The Florida Office of Insurance Regulation (OIR) has recently taken significant steps to address improper claims handling by property and casualty insurers in the aftermath of Hurricane Ian. Among the most notable actions is the imposition of a substantial $1 million fine on Heritage Property & Casualty Insurance Co. for failing to appropriately manage hundreds of insurance claims. This fine, accompanied by an additional $10,000 in administrative costs, is one of the largest in the history of Florida insurance regulation and underscores the OIR's commitment to scrutinizing insurance companies.
According to a May 9 consent order signed by Heritage executives and OIR officials, the violations were outlined in a market conduct examination report completed in March. This examination revealed a range of issues, including the use of unlicensed adjusters and failure to meet statutory requirements for claims processing.
Key Findings from the Market Conduct Examination
The examination, conducted by The INS Companies, randomly selected 324 claims from the more than 5,500 filed after Hurricane Ian. The report found multiple areas where Heritage failed to comply with state laws and regulations:
Unlicensed Adjusters:Â In 13 instances, Heritage utilized adjusters who were not properly appointed or had not yet received a temporary Florida license.
Adjuster Information:Â In 139 cases, adjusters failed to provide their license information to policyholders.
Communication Failures:Â In 66 instances, adjusters' names were not included in communications with property owners.
Acknowledgment of Claims:Â Heritage did not acknowledge receipt of claims communication within 14 days in about 30% of the claims examined.
Timely Payment or Denial of Claims: The carrier did not pay or deny claims within the 90-day statutory requirement in 22% of cases.
Accurate Calculation of Interest:Â In 59 of 216 closed claims with payment, Heritage did not accurately calculate the interest owed.
Voice Contact: The company did not initiate voice contact with insureds within one business day in 57% of cases, as required by their claims-handling manual.
Claims Records: Heritage maintained complete claims records in only about 3% of the examined claims.
These findings highlight significant deficiencies in Heritage's claims-handling processes, which have likely contributed to consumer dissatisfaction and complaints.
Response from Heritage
Heritage has acknowledged these issues and has taken steps to address them. CEO Ernie Garateix informed the Tampa Bay Times that the company has implemented corrective actions, including appointing a new compliance director and adopting new claims management software. Despite these challenges, the parent company of Heritage, based in Tampa, reported another profitable quarter, showing a rebound from the financial difficulties faced in 2021 and 2022.
Broader Regulatory Actions
In addition to the actions against Heritage, the OIR has fined four smaller property-casualty insurers for various non-willful violations. These include:
Granada Indemnity Co.: Fined $3,000 plus $1,000 in administrative costs for late submission of 2023 experience data.
Stillwater Property and Casualty: Fined $6,000 plus $1,000 in administrative costs for missing the deadline for providing claims litigation data.
Yel Co. Insurance: Fined $1,000 plus administrative costs for failing to timely provide 2022 experience data.
Lancer Insurance Co.: Fined $3,000 plus administrative costs for missing the experience reporting deadline.
Implications for Policyholders
For Florida property owners, these regulatory actions signify a robust effort by the OIR to hold insurers accountable and ensure they meet their obligations to policyholders. If you have experienced issues with your property insurance claims, it is crucial to understand your rights and the regulatory landscape. Consulting with a knowledgeable property damage attorney can help you navigate these challenges and seek the compensation you deserve.
Protect Your Rights
If you are dealing with property damage claims and facing difficulties with your insurance company, don't wait. Contact our experienced Florida property damage attorneys today for a free consultation. We are dedicated to fighting for your rights and ensuring you receive the compensation you deserve. Call us now or visit our website to schedule your consultation and take the first step toward resolving your insurance claims issues.
For more insights and updates on property damage claims and insurance regulations in Florida, feel free to contact our experienced team. We are here to help you navigate the complexities of insurance claims and ensure your rights are protected.
Source: Insurance Journal
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