What is the purpose of the office?
The Office of Insurance Regulation (OIR) is responsible for all activities concerning insurers and other risk bearing entities, including licensing, rates, policy forms, market conduct, claims, issuance of certificates of authority, solvency, viatical settlements, premium financing, and administrative supervision, as provided under the Florida Insurance Code or Ch. 636, Florida Statutes.
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.
- The Life and Health Market Regulation Unit examines and investigates life and health insurers and related parties regarding 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.
- Property and Casualty Market Regulation Unit conducts investigations of authorized and unauthorized property and casualty insurers and related parties regarding business practices and patterns of alleged violations of the Florida Insurance Code.
- 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 has primary responsibility for regulation, compliance and enforcement of statutes related to the business of insurance and is entrusted with the monitoring of statewide industry markets.
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?
Citizens 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. Citizens is governed by a Board of Governors. The board administers a Plan of Operation approved by the Florida Financial Services Commission, an oversight panel made up of the Governor, the Chief Financial Officer, the Attorney General, and the Commissioner of Agriculture.
Citizens has three policy accounts—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 May 2023, Citizens provided coverage to approximately
1.3 million policyholders and had exposure of more than $ 534 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?
Florida law requires insurers 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. 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.
Property Insurance. The 2023 Legislature enacted Ch. 2022-271, Laws of Florida, which makes several changes related to policyholder and insurer accountability. Among its provisions, the law
- reduces the deadline for policyholders to report a claim under the policy from two years to one year for a new or reopened claim, and from three years to 18 months for a supplemental claim;
- authorizes the Office of Insurance Regulation (OIR) to subject any authorized insurer to a market conduct examination after a hurricane under certain conditions relating to property insurance claims;
- amends the prompt pay laws to encourage the prompt payments of claims;
- provides that the one-way attorney fee provisions of s. 627.428, s. 626.9373, and s. 627.70152, Florida Statutes, are not applicable in a suit arising under a residential or commercial property insurance policy;
- reinstates application of the civil offer of judgment statute to civil actions arising under a residential or commercial property insurance policy;
- allows joint offers of settlement in property insurance litigation contingent on acceptance of all joint offerees;
- removes provisions regarding attorney fees relating to the alternative procedure for resolution of disputed sinkhole insurance claims;
- prohibits the assignment, in whole or in part, of any post-loss insurance benefit under any residential property insurance policy or under any commercial property insurance policy issued on or after January 1, 2023;
- provides that bad faith litigation for failure to settle a property insurance claim may not be filed until after the insured has established, through adverse adjudication by a court, that the insurer breached the insurance contract and a final judgment or decree has been rendered against the insurer;
- increases the eligibility threshold for Citizens renewal personal lines residential risk policyholders that renew on or after April 1, 2023, and renewal commercial lines residential risk policyholders;
- provides that Citizens personal lines residential policyholders must secure and maintain flood insurance that meets certain requirements as a condition of eligibility for Citizens coverage;
- amends the mandatory flood insurance notice by requiring it to be part of the declarations page and makes revisions to the content of notice to encourage purchase of flood insurance;
- provides conditions whereby a property insurer may include mandatory binding arbitration in its policies; and
- authorizes the OIR to extend the 30-day coverage period for policies of insolvent insurers by an additional 15 days if the OIR reasonably believes that market conditions are such that the policies cannot be placed with an authorized insurer within the 30-day period.
Civil Remedies. The 2023 Legislature enacted Ch. 2023-15, Laws of Florida, which makes changes to Florida's civil justice system and includes provisions particular to insurance cases. For example, the law
- limits to attorney fees awarded for insurance cases;
- reduces the statute of limitations for general negligence cases from four years to two years;
- modifies Florida's "bad faith" framework, providing that negligence alone is not enough to demonstrate bad faith from the insurer, and holding the insureds, claimants, and their representatives to "good faith" actions such as providing information, making demands, setting deadlines, and attempting to settle the insurance claim;
- provides an insurer has no liability for a bad faith involving a liability insurance claim if the insurer tenders the lesser of the policy limits or the amount demanded by the claimant within 90 days after receipt of the claim and sufficient evidence to support the claim; and
- allows an insurer, if there are multiple claimants in a single action, to limit the insurer’s bad faith liability if, within 90 days after receiving notice of competing claim in excess of the policy limits, the insurer pays the total amount of the policy.
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