Florida Senate - 2015                             CS for SB 1250
       By the Committee on Banking and Insurance; and Senator Montford
       597-03197-15                                          20151250c1
    1                        A bill to be entitled                      
    2         An act relating to motor vehicle insurance; amending
    3         s. 627.311, F.S.; authorizing a joint underwriting
    4         plan and the Florida Automobile Joint Underwriting
    5         Association to cancel certain insurance policies
    6         within a specified period under certain circumstances;
    7         prohibiting an insured from canceling certain
    8         insurance policies within a specified period;
    9         providing exceptions; amending s. 627.727. F.S.;
   10         authorizing insurers to electronically provide a form
   11         to reject, or to select lower coverage amounts of,
   12         uninsured motorist vehicle coverage to a named
   13         insured; authorizing the named insured to sign the
   14         form electronically; amending s. 627.736, F.S.;
   15         revising the period during which the applicable fee
   16         schedule or payment limitation under Medicare applies
   17         with respect to certain personal injury protection
   18         insurance coverage; defining the term “service year”;
   19         deleting an obsolete date; amending s. 627.744, F.S.;
   20         revising the exemption from the preinsurance
   21         inspection requirements for private passenger motor
   22         vehicles to include certain leased vehicles; revising
   23         the list of documents that an insurer may require for
   24         purposes of the exemption; prohibiting the physical
   25         damage coverage on a motor vehicle from being
   26         suspended during the term of a policy due to the
   27         insurer’s option not to require certain documents;
   28         authorizing a payment of a claim to be conditioned if
   29         the insurer requires a document under certain
   30         circumstances; providing an effective date.
   32  Be It Enacted by the Legislature of the State of Florida:
   34         Section 1. Paragraph (m) is added to subsection (3) of
   35  section 627.311, Florida Statutes, to read:
   36         627.311 Joint underwriters and joint reinsurers; public
   37  records and public meetings exemptions.—
   38         (3) The office may, after consultation with insurers
   39  licensed to write automobile insurance in this state, approve a
   40  joint underwriting plan for purposes of equitable apportionment
   41  or sharing among insurers of automobile liability insurance and
   42  other motor vehicle insurance, as an alternate to the plan
   43  required in s. 627.351(1). All insurers authorized to write
   44  automobile insurance in this state shall subscribe to the plan
   45  and participate therein. The plan shall be subject to continuous
   46  review by the office which may at any time disapprove the entire
   47  plan or any part thereof if it determines that conditions have
   48  changed since prior approval and that in view of the purposes of
   49  the plan changes are warranted. Any disapproval by the office
   50  shall be subject to the provisions of chapter 120. The Florida
   51  Automobile Joint Underwriting Association is created under the
   52  plan. The plan and the association:
   53         (m) May cancel personal lines or commercial policies issued
   54  by the plan within the first 60 days after the effective date of
   55  the policy or binder for nonpayment of premium if the reason for
   56  cancellation is the issuance of a check for the premium which is
   57  dishonored for any reason or any other type of premium payment
   58  which is rejected or deemed invalid. An insured may not cancel a
   59  policy or binder within the first 90 days, or within a lesser
   60  period as required by the plan, after the effective date of the
   61  policy or binder, except:
   62         1. Upon total destruction of the insured motor vehicle;
   63         2. Upon transfer of ownership of the insured motor vehicle;
   64  or
   65         3. After purchase of another policy or binder covering the
   66  motor vehicle that was covered under the policy being canceled.
