17 Florida Statutes and Rules
Office of Financial Regulation (OFR)
Provides regulatory oversight to Florida's financial service providers. Those providers include banks, credit unions, finance companies, and the securities industry. Reports to the Financial Service Commission.
Stock Company
An insurance company owned by its stockholders who share in profits through earnings distributions and increases in stock value.
Insurance Service Office (ISO)
An organization made up of member companies that collects and analyzes statistics collected from members and then establishes and files standard rates for many lines of insurance. Also develops standardized forms.
Roof Decking
The material used underneath the roof covering. Typically plywood or oriented strand board, but also dimensional lumber and concrete.
Preemption
The rule of law that if the federal government through Congress has enacted legislation on a subject matter it shall be controlling over state laws and/or preclude the state from enacting laws on the same subject if Congress has specifically stated it has "occupied the field."
Unfair Insurance Trade Practices Act
A Florida law describing certain practices that are prohibited, such as misrepresentation, denying claims without reasonable investigation, discrimination, etc.
Deemer Clause
A clause stating that a legitimate ERISA plan providing health benefits cannot be "deemed" to be an insurance company or to be engaged in the business of insurance.
Savings Clause
A clause stating that nothing in ERISA shall be construed to exempt or relieve any person from any law of any state which regulates insurance, banking, or securities.
Certificate of Insurance
A document used to verify the existence of insurance and usually contains information on types and limits of coverage, insurance company, policy number, named insured, and the policies' effective periods.
Professional Employer Organization (PEO)
A firm that provides a service under which an employer can outsource employee management tasks. Subject to state insurance regulation.
Independent Insurance Agents and Brokers of America (IIABA or the Big I)
A national alliance of more than a quarter million business owners and their employees who offer all types of insurance and financial services products.
Florida Insurance Guaranty Association (FIGA)
A non-profit organization created by legislation to help protect policyholders in the event their insurance company becomes insolvent and is liquidated.
Mutual Company
A private company owned by its clients or policyholders that returns part of its profits to the policyholders as dividends. The insurer uses the rest as a surplus cushion in case of large and unexpected losses. Does not have capital stock or shares.
Alien Company
Companies that are classified as other than domestic or foreign; i.e. Lloyds of London.
Unauthorized Companies
Companies that do not have a certificate of authority to transact business in Florida. The penalty is a 3rd degree felony and personal liability for all unpaid claims.
Domestic Company
Companies that have their home office in Florida. They do business in Florida, and they may also provide coverage in other states as well.
Foreign Company
Companies that have their home office in another state, but they sell coverage in Florida.
Authorized Companies
Companies that hold a certificate of authority allowing them to transact business in Florida.
Non-admitted Companies
Companies with a non-approved status by a state's insurance department for state regulation compliance regarding insurance. Does not allow payment for claims to be financially backed by the state if the company becomes insolvent, and policyholders cannot appeal to the state insurance department for the mishandling of their claim.
Admitted Companies
Companies with an approved status by a state's insurance department for state regulation compliance regarding insurance. Allows payment for claims to be financially backed by the state if the company becomes insolvent.
Division of Agents and Agency Services
Comprised of the Bureau of Licensing and the Bureau of Investigation.
Department of Financial Services (DFS)
Comprised of the Division of Agents and Agency Services and the Office of Insurance Regulation (OIR). Approves issuance of licenses to agents, customer representatives and adjusters, supervises claims activity, and investigate charges of unethical conduct and take judicious action in the case of misconduct.
Positive Internal Pressure
Created by wind forced into a structure.
Wind-borne Debris Regions
Designated by the Florida Building Code for either coastal or inland that are located in areas within one mile of the coastal mean high water line (where the wind speed is 130 mph or greater) or any location where the wind speed is 140 mph or greater.
Morality
Determination of what is right or wrong based on legality, truth and moral standards.
