Many states have prompt claim payment statutes.1 In Florida, we have myriad statutes aimed at facilitating the prompt adjustment of claims.2 So, are insurers adjusting claims as promptly as they should be? Here are statistics obtained by the Florida Office of Insurance Regulation while conducting a market conduct examination of one of the largest homeowners insurance writers in the State of Florida (note: the below statistics were derived from a random survey of claims opened by the subject carrier over a period of approximately two years):
GENERAL CLAIMS REVIEW (EXCLUDING SINKHOLE)
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SINKHOLE CLAIMS REVIEW
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Over 50% of open claims took more than 120 days to resolve? Hum. It is no wonder that “claim delay” is a basis for a Civil Remedy Notice. I found the above statistics interesting and thought you might too.
1 See, e.g., Subchapter B of Chapter 542 of the Texas Insurance Code.
2 See, e.g., Fla. Stat. § 626.9541(1)(i)(3)(c) (“Failing to acknowledge and act promptly upon communications with respect to claims” (emphasis added)); Fla. Stat. § 626.9541(1)(i)(3)(f) (“Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim of for the offer of a compromise settlement” (emphasis added)); Fla. Stat. § 626.9541(1)(i)(3)(g) (“Failing to promptly notify the insured of any additional information necessary for the processing of a claim” (emphasis added)); Fla. Stat. § 626.9541(1)(i)(4) (“Failing to pay undisputed amounts of partial or full benefits owed under first-party property insurance policies within 90 days after an insurer receives notice of a residential property insurance claim, determines the amounts of partial or full benefits, and agrees to coverage, unless payment of the undisputed benefits is prevented by an act of God, prevented by the impossibility of performance, or due to actions by the insured or claimant that constitute fraud, lack of cooperation, or intentional misrepresentation regarding the claim for which benefits are owed” (emphasis added)); Fla. Stat. § 624.155(d) (providing insurers 60 days within which to pay a claim or otherwise cure the circumstances giving rise to a 624.155(3) Civil Remedy Notice).
