Mediation of Commercial Residential Property Insurance Claims, Mediation of Residential Property Insurance Claims
DEPARTMENT OF FINANCIAL SERVICES
RULE NO.: RULE TITLE:
69J-166.002: Mediation of Commercial Residential Property Insurance Claims
69J-166.031: Mediation of Residential Property Insurance Claims
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 41 No. 244, December 18, 2015 issue of the Florida Administrative Register.
69J-166.002 Mediation of Commercial Residential Property Insurance Claims.
(1) through (3) No change.
(4) Claim Settlement.
(a) No change.
(b) Request for Mediation.
1. By the Policyholder. A policyholder may request mediation by submitting a completed Form DFS-I1-1669, Request for Commercial Residential Insurance Mediation Request Form (Rev. 2/16), (Revised 6/15) which is hereby incorporated by reference, to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy, and Research, 200 East Gaines Street, Tallahassee, Florida 32399-4212. A copy of the request form can be obtained online at the following website:
http://www.myfloridacfo.com/Division/Consumers/Mediation/documents/DFS-I1-1669CommResMedRequest.pdf or by calling (877) 693-5236. If a policyholder requests mediation prior to receipt of the notice of the right to mediation, the insurer shall be notified by the Department of the existence of the dispute 21 days prior to the Administrator processing the policyholder’s request for mediation. If an insurer receives a request for mediation, the insurer shall notify the Mediation Section within 3 business days of receipt of the request by to Mediation@myfloridacfo.com. The Administrator shall notify the insurer within 3 business days of receipt of requests filed with the Department. The policyholder should provide the following information, if known:
a. through e. No change.
2. By an Insurer. An insurer may request mediation by submitting a completed Form DFS-I1-1669, Request for Commercial Residential Insurance Mediation Request Form, as incorporated in subparagraph 1. of this subsection, to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy, and Research, 200 East Gaines Street, Tallahassee, Florida 32399-4212. A copy of the request form can be obtained online at the following website:
http://www.myfloridacfo.com/Division/Consumers/Mediation/documents/DFS-I1-1669CommResMedRequest.pdf or by calling (877) 693-5236. The insurer shall provide a copy of its written mediation request to the policyholder at the same time it submits the request to the Department. The written request should contain the information set forth in subparagraph (4)(b)1., if known. Mediation requests by insurers will be processed by the Administrator in the same manner as mediation requests by policyholders insureds.
(c) No change.
(5) through (7) No change.
(8) Mediation Conference.
(a) through (f) No change.
(g) Disposition. Mediators shall report to the Department on the status of property insurance mediation conferences by submitting Form DFS-I4-2169 DFS-I5-1971, Mediation Disposition Form “Disposition of Property Insurance Mediation Conference, (Rev. 2/16 rev. 10/08), which is hereby incorporated by reference, and available from the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy and Research, 200 East Gaines Street, Tallahassee, Florida 32399-4212. A copy of the form can be obtained at the following website: www.myfloridacfo.com/Division/Consumers/Mediation/CommercialResidentialMediation.htm. If the claim is settled prior to the mediation conference being held, the insurer shall report the outcome of the issue to the mediator prior to the scheduled hearing and the mediator will submit the Mediation Disposition Form DFS-I5-1971 confirming the settlement. A mediation conference will not be considered complete and the Administrator will not bill the insurer until this form is submitted.
(9) No change.
(10) Post-Mediation.
(a) At the conclusion of the mediation conference, the mediator will file Form DFS-I4-2169, Mediation Disposition Form, the “Disposition of Property Insurance Mediation Conference,” as incorporated in paragraph (8)(g) Form DFS-I5-1971, with the Department, indicating whether or not the parties reached a settlement. In the event a settlement is reached, the policyholder shall have 3 business days from the date of the written settlement within which he or she may rescind the settlement provided that the policyholder has not cashed or deposited any check or draft disbursed to him or her for the disputed matters as a result of the conference. If a settlement agreement is reached and not rescinded, it shall act as a release of specific issues that were presented at the conference.
(b) No change.
(11) through (12) No change.
69J-166.031 Mediation of Residential Property Insurance Claims.
(1) through (3) No change.
(4) Claim Settlement.