   67         Section 2. Subsection (1) of section 627.727, Florida
   68  Statutes, is amended to read:
   69         627.727 Motor vehicle insurance; uninsured and underinsured
   70  vehicle coverage; insolvent insurer protection.—
   71         (1) A No motor vehicle liability insurance policy that
   72  which provides bodily injury liability coverage may not shall be
   73  delivered or issued for delivery in this state with respect to a
   74  any specifically insured or identified motor vehicle registered
   75  or principally garaged in this state unless uninsured motor
   76  vehicle coverage is provided therein or supplemental thereto for
   77  the protection of persons insured by the policy thereunder who
   78  are legally entitled to recover damages from owners or operators
   79  of uninsured motor vehicles because of bodily injury, sickness,
   80  or disease, including death, resulting therefrom. However, the
   81  coverage required under this section is not applicable if when,
   82  or to the extent that, an insured named in the policy makes a
   83  written rejection of the coverage on behalf of all insureds
   84  under the policy. If When a motor vehicle is leased for a period
   85  of 1 year or longer and the lessor of the such vehicle, by the
   86  terms of the lease contract, provides liability coverage on the
   87  leased vehicle, the lessee of the such vehicle has shall have
   88  the sole privilege to reject uninsured motorist coverage or to
   89  select lower limits than the bodily injury liability limits,
   90  regardless of whether the lessor is qualified as a self-insurer
   91  pursuant to s. 324.171. Unless an insured, or lessee having the
   92  privilege of rejecting uninsured motorist coverage, requests
   93  such coverage or requests higher uninsured motorist limits in
   94  writing, the coverage or the such higher uninsured motorist
   95  limits are need not required to be provided in or supplemental
   96  to any other policy that which renews, extends, changes,
   97  supersedes, or replaces an existing policy with the same bodily
   98  injury liability limits when an insured or lessee had rejected
   99  the coverage. If When an insured or lessee has initially
  100  selected limits of uninsured motorist coverage lower than her or
  101  his bodily injury liability limits, higher limits of uninsured
  102  motorist coverage are need not required to be provided in or
  103  supplemental to any other policy that which renews, extends,
  104  changes, supersedes, or replaces an existing policy with the
  105  same bodily injury liability limits unless an insured requests
  106  higher uninsured motorist coverage in writing. The rejection or
  107  selection of lower limits must shall be made on a form approved
  108  by the office. The form must shall fully advise the named
  109  insured applicant of the nature of the coverage and must shall
  110  state that the coverage is equal to bodily injury liability
  111  limits unless lower limits are requested or the coverage is
  112  rejected. The heading of the form shall be in 12-point bold type
  113  and shall state: “You are electing not to purchase certain
  114  valuable coverage which protects you and your family or you are
  115  purchasing uninsured motorist limits less than your bodily
  116  injury liability limits when you sign this form. Please read
  117  carefully.” If this form is signed by a named insured, it will
  118  be conclusively presumed that there was an informed, knowing
  119  rejection of coverage or election of lower limits on behalf of
  120  all insureds. The form may be provided electronically to and may
  121  be signed electronically by the named insured. The requirement
  122  for 12-point bold type does not apply to a form that is provided
  123  electronically; however, the type for the heading of the form
  124  must be larger than the type used for the surrounding text. The
  125  insurer must shall notify the named insured at least annually of
  126  her or his options as to the coverage required by this section.
  127  Such notice must shall be part of, and attached to, the notice
  128  of premium, must shall provide for a means to allow the insured
  129  to request such coverage, and must shall be given in a manner
  130  approved by the office. Receipt of this notice does not
  131  constitute an affirmative waiver of the insured’s right to
  132  uninsured motorist coverage where the insured has not signed a
  133  selection or rejection form. The coverage described under this
  134  section must shall be over and above, but may shall not
  135  duplicate, the benefits available to an insured under any
  136  workers’ compensation law, personal injury protection benefits,
  137  disability benefits law, or similar law; under any automobile
  138  medical expense coverage; under any motor vehicle liability
  139  insurance coverage; or from the owner or operator of the
  140  uninsured motor vehicle or any other person or organization
  141  jointly or severally liable together with such owner or operator
  142  for the accident; and such coverage must shall cover the
  143  difference, if any, between the sum of such benefits and the
  144  damages sustained, up to the maximum amount of such coverage
  145  provided under this section. The amount of coverage available
  146  under this section may shall not be reduced by a setoff against
  147  any coverage, including liability insurance. Such coverage may
  148  shall not inure directly or indirectly to the benefit of a any
  149  workers’ compensation or disability benefits carrier or a any
  150  person or organization qualifying as a self-insurer under a any
  151  workers’ compensation or disability benefits law or similar law.
