626.9541 Unfair methods of competition and unfair
or deceptive acts or practices defined.--
(1) UNFAIR METHODS OF COMPETITION AND UNFAIR OR
DECEPTIVE ACTS.--The following are defined as unfair methods
of competition and unfair or deceptive acts or practices:
(a) Misrepresentations and false advertising
of insurance policies.--Knowingly making, issuing,
circulating, or causing to be made, issued, or circulated, any
estimate, illustration, circular, statement, sales
presentation, omission, or comparison which:
1. Misrepresents the benefits, advantages,
conditions, or terms of any insurance policy.
2. Misrepresents the dividends or share of the
surplus to be received on any insurance policy.
3. Makes any false or misleading statements as
to the dividends or share of surplus previously paid on any
insurance policy.
4. Is misleading, or is a misrepresentation, as
to the financial condition of any person or as to the legal
reserve system upon which any life insurer operates.
5. Uses any name or title of any insurance
policy or class of insurance policies misrepresenting the true
nature thereof.
6. Is a misrepresentation for the purpose of
inducing, or tending to induce, the lapse, forfeiture,
exchange, conversion, or surrender of any insurance policy.
7. Is a misrepresentation for the purpose of
effecting a pledge or assignment of, or effecting a loan
against, any insurance policy.
8. Misrepresents any insurance policy as being
shares of stock or misrepresents ownership interest in the
company.
9. Uses any advertisement that would mislead or
otherwise cause a reasonable person to believe mistakenly that
the state or the Federal Government is responsible for the
insurance sales activities of any person or stands behind any
person's credit or that any person, the state, or the Federal
Government guarantees any returns on insurance products or is
a source of payment of any insurance obligation of or sold by
any person.
(b) False information and advertising
generally.--Knowingly making, publishing, disseminating,
circulating, or placing before the public, or causing,
directly or indirectly, to be made, published, disseminated,
circulated, or placed before the public:
1. In a newspaper, magazine, or other
publication,
2. In the form of a notice, circular, pamphlet,
letter, or poster,
3. Over any radio or television station, or
4. In any other way,
an advertisement,
announcement, or statement containing any assertion,
representation, or statement with respect to the business of
insurance, which is untrue, deceptive, or misleading.
(c) Defamation.--Knowingly making,
publishing, disseminating, or circulating, directly or
indirectly, or aiding, abetting, or encouraging the making,
publishing, disseminating, or circulating of, any oral or
written statement, or any pamphlet, circular, article, or
literature, which is false or maliciously critical of, or
derogatory to, any person and which is calculated to injure
such person.
(d) Boycott, coercion, and
intimidation.--Entering into any agreement to commit, or
by any concerted action committing, any act of boycott,
coercion, or intimidation resulting in, or tending to result
in, unreasonable restraint of, or monopoly in, the business of
insurance.
(e) False statements and entries.--
1. Knowingly:
a. Filing with any supervisory or other public
official,
b. Making, publishing, disseminating,
circulating,
c. Delivering to any person,
d. Placing before the public,
e. Causing, directly or indirectly, to be made,
published, disseminated, circulated, delivered to any person,
or placed before the public,
any false material
statement.
2. Knowingly making any false entry of a
material fact in any book, report, or statement of any person,
or knowingly omitting to make a true entry of any material
fact pertaining to the business of such person in any book,
report, or statement of such person.
(f) Stock operations and advisory board
contracts.--Issuing or delivering, promising to issue or
deliver, or permitting agents, officers, or employees to issue
or deliver, agency company stock or other capital stock,
benefit certificates or shares in any common-law corporation,
or securities or any special or advisory board contracts or
other contracts of any kind promising returns or profits as an
inducement to insurance.
(g) Unfair discrimination.--
1. Knowingly making or permitting any unfair
discrimination between individuals of the same actuarially
supportable class and equal expectation of life, in the rates
charged for any life insurance or annuity contract, in the
dividends or other benefits payable thereon, or in any other
of the terms and conditions of such contract.
2. Knowingly making or permitting any unfair
discrimination between individuals of the same actuarially
supportable class, as determined at the original time of
issuance of the coverage, and essentially the same hazard, in
the amount of premium, policy fees, or rates charged for any
policy or contract of accident, disability, or health
insurance, in the benefits payable thereunder, in any of the
terms or conditions of such contract, or in any other manner
whatever.
3. For a health insurer, life insurer,
disability insurer, property and casualty insurer, automobile
insurer, or managed care provider to underwrite a policy, or
refuse to issue, reissue, or renew a policy, refuse to pay a
claim, cancel or otherwise terminate a policy, or increase
rates based upon the fact that an insured or applicant who is
also the proposed insured has made a claim or sought or should
have sought medical or psychological treatment in the past for
abuse, protection from abuse, or shelter from abuse, or that a
claim was caused in the past by, or might occur as a result
of, any future assault, battery, or sexual assault by a family
or household member upon another family or household member as
defined in s. 741.28.
