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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 pet insurance and wellness 2
programs; amending s. 624.604, F.S.; revising the 3
definition of the term "property insurance"; amending 4
s. 626.9541, F.S.; providing that certain practices 5
related to pet wellness programs are unfair methods of 6
competition and unfair or deceptive acts or practices; 7
creating s. 627.71545, F.S.; providing a short title; 8
providing purpose; providing applicability; providing 9
construction; defining terms; requiring pet insurers 10
that use such defined terms in their pe t insurance 11
policies to use and include the statutory definitions 12
in their policies; requiring pet insurers to also make 13
such definitions available on their websites or their 14
program administrators' websites; requiring pet 15
insurers to make certain disclosu res to pet insurance 16
applicants and policyholders; requiring pet insurers 17
to provide a summary of their bases or formulas for 18
determination of claim payments under a pet insurance 19
policy on their websites or their program 20
administrators' websites; requirin g pet insurers to 21
disclose certain requirements for required medical 22
examinations of a pet by a veterinarian; requiring pet 23
insurers to create a document with a summary of 24
certain disclosures, to post such document on their 25
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websites or their program admini strators' websites, 26
and, upon issuance or delivery of a policy to a 27
policyholder, to provide the disclosure document to 28
the policyholder; requiring additional written 29
disclosures; providing that certain required 30
disclosures are in addition to disclosures r equired by 31
the Florida Insurance Code or the Financial Services 32
Commission rules; authorizing pet insurance applicants 33
and policyholders to examine and return insurance 34
policies and riders under certain circumstances; 35
requiring that premiums be refunded un der certain 36
circumstances; requiring that pet insurance policies 37
and riders have a specified notice printed on or 38
attached to the first page; authorizing pet insurers 39
to issue policies that exclude coverage on the basis 40
of preexisting conditions with appro priate written 41
disclosure to the applicant or policyholder; providing 42
that the pet insurer has a specified burden of proof 43
with regard to such exclusions; authorizing pet 44
insurers to issue policies that impose a waiting 45
period of up to a specified period o f time for 46
specified illnesses, diseases, or conditions; 47
prohibiting pet insurers from issuing policies 48
imposing a waiting period for accidents; requiring pet 49
insurers who issue a policy that imposes a waiting 50
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period to include a provision allowing for wai ver of 51
the waiting period upon completion of a medical 52
examination of the covered pet by a veterinarian; 53
authorizing pet insurers to require an examination to 54
be conducted by a veterinarian after the purchase of 55
the policy; providing requirements and autho rizations 56
relating to such examination; prohibiting a pet 57
insurer from requiring a medical examination of the 58
covered pet to renew a policy; requiring that certain 59
benefits comply with certain provisions of the Florida 60
Insurance Code; prohibiting insurance applicants' 61
eligibility from being based on participation or lack 62
of participation in wellness programs; requiring pet 63
insurers to ensure that its agents are trained on 64
specified topics; providing rulemaking authority; 65
providing an effective date. 66
67
Be It Enacted by the Legislature of the State of Florida: 68
69
Section 1. Section 624.604, Florida Statutes, is amended 70
to read: 71
624.604 "Property insurance" defined. —"Property insurance" 72
is insurance on real or personal property of every kind and of 73
every interest therein, whether on land, water, or in the air, 74
against loss or damage from any and all hazard or cause, and 75
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against loss consequential upon such loss or damage, other than 76
noncontractual legal liability for any such loss or damage. 77
Property insurance may include pet insurance that provides 78
coverage for accidents and for illnesses or diseases of pets. 79
Property insurance may contain a provision for accidental death 80
or injury as part of a multiple peril homeowner's policy. Such 81
insurance, which is i ncidental to the property insurance, is not 82
subject to the provisions of this code applicable to life or 83
health insurance. Property insurance does not include title 84
insurance, as defined in s. 624.608. 85
Section 2. Paragraph (hh) is added to subsection ( 1) of 86
section 626.9541, Florida Statutes, to read: 87
626.9541 Unfair methods of competition and unfair or 88
deceptive acts or practices defined. — 89
(1) UNFAIR METHODS OF COMPETITION AND UNFAIR OR DECEPTIVE 90
ACTS.—The following are defined as unfair methods of competition 91
and unfair or deceptive acts or practices: 92
(hh) Sales practices for pet wellness programs. — 93
