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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
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" to include 4
a pet insurance option; amending s. 626.9541, F.S.; 5
providing that certain practices relating to pet 6
wellness programs are unfair methods of competition 7
and unfair or deceptive acts or practices; creating s. 8
627.71545, F.S.; providing a short title; provid ing 9
purpose; providing applicability; providing 10
construction; providing definitions; requiring pet 11
insurers that use such defined terms in their pet 12
insurance policies to use and include the statutory 13
definitions in their policies; requiring pet insurers 14
to also make such definitions available on their 15
websites or their program administrators' websites; 16
requiring pet insurers to make certain disclosures to 17
pet insurance applicants and policyholders; requiring 18
pet insurers to provide a summary of their bases or 19
formulas for determination of claim payments under a 20
pet insurance policy on their websites or their 21
program administrators' websites; requiring pet 22
insurers to disclose certain requirements for required 23
medical examinations of a pet by a veterinarian; 24
requiring pet insurers to create a document with a 25
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summary of certain disclosures, to post such document 26
on their websites or their program administrators' 27
websites, and, upon issuance or delivery of a policy 28
to a policyholder, to provide such document to the 29
policyholder; requiring additional written 30
disclosures; providing that certain required 31
disclosures are in addition to disclosures required by 32
the Florida Insurance Code or the Financial Services 33
Commission rules; authorizing pet insurance applicants 34
and policyholders to examine and return insurance 35
policies and riders under certain circumstances; 36
requiring that premiums be refunded under certain 37
circumstances; requiring that pet insurance policies 38
and riders have a specified notice printed on or 39
attached to the first page; authorizing pet insurers 40
to issue policies that exclude coverage on the basis 41
of preexisting conditions with appropriate written 42
disclosure to the applicant or policyholder; providing 43
that the pet insurer has a specified burden of pr oof 44
with regard to such exclusions; authorizing pet 45
insurers to issue new policies that impose a waiting 46
period of up to a specified period of time for 47
specified illnesses, diseases, or conditions; 48
prohibiting pet insurers from issuing policies 49
imposing a waiting period for accidents; requiring pet 50
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insurers who issue a policy that imposes a waiting 51
period to include a provision allowing for waiver of 52
the waiting period upon completion of a medical 53
examination of the covered pet by a veterinarian; 54
authorizing pet insurers to require an examination to 55
be conducted by a veterinarian after the purchase of 56
the policy; providing requirements and authorizations 57
relating to such examination; prohibiting a pet 58
insurer from requiring a medical examination of the 59
covered pet to renew a policy; requiring that certain 60
benefits comply with certain provisions of the Florida 61
Insurance Code; prohibiting insurance applicants' 62
eligibility from being based on participation or lack 63
of participation in wellness programs; requiring pet 64
insurers to ensure that their agents are trained on 65
specified topics; providing rulemaking authority; 66
providing an effective date. 67
68
Be It Enacted by the Legislature of the State of Florida: 69
70
Section 1. Section 624.604, Florida Statutes, is ame nded 71
to read: 72
624.604 "Property insurance" defined. —"Property insurance" 73
is insurance on real or personal property of every kind and of 74
every interest therein, whether on land, water, or in the air, 75
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against loss or damage from any and all hazard or cause , and 76
against loss consequential upon such loss or damage, other than 77
noncontractual legal liability for any such loss or damage. 78
Property insurance may include pet insurance that provides 79
coverage for accidents and for illnesses of pets. Property 80
insurance may contain a provision for accidental death or injury 81
as part of a multiple peril homeowner's policy. Such insurance, 82
which is incidental to the property insurance, is not subject to 83
the provisions of this code applicable to life or health 84
insurance. Property insurance does not include title insurance, 85
as defined in s. 624.608. 86
Section 2. Paragraph (hh) is added to subsection (1) of 87
section 626.9541, Florida Statutes, to read: 88
626.9541 Unfair methods of competition and unfair or 89
deceptive acts or practices defined.— 90
(1) UNFAIR METHODS OF COMPETITION AND UNFAIR OR DECEPTIVE 91
ACTS.—The following are defined as unfair methods of competition 92
and unfair or deceptive acts or practices: 93
(hh) Sales practices for pet wellness programs. — 94