A health insurer, life insurer, disability insurer, or managed
care provider may refuse to underwrite, issue, or renew a
policy based on the applicant's medical condition, but shall
not consider whether such condition was caused by an act of
abuse. For purposes of this section, the term "abuse" means
the occurrence of one or more of the following acts:
a. Attempting or committing assault, battery,
sexual assault, or sexual battery;
b. Placing another in fear of imminent serious
bodily injury by physical menace;
c. False imprisonment;
d. Physically or sexually abusing a minor child;
or
e. An act of domestic violence as defined in s.
741.28.
This subparagraph does not prohibit a property and
casualty insurer or an automobile insurer from excluding
coverage for intentional acts by the insured if such exclusion
does not constitute an act of unfair discrimination as defined
in this paragraph.
(h) Unlawful rebates.--
1. Except as otherwise expressly provided by
law, or in an applicable filing with the office, knowingly:
a. Permitting, or offering to make, or making,
any contract or agreement as to such contract other than as
plainly expressed in the insurance contract issued thereon;
b. Paying, allowing, or giving, or offering to
pay, allow, or give, directly or indirectly, as inducement to
such insurance contract, any unlawful rebate of premiums
payable on the contract, any special favor or advantage in the
dividends or other benefits thereon, or any valuable
consideration or inducement whatever not specified in the
contract;
c. Giving, selling, or purchasing, or offering
to give, sell, or purchase, as inducement to such insurance
contract or in connection therewith, any stocks, bonds, or
other securities of any insurance company or other
corporation, association, or partnership, or any dividends or
profits accrued thereon, or anything of value whatsoever not
specified in the insurance contract.
2. Nothing in paragraph (g) or subparagraph 1.
of this paragraph shall be construed as including within the
definition of discrimination or unlawful rebates:
a. In the case of any contract of life insurance
or life annuity, paying bonuses to all policyholders or
otherwise abating their premiums in whole or in part out of
surplus accumulated from nonparticipating insurance; provided
that any such bonuses or abatement of premiums is fair and
equitable to all policyholders and for the best interests of
the company and its policyholders.
b. In the case of life insurance policies issued
on the industrial debit plan, making allowance to
policyholders who have continuously for a specified period
made premium payments directly to an office of the insurer in
an amount which fairly represents the saving in collection
expenses.
c. Readjustment of the rate of premium for a
group insurance policy based on the loss or expense
thereunder, at the end of the first or any subsequent policy
year of insurance thereunder, which may be made retroactive
only for such policy year.
d. Issuance of life insurance policies or
annuity contracts at rates less than the usual rates of
premiums for such policies or contracts, as group insurance or
employee insurance as defined in this code.
e. Issuing life or disability insurance policies
on a salary savings, bank draft, preauthorized check, payroll
deduction, or other similar plan at a reduced rate reasonably
related to the savings made by the use of such plan.
3.a. No title insurer, or any member, employee,
attorney, agent, or agency thereof, shall pay, allow, or give,
or offer to pay, allow, or give, directly or indirectly, as
inducement to title insurance, or after such insurance has
been effected, any rebate or abatement of the premium or any
other charge or fee, or provide any special favor or
advantage, or any monetary consideration or inducement
whatever.
b. Nothing in this subparagraph shall be
construed as prohibiting the payment of fees to attorneys at
law duly licensed to practice law in the courts of this state,
for professional services, or as prohibiting the payment of
earned portions of the premium to duly appointed agents or
agencies who actually perform services for the title insurer.
Nothing in this subparagraph shall be construed as prohibiting
a rebate or abatement of an attorney's fee charged for
professional services, or that portion of the premium that is
not required to be retained by the insurer pursuant to s. 627.782(1),
or any other agent charge or fee to the person responsible for
paying the premium, charge, or fee.
c. No insured named in a policy, or any other
person directly or indirectly connected with the transaction
involving the issuance of such policy, including, but not
limited to, any mortgage broker, real estate broker, builder,
or attorney, any employee, agent, agency, or representative
thereof, or any other person whatsoever, shall knowingly
receive or accept, directly or indirectly, any rebate or
abatement of any portion of the title insurance premium or of
any other charge or fee or any monetary consideration or
inducement whatsoever, except as set forth in sub-subparagraph
b.; provided, in no event shall any portion of the attorney's
fee, any portion of the premium that is not required to be
retained by the insurer pursuant to s. 627.782(1),
any agent charge or fee, or any other monetary consideration
or inducement be paid directly or indirectly for the referral
of title insurance business.
