Volume 2, No. 6 - August 2011

Compliance Corner

We continue to see a pattern of noncompliance in the areas noted below. This section has been created to assist you in keeping your insurance business in compliance. The items are intended as reminders only and are not necessarily the exact text of the Florida Statutes or Florida Administrative Code. The legal cites have been provided for your further reference.

Reporting of Actions - Administrative, Criminal and Other

Subsection 626.451(7), F.S., requires each licensee to advise the department within 30 days after having been found guilty of or having pleaded guilty or nolo contendere to a felony or a crime punishable by imprisonment of 1 year or more under the laws of the United States, any state of the United States, or any other country, without regard to whether a judgment of conviction has been entered by the court having jurisdiction of such cases.

Section 626.536, F.S., requires each agent and insurance agency to submit to the department a copy of the order, consent to order, or other relevant legal documents within 30 days after the final disposition of any administrative action taken against the agent or insurance agency by a governmental agency in this or any other state or jurisdiction relating to the business of insurance, the sale of securities, or activity involving fraud, dishonesty, trustworthiness, or breach of a fiduciary duty.

Subsection 626.6215(6), F.S., requires that agencies and their officers to advise the department within 30 days after an individual licensee's violation is known or should have been known by one or more of the partners, officers, or managers acting on behalf of the agency. Actions taken against a license or registration for violations of state or federal securities or commodities law, such as an action taken by FINRA, are an example. Failure to do so could result in administrative action against the license(s) of the agency and/or majority owner, officer, partner, manager, director, or other person who manages or controls the insurance agency.

Actions may be reported via the NIPR's Attachment Warehouse, or by mailing the appropriate documents to us at:

Florida Department of Financial Services
Division of Agent and Agency Services
Bureau of Licensing
200 E. Gaines Street, Room 419
Tallahassee, FL 32399-0319

[See 626.451(7), 626.536, 626.621(13), and 626.6215(6), Florida Statutes]

In-House Claims Adjuster Licensing Requirement

Regardless if an adjuster is in-house or not, they must be licensed and appointed as such prior to adjusting any claim. The only exceptions to this are:

  • Attorneys that are duly licensed to practice law and in good standing with the Florida Bar.
  • An executive officer of any insurer, or a regularly salaried employee of an insurer handling claims with respect to health insurance, or the duly designated attorney or agent authorized and acting for subscribers to reciprocal insurers, from adjusting any claim loss or damage under any insurance contract of such insurer. However, if there is a problem that is determined to be the result of misconduct of the employee, the insurer could be held responsible.
  • A licensed and appointed insurance agent, if authorized to do so by the appointing insurer.

All adjusters and the company they represent should govern themselves accordingly with regard to adjuster licensing requirements. Any adjuster found not in compliance is subject to administrative and/or criminal action, in addition to the insurance company being referred for action against its certificate of authority by the Florida Office of Insurance Regulation.

[See 626.112(3), 626.860, and 626.861, Florida Statutes]

Non-residents and County Appointments

All agents and adjusters must be appointed in order to transact insurance or adjust claims in Florida. This applies to non-residents regardless of whether their home state requires an appointment or not. Non-resident agents also need a county appointment if they are physically coming to that county to engage in insurance activities.

[See 624.505 and 626.112(1)(a), Florida Statutes]

 

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