Page 159 - FDCC_InsightsSpecialIssue23.2

Property Law
future litigation is going to change. Time frames Related to Adjustment of Claims effective March 1, 2023
Of immediate import for carriers is the change to certain time frames set out during the adjustment process. Florida Statute 626.9541(1)(i)4 has amended the time for residential carriers to issue payments for undisputed amounts. The prior statute required undisputed payments to be issued within 90 days. This amendment decreases it to 60 days unless payment of the undisputed amount is prevented by factors “beyond the control of the insurer” as defined in Section 627.70131(5).
Such factors are defined as follows:
• The Office of Insurance Regulation issued an order finding that all or certain residential property insurers are reasonably unable to meet the time requirements of the statute in specified locations and ordering that such insurer or insurers may have additional time as specified by the Office.
• Actions by the policyholder or the policyholder’s representative which constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed when such actions reasonably prevent the insurer from complying with any requirement of this section.
This definition is also used in the section requiring timely payment of claims (within 60 days). The new statute mandates that:
(7)(a) Within 60 days after an insurer receives notice of an initial, reopened, or supplemental property insurance claim from a policyholder, the insurer shall pay or deny such claim or a portion of the claim unless the failure to pay is caused by factors beyond the control of the insurer... Any payment of an initial
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FDCC ANNUAL INSIGHTS 2023