Self-insurance
Includes any plan established by an entity that is not an insurer with the intent of indemnifying an employee or their beneficiary for benefits in the event of sickness, accident, disability or death.
Union Plan
Insurance for an organization of workers who have banded together to achieve common goals in key areas, such as health benefits. Subject to state regulation as a MEWA unless there is a bona fide express finding of a collective bargaining agreements between the organization and the employers.
Fraternal Insurance
Insurance plan for group whose members freely associate for a mutually beneficial purpose such as for social, professional or honorary principles. This type of insurance is not common today, but sometimes life insurance is available through non-profit associations.
Multiple-Employer Welfare Arrangement (MEWA)
This is an employee welfare benefit plan or other arrangement that is established or maintained to provide one or more of various insurance benefits (including health insurance) to the employees of two or more employers. Subject to state insurance regulation.
Florida Comprehensive Hurricane Damage Mitigation Program
This program within the Department of Financial Services was created by Florida Legislature in 2006 to provide assistance to Floridians on how they can reinforce their homes against hurricanes and to reduce hurricane damage exposure.
Proof of Loss
(1) The evidence offered by the insured to prove entitlement to collect the amount claimed from the insurer. (2) The statement, signed and sworn by the insured, setting forth the claim information required by the policy.
Chartered Property Casualty Underwriter (CPCU)
A professional designation in property-casualty insurance and risk management. Achieving the designation requires completion of courses covering topics such as insurance law, history, contracts, property insurance, liability insurance, operations, rate making, and risk management, as well as business courses in finance, corporate structure, and ethics.
Gable Roof
A roof shape that has two slopes that come together to form a peak or ridge giving the appearance of an "A" shape where the slopes come together.
Hip Roof
A roof shape that slopes upward from all sides of the building so that the lowest portion of the roof line is consistent all the way around the dwelling (i.e. Boston or Dutch). Subject to wind mitigation discount.
Surplus Lines (Excess Lines or Non-admitted Insurance)
A segment of the insurance market that allows consumers to buy property and casualty insurance through the state regulated insurance market, where policyholders, agents, brokers and insurance companies all have the ability to design specific insurance coverages and negotiate pricing based on the risks to be secured.
Florida Building Code (FBC)
A set of standards designed by the US state of Florida for buildings.
Uniform Mitigation Verification Inspection Form (OIR-B1-1802)
A standardized form produced by the Office of Insurance Regulation (OIR) for the purpose of verifying mitigation features of a structure that help reduce the possibility of damage to the building during high wind conditions.
Secondary Water Resistance Barrier
A water resistant /roof underlayment layer or product that provides protection to the structure to which it is affixed in the event the primary roof covering is damaged, removed, or penetrated by wind driven rain as the result of hurricane force winds.
National Council on Compensation Insurance (NCCI)
An organization that collects workers compensation statistical data (such as premiums, exposure units, and losses), computes advisory workers compensation rating information, develops standard workers compensation policy forms, and files workers compensation information with regulators on behalf of insurance companies that purchase its services.
Negative Pressure (Uplift)
As wind passes up and over the roof the force has a suction effect on the roof structure.
Rebating
Giving any valuable consideration, usually all or part of the commission, to the insured as an inducement to buy or renew. Allowed in accordance to a schedule which is uniformly applied to all insureds who purchase the same policy.
Small Missile Test
Hurricane rated protection involving a four and a half pound missile for basic rated shutters or openings in the upper 30 feet of multiple story buildings.
Large Missile Test (Nine Pound Missile Test)
Hurricane rated protection that involves shooting a nine pound 2x4 wood stud out of a cannon at 35 miles per hour. Required for openings in the lower 30 feet of multiple story buildings.
Certificate of Authority
Issued by the Department of Financial Services and it allows an insurance company to transact (write) business in the state of Florida.
Twisting
Knowingly making misleading representations or fraudulent comparisons or material omissions with respect to insurance or insurance companies for the purpose of getting a customer to switch companies.