  152         Section 3. Paragraph (a) of subsection (5) of section
  153  627.736, Florida Statutes, is amended to read:
  154         627.736 Required personal injury protection benefits;
  155  exclusions; priority; claims.—
  157         (a) A physician, hospital, clinic, or other person or
  158  institution lawfully rendering treatment to an injured person
  159  for a bodily injury covered by personal injury protection
  160  insurance may charge the insurer and injured party only a
  161  reasonable amount pursuant to this section for the services and
  162  supplies rendered, and the insurer providing such coverage may
  163  pay for such charges directly to such person or institution
  164  lawfully rendering such treatment if the insured receiving such
  165  treatment or his or her guardian has countersigned the properly
  166  completed invoice, bill, or claim form approved by the office
  167  upon which such charges are to be paid for as having actually
  168  been rendered, to the best knowledge of the insured or his or
  169  her guardian. However, such a charge may not exceed the amount
  170  the person or institution customarily charges for like services
  171  or supplies. In determining whether a charge for a particular
  172  service, treatment, or otherwise is reasonable, consideration
  173  may be given to evidence of usual and customary charges and
  174  payments accepted by the provider involved in the dispute,
  175  reimbursement levels in the community and various federal and
  176  state medical fee schedules applicable to motor vehicle and
  177  other insurance coverages, and other information relevant to the
  178  reasonableness of the reimbursement for the service, treatment,
  179  or supply.
  180         1. The insurer may limit reimbursement to 80 percent of the
  181  following schedule of maximum charges:
  182         a. For emergency transport and treatment by providers
  183  licensed under chapter 401, 200 percent of Medicare.
  184         b. For emergency services and care provided by a hospital
  185  licensed under chapter 395, 75 percent of the hospital’s usual
  186  and customary charges.
  187         c. For emergency services and care as defined by s. 395.002
  188  provided in a facility licensed under chapter 395 rendered by a
  189  physician or dentist, and related hospital inpatient services
  190  rendered by a physician or dentist, the usual and customary
  191  charges in the community.
  192         d. For hospital inpatient services, other than emergency
  193  services and care, 200 percent of the Medicare Part A
  194  prospective payment applicable to the specific hospital
  195  providing the inpatient services.
  196         e. For hospital outpatient services, other than emergency
  197  services and care, 200 percent of the Medicare Part A Ambulatory
  198  Payment Classification for the specific hospital providing the
  199  outpatient services.
  200         f. For all other medical services, supplies, and care, 200
  201  percent of the allowable amount under:
  202         (I) The participating physicians fee schedule of Medicare
  203  Part B, except as provided in sub-sub-subparagraphs (II) and
  204  (III).
  205         (II) Medicare Part B, in the case of services, supplies,
  206  and care provided by ambulatory surgical centers and clinical
  207  laboratories.
  208         (III) The Durable Medical Equipment Prosthetics/Orthotics
  209  and Supplies fee schedule of Medicare Part B, in the case of
  210  durable medical equipment.
  212  However, if such services, supplies, or care is not reimbursable
  213  under Medicare Part B, as provided in this sub-subparagraph, the
  214  insurer may limit reimbursement to 80 percent of the maximum
  215  reimbursable allowance under workers’ compensation, as
  216  determined under s. 440.13 and rules adopted thereunder which
  217  are in effect at the time such services, supplies, or care is
  218  provided. Services, supplies, or care that is not reimbursable
  219  under Medicare or workers’ compensation is not required to be
  220  reimbursed by the insurer.
