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What Does The New First Party Law (SB-76) Mean for Insurers?

Sarah R. Goldberg | May 4, 2021

Thorough Claims Investigation is Key


SB 76 was passed by the Florida Legislature on April 30, 2021. The bill includes much anticipated reform in the area of property insurance claims. In this article, we will outline some of the major changes included in the bill. We will also include our recommendations for best practices in claim handling in order to maximize the potential for the bill’s changes to help you reduce costs and reach timely resolution of claims.

Some of the major changes included in SB 76:

1. Notice of all claims and re-opened claims must be provided to the Insurance Carrier within two (2) years of the reported date of loss.

2. Requires a 10 day pre-suit notice be provided by the Insured to the Insurance Carrier. Failure to comply with this requirement will result in dismissal with prejudice of a lawsuit.

3. Requires a pre-suit demand by the Insured and a pre-suit settlement offer by the Insurance Carrier.

4. Requires notice by the Insured to the court of all pending lawsuits under the same residential insurance policy.

It appears that the spirit behind the bill is to (1) encourage timely reporting when claims become known to an Insured, and (2) timely adjustment of the claims by the Insurance Carrier in response to a claim. With the new provisions cited above requiring that the Insured and the Insurance Carrier communicate about the value of the claim pre-suit, it becomes imperative that the Insurance Carrier conduct a thorough and accurate investigation of the claim at the time of reporting.

In order to make meaningful pre-suit offers to the Insured, we recommend that the following be incorporated into everyday adjusting practices:

1. Task the field adjuster with conducting an investigation of all areas of the home including a full inspection of the roof, the attic, the exterior of the property and all interior rooms.

2. Send out causation experts at the early stages for claims where coverage is in question.

3. For claims where coverage is available based on the field adjuster’s inspection, ensure that the estimate of damages upon which pre-suit payments are made are reliable and sufficient to make the required repairs to the property. Updated training for field adjusters on estimating and using general contractors for more complicated cases should help you with this process.

4. Make a request for all repair documentation in writing as soon as the claim is reported.

5. Obtain a sworn statement on the cost and scope of repair.

6. Obtain a recorded statement of the Insured(s).

7. Obtain a full claim history for the Insured to evaluate potential overlap in damages.
 

Attorney’s Fees

One of the most important changes to the bill affects attorney’s fees and costs. The bill creates the following framework for recovery:

1. If the difference between the amount obtained during the lawsuit and the pre-suit settlement offer excluding attorney’s fees and costs is 20 percent or less of the disputed amount, each party pays its own attorney’s fees and costs.

2. If the difference between the amount obtained during the lawsuit and the pre-suit settlement offer excluding attorney’s fees and costs is between 20 and 50 percent of the disputed amount, the Insured recovers their attorney’s fees and costs in amount calculated by multiplying the percentage of recovery of the disputed amount by the amount of attorney’s fees and costs

3. If the difference between the amount obtained during the lawsuit and the pre-suit settlement offer excluding attorney’s fees and costs is more than 50 percent of the disputed amount, the Insured may recover the full amount of their attorney’s fees and costs.
 
It is estimated by the National Association of Insurance Commissioners (“NAIC”), that in 2019, homeowners’ insurance claims made in Florida represented 8.16 percent of all claims nationwide but a whopping 76.45 percent of all homeowners’ insurance lawsuits nationwide.

Great claims handling combined with the new law should result in the reduction of lawsuits. This will have an immediate impact on soaring litigation costs. If it can be demonstrated to the Insured’s attorney that a pre-suit offer was based upon an accurate assessment of damages - early resolutions should result – as the Insured’s attorney is discouraged from engaging in lengthy discovery because they risk collecting reduced or no attorney’s fees.

The lawyers at Kubicki Draper are experienced in handling First Party claims and are happy to assist with any questions you may have about the new law.

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