Bill Text: FL H1411 | 2011 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Motor Vehicle Personal Injury Protection Insurance

Spectrum: Slight Partisan Bill (Republican 6-1-1)

Status: (Introduced - Dead) 2011-05-07 - Indefinitely postponed and withdrawn from consideration [H1411 Detail]

Download: Florida-2011-H1411-Introduced.html
HB 1411

1
A bill to be entitled
2An act relating to motor vehicle personal injury
3protection insurance; providing a short title; providing
4legislative intent; amending s. 316.066, F.S.; revising
5provisions relating to the contents of written reports of
6motor vehicle crashes; authorizing the investigating
7officer to testify at trial or provide an affidavit
8concerning the content of the reports; amending s.
9400.991, F.S.; requiring that an application for licensure
10as a mobile clinic include a statement regarding insurance
11fraud; creating s. 626.9894, F.S.; providing definitions;
12authorizing the Division of Insurance Fraud to establish a
13direct-support organization for the purpose of
14prosecuting, investigating, and preventing motor vehicle
15insurance fraud; providing requirements for the
16organization and the organization's contract with the
17division; providing for a board of directors; authorizing
18the organization to use the division's property and
19facilities subject to certain requirements; authorizing
20contributions from insurers; providing that any moneys
21received by the organization may be held in a separate
22depository account in the name of the organization;
23requiring the division to deposit certain proceeds into
24the Insurance Regulatory Trust Fund; amending s. 627.730,
25F.S.; conforming a cross-reference; amending s. 627.731,
26F.S.; providing legislative intent with respect to the
27Florida Motor Vehicle No-Fault Law; amending s. 627.732,
28F.S.; defining the terms "claimant" and "no-fault law";
29amending s. 627.736, F.S.; conforming a cross-reference;
30requiring certain entities providing medical services to
31document that they meet required criteria; revising
32requirements relating to the form that must be submitted
33by providers; requiring an entity or clinic to file a new
34form within a specified period after the date of a change
35of ownership; revising provisions relating to when payment
36for a benefit is due; providing that the time period for
37paying or denying a claim is tolled during the
38investigation of a fraudulent insurance act; specifying
39when benefits are not payable; providing that a claimant
40that violates certain provisions is not entitled to any
41payment, regardless of whether a portion of the claim may
42be legitimate; authorizing an insurer to recover payments
43and bring a cause of action to recover payments;
44forbidding a physician, hospital, clinic, or other medical
45institution that fails to comply with certain provisions
46from billing the injured person or the insured; providing
47that an insurer has a right to conduct reasonable
48investigations of claims; authorizing an insurer to
49require a claimant to provide certain records; revising
50the insurer's reimbursement limitation; deleting an
51obsolete provision; revising requirements relating to
52discovery; authorizing an insurer to conduct examinations
53of claimants under oath or sworn statement; requiring the
54provider to produce persons having the most knowledge in
55specified circumstances; providing that an insurer that
56requests an examination under oath without a reasonable
57basis is engaging in an unfair and deceptive trade
58practice; authorizing the insurer to conduct a physical
59review of the treatment location; authorizing an insurer
60to contract with a preferred provider network; authorizing
61an insurer to provide a premium discount to an insured who
62selects a preferred provider; authorizing an insurance
63policy not to pay for nonemergency services performed by a
64nonpreferred provider in specified circumstances;
65authorizing an insurer to contract with a health insurer
66in specified circumstances; amending s. 817.234, F.S.;
67conforming a cross-reference; providing civil penalties
68for criminal acts that result in the unlawful receipt of
69insurance proceeds from a motor vehicle insurance
70contract; amending ss. 324.021, 456.057, 627.7295,
71627.733, 627.734, 627.737, 627.7401, 627.7405, 627.7407,
72and 628.909, F.S.; conforming cross-references; providing
73an effective date.
74
75Be It Enacted by the Legislature of the State of Florida:
76
77     Section 1.  (1)  SHORT TITLE.-This act may be cited as the
78"Comprehensive Insurance Fraud Investigation and Prevention
79Act."