1. A pet insurance agent may not market a wellness program 94
as pet insurance. 95
2. If a wellness program is sold by a pet insurance agent: 96
a. The purchase of the wellness program may not be a 97
prerequisite to the purchase of pet insurance; 98
b. The costs of the wellness program must be separate and 99
identifiable from any pet insurance policy sold by the pet 100
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insurance agent; 101
c. The terms and conditio ns of the wellness program must 102
be separate from any pet insurance policy sold by the agent; 103
d. The products or coverages available through the 104
wellness program may not duplicate the products or coverages 105
available through the pet insurance policy; and 106
e. The advertising of the wellness program must not be 107
misleading. 108
Section 3. Section 627.71545, Florida Statutes, is created 109
to read: 110
627.71545 Pet insurance; noninsurance wellness programs. — 111
(1) This section may be cited as the "Pet Insurance Ac t." 112
(2) The purpose of this section is to promote the public 113
welfare by creating a comprehensive regulatory framework within 114
which pet insurance may be sold in this state. 115
(3) This section applies to all of the following: 116
(a) Pet insurance policies t hat are issued to any resident 117
of this state or that are sold, solicited, negotiated, or 118
offered in this state. 119
(b) Pet insurance policies or certificates that are 120
delivered or issued for delivery in this state. 121
(4)(a) This section may not be construed to prohibit or 122
limit the types of exclusions pet insurers may use in their 123
policies or to require pet insurers to include in such policies 124
any of the limitations or exclusions specified in subsection 125
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(9). 126
(b) All other applicable provisions of the Flori da 127
Insurance Code apply to pet insurance, except that this section 128
supersedes any general provisions of the Florida Insurance Code 129
which otherwise apply to pet insurance. 130
(5)(a) As used in this section, the term: 131
1. "Chronic condition" means a conditio n that can be 132
treated or managed, but not cured. 133
2. "Congenital anomaly or disorder" means a condition that 134
is present from birth, whether inherited or caused by the 135
environment, and that may cause or contribute to illness or 136
disease. 137
3. "Hereditary disorder" means an abnormality that is 138
genetically transmitted from parent to offspring and may cause 139
illness or disease. 140
4. "Orthopedic" refers to a condition that affects the 141
bones, skeletal muscle, cartilage, tendons, ligaments, or 142
joints. Orthopedic co nditions include, but are not limited to, 143
elbow dysplasia, hip dysplasia, intervertebral disc 144
degeneration, patellar luxation, and cranial cruciate ligament 145
rupture but do not include any cancer or any metabolic, 146
hematopoietic, or autoimmune disease. 147
5. "Pet insurance" means an insurance policy that provides 148
coverage for accidents and for illnesses and diseases of pets. 149
Such insurance reimburses a policyholder for expenses associated 150
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with medical advice, diagnosis, care, or treatment provided by a 151
veterinarian, including, but not limited to, the cost of drugs 152
prescribed by the veterinarian. 153
6. "Pet insurance policy" or "policy" includes pet 154
insurance certificates. 155
7. "Preexisting condition" means a condition for which any 156
of the following is true befor e the effective date of or during 157
a waiting period applicable to a pet insurance policy: 158
a. A veterinarian provided medical advice. 159
b. The pet received previous treatment. 160
c. Based on information from verifiable sources, the pet 161
had signs or symptoms directly related to the condition for 162
which a claim is being made. 163
164
A condition for which coverage is afforded on a policy is not 165
deemed to be a preexisting condition on any renewal of the 166
policy. 167
8. "Renewal" means the issuance and delivery at the end of 168
an insurance policy period of a policy that supersedes the 169
policy previously issued and delivered by the same pet insurer 170
or affiliated pet insurer and that provides types and limits of 171
coverage substantially similar to those contained in the policy 172
being superseded. 173
9. "Veterinarian" means a health care practitioner who is 174
licensed to engage in the practice of veterinary medicine in 175
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this state under chapter 474. 176
10. "Waiting period" means the period of time specified in 177
a pet insurance policy which is required to run before some or 178
all of the coverage in the policy may begin. This period may not 179
be applied to renewals of existing coverage. 180
11. "Wellness program" means a subscription or 181
reimbursement-based program that is separate from an insurance 182
policy and that provides goods and services to promote the 183
general health, safety, or well -being of the covered pet. If the 184
subscription or program includes language such as "undertakes to 185