Defamation
Knowingly making, publishing, disseminating, or circulating directly or indirectly which is falsely or maliciously critical of any person and which is circulated to injure such person.
Bureau of Market Conduct
Monitors the conduct of insurers to protect the public from unethical insurance practices (i.e., accurate advertising materials, approved policy forms and rates, timely claims processing procedures, and other appropriate procedures).
Bureau of Property and Casualty Insurer Solvency
Monitors the solvency of property and casualty insurers authorized to operate in the State of Florida. Solvency oversight includes receipt and review of periodic financial statements from carriers along with periodic on-site financial examinations.
Office of Insurance Regulation (OIR)
Protects the public through regulatory oversight of company solvency, policy forms and rates, market conduct performance, and new company entrants to the Florida market. Its official name is the Department of Financial Services.
Bureau of Licensing
Responsible for the licensure and appointment of all life, health and variable annuity agents, property and casualty insurance agents, bail bond agents, title agents, customer representatives, adjusters and insurance-related entities and firms authorized to transact insurance in Florida. Ensures that licensed insurance representatives are trustworthy, qualified and competent to engage in the business of insurance.
Applications Coordination Section
Responsible for the receipt of all company applications, and coordination of the review of such applications.
Bureau of Specialty Insurers
Responsible for the regulation and oversight of insurance administrators and third-party administrators, continuing care retirement communities, motor vehicle service agreement companies, home warranty associations, service warranty associations, insurance premium finance companies, donor annuities, legal expense corporations, viatical settlement providers, and title insurance agents and insurers.
Bureau of Investigation
Responsible for the regulation, compliance and enforcement of the Florida Statutes, including the insurance rules and regulations. They are also responsible for the investigation of alleged violations of the Florida Insurance Code by licensed agents, customer representatives, adjusters, bail bond agents, and insurance agencies.
Florida Surplus Lines Service Office (FSLSO)
Reviews all surplus lines insurance policies and documents, maintains records of policies and reports to the DFS, collects surplus lines taxes, collects service fees, and trains and educates surplus lines agents.
Sliding
Selling an ancillary product with an insurance policy and indicating the entire package is required by law. An example of this is packaging a motor club membership with PIP/PD and indicating the entire package is required by law.
Association Health Plan (AHP)
State regulated programs providing health coverage via an industry organization to a grouping of businesses that share an affinity or common interest.
Gable End-wall Braces
Substantially reduces wind damage to a gable roof by bracing the joint between the wall and the gable end. Offers hurricane mitigation credit.
National Association of Insurance Commissioners (NAIC)
The U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories.
Employee Retirement Income Security Act (ERISA)
This federal law sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans. Not subject to direct state insurance regulation.
Altruism
The practice of consciously seeking and serving the welfare of others thereby relegating inherently selfish and acquisitive tendencies to obscurity.
Churning
The practice where existing policy values are used to purchase another policy with the same insurer for the purpose of earning additional profits or premium.
Roof Covering
The uppermost part of a building or shelter which provides protection from animals and weather, notably rain or snow, but also heat, wind and sunlight. Typically are shingles, tiles, and metal panels.
Financial Service Commission
This Commission is comprised of four members: the Governor, the Attorney General, the Chief Financial Officer and the Commissioner of Agriculture. The two offices within the Commission are the Office of Financial Regulation (OFR), which regulates the banking, finance and securities industries in Florida, and the Office of Insurance Regulation (OIR), which regulates insurance companies. Both offices are headed by commissioners who are appointed by the Financial Services Commission. This Commission is responsible for final approval of rules developed by each office. All regulatory decisions are vested with the offices.
Ethics
Unenforcible rules of behavior based on ideas about what is morally good and bad. Attributes are loyalty, honesty and commitment.
Unfair Discrimination
When an insurance company or an agent shows favoritism between individuals of the same actuarially supported class, or against individuals who have sought medical or psychological treatment for abuse.