80     (2)  FINDINGS AND INTENT.-The Legislature intends to
81balance the insured's interest in prompt payment of valid claims
82for insurance benefits under the no-fault law with the public's
83interest in reducing fraud, abuse, and overuse of the no-fault
84system. To that end, the Legislature intends that the
85investigation and prevention of fraudulent insurance acts in
86this state be enhanced, that additional sanctions for such acts
87be imposed, and that the no-fault law be revised to remove
88incentives for fraudulent insurance acts. The Legislature
89intends that the no-fault law be construed according to the
90plain language of the statutory provisions, which are designed
91to meet these goals.
92     (a)  The Legislature finds that:
93     1.  Motor vehicle insurance fraud remains a major problem
94for state consumers and insurers. According to the National
95Insurance Crime Bureau, in recent years this state has been
96among those states that have the highest number of fraudulent
97and questionable claims.
98     2.  The current regulatory process for health care clinics
99under part X of chapter 400, Florida Statutes, which was
100originally enacted to reduce motor vehicle insurance fraud, is
101not adequately preventing fraudulent insurance acts with respect
102to licensure exemptions and compliance with that part.
103     (b)  The Legislature intends that:
104     1.  Insurers properly investigate claims, and as such, this
105act clarifies that insurers are allowed to obtain examinations
106under oath and sworn statements from any claimant seeking no-
107fault insurance benefits and to request mental and physical
108examinations of persons seeking personal injury protection
109coverage or benefits.
110     2.  Any false, misleading, or otherwise fraudulent activity
111associated with a claim render the entire claim invalid. An
112insurer must be able to raise fraud as a defense to a claim for
113no-fault insurance benefits irrespective of any prior
114adjudication of guilt or determination of fraud by the
115Department of Financial Services.
116     3.  Insurers toll the payment or denial of a claim with
117respect to any portion of a claim for which the insurer has a
118reasonable belief that a fraudulent insurance act, as defined in
119s. 626.989 or s. 817.234, Florida Statutes, has been committed.
120     4.  Insurers discover the names of all passengers involved
121in a motor vehicle crash before paying claims or benefits
122pursuant to an insurance policy governed by the no-fault law. A
123rebuttable presumption must be established that a person was not
124involved in the event giving rise to the claim if that person's
125name does not appear on the police report.
126     Section 2.  Subsection (1) of section 316.066, Florida
127Statutes, is amended to read:
128     316.066  Written reports of crashes.-
129     (1)(a)  A Florida Traffic Crash Report, Long Form, must is
130required to be completed and submitted to the department within
13110 days after completing an investigation is completed by the
132every law enforcement officer who in the regular course of duty
133investigates a motor vehicle crash:
134     1.  That resulted in death of, or personal injury to, or
135any indication of complaints of pain or discomfort by any of the
136parties or passengers involved in the crash;
137     2.  That involved one or more passengers, other than the
138drivers of the vehicles, in any of the vehicles involved in the
139crash;.
140     3.2.  That involved a violation of s. 316.061(1) or s.
141316.193; or.
142     4.3.  In which a vehicle was rendered inoperative to a
143degree that required a wrecker to remove it from traffic, if
144such action is appropriate, in the officer's discretion.
145     (b)  The long form must include:
146     1.  The date, time, and location of the crash.
147     2.  A description of the vehicles involved.
148     3.  The names and addresses of the parties involved.
149     4.  The names and addresses of witnesses.
150     5.  The name, badge number, and law enforcement agency of
151the officer investigating the crash.
152     6.  The names of the insurance companies for the respective
153parties involved in the crash.
154     7.  The names and addresses of all passengers in all
155vehicles involved in the crash, each clearly identified as being
156a passenger, including the identification of the vehicle in
157which each was a passenger.
158     (c)(b)  In every crash for which a Florida Traffic Crash
159Report, Long Form, is not required by this section, the law
160enforcement officer may complete a short-form crash report or
161provide a short-form crash report to be completed by each party
162involved in the crash. The short-form report must include all of
163the items listed in subparagraphs (b)1.-6. Short-form crash
164reports prepared by the law enforcement officer shall be
165maintained by the officer's agency.:
166     1.  The date, time, and location of the crash.