(i) Unfair claim settlement practices.--
1. Attempting to settle claims on the basis of
an application, when serving as a binder or intended to become
a part of the policy, or any other material document which was
altered without notice to, or knowledge or consent of, the
insured;
2. A material misrepresentation made to an
insured or any other person having an interest in the proceeds
payable under such contract or policy, for the purpose and
with the intent of effecting settlement of such claims, loss,
or damage under such contract or policy on less favorable
terms than those provided in, and contemplated by, such
contract or policy; or
3. Committing or performing with such frequency
as to indicate a general business practice any of the
following:
a. Failing to adopt and implement standards for
the proper investigation of claims;
b. Misrepresenting pertinent facts or insurance
policy provisions relating to coverages at issue;
c. Failing to acknowledge and act promptly upon
communications with respect to claims;
d. Denying claims without conducting reasonable
investigations based upon available information;
e. Failing to affirm or deny full or partial
coverage of claims, and, as to partial coverage, the dollar
amount or extent of coverage, or failing to provide a written
statement that the claim is being investigated, upon the
written request of the insured within 30 days after
proof-of-loss statements have been completed;
f. Failing to promptly provide a reasonable
explanation in writing to the insured of the basis in the
insurance policy, in relation to the facts or applicable law,
for denial of a claim or for the offer of a compromise
settlement;
g. Failing to promptly notify the insured of any
additional information necessary for the processing of a
claim; or
h. Failing to clearly explain the nature of the
requested information and the reasons why such information is
necessary.
4. Failing to pay undisputed amounts of partial
or full benefits owed under first-party property insurance
policies within 90 days after an insurer receives notice of a
residential property insurance claim, determines the amounts
of partial or full benefits, and agrees to coverage, unless
payment of the undisputed benefits is prevented by an act of
God, prevented by the impossibility of performance, or due to
actions by the insured or claimant that constitute fraud, lack
of cooperation, or intentional misrepresentation regarding the
claim for which benefits are owed.
(j) Failure to maintain complaint-handling
procedures.--Failure of any person to maintain a complete
record of all the complaints received since the date of the
last examination. For purposes of this paragraph, "complaint"
means any written communication primarily expressing a
grievance.
(k) Misrepresentation in insurance
applications.--
1. Knowingly making a false or fraudulent
written or oral statement or representation on, or relative
to, an application or negotiation for an insurance policy for
the purpose of obtaining a fee, commission, money, or other
benefit from any insurer, agent, broker, or individual.
2. Knowingly making a material omission in the
comparison of a life, health, or Medicare supplement insurance
replacement policy with the policy it replaces for the purpose
of obtaining a fee, commission, money, or other benefit from
any insurer, agent, broker, or individual. For the purposes of
this subparagraph, a material omission includes the failure to
advise the insured of the existence and operation of a
preexisting condition clause in the replacement policy.
(l) Twisting.--Knowingly making any
misleading representations or incomplete or fraudulent
comparisons or fraudulent material omissions of or with
respect to any insurance policies or insurers for the purpose
of inducing, or tending to induce, any person to lapse,
forfeit, surrender, terminate, retain, pledge, assign, borrow
on, or convert any insurance policy or to take out a policy of
insurance in another insurer.
(m) Advertising gifts permitted.--No
provision of paragraph (f), paragraph (g), or paragraph (h)
shall be deemed to prohibit a licensed insurer or its agent
from giving to insureds, prospective insureds, and others, for
the purpose of advertising, any article of merchandise having
a value of not more than $25.
(n) Free insurance prohibited.--
1. Advertising, offering, or providing free
insurance as an inducement to the purchase or sale of real or
personal property or of services directly or indirectly
connected with such real or personal property.
2. For the purposes of this paragraph, "free"
insurance is:
a. Insurance for which no identifiable and
additional charge is made to the purchaser of such real
property, personal property, or services.
b. Insurance for which an identifiable or
additional charge is made in an amount less than the cost of
such insurance as to the seller or other person, other than
the insurer, providing the same.
3. Subparagraphs 1. and 2. do not apply to:
a. Insurance of, loss of, or damage to the real
or personal property involved in any such sale or services,
under a policy covering the interests therein of the seller or
vendor.
b. Blanket disability insurance as defined in s.
627.659.
c. Credit life insurance or credit disability
insurance.
d. Any individual, isolated, nonrecurring
unadvertised transaction not in the regular course of
business.
e. Title insurance.
f. Any purchase agreement involving the purchase
of a cemetery lot or lots in which, under stated conditions,
any balance due is forgiven upon the death of the purchaser.
g. Life insurance, trip cancellation insurance,
or lost baggage insurance offered by a travel agency as part
of a travel package offered by and booked through the agency.
4. Using the word "free" or words which imply
the provision of insurance without a cost to describe life or
disability insurance, in connection with the advertising or
offering for sale of any kind of goods, merchandise, or
services.
(o) Illegal dealings in premiums; excess or
reduced charges for insurance.--
1. Knowingly collecting any sum as a premium or
charge for insurance, which is not then provided, or is not in
due course to be provided, subject to acceptance of the risk
by the insurer, by an insurance policy issued by an insurer as
permitted by this code.
