Florida Senate - 2015                      CS for CS for SB 1250
       
       
        
       By the Committees on Transportation; and Banking and Insurance;
       and Senator Montford
       
       
       
       
       596-04182-15                                          20151250c2
    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; specifying requirements for the
   15         format, storage, and preservation of an electronically
   16         signed form; amending s. 627.736, F.S.; revising the
   17         period during which the applicable fee schedule or
   18         payment limitation under Medicare applies with respect
   19         to certain personal injury protection insurance
   20         coverage; defining the term “service year”; deleting
   21         an obsolete date; amending s. 627.744, F.S.; revising
   22         the exemption from the preinsurance inspection
   23         requirements for private passenger motor vehicles to
   24         include certain leased vehicles; revising the list of
   25         documents that an insurer may require for purposes of
   26         the exemption; prohibiting the physical damage
   27         coverage on a motor vehicle from being suspended
   28         during the term of a policy due to the insurer’s
   29         option not to require certain documents; authorizing a
   30         payment of a claim to be conditioned if the insurer
   31         requires a document under certain circumstances;
   32         providing an effective date.
   33          
   34  Be It Enacted by the Legislature of the State of Florida:
   35  
   36         Section 1. Paragraph (m) is added to subsection (3) of
   37  section 627.311, Florida Statutes, to read:
   38         627.311 Joint underwriters and joint reinsurers; public
   39  records and public meetings exemptions.—
   40         (3) The office may, after consultation with insurers
   41  licensed to write automobile insurance in this state, approve a
   42  joint underwriting plan for purposes of equitable apportionment
   43  or sharing among insurers of automobile liability insurance and
   44  other motor vehicle insurance, as an alternate to the plan
   45  required in s. 627.351(1). All insurers authorized to write
   46  automobile insurance in this state shall subscribe to the plan
   47  and participate therein. The plan shall be subject to continuous
   48  review by the office which may at any time disapprove the entire
   49  plan or any part thereof if it determines that conditions have
   50  changed since prior approval and that in view of the purposes of
   51  the plan changes are warranted. Any disapproval by the office
   52  shall be subject to the provisions of chapter 120. The Florida
   53  Automobile Joint Underwriting Association is created under the
   54  plan. The plan and the association:
   55         (m) May cancel personal lines or commercial policies issued
   56  by the plan within the first 60 days after the effective date of
   57  the policy or binder for nonpayment of premium if the reason for
   58  cancellation is the issuance of a check for the premium which is
   59  dishonored for any reason or any other type of premium payment
   60  which is rejected or deemed invalid. An insured may not cancel a
   61  policy or binder within the first 90 days, or within a lesser
   62  period as required by the plan, after the effective date of the
   63  policy or binder, except:
   64         1. Upon total destruction of the insured motor vehicle;
   65         2. Upon transfer of ownership of the insured motor vehicle;
   66  or
   67         3. After purchase of another policy or binder covering the
   68  motor vehicle that was covered under the policy being canceled.
