Florida Senate - 2015                                    SB 1250
       By Senator Montford
       3-00627A-15                                           20151250__
    1                        A bill to be entitled                      
    2         An act relating to motor vehicle insurance; amending
    3         s. 627.727, F.S.; authorizing insurers to
    4         electronically provide a form to reject, or select
    5         lower coverage amounts of, uninsured motorist vehicle
    6         coverage to an insurance applicant; authorizing the
    7         applicant to sign the form electronically; amending s.
    8         627.736, F.S.; revising the period during which the
    9         applicable fee schedule or payment limitation under
   10         Medicare applies with respect to certain personal
   11         injury protection insurance coverage; deleting an
   12         obsolete date; amending s. 627.744, F.S.; revising the
   13         exemption from the preinsurance inspection
   14         requirements for private passenger motor vehicles to
   15         include certain leased vehicles; revising the list of
   16         documents that an insurer may require for purposes of
   17         the exemption; prohibiting the physical damage
   18         coverage on a motor vehicle from being suspended
   19         during the term of a policy due to the insurer’s
   20         option not to require certain documents; authorizing a
   21         payment of a claim to be conditioned if the insurer
   22         requires a document under certain circumstances;
   23         providing an effective date.
   25  Be It Enacted by the Legislature of the State of Florida:
   27         Section 1. Subsection (1) of section 627.727, Florida
   28  Statutes, is amended to read:
   29         627.727 Motor vehicle insurance; uninsured and underinsured
   30  vehicle coverage; insolvent insurer protection.—
   31         (1) A No motor vehicle liability insurance policy that
   32  which provides bodily injury liability coverage may not shall be
   33  delivered or issued for delivery in this state with respect to a
   34  any specifically insured or identified motor vehicle registered
   35  or principally garaged in this state unless uninsured motor
   36  vehicle coverage is provided therein or supplemental thereto for
   37  the protection of persons insured by the policy thereunder who
   38  are legally entitled to recover damages from owners or operators
   39  of uninsured motor vehicles because of bodily injury, sickness,
   40  or disease, including death, resulting therefrom. However, the
   41  coverage required under this section is not applicable if when,
   42  or to the extent that, an insured named in the policy makes a
   43  written rejection of the coverage on behalf of all insureds
   44  under the policy. If When a motor vehicle is leased for a period
   45  of 1 year or longer and the lessor of the such vehicle, by the
   46  terms of the lease contract, provides liability coverage on the
   47  leased vehicle, the lessee of the such vehicle has shall have
   48  the sole privilege to reject uninsured motorist coverage or to
   49  select lower limits than the bodily injury liability limits,
   50  regardless of whether the lessor is qualified as a self-insurer
   51  pursuant to s. 324.171. Unless an insured, or lessee having the
   52  privilege of rejecting uninsured motorist coverage, requests
   53  such coverage or requests higher uninsured motorist limits in
   54  writing, the coverage or the such higher uninsured motorist
   55  limits are need not required to be provided in or supplemental
   56  to any other policy that which renews, extends, changes,
   57  supersedes, or replaces an existing policy with the same bodily
   58  injury liability limits when an insured or lessee had rejected
   59  the coverage. If When an insured or lessee has initially
   60  selected limits of uninsured motorist coverage lower than her or
   61  his bodily injury liability limits, higher limits of uninsured
   62  motorist coverage are need not required to be provided in or
   63  supplemental to any other policy that which renews, extends,
   64  changes, supersedes, or replaces an existing policy with the
   65  same bodily injury liability limits unless an insured requests
   66  higher uninsured motorist coverage in writing. The rejection or
   67  selection of lower limits must shall be made on a form approved
   68  by the office. The form must shall fully advise the applicant of
   69  the nature of the coverage and must shall state that the
   70  coverage is equal to bodily injury liability limits unless lower
   71  limits are requested or the coverage is rejected. The heading of
   72  the form shall be in 12-point bold type and shall state: “You
   73  are electing not to purchase certain valuable coverage which
   74  protects you and your family or you are purchasing uninsured
   75  motorist limits less than your bodily injury liability limits
   76  when you sign this form. Please read carefully.” If this form is
   77  signed by a named insured, it will be conclusively presumed that
   78  there was an informed, knowing rejection of coverage or election
   79  of lower limits on behalf of all insureds. The form may be
   80  provided electronically to and may be signed electronically by
   81  the applicant. The requirement for 12-point bold type does not
   82  apply to a form that is provided electronically; however, the
