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.
Assignment of Benefits. An assignment of benefits (AOB) is a legal tool that allows a third party to be paid for services performed for an insured homeowner who would normally be reimbursed by the insurance company directly after making a claim. AOB is commonly used when a homeowner experiences a water loss – such as a leaky pipe, an overflow from a sink, or a damaged appliance – and contacts a contractor or water remediation company for assistance. Most AOB agreements presented to the homeowner allow the contractor to stand in the shoes of the homeowner for insurance collection purposes. Some argue that this legal arrangement allows unscrupulous contractors to overinflate or submit improper claims, causing legal battles between the contractor and the insurance company, with the consumer left out of the picture.
The Insurance Consumer Advocate’s office is monitoring this issue for advocacy action and has asked the fifteen highest-writing homeowner insurance companies in Florida to provide claims data information in an effort to target the issue and the impact it has on the Florida consumer. The links below include a Request for Information to these companies, a template for company data input and a certification statement verifying the accuracy of the responsive data. The Insurance Consumer Advocate remains committed to collaboratively work with all interested parties on this issue to develop an advocacy and policy strategy that is in the best interest of the Florida consumer.
- Florida Claims Data Letter
- Florida Claims Data Certification Statement
- Florida Claims Data Template
- Frequently Asked Questions about the Florida Claims Data Call
Flood Insurance. Floods are the most common natural disaster in the United States and the damage caused by floods is well known to any seasoned Florida citizen. Yet, most homeowners insurance policies do not cover flood damage claims. Most Floridians purchase flood insurance through the National Flood Insurance Program, a federal initiative that writes the nation's flood risk by providing flood insurance to property owners. Florida faces challenges at both the federal and state levels in advocating for accessible, comprehensive, and affordable flood insurance solutions for consumers. As policy discussions continue to develop, the Insurance Consumer Advocate has identified a need to proactively advocate in the best interest of Florida consumers.
Troubled Waters: Finding a Balanced Approach to Florida's Water Loss Crisis. Florida's Insurance Consumer Advocate, Sha'Ron James, invites the public and members of the media to participate in a forum focused on the water loss claims crisis impacting Florida's homeowner's insurance industry. This forum hopes to find a balanced approach to the issue, calling on members of regulatory and industry groups, consumer representatives, and trade associations to participate and collaborate on this critical issue.
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.
Balance Billing. An issue affecting Floridians is unexpected charges related to medical services provided by non-network providers, known in the industry as “balance billing”. This issue impacts medical providers, insurers and others; however, it is often the consumer who is left financially burdened by this form of unexpected healthcare cost.
To learn more about unexpected medical bills, please review the Center on Health Insurance Reforms' (CHIR) resource:
Emergency Medical Transportation. After a life threatening accident or major medical emergency, air ambulances can quickly transport a patient to receive immediate health care attention at a nearby facility. Air ambulances are helicopters or airplanes that contain sophisticated medical equipment and staff trained to stabilize patients as they are transported to a facility for care. Although some health care policies provide coverage for this event, some coverage gaps can leave consumers with surprise high medical bills for the service. The Office of the Insurance Consumer Advocate has identified this issue as a concern for the Florida consumer and seeks to inform, engage and advocate for measures that will help ensure that this life saving service is affordable for Florida consumers.
Prior ICA Initiatives: