The purpose of this amendment is to clarify and correct Rule 69D-2.005, F.A.C., which provides that the Office of Insurance Regulation shall conduct audits to determine insurance company compliance with anti-fraud laws and shall take appropriate ...

 

DEPARTMENT OF FINANCIAL SERVICES

Division of Insurance Fraud

RULE NO.:RULE TITLE:

69D-2.005Compliance and Enforcement

PURPOSE AND EFFECT: The purpose of this amendment is to clarify and correct Rule 69D-2.005, F.A.C., which provides that the Office of Insurance Regulation shall conduct audits to determine insurance company compliance with anti-fraud laws and shall take appropriate administrative action against insurers for failure to comply.

SUMMARY: The amendment changes “shall” to “may” to comply with the law implemented. Thus, the Office of Insurance Regulation may conduct audits to determine insurance company compliance and may take appropriate administrative action against insurers for failure to comply. It also adds a sentence to clarify that the Department of Financial Services also has authority to take appropriate administrative action against insurers for failure to comply with the law.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 624.308, 626.9891, 626.9891(8) FS.

LAW IMPLEMENTED: 624.307, 626.9891(7) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: June 4, 2015, 11:00 a.m.

PLACE: 200 E. Gaines Street, Room 139, Larson Building, Tallahassee, FL 32301

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Nevada Martinez, [phone]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Simon Blank, Director of the Division of Insurance Fraud, Florida Department of Financial Services, 200 E. Gaines Street, Tallahassee, FL 32399-0318 or [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

69D-2.005 Compliance and Enforcement.

(1) The Division shall review the filings of SIU descriptions and insurer anti-fraud plans and the Office may shall conduct audits pursuant to Section 624.3161, F.S., to determine compliance with Section 626.9891, F.S., and this rule chapter.

(2) If an insurer fails to timely file an anti-fraud plan or SIU description, fails to implement or follow the provisions of its their anti-fraud plan or SIU description, or in any other way fails to comply with the requirements of Section 626.9891, F.S., and this rule chapter, the Division may take appropriate administrative action as provided in Section 626.9891(7), F.S., and the Office may shall take appropriate administrative action as provided in Sections 626.9891(7) and 624.4211, F.S.

Rulemaking Specific Authority 624.308, 626.9891, 626.9891(8) FS. Law Implemented 624.307, 626.9891(7) FS. History–New 10-5-06, Amended _________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Simon Blank, Director of the Division of Insurance Fraud, Department of Financial Services

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Jeff Atwater, Chief Financial Officer, Department of Financial Services

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: May 8, 2015

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: March 20, 2015