if, assuming guaranteed 105 interest and mortality and expense loads, the policy’s net cash 106 surrender value will not maintain insurance in force until the 107 end of the next reporting period unless further premium payments 108 are made, a notice to that effect. 109 (
i) For fixed premium or flexible premium policies, if, 110 assuming guaranteed interest and mortality and expense loads, 111 the policy’s net cash surrender value will not maintain 112 insurance in force until maturity of the contract, the projected 113 date on which policy values will be insufficient to continue 114 coverage in force. 115
(3) This
section applies to all universal life insurance 116
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 5 of 11 CODING: Words stricken are deletions; words underlined are additions. policies except variable contracts as defined in s. 627.8015. 117
Section 3. Subsection (2) of
section 627.6515, Florida 118 Statutes, is amended to read: 119 627.6515 Out-of-state groups.— 120
(2) Except as otherwise provided in this part, this
part 121 does not apply to a group health insurance policy issued or 122 delivered outside this state under which a resident of this 123 state is provided coverage if: 124 (
a) The policy is issued to an employee group the 125 composition of which is substantially as described in s. 126 627.653; a labor union group or association group the 127 composition of which is substantially as described in s. 128 627.654; an additional group the composition of which is 129 substantially as described in s. 627.656; a group insured under 130 a blanket health policy when the composition of the group is 131 substantially in compliance with s. 627.659; a group insured 132 under a franchise health policy when the composition of the 133 group is substantially in compliance with s. 627.663; an 134 association group to cover persons associated in any other 135 common group, which common group is formed primarily for 136 purposes other than providing insurance; a group that is 137 established primarily for the purpose of providing group 138 insurance, provided the benefits are reasonable in relation to 139 the premiums charged thereunder and the issuance of the group 140 policy has resulted, or will result, in economies of 141 administration; or a group of insurance agents of an insurer, 142 which insurer is the policyholder; 143 (
b) Certificates evidencing coverage under the policy are 144 issued to residents of this state and contain in contrasting 145
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 6 of 11 CODING: Words stricken are deletions; words underlined are additions. color and not less than 10-point type the following statement: 146 “The benefits of the policy providing your coverage are governed 147 primarily by the law of a state other than Florida”; and 148 (
c) The policy provides the benefits specified in ss. 149 627.419, 627.6562, 627.6574, 627.6575, 627.6579, 627.6612, 150 627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and 151 627.66911, and complies with the requirements of s. 627.66996. 152 (
d) Applications for certificates of coverage offered to 153 residents of this state must contain, in contrasting color and 154 not less than 12-point type, the following statement on the same 155 page as the applicant’s signature: 156 157 “This policy is primarily governed by the laws of 158 ...(insert state where the master policy is filed).... 159 As a result, all of the rating laws applicable to 160 policies filed in this state do not apply to this 161 coverage, which may result in increases in your 162 premium at renewal that would not be permissible under 163 a Florida-approved policy.
Any purchase of individual 164 health insurance should be considered carefully, as 165 future medical conditions may make it impossible to 166 qualify for another individual health policy. For 167 information concerning individual health coverage 168 under a Florida-approved policy, consult your agent or 169 the Florida Department of Financial Services.” 170 171 This paragraph applies only to group certificates providing 172 health insurance coverage which require individualized 173 underwriting to determine coverage eligibility for an individual 174
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 7 of 11 CODING: Words stricken are deletions; words underlined are additions. or premium rates to be charged to an individual except for the 175 following: 176 1. Policies issued to provide coverage to groups of persons 177 all of whom are in the same or functionally related licensed 178 professions, and providing coverage only to such licensed 179 professionals, their employees, or their dependents; 180 2. Policies providing coverage to small employers as 181 defined by s. 627.6699.
Such policies shall be subject to, and 182 governed by, the provisions of s. 627.6699; 183 3. Policies issued to a bona fide association, as defined 184 by s. 627.6571(5), provided that there is a person or board 185 acting as a fiduciary for the benefit of the members, and such 186 association is not owned, controlled by, or otherwise associated 187 with the insurance company; or 188 4.
Any accidental death, accidental death and 189 dismemberment, accident-only, vision-only, dental-only, hospital 190 indemnity-only, hospital accident-only, cancer, specified 191 disease, Medicare supplement, products that supplement Medicare, 192 long-term care, or disability income insurance, or similar 193 supplemental plans provided under a separate policy, 194 certificate, or contract of insurance, which cannot duplicate 195 coverage under an underlying health plan, coinsurance, or 196 deductibles or coverage issued as a supplement to workers’ 197 compensation or similar insurance, or automobile medical-payment 198 insurance. 199
Section
Section 627.7293, Florida Statutes, is created 200 to read: 201 627.7293 Towing and labor coverage requirements.— 202
(1) An automobile insurer that provides towing and labor 203
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 8 of 11 CODING: Words stricken are deletions; words underlined are additions. coverage as a filed claim shall provide the following language 204 or substantially similar language on any web or electronic 205 platform through which a towing or labor claim is made or 206 verbally stated to the claimant if the claim is being made over 207 the phone: 208 209 Your auto insurance policy provides coverage for 210 towing and labor. Use of this coverage requires a 211 filing of a claim.