(a) No change.
(b) Request for Mediation.
1. By the Policyholder. A policyholder may request mediation by contacting the Department at 1 (877) 693-5236; by faxing a request to the Department at (850)488-6372; or by submitting a completed Form DFS-I0-2082, Request for Personal Residential Insurance Mediation (Rev. 02/16), Personal Residential Mediation Request Form (Revised 02/15) which is hereby incorporated by reference, to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy, and Research, 200 East Gaines Street, Tallahassee, Florida 32399-4212. The form may be obtained online at the following website: http://www.myfloridacfo.com/Division/Consumers/Mediation/documents/DFS-I0-2082.pdf. If a policyholder requests mediation prior to receipt of the notice of the right to mediation, the insurer shall be notified by the Department of the existence of the dispute 21 days prior to the Administrator processing the policyholder’s request for mediation. If an insurer receives a request for mediation, the insurer shall notify the Mediation Section within 2 business days of receipt of the request by email at Mediation@myfloridacfo.com. The Administrator shall notify the insurer within 3 business days of receipt of requests filed with the Department. The policyholder shall provide the following information, if known:
a. through e. No change.
(5) through (6) No change.
(7) Mediators.
(a) No change.
(b) Procedure and Conduct. All mediation conferences shall be conducted in accordance with this rule and Rules 10.200 through 10.690, Part II, Standards of Professional Conduct, of the Florida Rules for Certified and Court-Appointed Mediators (Effective 10/1/14), which are hereby incorporated by reference and available at http://www.flcourts.org/core/fileparse.php/550/urlt/RuleBookletJanuary2015.pdf as set forth in Rules 10.020-10.290, Florida Rules of Civil Procedure, as incorporated above, and other consistent rules of conduct as promulgated by the Supreme Court of Florida. Mediators shall have the same responsibilities to the Department as they have to the courts under the Florida Rules for Certified and Court-Appointed Mediators. The Florida Rules for Certified and Court-Appointed Mediators shall be read in a manner consistent with this rule and any conflict between this rule and the Florida Rules for Certified and Court-Appointed Mediators shall be resolved in favor of this rule. The mediator may meet with the parties separately, encourage meaningful communications and negotiations, and otherwise assist the parties to arrive at a settlement. For purposes of this mediation program, mediators shall have the immunity from suit provided to mediators in Section 44.107, F.S. All communications with the mediator shall be confidential. All statements made and documents produced at a settlement conference constitute settlement negotiations in anticipation of litigation. The mediation proceedings are confidential and inadmissible in any subsequent adversarial proceeding
(8) Mediation Conference.
(a) through (d) No change.
(e) Disposition. Mediators shall report to the Department on the status of property insurance mediation conferences by submitting Form DFS-I4-2169 DFS-I5-1971, Mediation Disposition Form “Disposition of Property Insurance Mediation Conference” (Rev. 2/16 rev. 10/08), which is hereby adopted herein and incorporated by reference. A copy of the form can be obtained at the following website: www.myfloridacfo.com/Division/Consumers/Mediation/CommercialResidentialMediation.htm. If the claim is settled prior to the mediation conference being held, the insurer shall report the outcome of the issue to the mediator prior to the scheduled hearing and the mediator will submit the Mediation Disposition Form DFS-I5-1971 confirming the settlement. A mediation conference will not be considered complete and the Administrator will not bill the insurer until this form is submitted.
(9) No change.
(10) Post-Mediation.
(a) At the conclusion of the mediation conference, the mediator will file Form DFS-I4-2169, Mediation Disposition Form, Form DFS-I5-1971, the “Disposition of Property Insurance Mediation Conference,” as incorporated in paragraph (8)(e), with the Department, indicating whether or not the parties reached a settlement. A copy of the form can be obtained at the following website: www.myfloridacfo.com/Division/Consumers/Mediation/CommercialResidentialMediation.htm. In the event a settlement is reached, the policyholder shall have 3 business days from the date of the written settlement within which he or she may rescind the settlement provided that the policyholder has not cashed or deposited any check or draft disbursed to him or her for the disputed matters as a result of the conference. If a settlement agreement is reached and not rescinded, it shall act as a release of specific issues that were presented at the conference.