167     2.  A description of the vehicles involved.
168     3.  The names and addresses of the parties involved.
169     4.  The names and addresses of witnesses.
170     5.  The name, badge number, and law enforcement agency of
171the officer investigating the crash.
172     6.  The names of the insurance companies for the respective
173parties involved in the crash.
174     (d)(c)  Each party to the crash must shall provide the law
175enforcement officer with proof of insurance, which must to be
176included in the crash report. If a law enforcement officer
177submits a report on the accident, proof of insurance must be
178provided to the officer by each party involved in the crash. Any
179party who fails to provide the required information commits a
180noncriminal traffic infraction, punishable as a nonmoving
181violation as provided in chapter 318, unless the officer
182determines that due to injuries or other special circumstances
183such insurance information cannot be provided immediately. If
184the person provides the law enforcement agency, within 24 hours
185after the crash, proof of insurance that was valid at the time
186of the crash, the law enforcement agency may void the citation.
187     (e)(d)  The driver of a vehicle that was in any manner
188involved in a crash resulting in damage to any vehicle or other
189property in an amount of $500 or more, which crash was not
190investigated by a law enforcement agency, shall, within 10 days
191after the crash, submit a written report of the crash to the
192department or traffic records center. The entity receiving the
193report may require witnesses of the crash crashes to render
194reports and may require any driver of a vehicle involved in the
195a crash of which a written report must be made as provided in
196this section to file supplemental written reports if whenever
197the original report is deemed insufficient by the receiving
198entity.
199     (f)  The investigating law enforcement officer may testify
200at trial or provide a signed affidavit to confirm or supplement
201the information included on the long-form or short-form report.
202     (e)  Short-form crash reports prepared by law enforcement
203shall be maintained by the law enforcement officer's agency.
204     Section 3.  Subsection (6) is added to section 400.991,
205Florida Statutes, to read:
206     400.991  License requirements; background screenings;
207prohibitions.-
208     (6)  All forms that constitute part of the application for
209licensure or exemption from licensure under this part must
210contain the following statement:
211
212INSURANCE FRAUD NOTICE.-Submitting a false,
213misleading, or fraudulent application or other
214document when applying for licensure as a health care
215clinic, when seeking an exemption from licensure as a
216health care clinic, or when demonstrating compliance
217with part X of chapter 400, Florida Statutes, is a
218criminal act under s. 817.234, Florida Statutes, or a
219fraudulent insurance act as defined in s. 626.989,
220Florida Statutes, subject to investigation by the
221Division of Insurance Fraud, and is grounds for
222discipline by the appropriate licensing board of the
223Florida Department of Health.
224     Section 4.  Section 626.9894, Florida Statutes, is created
225to read:
226     626.9894  Motor vehicle insurance fraud direct-support
227organization.-
228     (1)  DEFINITIONS.-As used in this section, the term:
229     (a)  "Division" means the Division of Insurance Fraud of
230the Department of Financial Services.
231     (b)  "Motor vehicle insurance fraud" means any act defined
232as a "fraudulent insurance act" under s. 626.989 that relates to
233the coverage of motor vehicle insurance as described in part XI
234of chapter 627.
235     (c)  "Organization" means the direct-support organization
236established under this section.
237     (2)  ORGANIZATION ESTABLISHED.-The division may establish a
238direct-support organization, to be known as the "Fight Auto
239Fraud Fund," whose sole purpose is to support the prosecution,
240investigation, and prevention of motor vehicle insurance fraud.
241The organization shall:
242     (a)  Be a not-for-profit corporation incorporated under
243chapter 617 and approved by the Department of State.
244     (b)  Be organized and operated to conduct programs and
245activities; to raise funds; to request and receive grants,
246gifts, and bequests of money; to acquire, receive, hold, invest,
247and administer, in its own name, securities, funds, objects of
248value, or other real or personal property; and to make grants
249and expenditures to or for the direct or indirect benefit of the
250division, state attorneys' offices, the statewide prosecutor,
251the Agency for Health Care Administration, and the Department of
252Health, to the extent that such grants and expenditures are used
253exclusively to advance the purpose of prosecuting,
254investigating, or preventing motor vehicle insurance fraud.