   69         Section 2. Subsection (1) of section 627.727, Florida
   70  Statutes, is amended to read:
   71         627.727 Motor vehicle insurance; uninsured and underinsured
   72  vehicle coverage; insolvent insurer protection.—
   73         (1) A No motor vehicle liability insurance policy that
   74  which provides bodily injury liability coverage may not shall be
   75  delivered or issued for delivery in this state with respect to a
   76  any specifically insured or identified motor vehicle registered
   77  or principally garaged in this state unless uninsured motor
   78  vehicle coverage is provided therein or supplemental thereto for
   79  the protection of persons insured by the policy thereunder who
   80  are legally entitled to recover damages from owners or operators
   81  of uninsured motor vehicles because of bodily injury, sickness,
   82  or disease, including death, resulting therefrom. However, the
   83  coverage required under this section is not applicable if when,
   84  or to the extent that, an insured named in the policy makes a
   85  written rejection of the coverage on behalf of all insureds
   86  under the policy. If When a motor vehicle is leased for a period
   87  of 1 year or longer and the lessor of the such vehicle, by the
   88  terms of the lease contract, provides liability coverage on the
   89  leased vehicle, the lessee of the such vehicle has shall have
   90  the sole privilege to reject uninsured motorist coverage or to
   91  select lower limits than the bodily injury liability limits,
   92  regardless of whether the lessor is qualified as a self-insurer
   93  pursuant to s. 324.171. Unless an insured, or lessee having the
   94  privilege of rejecting uninsured motorist coverage, requests
   95  such coverage or requests higher uninsured motorist limits in
   96  writing, the coverage or the such higher uninsured motorist
   97  limits are need not required to be provided in or supplemental
   98  to any other policy that which renews, extends, changes,
   99  supersedes, or replaces an existing policy with the same bodily
  100  injury liability limits when an insured or lessee had rejected
  101  the coverage. If When an insured or lessee has initially
  102  selected limits of uninsured motorist coverage lower than her or
  103  his bodily injury liability limits, higher limits of uninsured
  104  motorist coverage are need not required to be provided in or
  105  supplemental to any other policy that which renews, extends,
  106  changes, supersedes, or replaces an existing policy with the
  107  same bodily injury liability limits unless an insured requests
  108  higher uninsured motorist coverage in writing. The rejection or
  109  selection of lower limits must shall be made on a form approved
  110  by the office. The form must shall fully advise the named
  111  insured applicant of the nature of the coverage and must shall
  112  state that the coverage is equal to bodily injury liability
  113  limits unless lower limits are requested or the coverage is
  114  rejected. The heading of the form shall be in 12-point bold type
  115  and shall state: “You are electing not to purchase certain
  116  valuable coverage which protects you and your family or you are
  117  purchasing uninsured motorist limits less than your bodily
  118  injury liability limits when you sign this form. Please read
  119  carefully.” If this form is signed by a named insured, it will
  120  be conclusively presumed that there was an informed, knowing
  121  rejection of coverage or election of lower limits on behalf of
  122  all insureds. The form may be provided electronically to and may
  123  be signed electronically by the named insured. The heading of a
  124  form provided electronically must be in boldfaced type that is
  125  larger than the surrounding text and in black type on a white
  126  background or white type on a black background. An electronic
  127  signature by the named insured must be affixed using technology
  128  that stores and preserves the form, as viewed and signed by the
  129  named insured, as an exact image and that creates a record of
  130  any attempt to modify or tamper with the form after signature.
  131  The insurer must shall notify the named insured at least
  132  annually of her or his options as to the coverage required by
  133  this section. Such notice must shall be part of, and attached
  134  to, the notice of premium, must shall provide for a means to
  135  allow the insured to request such coverage, and must shall be
  136  given in a manner approved by the office. Receipt of this notice
  137  does not constitute an affirmative waiver of the insured’s right
  138  to uninsured motorist coverage where the insured has not signed
  139  a selection or rejection form. The coverage described under this
  140  section must shall be over and above, but may shall not
  141  duplicate, the benefits available to an insured under any
  142  workers’ compensation law, personal injury protection benefits,
  143  disability benefits law, or similar law; under any automobile
  144  medical expense coverage; under any motor vehicle liability
  145  insurance coverage; or from the owner or operator of the
  146  uninsured motor vehicle or any other person or organization
  147  jointly or severally liable together with such owner or operator
  148  for the accident; and such coverage must shall cover the
  149  difference, if any, between the sum of such benefits and the
  150  damages sustained, up to the maximum amount of such coverage
  151  provided under this section. The amount of coverage available
  152  under this section may shall not be reduced by a setoff against
  153  any coverage, including liability insurance. Such coverage may
  154  shall not inure directly or indirectly to the benefit of a any
  155  workers’ compensation or disability benefits carrier or a any
  156  person or organization qualifying as a self-insurer under a any
  157  workers’ compensation or disability benefits law or similar law.
