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News & Press: News in Workers' Compensation

Insurance Insights- November 2015

Tuesday, December 1, 2015   (0 Comments)
Posted by: Tanyea Griffin
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Insurance Insights Newsletter - (November Edition)

Protecting Yourself from Fraud

Dear friends,

As the world turns and technology continues to advance, so does the ever-present threat of fraud in our lives. Whether it's shopping online or buying a new insurance policy or even a telephone call from a stranger, we must do our part to help protect ourselves and our private information from those who may want to take it. Fraud knows no boundaries and impacts Floridians of every age and income level. Each year, fraud costs consumers billions of dollars in higher fees, taxes and insurance rates that are collected to cover losses from fraudulent transactions.

Our Department works to cut down the cost of fraud each and every day in a variety of ways, some of which you may already know and some you may not.

Our Division of Insurance Fraud takes fraud head on by investigating a host of insurance-related crimes. From staged car accidents to fake water leaks for insurance payments to employers who fail to adequately protect their employees with workers' compensation coverage, our investigators are working in every corner of our state to root out and address these crimes that are driving up our insurance rates. We're making great strides, averaging four arrests per day, taking four more fraudsters out of your pockets. If you see something, say something. To report suspected insurance fraud, please call 1-800-378-0445.

Our Division of State Fire Marshal works to solve cases of suspicious fires in our state. You may not know that one of the primary reasons people intentionally start fires in our nation is in hopes of collecting the insurance money tied to the property they've destroyed. It happens more often than you'd think--since 2011, we've made nearly 1,500 arson arrests. If you have information regarding a fire you believe to be suspicious, tell our investigators by calling 1-877-662-7766.

Our Division of Public Assistance Fraud fights against those who try to cheat our public benefits system, which is designed to temporarily help Floridians through their time of need. Just last fiscal year, we opened 232 slots for hard-working families to enroll their children in daycare services so they can go to work to provide for themselves. When people steal these benefits, it takes away from another family in need. In total, we've stopped more than $167 million worth of public assistance fraud in the last four-and-a-half years. If you think someone is cheating the public assistance system, please report it by calling 1-866-762-2237.

Lastly, and the one area I encourage you to become familiar with, is our Division of Consumer Services, which works 365 days a year to assist and inform you and your loved ones about fraud and scams of all types.

Here are just a few of the services they provide:

·         Insurance Consumer Helpline: Consumers can chat with an insurance expert to get advice 
          about the purchase of a new policy, to go over coverage limits, or to ask for help during the
          claims process.

·         Mediation Services: Are you dissatisfied with the response you're getting from your carrier?
          Was your claim denied? Do you think your claim was not handled properly? Our insurance
          experts will reach out to your insurance company on your behalf to help you get the coverage
          you deserve.

Tools are available all-day, every day by visiting our website at To speak with an insurance expert or to request help with a claim, give us a call at 1-877-693-5236.

With the holidays quickly approaching, scammers tend to come out of the woodwork to try to steal your hard-earned cash. Stay on guard and give us a call if you need some assistance.


 Jeff Atwater 

Jeff Atwater
Chief Financial Officer
State of Florida

Compliance Topic of the Month:Failure to Collect Bail Bond Premium ~ Unlawful Rebating?

The Florida Statutes require bail bond agents to charge the exact surety bond premium amount filed by the surety company with the Florida Office of Insurance Regulation (OIR), nothing more and nothing less.

We are aware of bail bond agents and agencies who are not collecting the full premium, and in some cases, no premium. The bail bond agent must still pay the insurer and MGA their share of the premium. Not collecting the full premium costs the bail bond agent money to write and post the bail bond. This practice demonstrates more than questionable business skills, it is not permitted under the Florida Statutes.

If the bail bond agent is not making any attempt to collect the balance due, then he/she is discounting the premium filed with the OIR, or providing a rebate to the person who should have been paying the premium.

Click here to continue reading in Insurance Insights>>

Review Your Lender Closing Instructions Carefully

We reviewed the following article recently published by the Florida Bar Realty and Trust Law Section, which shared important information with its members. We are sharing this with all of our licensees.  

Representatives of the title insurance industry regularly meet with officials from the Florida Office of Insurance Regulation ("OIR") and the Florida Department of Financial Services ("DFS") regarding the regulation of the industry. These meetings focus primarily on forms, rules, and related industry matters.