255Grants and expenditures may include the cost of salaries or
256benefits of dedicated motor vehicle insurance fraud
257investigators, prosecutors, or support personnel if such grants
258and expenditures do not interfere with prosecutorial
259independence or otherwise create conflicts of interest that
260threaten the success of prosecutions.
261     (c)  Be determined by the division to operate in a manner
262that promotes the goals of laws relating to motor vehicle
263insurance fraud, that is in the best interest of the state, and
264that is in accordance with the adopted goals and mission of the
265division.
266     (d)  Use all of its grants and expenditures solely for the
267purpose of preventing and decreasing motor vehicle insurance
268fraud and not for the purpose of lobbying as defined in s.
26911.045.
270     (e)  Be subject to an annual financial audit in accordance
271with s. 215.981.
272     (3)  CONTRACT.-The organization shall operate under written
273contract with the division. The contract must provide for:
274     (a)  Approval of the articles of incorporation and bylaws
275of the organization by the division.
276     (b)  Submission of an annual budget for the approval of the
277division.
278     (c)  Certification by the division that the direct-support
279organization is complying with the terms of the contract and in
280a manner consistent with the goals and purposes of the
281department and in the best interest of the state. Such
282certification must be made annually and reported in the official
283minutes of a meeting of the organization.
284     (d)  Allocation of funds to address motor vehicle insurance
285fraud.
286     (e)  Reversion of moneys and property held in trust by the
287organization for motor vehicle insurance fraud prosecution,
288investigation, and prevention to the division if the
289organization is no longer approved to operate by the department
290or if the organization ceases to exist, or to the state if the
291division ceases to exist.
292     (f)  Specific criteria to be used by the organization's
293board of directors to evaluate the effectiveness of funding used
294to combat motor vehicle insurance fraud.
295     (g)  The fiscal year of the organization, which begins July
2961 of each year and ends June 30 of the following year.
297     (h)  Disclosure of the material provisions of the contract,
298and distinguishing between the department and the organization
299to donors of gifts, contributions, or bequests, including
300providing such disclosure on all promotional and fundraising
301publications.
302     (4)  BOARD OF DIRECTORS.-The board of directors of the
303organization shall consist of the following seven members:
304     (a)  The Chief Financial Officer, or his or her designee,
305who shall serve as chair.
306     (b)  Two state attorneys, one of whom shall be appointed by
307the Chief Financial Officer and one of whom shall be appointed
308by the Attorney General.
309     (c)  Two representatives of motor vehicle insurers
310appointed by the Chief Financial Officer.
311     (d)  Two representatives of local law enforcement agencies,
312both of whom shall be appointed by the Chief Financial Officer.
313
314The officer who appointed a member of the board may remove that
315member for cause. The term of office of an appointed member may
316not exceed 4 years and expires at the same time as the term of
317the officer who appointed him or her or at such earlier time as
318the member ceases to be qualified.
319     (5)  USE OF PROPERTY.-The department may authorize, without
320charge, appropriate use of fixed property and facilities of the
321division by the organization, subject to this subsection.
322     (a)  The department may prescribe by rule any condition
323with which the organization must comply in order to use the
324division's property or facilities.
325     (b)  The department may not authorize the use of the
326division's property or facilities if the organization does not
327provide equal membership and employment opportunities to all
328persons regardless of race, religion, sex, age, or national
329origin.
330     (c)  The department shall adopt rules prescribing the
331procedures by which the organization is governed.
332     (6)  CONTRIBUTIONS.-Any contributions made by an insurer to
333the organization shall be allowed as appropriate business
334expenses for all regulatory purposes.
335     (7)  DEPOSITORY.-Any moneys received by the organization
336may be held in a separate depository account in the name of the
337organization and subject to the provisions of the contract with
338the division.
339     (8)  DIVISION'S RECEIPT OF PROCEEDS.-If the division
340receives proceeds from the organization, those proceeds shall be
341deposited into the Insurance Regulatory Trust Fund.