  158         Section 3. Paragraph (a) of subsection (5) of section
  159  627.736, Florida Statutes, is amended to read:
  160         627.736 Required personal injury protection benefits;
  161  exclusions; priority; claims.—
  162         (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
  163         (a) A physician, hospital, clinic, or other person or
  164  institution lawfully rendering treatment to an injured person
  165  for a bodily injury covered by personal injury protection
  166  insurance may charge the insurer and injured party only a
  167  reasonable amount pursuant to this section for the services and
  168  supplies rendered, and the insurer providing such coverage may
  169  pay for such charges directly to such person or institution
  170  lawfully rendering such treatment if the insured receiving such
  171  treatment or his or her guardian has countersigned the properly
  172  completed invoice, bill, or claim form approved by the office
  173  upon which such charges are to be paid for as having actually
  174  been rendered, to the best knowledge of the insured or his or
  175  her guardian. However, such a charge may not exceed the amount
  176  the person or institution customarily charges for like services
  177  or supplies. In determining whether a charge for a particular
  178  service, treatment, or otherwise is reasonable, consideration
  179  may be given to evidence of usual and customary charges and
  180  payments accepted by the provider involved in the dispute,
  181  reimbursement levels in the community and various federal and
  182  state medical fee schedules applicable to motor vehicle and
  183  other insurance coverages, and other information relevant to the
  184  reasonableness of the reimbursement for the service, treatment,
  185  or supply.
  186         1. The insurer may limit reimbursement to 80 percent of the
  187  following schedule of maximum charges:
  188         a. For emergency transport and treatment by providers
  189  licensed under chapter 401, 200 percent of Medicare.
  190         b. For emergency services and care provided by a hospital
  191  licensed under chapter 395, 75 percent of the hospital’s usual
  192  and customary charges.
  193         c. For emergency services and care as defined by s. 395.002
  194  provided in a facility licensed under chapter 395 rendered by a
  195  physician or dentist, and related hospital inpatient services
  196  rendered by a physician or dentist, the usual and customary
  197  charges in the community.
  198         d. For hospital inpatient services, other than emergency
  199  services and care, 200 percent of the Medicare Part A
  200  prospective payment applicable to the specific hospital
  201  providing the inpatient services.
  202         e. For hospital outpatient services, other than emergency
  203  services and care, 200 percent of the Medicare Part A Ambulatory
  204  Payment Classification for the specific hospital providing the
  205  outpatient services.
  206         f. For all other medical services, supplies, and care, 200
  207  percent of the allowable amount under:
  208         (I) The participating physicians fee schedule of Medicare
  209  Part B, except as provided in sub-sub-subparagraphs (II) and
  210  (III).
  211         (II) Medicare Part B, in the case of services, supplies,
  212  and care provided by ambulatory surgical centers and clinical
  213  laboratories.
  214         (III) The Durable Medical Equipment Prosthetics/Orthotics
  215  and Supplies fee schedule of Medicare Part B, in the case of
  216  durable medical equipment.
  217  
  218  However, if such services, supplies, or care is not reimbursable
  219  under Medicare Part B, as provided in this sub-subparagraph, the
  220  insurer may limit reimbursement to 80 percent of the maximum
  221  reimbursable allowance under workers’ compensation, as
  222  determined under s. 440.13 and rules adopted thereunder which
  223  are in effect at the time such services, supplies, or care is
  224  provided. Services, supplies, or care that is not reimbursable
  225  under Medicare or workers’ compensation is not required to be
  226  reimbursed by the insurer.