   83  type for the heading of the form must be larger than the type
   84  used for the surrounding text. The insurer must shall notify the
   85  named insured at least annually of her or his options as to the
   86  coverage required by this section. Such notice must shall be
   87  part of, and attached to, the notice of premium, must shall
   88  provide for a means to allow the insured to request such
   89  coverage, and must shall be given in a manner approved by the
   90  office. Receipt of this notice does not constitute an
   91  affirmative waiver of the insured’s right to uninsured motorist
   92  coverage where the insured has not signed a selection or
   93  rejection form. The coverage described under this section must
   94  shall be over and above, but may shall not duplicate, the
   95  benefits available to an insured under any workers’ compensation
   96  law, personal injury protection benefits, disability benefits
   97  law, or similar law; under any automobile medical expense
   98  coverage; under any motor vehicle liability insurance coverage;
   99  or from the owner or operator of the uninsured motor vehicle or
  100  any other person or organization jointly or severally liable
  101  together with such owner or operator for the accident; and such
  102  coverage must shall cover the difference, if any, between the
  103  sum of such benefits and the damages sustained, up to the
  104  maximum amount of such coverage provided under this section. The
  105  amount of coverage available under this section may shall not be
  106  reduced by a setoff against any coverage, including liability
  107  insurance. Such coverage may shall not inure directly or
  108  indirectly to the benefit of a any workers’ compensation or
  109  disability benefits carrier or a any person or organization
  110  qualifying as a self-insurer under a any workers’ compensation
  111  or disability benefits law or similar law.
  112         Section 2. Paragraph (a) of subsection (5) of section
  113  627.736, Florida Statutes, is amended to read:
  114         627.736 Required personal injury protection benefits;
  115  exclusions; priority; claims.—
  117         (a) A physician, hospital, clinic, or other person or
  118  institution lawfully rendering treatment to an injured person
  119  for a bodily injury covered by personal injury protection
  120  insurance may charge the insurer and injured party only a
  121  reasonable amount pursuant to this section for the services and
  122  supplies rendered, and the insurer providing such coverage may
  123  pay for such charges directly to such person or institution
  124  lawfully rendering such treatment if the insured receiving such
  125  treatment or his or her guardian has countersigned the properly
  126  completed invoice, bill, or claim form approved by the office
  127  upon which such charges are to be paid for as having actually
  128  been rendered, to the best knowledge of the insured or his or
  129  her guardian. However, such a charge may not exceed the amount
  130  the person or institution customarily charges for like services
  131  or supplies. In determining whether a charge for a particular
  132  service, treatment, or otherwise is reasonable, consideration
  133  may be given to evidence of usual and customary charges and
  134  payments accepted by the provider involved in the dispute,
  135  reimbursement levels in the community and various federal and
  136  state medical fee schedules applicable to motor vehicle and
  137  other insurance coverages, and other information relevant to the
  138  reasonableness of the reimbursement for the service, treatment,
  139  or supply.
  140         1. The insurer may limit reimbursement to 80 percent of the
  141  following schedule of maximum charges:
  142         a. For emergency transport and treatment by providers
  143  licensed under chapter 401, 200 percent of Medicare.
  144         b. For emergency services and care provided by a hospital
  145  licensed under chapter 395, 75 percent of the hospital’s usual
  146  and customary charges.
  147         c. For emergency services and care as defined by s. 395.002
  148  provided in a facility licensed under chapter 395 rendered by a
  149  physician or dentist, and related hospital inpatient services
  150  rendered by a physician or dentist, the usual and customary
  151  charges in the community.
  152         d. For hospital inpatient services, other than emergency
  153  services and care, 200 percent of the Medicare Part A
  154  prospective payment applicable to the specific hospital
  155  providing the inpatient services.
  156         e. For hospital outpatient services, other than emergency
  157  services and care, 200 percent of the Medicare Part A Ambulatory
  158  Payment Classification for the specific hospital providing the
  159  outpatient services.
  160         f. For all other medical services, supplies, and care, 200
  161  percent of the allowable amount under:
  162         (I) The participating physicians fee schedule of Medicare
  163  Part B, except as provided in sub-sub-subparagraphs (II) and
  164  (III).
  165         (II) Medicare Part B, in the case of services, supplies,
  166  and care provided by ambulatory surgical centers and clinical
  167  laboratories.
  168         (III) The Durable Medical Equipment Prosthetics/Orthotics
  169  and Supplies fee schedule of Medicare Part B, in the case of
  170  durable medical equipment.