2. Knowingly collecting as a premium or charge
for insurance any sum in excess of or less than the premium or
charge applicable to such insurance, in accordance with the
applicable classifications and rates as filed with and
approved by the office, and as specified in the policy; or, in
cases when classifications, premiums, or rates are not
required by this code to be so filed and approved, premiums
and charges collected from a Florida resident in excess of or
less than those specified in the policy and as fixed by the
insurer. This provision shall not be deemed to prohibit the
charging and collection, by surplus lines agents licensed
under part VIII of this chapter, of the amount of applicable
state and federal taxes, or fees as authorized by s. 626.916(4),
in addition to the premium required by the insurer or the
charging and collection, by licensed agents, of the exact
amount of any discount or other such fee charged by a credit
card facility in connection with the use of a credit card, as
authorized by subparagraph (q)3., in addition to the premium
required by the insurer. This subparagraph shall not be
construed to prohibit collection of a premium for a universal
life or a variable or indeterminate value insurance policy
made in accordance with the terms of the contract.
3.a. Imposing or requesting an additional
premium for a policy of motor vehicle liability, personal
injury protection, medical payment, or collision insurance or
any combination thereof or refusing to renew the policy solely
because the insured was involved in a motor vehicle accident
unless the insurer's file contains information from which the
insurer in good faith determines that the insured was
substantially at fault in the accident.
b. An insurer which imposes and collects such a
surcharge or which refuses to renew such policy shall, in
conjunction with the notice of premium due or notice of
nonrenewal, notify the named insured that he or she is
entitled to reimbursement of such amount or renewal of the
policy under the conditions listed below and will subsequently
reimburse him or her or renew the policy, if the named insured
demonstrates that the operator involved in the accident was:
(I) Lawfully parked;
(II) Reimbursed by, or on behalf of, a person
responsible for the accident or has a judgment against such
person;
(III) Struck in the rear by another vehicle
headed in the same direction and was not convicted of a moving
traffic violation in connection with the accident;
(IV) Hit by a "hit-and-run" driver, if the
accident was reported to the proper authorities within 24
hours after discovering the accident;
(V) Not convicted of a moving traffic violation
in connection with the accident, but the operator of the other
automobile involved in such accident was convicted of a moving
traffic violation;
(VI) Finally adjudicated not to be liable by a
court of competent jurisdiction;
(VII) In receipt of a traffic citation which was
dismissed or nolle prossed; or
(VIII) Not at fault as evidenced by a written
statement from the insured establishing facts demonstrating
lack of fault which are not rebutted by information in the
insurer's file from which the insurer in good faith determines
that the insured was substantially at fault.
c. In addition to the other provisions of this
subparagraph, an insurer may not fail to renew a policy if the
insured has had only one accident in which he or she was at
fault within the current 3-year period. However, an insurer
may nonrenew a policy for reasons other than accidents in
accordance with s. 627.728.
This subparagraph does not prohibit nonrenewal of a policy
under which the insured has had three or more accidents,
regardless of fault, during the most recent 3-year period.
4. Imposing or requesting an additional premium
for, or refusing to renew, a policy for motor vehicle
insurance solely because the insured committed a noncriminal
traffic infraction as described in s. 318.14
unless the infraction is:
a. A second infraction committed within an
18-month period, or a third or subsequent infraction committed
within a 36-month period.
b. A violation of s. 316.183,
when such violation is a result of exceeding the lawful speed
limit by more than 15 miles per hour.
5. Upon the request of the insured, the insurer
and licensed agent shall supply to the insured the complete
proof of fault or other criteria which justifies the
additional charge or cancellation.
6. No insurer shall impose or request an
additional premium for motor vehicle insurance, cancel or
refuse to issue a policy, or refuse to renew a policy because
the insured or the applicant is a handicapped or physically
disabled person, so long as such handicap or physical
disability does not substantially impair such person's
mechanically assisted driving ability.
7. No insurer may cancel or otherwise terminate
any insurance contract or coverage, or require execution of a
consent to rate endorsement, during the stated policy term for
the purpose of offering to issue, or issuing, a similar or
identical contract or coverage to the same insured with the
same exposure at a higher premium rate or continuing an
existing contract or coverage with the same exposure at an
increased premium.
8. No insurer may issue a nonrenewal notice on
any insurance contract or coverage, or require execution of a
consent to rate endorsement, for the purpose of offering to
issue, or issuing, a similar or identical contract or coverage
to the same insured at a higher premium rate or continuing an
existing contract or coverage at an increased premium without
meeting any applicable notice requirements.
9. No insurer shall, with respect to premiums
charged for motor vehicle insurance, unfairly discriminate
solely on the basis of age, sex, marital status, or scholastic
achievement.
10. Imposing or requesting an additional premium
for motor vehicle comprehensive or uninsured motorist coverage
solely because the insured was involved in a motor vehicle
accident or was convicted of a moving traffic violation.
11. No insurer shall cancel or issue a
nonrenewal notice on any insurance policy or contract without
complying with any applicable cancellation or nonrenewal
provision required under the Florida Insurance Code.