Such claim filing will remain in 212 your claims’ history for use of future underwriting of 213 any initial or renewal offer made by this insurer or 214 any other insurer. 215 216
(2) The automobile insurer shall obtain the claimant’s 217 express consent before submitting a claim filed under the towing 218 and labor coverage. 219
(3) This disclosure requirement provided under subsection 220 (1) does not apply if the towing and labor claim is filed as 221 part of a crash-related damage claim. 222
Section
Section 627.7431, Florida Statutes, is created 223 to read: 224 627.7431 Payment of first-party claim.— 225
(1) For purposes of this section, the term: 226 (a) “Claim” means any first-party claim under an insurance 227 policy providing coverage for a private passenger motor vehicle 228 as defined in s. 627.732. 229 (b) “Factors beyond the control of the insurer” means: 230 1. Any of the following events that is the basis for the 231 office issuing an order finding that such event renders all or 232
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 9 of 11 CODING: Words stricken are deletions; words underlined are additions. specified motor vehicle insurers reasonably unable to meet the 233 requirements of this
section in specified locations and ordering 234 that such insurer or insurers may have additional time, not 235 exceeding 30 days, as specified by the office, to comply with 236 the requirements of this section: a state of emergency declared 237 by the Governor under s. 252.36, a breach of security that must 238 be reported under s. 501.171(3), or an information technology 239 issue. 240 2.
Actions by the policyholder or the policyholder’s 241 representative which constitute fraud, lack of cooperation, or 242 intentional misrepresentation regarding the claim for which 243 benefits are owed, when such actions reasonably prevent the 244 insurer from complying with any requirement of this section. 245 3. Actions by any repair company which constitute fraud, 246 lack of cooperation, or intentional misrepresentation regarding 247 the claim for which benefits are owed, when such actions 248 reasonably prevent the insurer from complying with any 249 requirement of this section. 250 4.
Inaccessibility to or delay in the arrival of parts 251 necessary for the repair of the vehicle. 252
(2) Within 60 days after an insurer receives notice of an 253 initial, reopened, or supplemental first-party physical damage 254 insurance claim from a policyholder, the insurer shall pay or 255 deny such claim or a portion of the claim unless the failure to 256 pay is caused by factors beyond the control of the insurer. The 257 insurer shall provide a reasonable explanation in writing to the 258 policyholder of the basis in the insurance policy, in relation 259 to the facts or applicable law, for the payment, denial, or 260 partial denial of a claim. If the insurer’s claim payment is 261
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 10 of 11 CODING: Words stricken are deletions; words underlined are additions. less than that specified in any insurer’s detailed estimate of 262 the amount of the loss, the insurer must provide a reasonable 263 explanation in writing of the difference to the policyholder. 264 Any payment of an initial or supplemental claim or portion of 265 such claim made 60 days after the insurer receives notice of the 266 claim, or made after the expiration of any additional timeframe 267 provided to pay or deny a claim or a portion of a claim made 268 pursuant to an order of the office finding factors beyond the 269 control of the insurer, whichever is later, bears interest at 270 the rate set forth in s. 55.03.
Interest begins to accrue from 271 the date the insurer receives notice of the claim. This 272 subsection may not be waived, voided, or nullified by the terms 273 of the insurance policy. If there is a right to prejudgment 274 interest, the insured must select whether to receive prejudgment 275 interest or interest under this subsection. Interest is payable 276 when the claim or portion of the claim is paid. Failure to 277 comply with this subsection constitutes a violation of this 278 code. However, failure to comply with this subsection does not 279 form the sole basis for a private cause of action. 280
(3) This
section applies to surplus lines insurers and 281 surplus lines insurance authorized under ss. 626.913-626.937 282 providing personal automobile coverage. 283
(4) This
section does not apply to any of the following 284 claims: 285 (
a) Any claims covered under an insurance policy providing 286 coverage for commercial motor vehicles as defined in s. 627.732. 287 (
b) Any portion of a claim covered under an insurance 288 policy covering private passenger motor vehicles if the portion 289 of the claim is based on coverage for: 290
Florida Senate - 2025 SB 1428 18-01081A-25 20251428__ Page 11 of 11 CODING: Words stricken are deletions; words underlined are additions. 1. Personal injury protection; 291 2. Property damage liability; 292 3. Bodily injury; 293 4. Uninsured motorists or underinsured motorists; or 294 5. Medical payments. 295
(5) The requirements of this
section are tolled: 296 (
a) During the pendency of any mediation proceeding under 297 s. 627.745 or any alternative dispute resolution proceeding 298 provided for in the insurance contract. The tolling period ends 299 upon the end of the mediation or alternative dispute resolution 300 proceeding. 301 (
b) Upon the failure of a policyholder or a representative 302 of the policyholder to provide material claims information 303 requested by the insurer within 10 days after the request was 304 received. The tolling period ends upon the insurer’s receipt of 305 the requested information. Tolling under this paragraph applies 306 only to requests sent by the insurer to the policyholder or to a 307 representative of the policyholder at least 15 days before the 308 insurer is required to pay or deny the claim or a portion of the 309 claim under subsection (2). 310