  172  However, if such services, supplies, or care is not reimbursable
  173  under Medicare Part B, as provided in this sub-subparagraph, the
  174  insurer may limit reimbursement to 80 percent of the maximum
  175  reimbursable allowance under workers’ compensation, as
  176  determined under s. 440.13 and rules adopted thereunder which
  177  are in effect at the time such services, supplies, or care is
  178  provided. Services, supplies, or care that is not reimbursable
  179  under Medicare or workers’ compensation is not required to be
  180  reimbursed by the insurer.
  181         2. For purposes of subparagraph 1., the applicable fee
  182  schedule or payment limitation under Medicare is the fee
  183  schedule or payment limitation in effect on March 1 of the year
  184  in which the services, supplies, or care is rendered and for the
  185  area in which such services, supplies, or care is rendered, and
  186  the applicable fee schedule or payment limitation applies from
  187  March 1 until the last day of February throughout the remainder
  188  of the following that year, notwithstanding any subsequent
  189  change made to the fee schedule or payment limitation, except
  190  that it may not be less than the allowable amount under the
  191  applicable schedule of Medicare Part B for 2007 for medical
  192  services, supplies, and care subject to Medicare Part B.
  193         3. Subparagraph 1. does not allow the insurer to apply any
  194  limitation on the number of treatments or other utilization
  195  limits that apply under Medicare or workers’ compensation. An
  196  insurer that applies the allowable payment limitations of
  197  subparagraph 1. must reimburse a provider who lawfully provided
  198  care or treatment under the scope of his or her license,
  199  regardless of whether such provider is entitled to reimbursement
  200  under Medicare due to restrictions or limitations on the types
  201  or discipline of health care providers who may be reimbursed for
  202  particular procedures or procedure codes. However, subparagraph
  203  1. does not prohibit an insurer from using the Medicare coding
  204  policies and payment methodologies of the federal Centers for
  205  Medicare and Medicaid Services, including applicable modifiers,
  206  to determine the appropriate amount of reimbursement for medical
  207  services, supplies, or care if the coding policy or payment
  208  methodology does not constitute a utilization limit.
  209         4. If an insurer limits payment as authorized by
  210  subparagraph 1., the person providing such services, supplies,
  211  or care may not bill or attempt to collect from the insured any
  212  amount in excess of such limits, except for amounts that are not
  213  covered by the insured’s personal injury protection coverage due
  214  to the coinsurance amount or maximum policy limits.
  215         5. Effective July 1, 2012, An insurer may limit payment as
  216  authorized by this paragraph only if the insurance policy
  217  includes a notice at the time of issuance or renewal that the
  218  insurer may limit payment pursuant to the schedule of charges
  219  specified in this paragraph. A policy form approved by the
  220  office satisfies this requirement. If a provider submits a
  221  charge for an amount less than the amount allowed under
  222  subparagraph 1., the insurer may pay the amount of the charge
  223  submitted.
  224         Section 3. Paragraphs (a) and (b) of subsection (2) of
  225  section 627.744, Florida Statutes, are amended to read:
  226         627.744 Required preinsurance inspection of private
  227  passenger motor vehicles.—
  228         (2) This section does not apply:
  229         (a) To a policy for a policyholder who has been insured for
  230  2 years or longer, without interruption, under a private
  231  passenger motor vehicle policy that which provides physical
  232  damage coverage for any vehicle, if the agent of the insurer
  233  verifies the previous coverage.
  234         (b) To a new, unused motor vehicle purchased or leased from
  235  a licensed motor vehicle dealer or leasing company., if The
  236  insurer may require is provided with:
  237         1. A bill of sale, or buyer’s order, or lease agreement
  238  that which contains a full description of the motor vehicle,
  239  including all options and accessories; or
  240         2. A copy of the title or registration that which
  241  establishes transfer of ownership from the dealer or leasing
  242  company to the customer and a copy of the window sticker or the
  243  dealer invoice showing the itemized options and equipment and
  244  the total retail price of the vehicle.
  246  For the purposes of this paragraph, the physical damage coverage
  247  on the motor vehicle may not be suspended during the term of the
  248  policy due to the applicant’s failure to provide or the
  249  insurer’s option not to require the required documents. However,
  250  if the insurer requires a document under this paragraph at the
  251  time the policy is issued, payment of a claim may be is
  252  conditioned upon the receipt by the insurer of the required
  253  documents, and no physical damage loss occurring after the
  254  effective date of the coverage is payable until the documents
  255  are provided to the insurer.
  256         Section 4. This act shall take effect July 1, 2015.