12. No insurer shall impose or request an
additional premium, cancel a policy, or issue a nonrenewal
notice on any insurance policy or contract because of any
traffic infraction when adjudication has been withheld and no
points have been assessed pursuant to s. 318.14(9)
and (10). However, this subparagraph does not apply to traffic
infractions involving accidents in which the insurer has
incurred a loss due to the fault of the insured.
(p) Insurance cost specified in "price
package".--
1. When the premium or charge for insurance of
or involving such property or merchandise is included in the
overall purchase price or financing of the purchase of
merchandise or property, the vendor or lender shall separately
state and identify the amount charged and to be paid for the
insurance, and the classifications, if any, upon which based;
and the inclusion or exclusion of the cost of insurance in
such purchase price or financing shall not increase, reduce,
or otherwise affect any other factor involved in the cost of
the merchandise, property, or financing as to the purchaser or
borrower.
2. This paragraph does not apply to transactions
which are subject to the provisions of part I of chapter 520,
entitled "The Motor Vehicle Sales Finance Act."
3. This paragraph does not apply to credit life
or credit disability insurance which is in compliance with s.
627.681(4).
(q) Certain insurance transactions through
credit card facilities prohibited.--
1. Except as provided in subparagraph 3., no
person shall knowingly solicit or negotiate any insurance;
seek or accept applications for insurance; issue or deliver
any policy; receive, collect, or transmit premiums, to or for
any insurer; or otherwise transact insurance in this state, or
relative to a subject of insurance resident, located, or to be
performed in this state, through the arrangement or facilities
of a credit card facility or organization, for the purpose of
insuring credit card holders or prospective credit card
holders. The term "credit card holder" as used in this
paragraph means any person who may pay the charge for
purchases or other transactions through the credit card
facility or organization, whose credit with such facility or
organization is evidenced by a credit card identifying such
person as being one whose charges the credit card facility or
organization will pay, and who is identified as such upon the
credit card either by name, account number, symbol, insignia,
or any other method or device of identification. This
subparagraph does not apply as to health insurance or to
credit life, credit disability, or credit property insurance.
2. Whenever any person does or performs in this
state any of the acts in violation of subparagraph 1. for or
on behalf of any insurer or credit card facility, such insurer
or credit card facility shall be held to be doing business in
this state and, if an insurer, shall be subject to the same
state, county, and municipal taxes as insurers that have been
legally qualified and admitted to do business in this state by
agents or otherwise are subject, the same to be assessed and
collected against such insurers; and such person so doing or
performing any of such acts shall be personally liable for all
such taxes.
3. A licensed agent or insurer may solicit or
negotiate any insurance; seek or accept applications for
insurance; issue or deliver any policy; receive, collect, or
transmit premiums, to or for any insurer; or otherwise
transact insurance in this state, or relative to a subject of
insurance resident, located, or to be performed in this state,
through the arrangement or facilities of a credit card
facility or organization, for the purpose of insuring credit
card holders or prospective credit card holders if:
a. The insurance or policy which is the subject
of the transaction is noncancelable by any person other than
the named insured, the policyholder, or the insurer;
b. Any refund of unearned premium is made
directly to the credit card holder; and
c. The credit card transaction is authorized by
the signature of the credit card holder or other person
authorized to sign on the credit card account.
The
conditions enumerated in sub-subparagraphs a.-c. do not apply
to health insurance or to credit life, credit disability, or
credit property insurance; and sub-subparagraph c. does not
apply to property and casualty insurance so long as the
transaction is authorized by the insured.
4. No person may use or disclose information
resulting from the use of a credit card in conjunction with
the purchase of insurance, when such information is to the
advantage of such credit card facility or an insurance agent,
or is to the detriment of the insured or any other insurance
agent; except that this provision does not prohibit a credit
card facility from using or disclosing such information in any
judicial proceeding or consistent with applicable law on
credit reporting.
5. No such insurance shall be sold through a
credit card facility in conjunction with membership in any
automobile club. The term "automobile club" means a legal
entity which, in consideration of dues, assessments, or
periodic payments of money, promises its members or
subscribers to assist them in matters relating to the
ownership, operation, use, or maintenance of a motor vehicle;
however, the definition of automobile clubs does not include
persons, associations, or corporations which are organized and
operated solely for the purpose of conducting, sponsoring, or
sanctioning motor vehicle races, exhibitions, or contests upon
racetracks, or upon race courses established and marked as
such for the duration of such particular event. The words
"motor vehicle" used herein shall be the same as defined in
chapter 320.
(r) Interlocking ownership and
management.--
1. Any domestic insurer may retain, invest in,
or acquire the whole or any part of the capital stock of any
other insurer or insurers, or have a common management with
any other insurer or insurers, unless such retention,
investment, acquisition, or common management is inconsistent
with any other provision of this code, or unless by reason
thereof the business of such insurers with the public is
conducted in a manner which substantially lessens competition
generally in the insurance business.
2. Any person otherwise qualified may be a
director of two or more domestic insurers which are
competitors, unless the effect thereof is substantially to
lessen competition between insurers generally or materially
tend to create a monopoly.
