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 February 2022, Citizens provided coverage to approximately 793,000 policyholders and had exposure of $248 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.
Regulation of Property Insurers and Insurer Insolvencies. The 2022 Legislature enacted Ch. 2022-268, Laws of Florida, which revises statutes relating to property insurance. Among its provisions, the law
- requires the Office of Insurance Regulation (OIR) to maintain and make available upon request reports relating to the health of the homeowners' and condominium unit owners' insurance market, including the percentage of policies written by voluntary carriers and Citizens Property Insurance, and any trends related to the relative shares of the voluntary and residual market;
- directs OIR to make data publicly available that includes the statewide number of policies, number of cancellations, and other data for each property insurer; and specifies that such information is not a trade secret;
- requires OIR to include within its annual report additional data regarding property insurers against which delinquency or similar proceedings were instituted, including a concise statement of the circumstances that led to the delinquency, a summary of actions taken by the insurer and OIR to avoid delinquency, and results or status of delinquency proceedings; and
- creates a Property Insurer Stability Unit within OIR to aid in the detection and prevention of insurer insolvencies in the homeowners' and condominium unit owners' insurance market; the unit shall
- provide enhanced monitoring when OIR identifies significant concerns about an insurer,
- conduct a target market exam when there is reason to suspect an insurer is in an unsound financial condition,
- closely monitor certain insurer financial data,
- conduct annual catastrophic stress tests of domestic insurers,
- update wind mitigation credits,
- review the causes of insolvency and business practices of insurers referred to the Department of Financial Services' Division of Rehabilitation and Liquidation, and
- twice annually, provide a report on the status of the homeowners' and condominium unit owners' insurance market.
Oversight of Pharmacy Benefit Managers. The 2022 Legislature enacted Ch. 2022-200, Laws of Florida, which amends statutes relating to the Office of Insurance Regulation's oversight of pharmacy benefit managers (PBMs). Among its provisions, the law
- requires a health insurer or health maintenance organization (HMO) or any entity acting on their behalf to comply with pharmacy audit provisions, which include requirements for pharmacy notification, audit duration, and expertise of the auditor;
- specifies that a health insurer or HMO that contracts with a PBM is responsible for any violation of the pharmacy audit provisions the PBM commits; and
- provides that a person who operates as a PBM without registering with the Office of Insurance Regulation is subject to a fine of $10,000.
Living Organ Donors. The 2022 Legislature enacted Ch. 2022-59, Laws of Florida, which amends statutes relating to insurers of living organ donors. Among other provisions, the law provides that insurers for individual or group life insurance, industrial life insurance, credit life insurance, credit disability insurance, or long-term care insurance may not
- decline or limit coverage of a person solely due to his or her status as a living organ donor;
- preclude an insured from donating all or part of an organ as a condition for continuing to receive coverage under a policy; or
- otherwise discriminate in the offering, issuance, cancellation, coverage, premium, or any other condition of the policy without any additional actuarial risk and based solely on his or her status as a living organ donor.
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