SB 156                                          Second Engrossed
       
       
       
       
       
       
       
       
       2022156e2
       
    1                        A bill to be entitled                      
    2         An act relating to loss run statements; amending s.
    3         626.9202, F.S.; revising the definition of the term
    4         “loss run statement”; specifying the entities that
    5         must receive requests for loss run statements;
    6         specifying that insurers must provide loss run
    7         statements under certain circumstances; providing
    8         construction; specifying the required claims history
    9         in loss run statements for group health insurance;
   10         providing applicability; limiting loss run statement
   11         requests with respect to group health insurance
   12         policies to group policyholders; amending s. 627.444,
   13         F.S.; revising the definition of the term “loss run
   14         statement”; specifying the entities that must receive
   15         requests for loss run statements; specifying that
   16         insurers must provide loss run statements under
   17         certain circumstances; specifying the required claims
   18         history in loss run statements for group health
   19         insurance; providing applicability; limiting loss run
   20         statement requests with respect to group health
   21         insurance policies to group policyholders; repealing
   22         s. 627.6647, F.S., relating to release of claims
   23         experience; providing an effective date.
   24          
   25  Be It Enacted by the Legislature of the State of Florida:
   26  
   27         Section 1. Subsections (1), (2), and (4) of section
   28  626.9202, Florida Statutes, are amended, and subsections (7) and
   29  (8) are added to that section, to read:
   30         626.9202 Loss run statements for all lines of insurance.—
   31         (1) As used in this section, the term:
   32         (a) “Loss run statement” means a report that contains the
   33  policy number, the period of coverage, the number of claims, the
   34  paid losses on all claims, and the date of each loss. The term
   35  does not include supporting claim file documentation, including,
   36  but not limited to, copies of claim files, investigation
   37  reports, evaluation statements, insureds’ statements, and
   38  documents protected by a common law or statutory privilege. As
   39  applied to group health insurance, the term means a report that
   40  also contains the premiums paid, the number of insureds on a
   41  monthly basis, and the dependent status.
   42         (b) “Provide” means to electronically send a document or to
   43  allow access through an electronic portal to view or generate a
   44  document.
   45         (2) Notwithstanding any other law, an insurer shall provide
   46  to an insured within 15 calendar days after an individual or
   47  entity designated by the insurer receives receipt of the
   48  insured’s written request, either:
   49         (a) A loss run statement; or
   50         (b) For personal lines of insurance, information on how to
   51  obtain a loss run statement at no charge through a consumer
   52  reporting agency. However, this section does not prohibit an
   53  insured from requesting a loss run statement after receiving
   54  information from a consumer reporting agency, in which case the
   55  insurer shall then provide the loss run statement within 15
   56  calendar days after the individual or entity designated by the
   57  insurer receives the insured’s subsequent written request.
   58  
   59  The insurer is deemed to be in compliance with this subsection
   60  if the surplus lines agent provides the loss run statement on
   61  behalf of the insurer.
   62         (4) Except for group health insurance, a loss run statement
   63  provided pursuant to this section must contain a claims history
   64  with the insurer for the preceding 5 years or, if the claims
   65  history is less than 5 years, a complete claims history with the
   66  insurer. For purposes of group health insurance, a loss run
   67  statement provided pursuant to this section must contain a
   68  claims history with the insurer for the preceding 3 years or, if
   69  the claims history is less than 3 years, a complete claims
   70  history with the insurer.
   71         (7) This section does not apply to a life insurer as
   72  defined in s. 624.602.
   73         (8) For group health insurance, only the group policyholder
   74  may request and be provided a loss run statement pursuant to
   75  this section.
   76         Section 2. Subsections (1), (2), and (4) of section
   77  627.444, Florida Statutes, are amended, and subsections (7) and
   78  (8) are added to that section, to read:
   79         627.444 Loss run statements for all lines of insurance.—
   80         (1) As used in this section, the term:
   81         (a) “Loss run statement” means a report that contains the
   82  policy number, the period of coverage, the number of claims, the
   83  paid losses on all claims, and the date of each loss. The term
   84  does not include supporting claim file documentation, including,
   85  but not limited to, copies of claim files, investigation
   86  reports, evaluation statements, insureds’ statements, and
   87  documents protected by a common law or statutory privilege. As
   88  applied to group health insurance, the term means a report that
   89  also contains the premiums paid, the number of insureds on a
   90  monthly basis, and the dependent status.
   91         (b) “Provide” means to electronically send a document or to
   92  allow access through an electronic portal to view or generate a
   93  document.
   94         (2) Notwithstanding any other law, an insurer shall provide
   95  to an insured within 15 calendar days after an individual or
   96  entity designated by the insurer receives receipt of the
   97  insured’s written request, either:
   98         (a) A loss run statement; or
   99         (b) For personal lines of insurance, information on how to
  100  obtain a loss run statement at no charge through a consumer
  101  reporting agency. However, this section does not prohibit an
  102  insured from requesting a loss run statement after receiving
  103  information from a consumer reporting agency, in which case the
  104  insurer shall then provide the loss run statement within 15
  105  calendar days after the individual or entity designated by the
  106  insurer receives the insured’s subsequent written request.
  107         (4) Except for group health insurance, a loss run statement
  108  provided pursuant to this section must contain a claims history
  109  with the insurer for the preceding 5 years or, if the claims
  110  history is less than 5 years, a complete claims history with the
  111  insurer. For purposes of group health insurance, a loss run
  112  statement provided pursuant to this section must contain a
  113  claims history with the insurer for the preceding 3 years or, if
  114  the claims history is less than 3 years, a complete claims
  115  history with the insurer.
  116         (7)This section does not apply to a life insurer as
  117  defined in s. 624.602.
  118         (8)For group health insurance, only the group policyholder
  119  may request and be provided a loss run statement pursuant to
  120  this section.
  121         Section 3. Section 627.6647, Florida Statutes, is repealed.
  122         Section 4. This act shall take effect upon becoming a law.