3. Any limitation contained in this paragraph
does not apply to any person who is a director of two or more
insurers under common control or management.
(s) Prohibited arrangements as to
funerals.--
1. No life insurer shall designate in any life
insurance policy the person to conduct the funeral of the
insured, or organize, promote, or operate any enterprise or
plan to enter into any contract with any insured under which
the freedom of choice in the open market of the person having
the legal right to such choice is restricted as to the
purchase, arrangement, and conduct of a funeral service or any
part thereof for any individual insured by the insurer. No
life insurer shall designate in any life insurance policy the
person to conduct the funeral of the insured as the owner of
the policy.
2. No insurer shall contract or agree to furnish
funeral merchandise or services in connection with the
disposition of any person upon the death of any person insured
by such insurer.
3. No insurer shall contract or agree with any
funeral director or direct disposer to the effect that such
funeral director or direct disposer shall conduct the funeral
of any person insured by such insurer.
4. No insurer shall provide, in any insurance
contract covering the life of any person in this state, for
the payment of the proceeds or benefits thereof in other than
legal tender of the United States and of this state, or for
the withholding of such proceeds or benefits, all for the
purpose of either directly or indirectly providing, inducing,
or furthering any arrangement or agreement designed to require
or induce the employment of a particular person to conduct the
funeral of the insured.
(t) Certain life insurance relations with
funeral directors prohibited.--
1. No life insurer shall permit any funeral
director or direct disposer to act as its representative,
adjuster, claim agent, special claim agent, or agent for such
insurer in soliciting, negotiating, or effecting contracts of
life insurance on any plan or of any nature issued by such
insurer or in collecting premiums for holders of any such
contracts except as prescribed in s. 626.785(3).
2. No life insurer shall:
a. Affix, or permit to be affixed, advertising
matter of any kind or character of any licensed funeral
director or direct disposer to such policies of insurance.
b. Circulate, or permit to be circulated, any
such advertising matter with such insurance policies.
c. Attempt in any manner or form to influence
policyholders of the insurer to employ the services of any
particular licensed funeral director or direct disposer.
3. No such insurer shall maintain, or permit its
agent to maintain, an office or place of business in the
office, establishment, or place of business of any funeral
director or direct disposer in this state.
(u) False claims; obtaining or retaining
money dishonestly.--
1. Any agent, physician, claimant, or other
person who causes to be presented to any insurer a false claim
for payment, knowing the same to be false; or
2. Any agent, collector, or other person who
represents any insurer or collects or does business without
the authority of the insurer, secures cash advances by false
statements, or fails to turn over when required, or
satisfactorily account for, all collections of such insurer,
shall, in addition to the other penalties provided in
this act, be guilty of a misdemeanor of the second degree and,
upon conviction thereof, shall be subject to the penalties
provided by s. 775.082
or s. 775.083.
(v) Proposal required.--If a person
simultaneously holds a securities license and a life insurance
license, he or she shall prepare and leave with each
prospective buyer a written proposal, on or before delivery of
any investment plan. "Investment plan" means a mutual funds
program, and the proposal shall consist of a prospectus
describing the investment feature and a full illustration of
any life insurance feature. The proposal shall be prepared in
duplicate, dated, and signed by the licensee. The original
shall be left with the prospect, the duplicate shall be
retained by the licensee for a period of not less than 3
years, and a copy shall be furnished to the department upon
its request. In lieu of a duplicate copy, a receipt for
standardized proposals filed with the department may be
obtained and held by the licensee.
(w) Soliciting or accepting new or renewal
insurance risks by insolvent or impaired insurer prohibited;
penalty.--
1. Whether or not delinquency proceedings as to
the insurer have been or are to be initiated, but while such
insolvency or impairment exists, no director or officer of an
insurer, except with the written permission of the office,
shall authorize or permit the insurer to solicit or accept new
or renewal insurance risks in this state after such director
or officer knew, or reasonably should have known, that the
insurer was insolvent or impaired. "Impaired" includes
impairment of capital or surplus, as defined in s. 631.011(12)
and (13).
2. Any such director or officer, upon conviction
of a violation of this paragraph, is guilty of a felony of the
third degree, punishable as provided in s. 775.082,
s. 775.083,
or s. 775.084.
(x) Refusal to insure.--In addition to
other provisions of this code, the refusal to insure, or
continue to insure, any individual or risk solely because of:
1. Race, color, creed, marital status, sex, or
national origin;
2. The residence, age, or lawful occupation of
the individual or the location of the risk, unless there is a
reasonable relationship between the residence, age, or lawful
occupation of the individual or the location of the risk and
the coverage issued or to be issued;
3. The insured's or applicant's failure to agree
to place collateral business with any insurer, unless the
coverage applied for would provide liability coverage which is
excess over that provided in policies maintained on property
or motor vehicles;
4. The insured's or applicant's failure to
purchase noninsurance services or commodities, including
automobile services as defined in s. 624.124;
5. The fact that the insured or applicant is a
public official; or
6. The fact that the insured or applicant had
been previously refused insurance coverage by any insurer,
when such refusal to insure or continue to insure for this
reason occurs with such frequency as to indicate a general
business practice.
