HB 731 2024
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to insurance claims; providing a short 2
title; amending s. 627.0651, F.S.; requiring the 3
Office of Insurance Regulation to consider the 4
recovery of funds under specified provisions in 5
reviewing rates; amending s. 817.234, F.S.; requiring 6
insurers to report the recovery of funds under 7
specified provisions; specifying that an insured's 8
payment of a deductible or copayment is not a 9
condition of an insurer's payment obligations; 10
providing an effective date. 11
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Be It Enacted by the Legislature of the State of Florida: 13
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Section 1. This act may be cited as the "Transparency in 15
Recoveries Act." 16
Section 2. Paragraphs (g) through (l) of subsection ( 2) of 17
section 627.0651, Florida Statutes, are redesignated as 18
paragraphs (h) through (m), respectively, a new paragraph (g) is 19
added to that subsection, and paragraphs (d) and (e) of 20
subsection (14) of that section are amended, to read: 21
627.0651 Making and use of rates for motor vehicle 22
insurance.— 23
(2) Upon receiving notice of a rate filing or rate change, 24
the office shall review the rate or rate change to determine if 25
HB 731 2024
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
the rate is excessive, inadequate, or unfairly discriminatory. 26
In making that determi nation, the office shall in accordance 27
with generally accepted and reasonable actuarial techniques 28
consider the following factors: 29
(g) Recovery of funds by judgment or settlement and 30
attorney fees and costs awarded or returned for payments 31
recovered as a result of claimed violations of s. 456.054, part 32
X of chapter 400, part II of chapter 501, s. 627.732, s. 33
627.736(17), s. 817.234, or s. 817.505 or repayment of claims 34
paid for pursuant to actions or allegations of common law fraud, 35
civil conspiracy, unju st enrichment, or unlawful conduct. 36
(14) 37
(d) An insurer must notify the office of any changes to 38
rates for type of insurance described in this subsection no 39
later than 30 days after the effective date of the change. The 40
notice shall include the name of the insurer, the type or kind 41
of insurance subject to rate change, and the average statewide 42
percentage change in rates. Actuarial data with regard to rates 43
for risks described in this subsection shall be maintained by 44
the insurer for 2 years after the eff ective date of changes to 45
those rates and are subject to examination by the office. The 46
office may require the insurer to incur the costs associated 47
with an examination. Upon examination, the office shall, in 48
accordance with generally accepted and reasonab le actuarial 49
techniques, consider the factors in paragraphs (2)(a)-(m) 50
HB 731 2024
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(2)(a)-(l) and apply subsections (3) -(8) to determine if the 51
rate is excessive, inadequate, or unfairly discriminatory. 52
(e) A rating organization must notify the office of any 53
changes to loss cost for the type of insurance described in this 54
subsection no later than 30 days after the effective date of the 55
change. The notice shall include the name of the rating 56
organization, the type or kind of insurance subject to a loss 57
cost change, loss costs during the immediately preceding year 58
for the type or kind of insurance subject to the loss cost 59
change, and the average statewide percentage change in loss 60
cost. Actuarial data with regard to changes to loss cost for 61
risks not subject to subsecti on (1), subsection (2), or 62
subsection (9) shall be maintained by the rating organization 63
for 2 years after the effective date of the change and are 64
subject to examination by the office. The office may require the 65
rating organization to incur the costs asso ciated with an 66
examination. Upon examination, the office shall, in accordance 67
with generally accepted and reasonable actuarial techniques, 68
consider the rate factors in paragraphs (2)(a)-(m) (2)(a)-(l) 69
and apply subsections (3) -(8) to determine if the rate is 70
excessive, inadequate, or unfairly discriminatory. 71
Section 3. Paragraph (c) is added to subsection (5) of 72
section 817.234, Florida Statutes, and subsection (7) of that 73
section is amended, to read: 74
817.234 False and fraudulent insurance claims. — 75
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(5) 76
(c) If an insurer damaged as a result of a violation of 77
any provision of this section or s. 456.054, part X of chapter 78
400, part II of chapter 501, s. 627.732, s. 627.736(17), s. 79
817.234, or s. 817.505 and the insurer obtains repayment or a 80
refund of claims paid pursuant to s. 627.736, the insurer shall 81
report to the department the amount of funds received as a 82
result of a claim, settlement, or judgment, inclusive of 83
attorney fees and costs, of such repayment of funds. 84
(7)(a) It shall constitute a material omission and 85
insurance fraud, punishable as provided in subsection (11), for 86
any service provider, other than a hospital, to engage in a 87
general business practice of billing amounts as its usual and 88
customary charge, if such provider has agreed with the insured 89
or intends to waive deductibles or copayments, or does not for 90
any other reason intend to collect the total amount of such 91
charge. With respect to a determination as to whether a service 92
provider has engaged in such general business practice, 93
consideration shall be given to evidence of whether the 94
physician or other provider made a good faith attempt to collect 95
such deductible or copayment. This paragraph does not apply to 96
physicians or other providers who defer collection of waive 97
deductibles or copayments or reduce their bills as part of a 98
bodily injury settlement or verdict. Payment by an insured of a 99
deductible or copayment is not a condition of an insurer's 100
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payment obligations. 101
(b) The provisions of this se ction shall also apply as to 102
any insurer or adjusting firm or its agents or representatives 103
who, with intent, injure, defraud, or deceive any claimant with 104
regard to any claim. The claimant shall have the right to 105
recover the damages provided in this secti on. 106
(c) An insurer, or any person acting at the direction of 107
or on behalf of an insurer, may not change an opinion in a 108
mental or physical report prepared under s. 627.736(7) or direct 109
the physician preparing the report to change such opinion; 110
however, this paragraph provision does not preclude the insurer 111
from calling to the attention of the physician errors of fact in 112
the report based upon information in the claim file. Any person 113
who violates this paragraph commits a felony of the third 114
degree, punishable as provided in s. 775.082, s. 775.083, or s. 115
775.084. 116
(d) A contractor, or a person acting on behalf of a 117
contractor, may not knowingly or willfully and with intent to 118
injure, defraud, or deceive, pay, waive, or rebate all or part 119
of an insurance deductible applicable to payment to the 120
contractor, or a person acting on behalf of a contractor, for 121
repairs to property covered by a property insurance policy. A 122
person who violates this paragraph commits a third degree felony 123
of the third degree, punishable as provided in s. 775.082, s. 124
775.083, or s. 775.084. 125
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Section 4. This act shall take effect July 1, 2024. 126