indemnify another," "pays a specified amount upon determinable 186
contingencies," or "provides coverage for a fortuitous event," 187
the subscription or program is transacting in the business of 188
insurance and is subject to the Florida Insurance Code. This 189
definition is not intended to classify a contract directly 190
between a service provider and a pet owner which involves only 191
the two parties as being the business of insurance, unless other 192
indications of insurance also exist. 193
(b) If a pet insurer uses any of the terms defined in 194
paragraph (a) in a pet insurance policy, the pet i nsurer must 195
use the definition of each term as provided in paragraph (a) and 196
must include each such definition in the policy. The pet insurer 197
must also make such definitions available through a clear and 198
conspicuous link on the main page of the website of the pet 199
insurer or the pet insurer's program administrator. 200
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(6)(a) A pet insurer transacting pet insurance must 201
disclose the following to pet insurance applicants and 202
policyholders: 203
1. Whether the policy excludes coverage due to any of the 204
following: 205
a. A chronic condition; 206
b. A congenital anomaly or disorder; 207
c. A hereditary disorder; or 208
d. A preexisting condition. 209
2. If the policy includes any other exclusions not listed 210
in subparagraph 1., the pet insurer must state the following in 211
the disclosure: "Other exclusions may apply. Please refer to the 212
exclusions section of the policy for more information." 213
3. Any policy provision that limits coverage through a 214
waiting period, a deductible, a coinsurance payment, or an 215
annual or lifetime poli cy limit. Waiting periods and applicable 216
requirements must be clearly and prominently disclosed to 217
applicants before the policy purchase. 218
4. Whether the pet insurer reduces coverage or increases 219
premium based on the policyholder's claims history, the age of 220
the covered pet, or a change in the geographic location of the 221
policyholder. 222
5. Whether the underwriting company differs from the brand 223
name used to market and sell the pet insurance. 224
(b) Before issuing a pet insurance policy, a pet insurer 225
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shall, through a clear and conspicuous link on the main page of 226
the pet insurer's or the pet insurer's program administrator's 227
website, provide a summary description of the basis or formula 228
for the pet insurer's determination of claim payments under the 229
policy. 230
1. A pet insurer that uses a benefit schedule to determine 231
claim payments under a pet insurance policy must clearly 232
disclose both of the following: 233
a. The applicable benefit schedule in the policy. 234
b. All benefit schedules used by the pet insurer unde r its 235
pet insurance policies through a clear and conspicuous link on 236
the main page of the pet insurer's or pet insurer's program 237
administrator's website. 238
2. A pet insurer that determines claim payments under a 239
pet insurance policy based on usual and cust omary fees, or any 240
other reimbursement limitation based on prevailing veterinary 241
service provider charges, shall do both of the following: 242
a. Include a usual and customary fee limitation provision 243
in the policy which clearly describes the pet insurer's b asis or 244
formula for determining usual and customary fees and the manner 245
in which that basis or formula is applied in calculating claim 246
payments. 247
b. Disclose the pet insurer's basis for determining usual 248
and customary fees through a clear and conspicuous link on the 249
main page of the pet insurer's or pet insurer's program 250
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administrator's website. 251
(c) If any medical examination of the pet by a 252
veterinarian is required to effectuate coverage, the pet insurer 253
must clearly and conspicuously disclose any requi rement for the 254
examination before the policy is purchased and must disclose 255
that examination documentation may result in a preexisting 256
condition exclusion. 257
(d) A pet insurer shall create a summary of all policy 258
disclosures required in paragraphs (a), (b) , and (c) in a 259
separate document titled "Insurer Disclosure of Important Policy 260
Provisions." The pet insurer shall post the document through a 261
clear and conspicuous link on the main page of the pet insurer's 262
or pet insurer's program administrator's website . 263
(e) At the time a pet insurance policy is issued or 264
delivered to a policyholder, the pet insurer shall provide the 265
policyholder with a copy of the Insurer Disclosure of Important 266
Policy Provisions document required under paragraph (d), in at 267
least 12-point type. At such time, the pet insurer shall also 268
include a written disclosure with all of the following: 269
1. Contact information for the Division of Consumer 270
Services of the department, including a link and toll -free 271
telephone number, for consumers to submit inquiries and 272