(y) Powers of attorney.--Except as
provided in s. 627.842(2):
1. Requiring, as a condition to the purchase or
continuation of an insurance policy, that an applicant for
insurance or an insured execute a power of attorney in favor
of an insurance agent or agency or employee thereof; or
2. Presenting to the applicant or the insured,
as a routine business practice, a form that authorizes the
insurance agent or agency to sign the applicant's or insured's
name on any insurance-related document or application for the
purchase of motor vehicle services as described in s. 624.124.
To be valid, a power of attorney must be an act or practice
other than as described in this paragraph, must be a separate
writing in a separate document, must be executed with the full
knowledge and consent of the applicant or insured who grants
the power of attorney, must be in the best interests of the
insured or applicant, and a copy of the power of attorney must
be provided to the applicant or insured at the time of the
transaction.
(z) Sliding.--Sliding is the act or
practice of:
1. Representing to the applicant that a specific
ancillary coverage or product is required by law in
conjunction with the purchase of insurance when such coverage
or product is not required;
2. Representing to the applicant that a specific
ancillary coverage or product is included in the policy
applied for without an additional charge when such charge is
required; or
3. Charging an applicant for a specific
ancillary coverage or product, in addition to the cost of the
insurance coverage applied for, without the informed consent
of the applicant.
1(aa) Churning.--
1. Churning is the practice whereby policy
values in an existing life insurance policy or annuity
contract, including, but not limited to, cash, loan values, or
dividend values, and in any riders to that policy or contract,
are directly or indirectly used to purchase another insurance
policy or annuity contract with that same insurer for the
purpose of earning additional premiums, fees, commissions, or
other compensation:
a. Without an objectively reasonable basis for
believing that the replacement or extraction will result in an
actual and demonstrable benefit to the policyholder;
b. In a fashion that is fraudulent, deceptive,
or otherwise misleading or that involves a deceptive omission;
c. When the applicant is not informed that the
policy values including cash values, dividends, and other
assets of the existing policy or contract will be reduced,
forfeited, or used in the purchase of the replacing or
additional policy or contract, if this is the case; or
d. Without informing the applicant that the
replacing or additional policy or contract will not be a
paid-up policy or that additional premiums will be due, if
this is the case.
Churning by an insurer or an agent
is an unfair method of competition and an unfair or deceptive
act or practice.
2. Each insurer shall comply with
sub-subparagraphs 1.c. and 1.d. by disclosing to the applicant
at the time of the offer on a form designed and adopted by
rule by the commission if, how, and the extent to which the
policy or contract values (including cash value, dividends,
and other assets) of a previously issued policy or contract
will be used to purchase a replacing or additional policy or
contract with the same insurer. The form must include
disclosure of the premium, the death benefit of the proposed
replacing or additional policy, and the date when the policy
values of the existing policy or contract will be insufficient
to pay the premiums of the replacing or additional policy or
contract.
3. Each insurer shall adopt written procedures
to reasonably avoid churning of policies or contracts that it
has issued, and failure to adopt written procedures sufficient
to reasonably avoid churning shall be an unfair method of
competition and an unfair or deceptive act or practice.
(bb) Deceptive use of name.--Using the
name or logo of a financial institution, as defined in s. 655.005(1),
or its affiliates or subsidiaries when marketing or soliciting
existing or prospective customers if such marketing materials
are used without the written consent of the financial
institution and in a manner that would lead a reasonable
person to believe that the material or solicitation originated
from, was endorsed by, or is related to or the responsibility
of the financial institution or its affiliates or
subsidiaries.
(cc) Unfair rate increases for persons in
military service.--Charging an increased premium for
reinstating a motor vehicle insurance policy that was canceled
or suspended by the insured solely for the reason that he or
she was transferred out of this state while serving in the
United States Armed Forces or on active duty in the National
Guard or United States Armed Forces Reserve. It is also an
unfair practice for an insurer to charge an increased premium
for a new motor vehicle insurance policy if the applicant for
coverage or his or her covered dependents were previously
insured with a different insurer and canceled that policy
solely for the reason that he or she was transferred out of
this state while serving in the United States Armed Forces or
on active duty in the National Guard or United States Armed
Forces Reserve. For purposes of determining premiums, an
insurer shall consider such persons as having maintained
continuous coverage.
(dd) Life insurance limitations based on past
foreign travel experiences or future foreign travel
plans.--
1. An insurer may not refuse life insurance to;
refuse to continue the life insurance of; or limit the amount,
extent, or kind of life insurance coverage available to an
individual based solely on the individual's past lawful
foreign travel experiences.
