What is the purpose of the office?
The Office of Insurance Regulation (OIR)
ensures that insurance companies licensed to do business in Florida are financially viable, operating within the laws and regulations governing the industry, and offering insurance policy products at fair and adequate rates that do not unfairly discriminate against the public.
What regulatory functions does the office perform?
The Office of Insurance Regulation has responsibility for the regulation, compliance and enforcement of statutes related to insurance and the monitoring of industry markets. These regulatory functions are performed primarily through the units listed below.
- Company Admissions Section receives company applications and coordinates the review of these applications to determine whether to license companies to sell insurance in Florida.
- Life and Health Financial Oversight Unit monitors the financial condition of life and health insurers using internal financial analysis and on-site examinations. The unit is also responsible for the admissions process for new life and health entities as well as those proposing to expand into additional lines of business.
- Life and Health Product Review Unit reviews and approves life and health insurance policy forms and rates to ensure compliance with statutes and rules.
- Market Regulation Unit examines and investigates business practices and alleged violations of the Florida Insurance Code.
- Market Research and Technology Unit is responsible for data collection, data analysis, market research and reporting, application maintenance and support, and technology innovation and planning.
- Property and Casualty Financial Oversight Unit monitors the financial stability of property and casualty insurers, title insurers, and self-insurance funds by conducting financial examinations and ongoing financial analysis.
- Property and Casualty Product Review Unit reviews property and casualty contracts and rate filings to ensure compliance with actuarial standards, statutes, and rules.
- Specialty Product Administration Unit provides regulation and oversight to various insurance-related industries including continuing care retirement communities, motor vehicle and home service warranty associations, premium finance companies, legal expense insurers, viatical settlement providers, and third party administrators. The unit licenses and monitors these entities for compliance with statutes and rules and monitors their financial condition to protect the public from insolvency risks and unethical business practices.
What type of companies does the office regulate?
The Office of Insurance Regulation regulates and provides oversight for all insurance companies and insurance-related entities licensed to do business in Florida as described above.
Additionally, the office provides oversight to residual markets, which provide insurance to consumers who are unable to obtain coverage in the private market. Examples of these entities include Citizens Property Insurance Corporation
and the Florida Automobile Joint Underwriting Association
What is Citizens Property Insurance Corporation?
is a not-for-profit, tax-exempt government corporation whose purpose is to provide insurance protection to Florida property owners who otherwise might not be able to find coverage. The corporation is under the direction of a board of governors with members appointed by the Governor, President of the Florida Senate, Speaker of the Florida House of Representatives, and Chief Financial Officer. Citizens offers three types of property and casualty insurance—
personal lines, commercial lines, and coastal. When Citizens incurs a deficit due to policyholder losses exceeding its reserves, Florida law requires Citizens to levy assessments against Citizens policyholders, as well as non-Citizens policyholders if the Citizens policyholder assessment is insufficient to cover the deficit. Citizens is also required by law to create programs to help return its policies to the private market and reduce the risk of additional assessments. As such, the Citizens depopulation program works with private-market insurance companies that would like to offer coverage to Citizens policyholders, subject to the approval of the Office of Insurance Regulation. As of March 2020, Citizens provided coverage to approximately 446,000 policyholders and had exposure of $112 billion.
How do I find out whether a company is authorized to conduct business in Florida?
- The Office of Insurance Regulation maintains a searchable online database of companies authorized to conduct business in the state.
- The Department of Financial Services maintains a searchable database of individuals licensed to conduct insurance business in the state. This site also offers information on recent enforcement actions taken by the department against licensees, registrants, and other entities.
- A toll-free helpline (1-877-693-5236) is available for consumers.
How are consumer interests represented in insurance matters?
Are life insurance companies required to search for beneficiaries when an insured person has died but no claim has been filed?
As a result of legislation enacted in 2016 (Ch. 2016-219, Laws of Florida), insurers are required to compare the records of their insureds' life or endowment insurance policies, annuity contracts that provide a death benefit, and retained asset accounts that were in force on or after January 1, 1992, against the Social Security Administration's Death Master File. Insurers are also required to make such comparisons on at least an annual basis. No later than 120 days upon learning of the death of an insured, insurers must determine whether benefits may be due under a policy, annuity, or retained asset account and complete an effort to locate and contact the beneficiary.
OIR reports that a 2009 investigation revealed that life insurance companies were not taking adequate steps to try to pay out policies where information in the companies' possession indicated that the insured had died but no claim had been filed. According to OIR, these companies were using information from the Social Security Administration's Death Master File to stop paying a deceased person's annuity, but not using the master file to search for beneficiaries of life insurance policies. This finding was the basis of a multi-state task force, with Florida, California, Illinois, North Dakota, New Hampshire, and Pennsylvania serving as lead states for examinations of the 40 largest insurance groups. To date, Florida has regulatory agreements with 27 life insurance companies; these agreements generally stipulate that the companies agree to compare their records against the master file. Insurers that have been unsuccessful in locating a Florida beneficiary remit applicable funds to the Department of Financial Services' Division of Unclaimed Property, where families can search for the funds.
How are these activities funded?
The office is funded by taxes and fees charged to the insurance industry.
Prohibition on the Use of Genetic Information by Insurers. Chapter 2020-159, Laws of Florida, prohibits life insurers and long-term care insurers from cancelling, limiting, or denying coverage, or establishing differentials in premium rates based on genetic information, absent a diagnosis of a condition related to genetic information. Health insurers already had such a prohibition in law. In addition, these types of insurers may not require or solicit genetic information, use genetic test results, or consider a person's decisions or actions relating to genetic testing in any manner for any insurance purposes. Insurance Administration. The 2020 Florida Legislature enacted Ch. 2020-63, Laws of Florida, which amends laws relating to insurance administration. Among other provisions, the law
- prohibits the Department of Financial Services and Office of Insurance Regulation (OIR) from disseminating aggregated information if it contains trade secret information that can be individually extrapolated;
- provides that when the OIR period for reviewing certain rates and forms falls on a weekend or holiday, the period is extended to the conclusion of the next business day;
- reduces from 60 days to 30 days the time period in which a motor vehicle insurer is prohibited from cancelling a new policy for nonpayment of the premium, unless the reason for the cancellation is the issuance of a check for the premium that is dishonored or any other type of payment for the premium that is determined to be rejected or invalid; and
- creates a new chapter of law to regulate the transaction of travel insurance.
Where can I find related OPPAGA reports?
Several Factors Hinder Homeowner and Auto Glass Insurance Fraud Processing, Report 21-05, March 2021
Review of Professional Employer Organizations and Workers' Compensation, Report 21-04, March 2021
Where can I get more information?
What are the applicable statutes?
, Florida Statutes.
Whom do I contact for help?
Office of Insurance Regulation, 850-413-3140