At a recent meeting, OIR officials focused comments on Sec. 626.9541(1)(a), F. S. That provision reads in pertinent part, "(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 ... statement ... which: 1. Misrepresents the benefits, advantages, conditions, or terms of any insurance policy:"

 Click here to continue reading in Insurance Insights>>

Citizens Accepting Electronic Signature Submissions

On August 1, 2015, Citizens began accepting agents’, applicants’ and policyholders’ electronic signatures (also called esignatures) on all required documents, with two exceptions that require “wet” signatures: 

• Due to statutory requirements, policyholder statements to exclude windstorm coverage and/or contents coverage
• Notarized forms and required forms signed by a customer’s authorized representative

  Click here to continue reading in Insurance Insights>>

Marking Emails from the Department as SPAM

If a licensee marks an email notification from the Department as SPAM, they may not get our future emails but will still be held responsible for complying with the Florida Insurance Code. We have become aware that some licensees mark our communications as SPAM accidentally since they are quickly marking a lot of messages in their Inbox as SPAM. Please be sure to pay close attention when you are doing this as it could cause you to unknowingly miss important information about your license and possibly violate the Florida Insurance Code.

Click here to continue reading in Insurance Insights>>

Agents/Brokers: Important NPN Tips for Re-enrollments

The Centers for Medicare & Medicaid Services (CMS) would like to provide you with a few tips to ensure that your National Producer Number (NPN) is retained when your clients re-enroll in coverage through the Marketplace for plan year 2016. 

Please note that the following guidance applies only to the Marketplace for Individuals and Families. NPNs are automatically carried over when agents and brokers assist small employers when logged into the Small Business Health Option Program (SHOP) Marketplace Agent/Broker Portal.

 Click here to continue reading in Insurance Insights>>

What is an Elective CE Course?

Compliance cycles, ending October 31, 2014 and later, rolled out new continuing education requirements for Florida licensees. The main course being offered in the new compliance cycle is the 5-hour Law and Ethics course. Florida licensees are required to complete a 5-hour Law and Ethics course applicable to their license type. Please note title insurance agents are not included in the 5-hour course requirement and therefore, must complete courses that are approved in the line of title insurance.

What about all of those other courses listed? These courses are elective credits available in the new compliance cycle. An elective course is any approved continuing education course. Public adjusters are required to complete elective courses designed specifically for them.

 Click here to continue reading in Insurance Insights>>

What's the Difference? Referral Fees, Marketing/Advertising Gifts and Unlawful Inducements

We are frequently asked about referral fees, marketing or advertising gifts, and what constitutes an unlawful inducement. These three topics are often confused by licensees. Let's review the definition and practical use of each, lawful and unlawful:

Referral fees - referral fees are either cash or an item given to the source of a referral provided for the referral of a prospective insurance customer. The fees are lawful provided they are given for every referral, not just those that result in insurance sales. Acceptable fees can be paid in cash, with a gift card, merchandise, lottery tickets, etc. There is NO limit on the amount of a cash referral fee or the value of merchandise. [s.626.112(8), F.S.]

       Click here to continue reading in Insurance Insights>>

Title Agencies: Update Your Info for the 2016 Administrative Surcharge

Subsection 624.501(27)(e)2, F.S., requires any title insurance agency licensed in Florida on January 1 of each year to remit an administrative surcharge of $200 to the Florida Department of Financial Services. Therefore, we are reminding all title agencies that the 2016 administrative surcharge due date will soon be approaching.

NOTE: This surcharge is not related to the one imposed on each new policy written due to the receiverships of National Title Insurance Company and K.E.L. Title Insurance Group, Inc.

Any title insurance agency licensed in Florida on January 1, 2016, will be emailed a reminder a few days afterward to the agency's email address on file with the Department. To ensure you receive the invoice and avoid failing to pay by the January 30 due date, please log in to the MyProfile account for your title agency and make sure the correct email address is on file. While doing so, we also recommend you do the same for your individual MyProfile account.

Click here to continue reading in Insurance Insights>>

Compliance Information

Licensees and consumers can access compliance information at the Division's webpage Compliance Information. Additional information is available by type of license at our Frequently Asked Questions web page.

Other Items of Interest

* Case Notes >>
* Enforcement Actions for October 2015 >>
* Clearwater Insurance Agent’s License Stripped After Ruling in First District Court of Appeals>>
* State Fire Marshal’s Office Arrests Serial Arsonist in Pensacola>>
* Florida Health Insurance Advisory Board Adopts 2015 Florida Health Insurance Market Report>>
*Office Issues Final Order Approving Workers' Compensation Rates for 2016>>
*Florida Office of Financial Regulation Supports Operation Collection Protection>>
*Duo Sentenced for Investment Fraud Scheme Arrests>>