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Florida Statutes, Title XXXVII

Florida/Statutes

← All Florida coverage

Title XXXVII, Insurance

19 chapters · 2,278 sections in this title.

All chapters in Title XXXVII2,278 Ch 627, Insurance Rates and Contracts626 Ch 626, Insurance Field Representatives and …368 Ch 624, Insurance Code: Administration and G…222 Ch 641, Health Care Service Programs165 Ch 634, Warranty Associations154 Ch 631, Insurer Insolvency; Guaranty of Payment150 Ch 628, Stock and Mutual Insurers; Holding C…100 Ch 633, Fire Prevention and Control89 Ch 636, Prepaid Limited Health Service Organ…79 Ch 625, Accounting, Investments, and Deposit…78 Ch 651, Continuing Care Contracts54 Ch 648, Bail Bond Agents49 Ch 629, Reciprocal Insurers35 Ch 632, Fraternal Benefit Societies35

626 sections·Filtered byTitle XXXVII✕Ch 627✕

Fla. Stat. § 627.606 Entire contract; changes
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The contract shall include the following provision:“Entire Contract; Changes: This policy, with the application and attached papers, is the entire contract between the insured and the insurer. No change in this policy will be effective until approved by an officer of the insurer.…
Fla. Stat. § 627.607 Time limit on certain defenses
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(1) The contract shall include the following provision:“Time Limit on Certain Defenses: After 2 years from the issue date, only fraudulent misstatements in the application may be used to void the policy or deny any claim for loss incurred or disability starting after the 2-year p…
Fla. Stat. § 627.608 Grace period
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(1) If the insurer reserves the right to refuse renewal, the contract shall include the following provision:“Grace Period: This policy has a (insert a number not less than ‘7’ for a weekly premium policy, ‘10’ for a monthly premium policy, or ‘31’ for all other policies) day grac…
Fla. Stat. § 627.609 Reinstatement
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(1) The contract shall include the following provision:“Reinstatement: If the renewal premium is not paid before the grace period ends, the policy will lapse. Later acceptance of the premium by the insurer, or by an agent authorized to accept payment without requiring an applicat…

Showing 251–300 of 626

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Fla. Stat. § 627.610 Notice of claim

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(1) The contract shall include the following provision:“Notice of Claim: Written notice of claim must be given within 20 days after a covered loss starts or as soon as reasonably possible. The notice may be given to the insurer at its home office or to the insurer’s agent. Notice…

Fla. Stat. § 627.611 Claim forms

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The contract shall include the following provision:“Claim Forms: When the insurer receives the notice of claim, it will send the claimant forms for filing proof of loss. If these forms are not given to the claimant within 15 days, the claimant may meet the proof of loss requireme…

Fla. Stat. § 627.612 Proof of loss

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The contract shall include the following provision:“Proof of Loss: If the policy provides for periodic payment for a continuing loss, written proof of loss must be given the insurer within 90 days after the end of each period for which the insurer is liable. For any other loss, w…

Fla. Stat. § 627.613 Time of payment of claims

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(1) The contract shall include the following provision:“Time of Payment of Claims: After receiving written proof of loss, the insurer will pay monthly all benefits then due for (type of benefit) . Benefits for any other loss covered by this policy will be paid as soon as the insu…

Fla. Stat. § 627.6131 Payment of claims

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(1) The contract shall include the following provision: “Time of Payment of Claims: After receiving written proof of loss, the insurer will pay monthly all benefits then due for (type of benefit) . Benefits for any other loss covered by this policy will be paid as soon as the ins…

Fla. Stat. § 627.614 Payment of claims

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(1) The contract shall include the following provision: “Payment of Claims: Benefits will be paid to the insured. Loss-of-life benefits are payable in accordance with the beneficiary designation in effect at the time of payment. If none is then in effect, the benefits will be pai…

Fla. Stat. § 627.6141 Denial of claims

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Each claimant, or provider acting for a claimant, who has had a claim denied as not medically necessary must be provided an opportunity for an appeal to the insurer’s licensed physician who is responsible for the medical necessity reviews under the plan or is a member of the plan…

Fla. Stat. § 627.615 Physical examination, autopsy

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The contract shall include the following provision:“Physical Examinations and Autopsy: The insurer at its expense has the right to have the insured examined as often as reasonably necessary while a claim is pending. It may also have an autopsy made unless prohibited by law.”Histo…

Fla. Stat. § 627.616 Legal actions

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The contract shall include the following provision:“Legal Actions: No legal action may be brought to recover on this policy within 60 days after written proof of loss has been given as required by this policy. No such action may be brought after the expiration of the applicable s…

Fla. Stat. § 627.617 Change of beneficiary

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The contract shall include the following provision:“Change of Beneficiary: The insured can change the beneficiary at any time by giving the insurer written notice. The beneficiary’s consent is not required for this or any other change in the policy, unless the designation of the …