complaints relating to pet insurance products regulated by the 273
department or office. 274
2. The address and customer service telephone number of 275
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the pet insurance agent. 276
(f) The disclosures required in this subsection are in 277
addition to any other disclosures required by the insurance code 278
or rules prescribed by the commission. 279
(7) Unless the policyholder has filed a claim under the 280
pet insurance policy, a pet insurance applicant or policyholder 281
may examine and return the policy or rid er to the pet insurer or 282
pet insurance agent or broker within 30 days after the applicant 283
or policyholder obtains the receipt and is entitled to the 284
premium refunded if, after examining the policy or rider, he or 285
she is not satisfied for any reason. 286
(8) A pet insurance policy and rider must have a notice 287
prominently printed on or attached to the first page which 288
includes specific instructions to accomplish a return, in type 289
at least as large as any type appearing on the policy or rider 290
contract and in substantially the following language: 291
292
You have 30 days after the date you receive this 293
policy, certificate, or rider to review and return it 294
to the company if you decide not to keep it. You do 295
not have to tell the company why you are returning it. 296
If you decide not to keep policy, certificate, or 297
rider, simply return it to the company at the 298
company's administrative office, or to the insurance 299
agent or broker from whom you bought it, as long as 300
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you have not filed a claim. You must return the 301
policy, certificate, or rider within 30 days after the 302
day you first receive it in order to receive a refund. 303
The company must refund the full amount of any premium 304
paid within 30 days after it receives the returned 305
policy, certificate, or rider. The premium refund will 306
be sent directly to the person who paid it. The 307
policy, certificate, or rider will be void as if it 308
had never been issued. 309
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(9)(a) A pet insurer may issue a policy that excludes 311
coverage on the basis of one or more preexisting conditions with 312
appropriate written disclosure to the applicant or policyholder. 313
The pet insurer has the burden of proving that the preexisting 314
condition exclusion applies to the condition for which a claim 315
is being made. 316
(b)1. A pet insurer may issue a policy imposing a waiting 317
period before the effective date of a new policy which does not 318
exceed 30 days for illnesses or diseases or for orthopedic 319
conditions not resulting from an accident. A pet insurer may not 320
issue a policy imposing a waiting period for accidents. 321
2. A pet insurer issuing a policy that imposes a waiting 322
period must include a provision in its contract which allows the 323
waiting period to be waived upon completion of a medical 324
examination of the pet by a veterinarian. The pet insurer may 325
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require the examination to be conducted by a veterinarian after 326
the purchase of the policy. 327
a. A medical examination required under this subparagraph 328
must be paid for by the policyholder, unless the policy 329
specifies that the pet insurer will pay for the examination. 330
b. A pet insurer may specify requirements for the 331
examination and require documentation that the requirements have 332
been satisfied, provided that the specifications do not 333
unreasonably restrict the ability of the applicant or 334
policyholder to waive the waiting period. 335
(c) A pet insurer may not require a medical examination of 336
the covered pet for the policyholder to renew a policy. 337
(d) If a pet insurer includes any prescriptive, wellness, 338
or noninsurance benefit in the policy form, the benefit is made 339
part of the policy contract and must comply with all of the 340
applicable provisions of the Florida Insurance Code. 341
(e) An applicant's eligibility to purchase a pet insurance 342
policy may not be based on his or her participation, or lack of 343
participation, in a separate welln ess program. 344
(10)(a) A pet insurer must ensure that its agents are 345
trained on the topics specified in paragraph (b) and that its 346
agents have been appropriately trained on the coverages and 347
conditions of its pet insurance products. 348
(b) The training requ ired under this subsection must 349
include information on all of the following topics: 350
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1. Preexisting conditions and waiting periods. 351
2. The differences between pet insurance and noninsurance 352
wellness programs. 353
3. Chronic conditions, congenital anomalie s or disorders, 354
and hereditary disorders and the way pet insurance policies 355
address those conditions or disorders. 356
4. Rating, underwriting, renewal, and other related 357
administrative topics. 358
(11) The commission may adopt rules necessary to 359
administer this section. 360
Section 4. This act shall take effect January 1, 2025. 361