Florida Regulations 69O-171.005: Annual Claims Report by Liability Insurers
Current as of: 2024 | Check for updates
|
Other versions
(1) If requested by the Office, all authorized liability insurers in Florida shall prepare and submit a report to the Office containing information about personal injury, bodily injury and/or property damage liability claims, as further identified in this rule, which were closed by the insurer, its employees or agents during the preceding calendar year. The Office shall consider the availability of insurance in the market place, any restrictions on availability of coverage, the increased placement of traditional coverages in the surplus lines market, and the affordability of insurance coverages in determining whether to request the reports.
(2) For purposes of this rule, the term “”liability insurer”” shall mean all insurers authorized to do business in Florida by a subsisting certificate of authority issued by the Office to transact commercial multiperil, products liability, general liability, commercial automobile liability, private passenger automobile liability, or other line of liability insurance.
(3) At such time that the Office requires insurers to report under this rule, the information shall be submitted electronically by using computer software provided by the Office. The following form has been converted into the software provided by the Office, is hereby incorporated by reference, and shall take effect on the effective date of this rule amendment: Form OIR-367 (5/99) “”Liability Closed Claim Reporting Form.”” A closed claim report which is inaccurate, incomplete, or not properly formatted will be returned unprocessed and will be considered late until an accurate, complete and properly formatted report is received.
(4) At such time that a sampling of closed claims is required for a particular year, the Office will provide written instructions to all liability insurers indicating both:
(a) The lines of insurance from which claims closed during the preceding calendar year will be sampled; and,
(b) The size of the sample that is to be taken of claims arising under each specified line of insurance. The size of the sample for each line will be expressed in terms of a percentage of the total claims closed by each insurer during the preceding calendar year.
(5) For each line of insurance specified in the Office’s instructions, insurers shall randomly select a sufficient number of claims to satisfy the sample size required by the Office of each line of insurance of which claims are to be sampled.
(6) Reports shall be submitted to: Office of Insurance Regulation, at: http://www.floir.com/iportal.
(7) This report applies to direct Florida business on actions for damages for personal injury, bodily injury and/or property damage liability claimed to have been caused by the error, omission, or negligence of insureds if the claim resulted in:
(a) A final judgment in any amount;
(b) A settlement in any amount; or
(c) A final disposition not resulting in payment on behalf of the insured. The report should not include claims arising under workers’ compensation or employer’s liability insurance, nor claims arising under coverages for automobile uninsured motorist, medical payments, and personal injury protection benefits.
(8) A copy of the judgment or settlement must be provided along with any other information required by the Office that is not included in the computer software. If, upon its review, the Office determines that the sample reported by an insurer was not selected on a truly random basis, the Office may require the insurer to report additional claims for the line in question.
(9) Copies of the Annual Claims Report Software are available from the Office of Insurance Regulation, at: http://www.floir.com/iportal.
Rulemaking Authority Florida Statutes § 624.308(1). Law Implemented 624.307(1), 627.9126, 627.918(1) FS. History-New 5-19-88, Formerly 4-59.0051, Amended 6-4-92, 6-13-99, Formerly 4-171.005.
Terms Used In Florida Regulations 69O-171.005
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
(3) At such time that the Office requires insurers to report under this rule, the information shall be submitted electronically by using computer software provided by the Office. The following form has been converted into the software provided by the Office, is hereby incorporated by reference, and shall take effect on the effective date of this rule amendment: Form OIR-367 (5/99) “”Liability Closed Claim Reporting Form.”” A closed claim report which is inaccurate, incomplete, or not properly formatted will be returned unprocessed and will be considered late until an accurate, complete and properly formatted report is received.
(4) At such time that a sampling of closed claims is required for a particular year, the Office will provide written instructions to all liability insurers indicating both:
(a) The lines of insurance from which claims closed during the preceding calendar year will be sampled; and,
(b) The size of the sample that is to be taken of claims arising under each specified line of insurance. The size of the sample for each line will be expressed in terms of a percentage of the total claims closed by each insurer during the preceding calendar year.
(5) For each line of insurance specified in the Office’s instructions, insurers shall randomly select a sufficient number of claims to satisfy the sample size required by the Office of each line of insurance of which claims are to be sampled.
(6) Reports shall be submitted to: Office of Insurance Regulation, at: http://www.floir.com/iportal.
(7) This report applies to direct Florida business on actions for damages for personal injury, bodily injury and/or property damage liability claimed to have been caused by the error, omission, or negligence of insureds if the claim resulted in:
(a) A final judgment in any amount;
(b) A settlement in any amount; or
(c) A final disposition not resulting in payment on behalf of the insured. The report should not include claims arising under workers’ compensation or employer’s liability insurance, nor claims arising under coverages for automobile uninsured motorist, medical payments, and personal injury protection benefits.
(8) A copy of the judgment or settlement must be provided along with any other information required by the Office that is not included in the computer software. If, upon its review, the Office determines that the sample reported by an insurer was not selected on a truly random basis, the Office may require the insurer to report additional claims for the line in question.
(9) Copies of the Annual Claims Report Software are available from the Office of Insurance Regulation, at: http://www.floir.com/iportal.
Rulemaking Authority Florida Statutes § 624.308(1). Law Implemented 624.307(1), 627.9126, 627.918(1) FS. History-New 5-19-88, Formerly 4-59.0051, Amended 6-4-92, 6-13-99, Formerly 4-171.005.