(1) As used in this section, the term:
(a) “Loss run statement” means a report that contains the policy number, the period of coverage, the number of claims, the paid losses on all claims, and the date of each loss. The term does not include supporting claim file documentation, including, but not limited to, copies of claim files, investigation reports, evaluation statements, insureds’ statements, and documents protected by a common law or statutory privilege. As applied to group health insurance, the term means a report that also contains the premiums paid, the number of insureds on a monthly basis, and the dependent status.
(b) “Provide” means to electronically send a document or to allow access through an electronic portal to view or generate a document.
(2) Notwithstanding any other law, an insurer shall provide to an insured within 15 calendar days after an individual or entity designated by the insurer receives the insured’s written request, either:
(a) A loss run statement; or
(b) For personal lines of insurance, information on how to obtain a loss run statement at no charge through a consumer reporting agency. However, this section does not prohibit an insured from requesting a loss run statement after receiving information from a consumer reporting agency, in which case the insurer shall then provide the loss run statement within 15 calendar days after the individual or entity designated by the insurer receives the insured’s subsequent written request.
(3) At the time a loss run statement is provided to the insured, the insurer shall notify the agent of record that the loss run statement was provided to the insured.
(4) Except for group health insurance, a loss run statement provided pursuant to this section must contain a claims history with the insurer for the preceding 5 years or, if the claims history is less than 5 years, a complete claims history with the insurer. For purposes of group health insurance, a loss run statement provided pursuant to this section must contain a claims history with the insurer for the preceding 3 years or, if the claims history is less than 3 years, a complete claims history with the insurer.
(5) Notwithstanding any other provision of this section, an insurer is not required to provide loss reserve information.
(6) Notwithstanding any other law, an insurer may not charge any fee to prepare and provide annually one loss run statement in accordance with this section.
(7) This section does not apply to a life insurer as defined in s. 624.602.
(8) For group health insurance, only the group policyholder may request and be provided a loss run statement pursuant to this section.
History.—s. 2, ch. 2020-51; s. 2, ch. 2022-207.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part II - The Insurance Contract (Ss. 627.401-627.444)
627.4025 - Residential coverage and hurricane coverage defined.
627.4035 - Payment of premiums; claims.
627.404 - Insurable interest; personal insurance.
627.405 - Insurable interest; property.
627.406 - Power to contract; purchase of insurance by or for minor.
627.407 - Alteration of application.
627.408 - Application as evidence.
627.4085 - Insurer name, agent name, and license identification number required on application.
627.409 - Representations in applications; warranties.
627.4091 - Specific reasons for denial, cancellation, or nonrenewal.
627.40951 - Standard personal lines residential insurance policy.
627.410 - Filing, approval of forms.
627.4101 - Credit insurance enrollment forms.
627.4102 - Informational filing of forms.
627.4105 - Life and health insurance; reduced premiums upon rigorous physical examination.
627.411 - Grounds for disapproval.
627.412 - Standard provisions, in general.
627.413 - Contents of policies, in general; identification.
627.4131 - Telephone number required.
627.4132 - Stacking of coverages prohibited.
627.4133 - Notice of cancellation, nonrenewal, or renewal premium.
627.4135 - Casualty insurance contracts subject to general provisions for insurance contracts.
627.4136 - Nonjoinder of insurers.
627.4137 - Disclosure of certain information required.
627.4138 - Wrap-up insurance policies for nonpublic construction projects.
627.414 - Additional policy contents.
627.4143 - Outline of coverage.
627.4145 - Readable language in insurance policies.
627.4147 - Medical malpractice insurance contracts.
627.4148 - Medical malpractice insurers; required offer of coverage limits.
627.41495 - Public notice of medical malpractice rate filings.
627.415 - Charter, bylaw provisions.
627.416 - Execution of policies.
627.417 - Underwriters’ and combination policies.
627.418 - Validity of noncomplying contracts.
627.419 - Construction of policies.
627.4195 - Health insurance; claims for payment of psychotherapeutic services; confidentiality.
627.4205 - Coverage identification number required.
627.4215 - Disclosures to policyholders; coverage of behavioral health care services.
627.422 - Assignment of policies or post-loss benefits.
627.423 - Payment discharges insurer.
627.4232 - Health insurance out-of-hospital benefits.
627.4233 - Total disability defined.
627.4234 - Health insurance cost containment provisions required.
627.4235 - Coordination of benefits.
627.4236 - Coverage for bone marrow transplant procedures.
627.4237 - Sickness disability or disability due to sickness.
627.4238 - Health insurer examinations.
627.4239 - Coverage for use of drugs in treatment of cancer.
627.42392 - Prior authorization.
627.42393 - Step-therapy protocol.
627.42395 - Coverage for certain prescription and nonprescription enteral formulas.
627.42396 - Reimbursement for telehealth services.
627.42397 - Coverage for air ambulance services.
627.424 - Minor may give acquittance.
627.425 - Forms for proof of loss to be furnished.
627.426 - Claims administration.
627.4265 - Payment of settlement.
627.427 - Payment of judgment by insurer; penalty for failure.
627.429 - Medical tests for HIV infection and AIDS for insurance purposes.
627.4295 - Dental procedures; anesthesia and hospitalization coverage.
627.4301 - Genetic information for insurance purposes.
627.4302 - Identification cards for processing prescription drug claims.
627.43141 - Notice of change in policy terms.
627.441 - Commercial general liability policies; coverage to contractors for completed operations.
627.442 - Insurance contracts.