342     Section 5.  Section 627.730, Florida Statutes, is amended
343to read:
344     627.730  Florida Motor Vehicle No-Fault Law.-Sections
345627.730-627.7407 627.730-627.7405 may be cited and known as the
346"Florida Motor Vehicle No-Fault Law."
347     Section 6.  Section 627.731, Florida Statutes, is amended
348to read:
349     627.731  Purpose; legislative intent.-
350     (1)  The purpose of the no-fault law ss. 627.730-627.7405
351is to provide for medical, surgical, funeral, and disability
352insurance benefits without regard to fault, and to require motor
353vehicle insurance securing such benefits, for motor vehicles
354required to be registered in this state and, with respect to
355motor vehicle accidents, a limitation on the right to claim
356damages for pain, suffering, mental anguish, and inconvenience.
357     (2)  The Legislature intends that the provisions,
358schedules, and procedures authorized under the no-fault law be
359implemented by the insurers offering policies pursuant to the
360no-fault law. These provisions, schedules, and procedures have
361full force and effect regardless of their express inclusion in
362an insurance policy, and an insurer is not required to amend its
363policy to implement and apply such provisions, schedules, or
364procedures.
365     Section 7.  Section 627.732, Florida Statutes, is amended
366to read:
367     627.732  Definitions.-As used in the no-fault law ss.
368627.730-627.7405, the term:
369     (1)  "Broker" means any person not possessing a license
370under chapter 395, chapter 400, chapter 429, chapter 458,
371chapter 459, chapter 460, chapter 461, or chapter 641 who
372charges or receives compensation for any use of medical
373equipment and is not the 100-percent owner or the 100-percent
374lessee of such equipment. For purposes of this section, such
375owner or lessee may be an individual, a corporation, a
376partnership, or any other entity and any of its 100-percent-
377owned affiliates and subsidiaries. For purposes of this
378subsection, the term "lessee" means a long-term lessee under a
379capital or operating lease, but does not include a part-time
380lessee. The term "broker" does not include a hospital or
381physician management company whose medical equipment is
382ancillary to the practices managed, a debt collection agency, or
383an entity that has contracted with the insurer to obtain a
384discounted rate for such services; or nor does the term include
385a management company that has contracted to provide general
386management services for a licensed physician or health care
387facility and whose compensation is not materially affected by
388the usage or frequency of usage of medical equipment or an
389entity that is 100-percent owned by one or more hospitals or
390physicians. The term "broker" does not include a person or
391entity that certifies, upon request of an insurer, that:
392     (a)  It is a clinic licensed under ss. 400.990-400.995;
393     (b)  It is a 100-percent owner of medical equipment; and
394     (c)  The owner's only part-time lease of medical equipment
395for personal injury protection patients is on a temporary basis,
396not to exceed 30 days in a 12-month period, and such lease is
397solely for the purposes of necessary repair or maintenance of
398the 100-percent-owned medical equipment or pending the arrival
399and installation of the newly purchased or a replacement for the
400100-percent-owned medical equipment, or for patients for whom,
401because of physical size or claustrophobia, it is determined by
402the medical director or clinical director to be medically
403necessary that the test be performed in medical equipment that
404is open-style. The leased medical equipment may not cannot be
405used by patients who are not patients of the registered clinic
406for medical treatment of services. Any person or entity making a
407false certification under this subsection commits insurance
408fraud as defined in s. 817.234. However, the 30-day period
409provided in this paragraph may be extended for an additional 60
410days as applicable to magnetic resonance imaging equipment if
411the owner certifies that the extension otherwise complies with
412this paragraph.
413     (2)(7)  "Certify" means to swear or attest to being true or
414represented in writing.
415     (3)  "Claimant" means the person, organization, or entity
416seeking benefits, including all assignees.
417     (4)(12)  "Hospital" means a facility that, at the time
418services or treatment were rendered, was licensed under chapter
419395.
420     (5)(8)  "Immediate personal supervision," as it relates to
421the performance of medical services by nonphysicians not in a
422hospital, means that an individual licensed to perform the
423medical service or provide the medical supplies must be present
424within the confines of the physical structure where the medical
425services are performed or where the medical supplies are
426provided such that the licensed individual can respond
427immediately to any emergencies if needed.