Fla. Stat. § 627.618 Optional policy provisions

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Except as provided in s. 627.605(2), no health insurance policy delivered or issued for delivery to any person in this state shall contain any provision respecting the matters set forth in ss. 627.619-627.629, inclusive, unless such provision is in the words in which the same app…

Fla. Stat. § 627.619 Change of occupation

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There may be a provision as follows:“Change of Occupation: If the insured is injured or contracts sickness after having changed his or her occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertai…

Fla. Stat. § 627.620 Misstatement of age or sex

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The contract may include the following provision:“Misstatement of Age or Sex: If the age or sex of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased according to the correct age or sex.”History.—s. 563, ch…

Fla. Stat. § 627.621 Other insurance with this insurer

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The contract may include the following provision:“Other Insurance with This Insurer: If two or more health insurance policies, exclusive of guaranteed-issue policies, are issued by the insurer covering the same insured, the insurer shall pay the total benefits payable under all p…

Fla. Stat. § 627.622 Insurance with other insurers

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(1) The contract may include the following provision:“Insurance with Other Insurers: If there is other valid coverage, not with this insurer, providing benefits for the same loss on a provision-of-service basis or on an expense-incurred basis and of which this insurer has not bee…

Fla. Stat. § 627.623 Insurance with other insurers; other benefits

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(1) The contract may include the following provision:“Insurance With Other Insurers: If there is other valid coverage, not with this insurer, providing benefits for the same loss on other than an expense-incurred basis and of which this insurer has not been given written notice p…

Fla. Stat. § 627.624 Relation of earnings to insurance

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(1) The contract may include the following provision:“Relation of Earnings to Insurance: If the total monthly amount of loss-of-time benefits promised for the same loss under all valid loss-of-time coverage upon the insured, whether payable on a weekly or monthly basis, exceeds t…

Fla. Stat. § 627.625 Unpaid premiums

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The contract may include the following provision:“Unpaid Premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.”History.—s. 568, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss.…

Fla. Stat. § 627.6265 Cancellation or nonrenewal prohibited

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Notwithstanding any other provision of law to the contrary, no insurer shall cancel or nonrenew the health insurance policy of any insured because of diagnosis or treatment of human immunodeficiency virus infection or acquired immune deficiency syndrome.History.—ss. 49, 53, ch. 8…

Fla. Stat. § 627.627 Conformity with statutes

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The contract may include the following provision:“Conformity with State Statutes: Any provision of this policy which, on its effective date, is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum require…

Fla. Stat. § 627.628 Illegal occupation

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The contract may include the following provision:“Illegal Occupation: The insurer will not be liable for any loss which results from the insured committing or attempting to commit a felony or from the insured engaging in an illegal occupation.”History.—s. 571, ch. 59-205; s. 3, c…

Fla. Stat. § 627.629 Intoxicants and narcotics

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The contract may include the following provision:“Intoxicants and Narcotics: The insurer will not be liable for any loss resulting from the insured being drunk or under the influence of any narcotic unless taken on the advice of a physician.”History.—s. 572, ch. 59-205; s. 3, ch.…

Fla. Stat. § 627.630 Order of certain provisions

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The provisions which are the subject of ss. 627.606-627.629, inclusive, shall be printed in the consecutive order of the provisions in such sections; or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to whic…

Fla. Stat. § 627.631 Third-party ownership

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The word “insured,” as used in this part, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, bene…

Fla. Stat. § 627.632 Requirements of other jurisdictions

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(1) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the …

Fla. Stat. § 627.633 Other policy provisions

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No policy provision which is not subject to this part shall be less favorable in any respect to the insured or the beneficiary than the policy provisions which are subject to this chapter.History.—s. 576, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 4…

Fla. Stat. § 627.634 Age limit

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If any health insurance policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which a premium is accepted by the insurer or if the insurer ac…

Fla. Stat. § 627.635 Excess insurance

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(1) No provision of this chapter shall be deemed to prohibit an insurer from issuing a health insurance policy as, or including in a policy a provision providing for, excess insurance; that is, to the effect that the insurer’s liability for benefits payable on account of expense …

Fla. Stat. § 627.636 Industrial health insurance

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Industrial health insurance is that form of individual health insurance for which the premium is payable weekly. No policy of industrial health insurance may be delivered or issued for delivery in this state unless it has printed thereon the words “industrial policy” or “weekly p…

Fla. Stat. § 627.637 Construction of noncomplying contracts

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If any insurer writes or issues in this state any health insurance contract, as contemplated by this chapter, and the form of such contract is not authorized by or in conformity with the provisions of this chapter, the contract shall nevertheless be a valid and binding contract o…

