Current Insurance Market Monitoring Initiatives 

• Property Insurance. --  Although recent legislation and regulatory action have relieved the immediate pressure on rate increases to property owners, Florida remains vulnerable to catastrophic financial loss in the event of major storm damage.  The Insurance Consumer Advocate’s office continues to explore innovative measures that create a responsible structure of insurance, reinsurance and Catastrophe Fund coverage that can pay claims in a timely manner without subjecting Florida policyholders and taxpayers to inordinate assessments to cover loss.

• Health Care Reform. --  At the local, state and national levels, in both the public and the private sector, the issue of available and affordable health care is a growing concern as employers find themselves, along with their employees, paying higher premiums, co-pays and deductibles while experiencing significant benefit erosion.  The Insurance Consumer Advocate seeks to work with regulatory agencies, employee groups and employers to identify those measures that can contribute to reform of the health care system and the regulated health plan marketplace.

• Workers Compensation.--  The Insurance Consumer Advocate has received indications from workers’ advocacy groups that implementation of workers’ compensation reforms adopted in 2003 have made access to medical care more difficult for injured workers.  The Office is attempting to gather data to determine the extent of the difficulties in order to pursue resolutions if difficulties do exist. This will be critical in light of the Florida Supreme Court’s decision in October, 2008, which ruled that limits on attorney fees adopted in 2003 to a percentage of benefits obtained do not apply in cases where the statute provides for an award of “reasonable” attorney fees. In such cases, fees can be awarded on an hourly basis pursuant to Supreme Court guidelines set forth in the Rules Regulating the Florida Bar.

  With regard to insurance rates, an actuarial analysis by the Insurance Consumer Advocate’s property and casualty actuary indicates that despite the tremendous decrease in rates for workers’ compensation insurance since legislative reforms in 2003, the approved rates may have still been excessive. The Office of the Insurance Consumer Advocate is continuing to study the system to determine if legislative reforms in laws governing the approval of workers’ compensation rates should be amended to require each insurer to file its own rates rather than having all insurers use the rates filed by a national ratemaking organization. This change would result in price competition between insurers and presumably lower costs for employers who purchase workers’ compensation.

• Task Force on Citizens Property Insurance Claims Handling and Resolution.--  The Florida Legislature adopted legislation (HB 1-A, 2007 Special Session) which required the Department of Financial Service to administer a Task Force to monitor the disposition of hurricane claims filed with Citizens for the 2004 and 2005 hurricanes and to examine Citizens’ service standards with respect to responsiveness, timeliness, customer courtesy and overall dealings with policyholders and applicants to assure that they are no less than those applied to insurers in the voluntary market.  Since May 2007, the Task Force held nine meetings, two public hearings, three conference call meetings, an informal workshop to develop recommendations for legislation and submitted 4 reports to the appointing elected officials.  Based on testimony from Citizens’ management teams, the Task Force concluded that Citizens’ policyholders will not experience the same type of delays in the claims handling process as those affected by the 2004 and 2005 hurricane seasons as long as the policies and procedures presented to the Task Force are implemented, tested and adjusted to meet intended goals. It is anticipated that the operational audits conducted by the Office of the Auditor General and the Office of Insurance Regulation will determine whether the policy and procedures have been implemented and are being followed.  The Task Force also followed the development of Citizen’s Office of Internal Auditor.  Finally, due to the hard work and diligent efforts of the Task Force, legislation was adopted that ensures that Public Adjusters are properly trained and that Florida consumers are protected from unfair solicitation practices and excessive fees.

  The Task Force developed three reports on its activities and findings. These reports are available on the Task Force website: http://taskforceoncitizensclaimshandling.org.  Also available on the website are copies of presentations made to the Task Force by Citizens and other interested parties.  Although the work of the Task Force ends in November 2008, the Office of the Insurance Advocate will continue to monitor requests for assistance that are submitted to the Department of Financial Services, Division of Consumer Services to ensure that Citizens’ consumer service standards are meeting the needs of its policyholders.