1. A pet insurance agent may not market a wellness program 95
as pet insurance. 96
2. If a wellness program is sold by a pet insurance agent: 97
a. The purchase of the wellness program may not be a 98
prerequisite to the purchase of pet insurance; 99
b. The costs of the wellness p rogram must be separate and 100
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identifiable from any pet insurance policy sold by the pet 101
insurance agent; 102
c. The terms and conditions of the wellness program must 103
be separate from any pet insurance policy sold by the agent; 104
d. The products or coverages a vailable through the 105
wellness program may not duplicate the products or coverages 106
available through the pet insurance policy; and 107
e. The advertising of the wellness program must not be 108
misleading. 109
Section 3. Section 627.71545, Florida Statutes, is created 110
to read: 111
627.71545 Pet insurance; noninsurance wellness programs. — 112
(1) This section may be cited as the "Pet Insurance Act." 113
(2) The purpose of this section is to promote the public 114
welfare by creating a comprehensive regulatory framework within 115
which pet insurance may be sold in this state. 116
(3) This section applies to all of the following: 117
(a) Pet insurance policies that are issued to any resident 118
of this state or that are sold, solicite d, negotiated, or 119
offered in this state. 120
(b) Pet insurance policies or certificates that are 121
delivered or issued for delivery in this state. 122
(4)(a) This section may not be construed to prohibit or 123
limit the types of exclusions pet insurers may use in t heir 124
policies or to require pet insurers to include in such policies 125
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any of the limitations or exclusions specified in subsection 126
(9). 127
(b) All other applicable provisions of the Florida 128
Insurance Code apply to pet insurance, except that this section 129
supersedes any general provisions of the Florida Insurance Code 130
which otherwise apply to pet insurance. 131
(5)(a) As used in this section, the term: 132
1. "Chronic condition" means a condition that can be 133
treated or managed, but not cured. 134
2. "Congenital anoma ly or disorder" means a condition that 135
is present from birth, whether inherited or caused by the 136
environment, and that may cause or contribute to illness or 137
disease. 138
3. "Hereditary disorder" means an abnormality that is 139
genetically transmitted from paren t to offspring and may cause 140
illness or disease. 141
4. "Orthopedic conditions" means a condition that affects 142
the bones, skeletal muscle, cartilage, tendons, ligaments, or 143
joints. The term includes, but is not limited to, elbow 144
dysplasia, hip dysplasia, int ervertebral disc degeneration, 145
patellar luxation, and cranial cruciate ligament rupture, but 146
does not include any cancer or any metabolic, hematopoietic, or 147
autoimmune disease. 148
5. "Pet insurance" means an insurance policy that provides 149
coverage for accidents and for illnesses and diseases of pets. 150
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Such insurance reimburses a policyholder for expenses associated 151
with medical advice, diagnosis, care, or treatment provided by a 152
veterinarian, including, but not limited to, the cost of drugs 153
prescribed by the veterinarian. 154
6. "Pet insurance policy" or "policy" includes pet 155
insurance certificates. 156
7. "Preexisting condition" means a condition for which any 157
of the following is true before the effective date of or during 158
a waiting period applicable to a pet ins urance policy: 159
a. A veterinarian provided medical advice. 160
b. The pet received previous treatment. 161
c. Based on information from verifiable sources, the pet 162
had signs or symptoms directly related to the condition for 163
which a claim is being made. 164
165
A condition for which coverage is afforded on a policy is not 166
deemed to be a preexisting condition on any renewal of the 167
policy. 168
8. "Renewal" means the issuance and delivery at the end of 169
an insurance policy period of a policy that supersedes the 170
policy previously issued and delivered by the same pet insurer 171
or affiliated pet insurer and that provides types and limits of 172
coverage substantially similar to those contained in the policy 173
being superseded. 174
9. "Veterinarian" means a health care practitioner who is 175
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licensed to engage in the practice of veterinary medicine in 176
this state under chapter 474. 177
10. "Waiting period" means the period of time specified in 178
a pet insurance policy which is required to run before some or 179
all of the coverage in the policy may be gin. This period may not 180
be applied to renewals of existing coverage. 181
11. "Wellness program" means a subscription or 182
reimbursement-based program that is separate from an insurance 183
policy and that provides goods and services to promote the 184
general health, safety, or well-being of the covered pet. If the 185
subscription or program includes language such as "undertakes to 186