Fla. Stat. § 627.638 Direct payment for hospital, medical services

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(1) Any health insurance policy insuring against loss or expense due to hospital confinement or to medical and related services may provide for payment of benefits directly to any recognized hospital, licensed ambulance provider, doctor, or other person who provided the services,…

Fla. Stat. § 627.6385 Disclosures to policyholders; calculations of cost sharing

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(1) Each health insurer shall make available on its website:(a) A method for policyholders to estimate their copayments, deductibles, and other cost-sharing responsibilities for health care services and procedures. Such method of making an estimate shall be based on service bundl…

Fla. Stat. § 627.6387 Shared savings incentive program

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(1) This section and ss. 627.6648 and 641.31076 may be cited as the “Patient Savings Act.”(2) As used in this section, the term:(a) “Health care provider” means a hospital or facility licensed under chapter 395; an entity licensed under chapter 400; a health care practitioner as …

Fla. Stat. § 627.639 Application signed by agent

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If the application for a health insurance policy is to be made a part of the contract of insurance, the insurer’s agent who completed the application shall sign the same in the capacity of soliciting agent.History.—s. 582, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3,…

Fla. Stat. § 627.640 Filing of classifications and rates

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An insurer shall not deliver or issue for delivery in this state any health insurance policy until it has filed with the office a copy of any applicable classification of risks and premium rates.History.—s. 583, ch. 59-205; ss. 13, 35, ch. 69-106; s. 3, ch. 76-168; s. 1, ch. 77-4…

Fla. Stat. § 627.6401 Refunds for persons age 64

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If an insured who has reached his or her 64th birthday but who is not yet 65 years of age pays an annual or semiannual premium that would otherwise pay for coverage beyond his or her 65th birthday, such person shall be entitled to an appropriate refund of unearned premium from th…

Fla. Stat. § 627.6402 Insurance rebates for healthy lifestyles

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(1) Any rate, rating schedule, or rating manual for an individual health insurance policy filed with the office may provide for an appropriate rebate of premiums paid in the last year when the individual covered by such plan is enrolled in and maintains participation in any healt…

Fla. Stat. § 627.64025 Advanced practice registered nurse services

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A health insurance policy that provides major medical coverage and that is delivered, issued, or renewed in this state on or after January 1, 2021, may not require an insured to receive services from an advanced practice registered nurse registered under s. 464.0123 in place of a…

Fla. Stat. § 627.6403 Payment of acupuncture benefits to certified acupuncturists

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Any policy of individual health insurance that provides coverage for acupuncture shall cover the services of an acupuncturist certified pursuant to chapter 457 under the same conditions that apply to services of a licensed physician.History.—ss. 1, 3, ch. 87-176; s. 114, ch. 92-3…

Fla. Stat. § 627.6405 Decreasing inappropriate utilization of emergency care

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(1) A health insurer shall post on its website, and update annually, information regarding appropriate utilization of emergency care services which shall include, but need not be limited to:(a) A list of alternative urgent care contracted providers;(b) The types of services offer…

Fla. Stat. § 627.6406 Maternity care

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(1) Any policy of health insurance which provides coverage for maternity care must also cover the services of certified nurse-midwives and midwives licensed pursuant to chapter 467, and the services of birth centers licensed under ss. 383.30-383.332.(2) An insurer issuing a healt…

Fla. Stat. § 627.6407 Massage

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Any policy of health insurance that provides coverage for massage shall also cover the services of persons licensed to practice massage therapy pursuant to chapter 480, where the massage therapy, as defined in chapter 480, has been prescribed by a physician licensed under chapter…

Fla. Stat. § 627.6408 Diabetes treatment services

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(1) A health insurance policy or group health insurance policy sold in this state must provide coverage for all medically appropriate and necessary equipment, supplies, and diabetes outpatient self-management training and educational services used to treat diabetes, if the patien…

Fla. Stat. § 627.6409 Coverage for osteoporosis screening, diagnosis, treatment, and management

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Any health insurance policy that covers a resident of this state and that is issued, amended, delivered, or renewed in this state after October 1, 1996, must provide coverage for the medically necessary diagnosis and treatment of osteoporosis for high-risk individuals, including,…

Fla. Stat. § 627.641 Coverage for newborn children

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(1) A health insurance policy that provides coverage on an expense-incurred basis for a member of the family of the insured or subscriber shall, as to the family member’s coverage, also provide that the health insurance benefits applicable for children will be payable with respec…

Fla. Stat. § 627.6415 Coverage for natural-born, adopted, and foster children; children in insured’s custodial care

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(1) A health insurance policy that provides coverage for a member of the family of the insured shall, as to the family member’s coverage, provide that the health insurance benefits applicable to children of the insured also apply to an adopted child or a foster child of the insur…