2. An insurer may not refuse life insurance to;
refuse to continue the life insurance of; or limit the amount,
extent, or kind of life insurance coverage available to an
individual based solely on the individual's future lawful
travel plans unless the insurer can demonstrate and the Office
of Insurance Regulation determines that:
a. Individuals who travel are a separate
actuarially supportable class whose risk of loss is different
from those individuals who do not travel; and
b. Such risk classification is based upon sound
actuarial principles and actual or reasonably anticipated
experience that correlates to the risk of travel to a specific
destination.
3. The commission may adopt rules pursuant to
ss. 120.536(1)
and 120.54
necessary to implement this paragraph and may provide for
limited exceptions that are based upon national or
international emergency conditions that affect the public
health, safety, and welfare and that are consistent with
public policy.
4. Each market conduct examination of a life
insurer conducted pursuant to s. 624.3161
shall include a review of every application under which such
insurer refused to issue life insurance; refused to continue
life insurance; or limited the amount, extent, or kind of life
insurance issued, based upon future lawful travel plans.
5. The administrative fines provided in s. 624.4211(2)
and (3) shall be trebled for violations of this paragraph.
6. The Office of Insurance Regulation shall
report to the President of the Senate and the Speaker of the
House of Representatives by March 1, 2007, and on the same
date annually thereafter, on the implementation of this
paragraph. The report shall include, but not be limited to,
the number of applications under which life insurance was
denied, continuance was refused, or coverage was limited based
on future travel plans; the number of insurers taking such
action; and the reason for taking each such action.
1(ee) Fraudulent signatures on an
application or policy-related document.--Willfully
submitting to an insurer on behalf of a consumer an insurance
application or policy-related document bearing a false or
fraudulent signature.
1(ff) Unlawful use of
designations; misrepresentation of agent qualifications.--
1. A licensee may not, in any sales presentation
or solicitation for insurance, use a designation or title in
such a way as to falsely imply that the licensee:
a. Possesses special financial knowledge or has
obtained specialized financial training; or
b. Is certified or qualified to provide
specialized financial advice to senior citizens.
2. A licensee may not use terms such as
"financial advisor" in such a way as to falsely imply that the
licensee is licensed or qualified to discuss, sell, or
recommend financial products other than insurance products.
3. A licensee may not, in any sales presentation
or solicitation for insurance, falsely imply that he or she is
qualified to discuss, recommend, or sell securities or other
investment products in addition to insurance products.
4. A licensee who also holds a designation as a
certified financial planner (CFP), chartered life underwriter
(CLU), chartered financial consultant (ChFC), life underwriter
training council fellow (LUTC), or the appropriate license to
sell securities from the Financial Industry Regulatory
Authority (FINRA) may inform the customer of those licenses or
designations and make recommendations in accordance with those
licenses or designations, and in so doing does not violate
this paragraph.
(2) ALTERNATIVE RATES OF PAYMENT.--Nothing in
this section shall be construed to prohibit an insurer or
insurers from negotiating or entering into contracts with
licensed health care providers for alternative rates of
payment, or from limiting payments under policies pursuant to
agreements with insureds, as long as the insurer offers the
benefit of such alternative rates to insureds who select
designated providers.
History.--s. 9, ch. 76-260; s. 1, ch. 77-174; s. 19,
ch. 77-468; s. 1, ch. 78-377; s. 1, ch. 79-289; s. 1, ch.
80-152; s. 1, ch. 80-373; s. 1, ch. 82-235; s. 807, ch.
82-243; s. 90, ch. 83-216; ss. 1, 2, ch. 83-342; s. 1, ch.
84-157; s. 14, ch. 85-62; s. 3, ch. 85-182; s. 1, ch. 85-233;
s. 4, ch. 86-160; s. 27, ch. 87-226; s. 13, ch. 88-370; ss.
60, 65, ch. 89-360; s. 1, ch. 90-85; s. 33, ch. 90-119; ss.
186, 206, 207, ch. 90-363; s. 58, ch. 91-110; s. 256, ch.
91-224; s. 4, ch. 91-429; s. 38, ch. 92-146; s. 6, ch. 95-187;
s. 1, ch. 95-219; s. 314, ch. 97-102; s. 24, ch. 99-3; s. 5,
ch. 99-286; s. 1, ch. 99-388; s. 2, ch. 2000-192; s. 1, ch.
2001-178; s. 2, ch. 2002-25; s. 7, ch. 2002-55; s. 65, ch.
2002-206; s. 88, ch. 2003-1; s. 2, ch. 2003-139; s. 1028, ch.
2003-261; ss. 4, 65, ch. 2003-267; ss. 58, 80, ch. 2003-281;
s. 4, ch. 2004-340; s. 87, ch. 2004-390; s. 1, ch. 2005-41; s.
2, ch. 2006-277; s. 2, ch. 2007-44; s. 8, ch. 2008-66; s. 7,
ch. 2008-237.
1Note.--Section 12, ch. 2008-237,
provides in part that "[e]ffective [June 30, 2008,] the
Department of Financial Services may adopt rules to implement
this act."