428     (6)(9)  "Incident," with respect to services considered as
429incident to a physician's professional service, for a physician
430licensed under chapter 458, chapter 459, chapter 460, or chapter
431461, if not furnished in a hospital, means such services that
432are must be an integral, even if incidental, part of a covered
433physician's service.
434     (7)(10)  "Knowingly" means that a person, with respect to
435information, has actual knowledge of the information,; acts in
436deliberate ignorance of the truth or falsity of the
437information,; or acts in reckless disregard of the information.,
438and Proof of specific intent to defraud is not required.
439     (8)(11)  "Lawful" or "lawfully" means in substantial
440compliance with all relevant applicable criminal, civil, and
441administrative requirements of state and federal law related to
442the provision of medical services or treatment.
443     (9)(2)  "Medically necessary" refers to a medical service
444or supply that a prudent physician would provide for the purpose
445of preventing, diagnosing, or treating an illness, injury,
446disease, or symptom in a manner that is:
447     (a)  In accordance with generally accepted standards of
448medical practice;
449     (b)  Clinically appropriate in terms of type, frequency,
450extent, site, and duration; and
451     (c)  Not primarily for the convenience of the patient,
452physician, or other health care provider.
453     (10)(3)  "Motor vehicle" means a any self-propelled vehicle
454with four or more wheels that which is of a type both designed
455and required to be licensed for use on the highways of this
456state, and any trailer or semitrailer designed for use with such
457vehicle, and includes:
458     (a)  A "private passenger motor vehicle," which is any
459motor vehicle that which is a sedan, station wagon, or jeep-type
460vehicle and, if not used primarily for occupational,
461professional, or business purposes, a motor vehicle of the
462pickup, panel, van, camper, or motor home type.
463     (b)  A "commercial motor vehicle," which is any motor
464vehicle that which is not a private passenger motor vehicle.
465
466The term "motor vehicle" does not include a mobile home or any
467motor vehicle that which is used in mass transit, other than
468public school transportation, and designed to transport more
469than five passengers exclusive of the operator of the motor
470vehicle and that which is owned by a municipality, a transit
471authority, or a political subdivision of the state.
472     (11)(4)  "Named insured" means a person, usually the owner
473of a vehicle, identified in a policy by name as the insured
474under the policy.
475     (12)  "No-fault law" means the Florida Motor Vehicle No-
476Fault Law, ss. 627.730-627.7407.
477     (13)(5)  "Owner" means a person who holds the legal title
478to a motor vehicle; or, if in the event a motor vehicle is the
479subject of a security agreement or lease with an option to
480purchase with the debtor or lessee having the right to
481possession, then the debtor or lessee is shall be deemed the
482owner for the purposes of the no-fault law ss. 627.730-627.7405.
483     (14)(13)  "Properly completed" means providing truthful,
484substantially complete, and substantially accurate responses as
485to all material elements of to each applicable request for
486information or statement by a means that may lawfully be
487provided and that complies with this section, or as agreed by
488the parties.
489     (15)(6)  "Relative residing in the same household" means a
490relative of any degree by blood or by marriage who usually makes
491her or his home in the same family unit, whether or not
492temporarily living elsewhere.
493     (16)(15)  "Unbundling" means submitting an action that
494submits a billing code that is properly billed under one billing
495code, but that has been separated into two or more billing
496codes, and would result in payment greater than the in amount
497that than would be paid using one billing code.
498     (17)(14)  "Upcoding" means submitting an action that
499submits a billing code that would result in payment greater than
500the in amount that than would be paid using a billing code that
501accurately describes the services performed. The term does not
502include an otherwise lawful bill by a magnetic resonance imaging
503facility, which globally combines both technical and
504professional components, if the amount of the global bill is not
505more than the components if billed separately; however, payment
506of such a bill constitutes payment in full for all components of
507such service.