  227         2. For purposes of subparagraph 1., the applicable fee
  228  schedule or payment limitation under Medicare is the fee
  229  schedule or payment limitation in effect on March 1 of the
  230  service year in which the services, supplies, or care is
  231  rendered and for the area in which such services, supplies, or
  232  care is rendered, and the applicable fee schedule or payment
  233  limitation applies to services, supplies, or care rendered
  234  during throughout the remainder of that service year,
  235  notwithstanding any subsequent change made to the fee schedule
  236  or payment limitation, except that it may not be less than the
  237  allowable amount under the applicable schedule of Medicare Part
  238  B for 2007 for medical services, supplies, and care subject to
  239  Medicare Part B. For purposes of this subparagraph, the term
  240  “service year” means the period from March 1 through the end of
  241  February of the following year.
  242         3. Subparagraph 1. does not allow the insurer to apply any
  243  limitation on the number of treatments or other utilization
  244  limits that apply under Medicare or workers’ compensation. An
  245  insurer that applies the allowable payment limitations of
  246  subparagraph 1. must reimburse a provider who lawfully provided
  247  care or treatment under the scope of his or her license,
  248  regardless of whether such provider is entitled to reimbursement
  249  under Medicare due to restrictions or limitations on the types
  250  or discipline of health care providers who may be reimbursed for
  251  particular procedures or procedure codes. However, subparagraph
  252  1. does not prohibit an insurer from using the Medicare coding
  253  policies and payment methodologies of the federal Centers for
  254  Medicare and Medicaid Services, including applicable modifiers,
  255  to determine the appropriate amount of reimbursement for medical
  256  services, supplies, or care if the coding policy or payment
  257  methodology does not constitute a utilization limit.
  258         4. If an insurer limits payment as authorized by
  259  subparagraph 1., the person providing such services, supplies,
  260  or care may not bill or attempt to collect from the insured any
  261  amount in excess of such limits, except for amounts that are not
  262  covered by the insured’s personal injury protection coverage due
  263  to the coinsurance amount or maximum policy limits.
  264         5. Effective July 1, 2012, An insurer may limit payment as
  265  authorized by this paragraph only if the insurance policy
  266  includes a notice at the time of issuance or renewal that the
  267  insurer may limit payment pursuant to the schedule of charges
  268  specified in this paragraph. A policy form approved by the
  269  office satisfies this requirement. If a provider submits a
  270  charge for an amount less than the amount allowed under
  271  subparagraph 1., the insurer may pay the amount of the charge
  272  submitted.
  273         Section 4. Paragraphs (a) and (b) of subsection (2) of
  274  section 627.744, Florida Statutes, are amended to read:
  275         627.744 Required preinsurance inspection of private
  276  passenger motor vehicles.—
  277         (2) This section does not apply:
  278         (a) To a policy for a policyholder who has been insured for
  279  2 years or longer, without interruption, under a private
  280  passenger motor vehicle policy that which provides physical
  281  damage coverage for any vehicle, if the agent of the insurer
  282  verifies the previous coverage.
  283         (b) To a new, unused motor vehicle purchased or leased from
  284  a licensed motor vehicle dealer or leasing company., if The
  285  insurer may require is provided with:
  286         1. A bill of sale, or buyer’s order, or lease agreement
  287  that which contains a full description of the motor vehicle,
  288  including all options and accessories; or
  289         2. A copy of the title or registration that which
  290  establishes transfer of ownership from the dealer or leasing
  291  company to the customer and a copy of the window sticker or the
  292  dealer invoice showing the itemized options and equipment and
  293  the total retail price of the vehicle.
  294  
  295  For the purposes of this paragraph, the physical damage coverage
  296  on the motor vehicle may not be suspended during the term of the
  297  policy due to the applicant’s failure to provide or the
  298  insurer’s option not to require the required documents. However,
  299  if the insurer requires a document under this paragraph at the
  300  time the policy is issued, payment of a claim may be is
  301  conditioned upon the receipt by the insurer of the required
  302  documents, and no physical damage loss occurring after the
  303  effective date of the coverage is payable until the documents
  304  are provided to the insurer.
  305         Section 5. This act shall take effect July 1, 2015.