Mediation Procedures for Resolution of Disputed Personal Lines Insurance Claims Arising from the 2004 and 2005 Hurricanes and Tropical Storms  

  •  

    DEPARTMENT OF FINANCIAL SERVICES
    Division of Consumer Services

    RULE NO: RULE TITLE
    69J-2.003: Mediation Procedures for Resolution of Disputed Personal Lines Insurance Claims Arising from the 2004 and 2005 Hurricanes and Tropical Storms

    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. 34, No. 15, April 11, 2008 issue of the Florida Administrative Weekly.

    These changes are being made to address concerns expressed at the public hearing, and the Joint Administrative Procedures Committee.

    69J-2.003 Mediation Procedures for Resolution of Disputed Personal Lines Insurance Claims Arising from the 2004 and 2005 Hurricanes and Tropical Storms.

    (1) through (2) No change.

    (3) Notification of Right to Mediate; Procedures.

    (a) Responsibilities of the Insurer.

    1. through 3. No change.

    4. If, after receiving the information described in subsection (4)(a)1. and 2., below, the insurer has not rendered a decision regarding the reported hurricane loss within 90 days, the insurer shall mail a notification of right to mediate to the insured.

    5. No change.

    (b) through (e) No change.

    (4) Procedures for Requesting Mediation Request for Mediation.

    (a) By the Insured. After 21 days from the date of the notice of the right to mediation, an insured may request mediation by contacting the insurer or by calling the Department at 1(877)MYFLCFO or (1(877)693-5236) 1(800)22-STORM (1(800)227-8676); by faxing a request to the Department at (850)488-6372; or by writing to the Department of Financial Services, Mediation Section, Bureau of Education, Advocacy, and Research, Tallahassee, Florida 32399-4212. Alternatively, an insured may request mediation prior to receipt of the notice of the right to mediation. If an insured requests mediation prior to receipt of the notice of the right to mediation or if the date of the notice cannot be established, the insurer shall be notified by the Department of the existence of the dispute 21 days prior to the Administrator processing the insured’s request for mediation. Upon such request, in order to be scheduled for mediation, the insured shall should provide the following information if known:

    1. through 5. No change.

    If an insurer receives a request for mediation, the insurer shall fax the request to the Department’s Mediation Section within 48 hours of receipt of the request. The Department will forward requests to the Administrator within 24 hours of receipt of the request. The Administrator shall notify the insurer within 48 hours of receipt of requests filed with the Department. In instances where the insured has requested mediation prior to receiving a notice of the right to mediation, and has provided the information described above, upon notification, the Administrator shall process the request for mediation no less than 21 days thereafter.

    (b) No change.

    (5) through (14) No change.

    The remainder of the rule reads as previously published.