508     Section 8.  Subsections (1), (3), and (4) of section
509627.736, Florida Statutes, are amended, subsections (5) through
510(16) of that section are renumbered as subsections (6) through
511(17), respectively, a new subsection (5) is added to that
512section, and present subsections (5), (6), (8), and (9),
513paragraph (b) of present subsection (7), and present subsection
514(16) of that section are amended, to read:
515     627.736  Required personal injury protection benefits;
516exclusions; priority; claims.-
517     (1)  REQUIRED BENEFITS.-Every insurance policy complying
518with the security requirements of s. 627.733 must shall provide
519personal injury protection to the named insured, relatives
520residing in the same household, persons operating the insured
521motor vehicle, passengers in such motor vehicle, and other
522persons struck by such motor vehicle and suffering bodily injury
523while not an occupant of a self-propelled vehicle, subject to
524the provisions of subsection (2) and paragraph (4)(g) (4)(e), to
525a limit of $10,000 for loss sustained by any such person as a
526result of bodily injury, sickness, disease, or death arising out
527of the ownership, maintenance, or use of a motor vehicle as
528follows:
529     (a)  Medical benefits.-Eighty percent of all reasonable
530expenses for medically necessary medical, surgical, X-ray,
531dental, and rehabilitative services, including prosthetic
532devices, and for medically necessary ambulance, hospital, and
533nursing services. However, the medical benefits shall provide
534reimbursement only for such services and care that are lawfully
535provided, supervised, ordered, or prescribed by a physician
536licensed under chapter 458 or chapter 459, a dentist licensed
537under chapter 466, or a chiropractic physician licensed under
538chapter 460 or that are provided by any of the following persons
539or entities:
540     1.  A hospital or ambulatory surgical center licensed under
541chapter 395.
542     2.  A person or entity licensed under part III of chapter
543401 that ss. 401.2101-401.45 that provides emergency
544transportation and treatment.
545     3.  An entity wholly owned by one or more physicians
546licensed under chapter 458 or chapter 459, chiropractic
547physicians licensed under chapter 460, or dentists licensed
548under chapter 466 or by such practitioner or practitioners and
549the spouses, parents, children, or siblings spouse, parent,
550child, or sibling of such that practitioner or those
551practitioners.
552     4.  An entity wholly owned, directly or indirectly, by a
553hospital or hospitals.
554     5.  A health care clinic licensed under part X of chapter
555400 ss. 400.990-400.995 that is:
556     a.  Accredited by the Joint Commission on Accreditation of
557Healthcare Organizations, the American Osteopathic Association,
558the Commission on Accreditation of Rehabilitation Facilities, or
559the Accreditation Association for Ambulatory Health Care, Inc.;
560or
561     b.  A health care clinic that:
562     (I)  Has a medical director licensed under chapter 458,
563chapter 459, or chapter 460;
564     (II)  Has been continuously licensed for more than 3 years
565or is a publicly traded corporation that issues securities
566traded on an exchange registered with the United States
567Securities and Exchange Commission as a national securities
568exchange; and
569     (III)  Provides at least four of the following medical
570specialties:
571     (A)  General medicine.
572     (B)  Radiography.
573     (C)  Orthopedic medicine.
574     (D)  Physical medicine.
575     (E)  Physical therapy.
576     (F)  Physical rehabilitation.
577     (G)  Prescribing or dispensing outpatient prescription
578medication.
579     (H)  Laboratory services.
580
581If any services under this paragraph are provided by an entity
582or clinic described in subparagraph 3., subparagraph 4., or
583subparagraph 5., the entity or clinic must provide the insurer
584at the initial submission of the claim with a form adopted by
585the Department of Financial Services that documents that the
586entity or clinic meets applicable criteria for such entity or
587clinic and includes a sworn statement or affidavit to that
588effect. Any change in ownership requires the filing of a new
589form within 10 days after the date of the change in ownership.
590The Financial Services Commission shall adopt by rule the form
591that must be used by an insurer and a health care provider
592specified in subparagraph 3., subparagraph 4., or subparagraph
5935. to document that the health care provider meets the criteria
594of this paragraph, which rule must include a requirement for a
595sworn statement or affidavit.
