In The Know - December 2024

Bail Bond Appointments Can Be Submitted In eAppoint January 1st

Beginning January 1, 2025, Bail Bond surety companies can use eAppoint to submit new limited surety (bail bond) appointments. As a result, surety companies are no longer required to submit a paper form with the payment attached for new bail bond appointments. Previously, only bail bond appointment renewals were submitted in eAppoint.

Understanding Limited Benefit Plans

Limited benefits health insurance plans offer what their name implies - limited medical benefits for insureds. Agents must be very cautious when proposing a limited benefits policy to a consumer. There are instances when a limited benefit plan is appropriate for a consumer. However, complaints against agents for selling these plans to consumer generally involve:

Misrepresentation of when the coverage can be used.
Misrepresentation of the level of benefits the plan offers.
Misrepresentation of pre-existing conditions in general.
Misrepresentation that the policy will provide continuity of coverage if the consumer was previously insured.
Misrepresentation of deductibles, when they are applied, and policy maximum benefits.

Unfortunately, consumers may be attracted to the plans due to their lower-than-average premiums but there is a reason for that. Unscrupulous agents sell these products to individuals and families that may be desperate for health insurance without disclosing the inherent limitations of the policies. Because of this and other factors, the consumer may end up owing thousands of dollars in medical bills or have their claims rejected outright.

Licensees of the Department and associated agencies who market these plans are required to understand the products they sell. The Department takes a very dim view of agents who knowingly sell the products to unsuspecting consumers and will take enforcement action when appropriate against those agents who harm consumers by their actions.

Steps A Consumer Should Take If Enrolled In A Federally Facilitated Marketplace Plan Without Their Knowledge

Before reporting an alleged fraudulent health insurance policy issued through the Marketplace, consumer-insureds should first file a complaint with the Marketplace to have the policy cancelled and find out the name and National Producer Number (NPN) of the agent who submitted the application. If the consumer was charged for premiums for the fraudulent policy, the insurer will refund any premiums paid after a utilization review. The consumer can contact the Federally Facilitated Marketplace (FFM) at 1-800-318-2596, TTY: 1-855-889-4325) . This is an important step before filing a complaint with the Department regarding the agent's activities and should be done prior to filing a complaint with us.

It is important that the customer obtains the name of the insurer (if known) and the agent's name and National Producer Number (NPN) who wrote the policy so they can submit an insurance concern with our Department. Complaints can be submitted to our Division of Consumer Services at this link to its website. If the review of Consumer Services' findings indicate a violation may have occurred, the Bureau of Investigation will be notified to open an investigation and seek administrative action against the license when warranted.

Check My Contract - A New Service Offered to Florida Consumers

On November 8, 2024, the Department announced its "Check My Contract" service. The service is designed to assist residential or commercial property insurance policyholders who have entered into a repair contract with contractors, restoration professionals, or public adjusters related to an insurance claim.

Check My Contract allows these policyholders to submit repair contracts to DFS for independent review to gather any potential evidence of insurance fraud against Florida policyholders, especially following storms and ensure the contract complies with Florida Law.

The Department will review:

Compliance with Emergency-Specific Protections: Review roofing and public adjusting contracts to ensure they meet Florida’s cancellation criteria outlined in 626.854, 626.8796, Florida Statutes and Rule 69B-220.051, Florida Administrative Code. The consumer will receive the appropriate cancellation form if a contract does not meet these criteria.

Consumer Protection in Post-Storm Recovery: Examine storm recovery contracts to determine if they involve an unlawful Assignment of Benefits (AOB), rendering them void under Florida Statute 627.7152. If a contract is identified as an unlawful AOB, the consumer will receive a notice informing them that it is void, invalid, and unenforceable. To access the Check My Contract website, please click here.