News & Resources

State Farm Mut. Auto. Ins. Co. v. Curran, Case Nos. 5D-09-1488, 5D09-2091, 2011 WL 248541 (Fla. 5th DCA Jan. 28, 2011)

In our last post, we were discussing Senate Bill 408. The Florida Legislature will convene next week, and SB 408, the insurance bill, will probably generate some heated discussions. Two provisions in particular have garnered some strong opinions from insurance companies and policyholder advocates: claims payment, discussed in our last post, and sinkhole coverage.

It is usually policyholders and health-care providers that must go to battle over health insurance. But many Florida lawmakers have been busy fighting within the health insurance arena, by attacking the federal law requiring health insurance coverage for all Americans. Many politicians, including Governor Rick Scott, have found the health-insurance mandate to overstep the role of government in the lives of Floridians.

The Florida Legislature will convene next Monday, and media outlets are anxious to get some movement, finally, on Senate Bill 408, the insurance bill. After weeks of hearing the pros and cons of the bill’s provisions, it may be a refreshing change to hear open debate about claims payment and sinkhole coverage, among other issues.

This is the last in a short series of posts about long-term care insurance. The insurance is supposed to cover the costs of home care or a nursing facility when the policyholder becomes disabled. Many insurance companies underestimated their costs when they introduced the coverage, and they’ve pulled out of the market. Meanwhile, policyholders are getting frustrated when claims are denied or delayed, or when they realize the terms of their policy aren’t quite what they thought. A recent article highlighted some of the issues and posed some thoughtful responses to common questions.

In our last post, we were talking about long-term care insurance. The insurance has an interesting, and perhaps undeserved, reputation, thanks to headlines about companies pulling out of the business and reports of policyholders’ denied or delayed claims. A recent article laid out some ways to ensure a long-term care insurance policy will actually cover the expenses associated with long-term care.

Long-term care insurance has received a lot of press coverage lately. Insurers are getting out of the market; companies holding on are asking for double-digit rate hikes. And as that big chunk of Americans, the Baby Boomers, reach retirement age, industry insiders were hoping more people would buy long-term care policies for themselves or for their Boomer parents. The market conditions have put a damper on those hopes. Market conditions may also be responsible for an increase in long-term care insurance claim denials.

The Florida Office of Insurance Regulation heard testimony at a public hearing this week regarding State Farm Florida’s proposed rate increase. The insurance company is asking that the OIR approve an average 28 percent increase for its homeowner policyholders in order to cover the rising costs of non-catastrophic claims.

In our last post, we were talking about the “file and use” and “use and file” rate approval rules. Insurance companies in Florida may elect to use either, but the industry complains that the “use and file” rule is meaningless, because the Office of Insurance Regulation rarely approves the rate change. Insurers must then reimburse their policyholders for premiums collected at the proposed, but disapproved rate.

Last year, Florida lawmakers took a step toward deregulating commercial motor vehicle insurance; this year, some legislators hope to go even farther. A bill that passed out of the Senate Banking and Insurance Committee this week would allow insurance companies to offer a number of different commercial insurance products before the rates are approved by the Office of Insurance Regulation.