  221         2. For purposes of subparagraph 1., the applicable fee
  222  schedule or payment limitation under Medicare is the fee
  223  schedule or payment limitation in effect on March 1 of the
  224  service year in which the services, supplies, or care is
  225  rendered and for the area in which such services, supplies, or
  226  care is rendered, and the applicable fee schedule or payment
  227  limitation applies to services, supplies, or care rendered
  228  during throughout the remainder of that service year,
  229  notwithstanding any subsequent change made to the fee schedule
  230  or payment limitation, except that it may not be less than the
  231  allowable amount under the applicable schedule of Medicare Part
  232  B for 2007 for medical services, supplies, and care subject to
  233  Medicare Part B. For purposes of this subparagraph, the term
  234  “service year” means the period from March 1 through the end of
  235  February of the following year.
  236         3. Subparagraph 1. does not allow the insurer to apply any
  237  limitation on the number of treatments or other utilization
  238  limits that apply under Medicare or workers’ compensation. An
  239  insurer that applies the allowable payment limitations of
  240  subparagraph 1. must reimburse a provider who lawfully provided
  241  care or treatment under the scope of his or her license,
  242  regardless of whether such provider is entitled to reimbursement
  243  under Medicare due to restrictions or limitations on the types
  244  or discipline of health care providers who may be reimbursed for
  245  particular procedures or procedure codes. However, subparagraph
  246  1. does not prohibit an insurer from using the Medicare coding
  247  policies and payment methodologies of the federal Centers for
  248  Medicare and Medicaid Services, including applicable modifiers,
  249  to determine the appropriate amount of reimbursement for medical
  250  services, supplies, or care if the coding policy or payment
  251  methodology does not constitute a utilization limit.
  252         4. If an insurer limits payment as authorized by
  253  subparagraph 1., the person providing such services, supplies,
  254  or care may not bill or attempt to collect from the insured any
  255  amount in excess of such limits, except for amounts that are not
  256  covered by the insured’s personal injury protection coverage due
  257  to the coinsurance amount or maximum policy limits.
  258         5. Effective July 1, 2012, An insurer may limit payment as
  259  authorized by this paragraph only if the insurance policy
  260  includes a notice at the time of issuance or renewal that the
  261  insurer may limit payment pursuant to the schedule of charges
  262  specified in this paragraph. A policy form approved by the
  263  office satisfies this requirement. If a provider submits a
  264  charge for an amount less than the amount allowed under
  265  subparagraph 1., the insurer may pay the amount of the charge
  266  submitted.
  267         Section 4. Paragraphs (a) and (b) of subsection (2) of
  268  section 627.744, Florida Statutes, are amended to read:
  269         627.744 Required preinsurance inspection of private
  270  passenger motor vehicles.—
  271         (2) This section does not apply:
  272         (a) To a policy for a policyholder who has been insured for
  273  2 years or longer, without interruption, under a private
  274  passenger motor vehicle policy that which provides physical
  275  damage coverage for any vehicle, if the agent of the insurer
  276  verifies the previous coverage.
  277         (b) To a new, unused motor vehicle purchased or leased from
  278  a licensed motor vehicle dealer or leasing company., if The
  279  insurer may require is provided with:
  280         1. A bill of sale, or buyer’s order, or lease agreement
  281  that which contains a full description of the motor vehicle,
  282  including all options and accessories; or
  283         2. A copy of the title or registration that which
  284  establishes transfer of ownership from the dealer or leasing
  285  company to the customer and a copy of the window sticker or the
  286  dealer invoice showing the itemized options and equipment and
  287  the total retail price of the vehicle.
  289  For the purposes of this paragraph, the physical damage coverage
  290  on the motor vehicle may not be suspended during the term of the
  291  policy due to the applicant’s failure to provide or the
  292  insurer’s option not to require the required documents. However,
  293  if the insurer requires a document under this paragraph at the
  294  time the policy is issued, payment of a claim may be is
  295  conditioned upon the receipt by the insurer of the required
  296  documents, and no physical damage loss occurring after the
  297  effective date of the coverage is payable until the documents
  298  are provided to the insurer.
  299         Section 5. This act shall take effect July 1, 2015.