indemnify another," "pays a specified amount upon determinable 187
contingencies," or "provides coverage for a fortuitous event," 188
the subscription or program is transacting in the business of 189
insurance and is subject to the Florida Insurance Code. This 190
definition is not intended to classify a contract directly 191
between a service provider and a pet owner which involves only 192
the two parties as being t he business of insurance, unless other 193
indications of insurance also exist. 194
(b) If a pet insurer uses any of the terms defined in 195
paragraph (a) in a pet insurance policy, the pet insurer must 196
use the definition of each term as provided in paragraph (a) a nd 197
must include each such definition in the policy. The pet insurer 198
must also make such definitions available through a clear and 199
conspicuous link on the main page of the website of the pet 200
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insurer or the pet insurer's program administrator. 201
(6)(a) A pet insurer transacting pet insurance must 202
disclose the following to pet insurance applicants and 203
policyholders: 204
1. Whether the policy excludes coverage due to any of the 205
following: 206
a. A chronic condition; 207
b. A congenital anomaly or disorder; 208
c. A hereditary disorder; or 209
d. A preexisting condition. 210
2. If the policy includes any other exclusions not listed 211
in subparagraph 1., the following information in a statement in 212
the disclosure: "Other exclusions may apply. Please refer to the 213
exclusions section of the policy for more information." 214
3. Any policy provision that limits coverage through a 215
waiting period, a deductible, a coinsurance payment, or an 216
annual or lifetime policy limit. Waiting periods and applicable 217
requirements must be clearly and prominently disclosed to 218
applicants before the policy purchase. 219
4. Whether the pet insurer reduces coverage or increases 220
premium based on the policyholder's claims history, the age of 221
the covered pet, or a change in the geographic location of the 222
policyholder. 223
5. Whether the underwriting company differs from the brand 224
name used to market and sell the pet insurance. 225
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(b) Before issuing a pet insurance policy, a pet insurer 226
shall, through a clear and conspicuous link on the main page of 227
the pet insurer's or the pet insurer's program administrator's 228
website, provide a summary description of the basis or formula 229
for the pet insurer's determination of claim payments under the 230
policy. 231
1. A pet insurer that uses a benefit schedule to determine 232
claim payments under a pet insurance policy must clearly 233
disclose both of the following: 234
a. The applicable benefit schedule in the policy. 235
b. All benefit schedules used by the pet insurer under its 236
pet insurance policies through a clear and conspicuous link on 237
the main page of the pet insurer's or pet insurer's program 238
administrator's website. 239
2. A pet insurer that determines claim payments under a 240
pet insurance policy based on usual and customary fees, or any 241
other reimbursement limitation based on prevailing vete rinary 242
service provider charges, shall do both of the following: 243
a. Include a usual and customary fee limitation provision 244
in the policy which clearly describes the pet insurer's basis or 245
formula for determining usual and customary fees and the manner 246
in which that basis or formula is applied in calculating claim 247
payments. 248
b. Disclose the pet insurer's basis for determining usual 249
and customary fees through a clear and conspicuous link on the 250
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main page of the pet insurer's or pet insurer's program 251
administrator's website. 252
(c) If any medical examination of the pet by a 253
veterinarian is required to effectuate coverage, the pet insurer 254
must clearly and conspicuously disclose any requirement for the 255
examination before the policy is purchased and must disclos e 256
that examination documentation may result in a preexisting 257
condition exclusion. 258
(d) A pet insurer shall create a summary of all policy 259
disclosures required in paragraphs (a), (b), and (c) in a 260
separate document entitled "Insurer Disclosure of Important 261
Policy Provisions." The pet insurer shall post the document 262
through a clear and conspicuous link on the main page of the pet 263
insurer's or pet insurer's program administrator's website. 264
(e) At the time a pet insurance policy is issued or 265
delivered to a policyholder, the pet insurer shall provide the 266
policyholder with a copy of the Insurer Disclosure of Important 267
Policy Provisions document required under paragraph (d), in at 268
least 12-point type. At such time, the pet insurer shall also 269
include a written di sclosure with all of the following: 270
1. Contact information for the Division of Consumer 271
Services of the department, including a link and toll -free 272
telephone number, for consumers to submit inquiries and 273
complaints relating to pet insurance products regul ated by the 274
department or office. 275
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2. The address and customer service telephone number of 276
the pet insurance agent. 277
(f) The disclosures required in this subsection are in 278
addition to any other disclosures required by the Florida 279
Insurance Code or rules prescribed by the commission. 280
(7) Unless the policyholder has filed a claim under the 281
pet insurance policy, a pet insurance applicant or policyholder 282
may examine and return the policy or rider to the pet insurer or 283
pet insurance agent or broker within 30 days after the applicant 284
or policyholder obtains the receipt and is entitled to the 285
premium refunded if, after examining the policy or rider, he or 286
she is not satisfied for any reason. 287
(8) A pet insurance policy and rider must have a notice 288
prominently printed on or attached to the first page which 289
includes specific instructions to accomplish a return, in type 290
at least as large as any type appearing on the policy or rider 291
contract and in substantially the following language: 292
293
You have 30 days after the d ate you receive this 294
policy, certificate, or rider to review and return it 295
to the company if you decide not to keep it. You do 296
not have to tell the company why you are returning it. 297
If you decide not to keep policy, certificate, or 298
rider, simply return it to the company at the 299
company's administrative office, or to the insurance 300
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agent or broker from whom you bought it, as long as 301
you have not filed a claim. You must return the 302
policy, certificate, or rider within 30 days after the 303
day you first receive it i n order to receive a refund. 304
The company must refund the full amount of any premium 305
paid within 30 days after it receives the returned 306
policy, certificate, or rider. The premium refund will 307
be sent directly to the person who paid it. The 308
policy, certificate, or rider will be void as if it 309
had never been issued. 310
311
(9)(a) A pet insurer may issue a policy that excludes 312
coverage on the basis of one or more preexisting conditions with 313
appropriate written disclosure to the applicant or policyholder. 314
The pet insurer has the burden of proving that the preexisting 315
condition exclusion applies to the condition for which a claim 316
is being made. 317
(b)1. A pet insurer may issue a new policy imposing a 318
waiting period that does not exceed 30 days after effectuat ion 319
of coverage for illnesses or diseases or for orthopedic 320
conditions not resulting from an accident. A pet insurer may not 321
issue a policy imposing a waiting period for accidents. 322
2. A pet insurer issuing a policy that imposes a waiting 323
period must include a provision in its contract which allows the 324
waiting period to be waived upon completion of a medical 325
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examination of the pet by a veterinarian. The pet insurer may 326
require the examination to be conducted by a veterinarian after 327
the purchase of the poli cy. 328
a. A medical examination required under this subparagraph 329
must be paid for by the policyholder, unless the policy 330
specifies that the pet insurer will pay for the examination. 331
b. A pet insurer may specify requirements for the 332
examination and require documentation that the requirements have 333
been satisfied, provided that the specifications do not 334
unreasonably restrict the ability of the applicant or 335
policyholder to waive the waiting period. 336
(c) A pet insurer may not require a medical examination of 337
the covered pet for the policyholder to renew a policy. 338
(d) If a pet insurer includes any prescriptive, wellness, 339
or noninsurance benefit in the policy form, the benefit is made 340
part of the policy contract and must comply with all of the 341
applicable provisions of the Florida Insurance Code. 342
(e) An applicant's eligibility to purchase a pet insurance 343
policy may not be based on his or her participation, or lack of 344
participation, in a separate wellness program. 345
(10)(a) A pet insurer must ensure that its age nts are 346
trained on the topics specified in paragraph (b) and that its 347
agents have been appropriately trained on the coverages and 348
conditions of its pet insurance products. 349
(b) The training required under this subsection must 350
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include information on all of the following topics: 351
1. Preexisting conditions and waiting periods. 352
2. The differences between pet insurance and noninsurance 353
wellness programs. 354
3. Chronic conditions, congenital anomalies or disorders, 355
and hereditary disorders and the way pet insu rance policies 356
address those conditions or disorders. 357
4. Rating, underwriting, renewal, and other related 358
administrative topics. 359
(11) The commission may adopt rules necessary to 360
administer this section. 361
Section 4. This act shall take effect January 1, 2026. 362