596     (b)  Disability benefits.-Sixty percent of any loss of
597gross income and loss of earning capacity per individual from
598inability to work proximately caused by the injury sustained by
599the injured person, plus all expenses reasonably incurred in
600obtaining from others ordinary and necessary services in lieu of
601those that, but for the injury, the injured person would have
602performed without income for the benefit of his or her
603household. All disability benefits payable under this paragraph
604must provision shall be paid at least not less than every 2
605weeks.
606     (c)  Death benefits.-Death benefits equal to the lesser of
607$5,000 or the remainder of unused personal injury protection
608benefits per individual. The insurer may pay such benefits to
609the executor or administrator of the deceased, to any of the
610deceased's relatives by blood, or legal adoption, or connection
611by marriage, or to any person appearing to the insurer to be
612equitably entitled thereto.
613
614Only insurers writing motor vehicle liability insurance in this
615state may provide the required benefits of this section, and no
616such insurers may not insurer shall require the purchase of any
617other motor vehicle coverage other than the purchase of property
618damage liability coverage as required by s. 627.7275 as a
619condition for providing such required benefits. Insurers may not
620require that property damage liability insurance in an amount
621greater than $10,000 be purchased in conjunction with personal
622injury protection. Such insurers shall make benefits and
623required property damage liability insurance coverage available
624through normal marketing channels. An Any insurer writing motor
625vehicle liability insurance in this state who fails to comply
626with such availability requirement as a general business
627practice violates shall be deemed to have violated part IX of
628chapter 626, and such violation constitutes shall constitute an
629unfair method of competition or an unfair or deceptive act or
630practice involving the business of insurance. An; and any such
631insurer committing such violation is shall be subject to the
632penalties afforded in such part, as well as those that are which
633may be afforded elsewhere in the insurance code.
634     (3)  INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN
635TORT CLAIMS.-An No insurer shall not have a lien on any recovery
636in tort by judgment, settlement, or otherwise for personal
637injury protection benefits, whether suit has been filed or
638settlement has been reached without suit. An injured party who
639is entitled to bring suit under the no-fault law provisions of
640ss. 627.730-627.7405, or his or her legal representative, shall
641have no right to recover any damages for which personal injury
642protection benefits are paid or payable. The plaintiff may prove
643all of his or her special damages notwithstanding this
644limitation, but if special damages are introduced in evidence,
645the trier of facts, whether judge or jury, shall not award
646damages for personal injury protection benefits paid or payable.
647In all cases in which a jury is required to fix damages, the
648court shall instruct the jury that the plaintiff shall not
649recover such special damages for personal injury protection
650benefits paid or payable.
651     (4)  BENEFITS; WHEN DUE.-Benefits due from an insurer under
652the no-fault law are ss. 627.730-627.7405 shall be primary,
653except that benefits received under any workers' compensation
654law shall be credited against the benefits provided by
655subsection (1) and are shall be due and payable as loss accrues,
656upon the receipt of reasonable proof of such loss and the amount
657of expenses and loss incurred that which are covered by the
658policy issued under the no-fault law ss. 627.730-627.7405. If
659When the Agency for Health Care Administration provides, pays,
660or becomes liable for medical assistance under the Medicaid
661program related to injury, sickness, disease, or death arising
662out of the ownership, maintenance, or use of a motor vehicle,
663the benefits are under ss. 627.730-627.7405 shall be subject to
664the provisions of the Medicaid program.
665     (a)  An insurer may require written notice to be given as
666soon as practicable after an accident involving a motor vehicle
667with respect to which the policy affords the security required
668by the no-fault law ss. 627.730-627.7405.
669     (b)  Personal injury protection insurance benefits paid
670pursuant to this section are shall be overdue if not paid within
67130 days after the insurer is furnished written notice of the
672fact of a covered loss and of the amount of same. If such
673written notice is not furnished to the insurer as to the entire
674claim, any partial amount supported by written notice is overdue
675if not paid within 30 days after such written notice is
676furnished to the insurer. Any part or all of the remainder of
677the claim that is subsequently supported by written notice is
678overdue if not paid within 30 days after such written notice is
679furnished to the insurer.
680     (c)  If When an insurer pays only a portion of a claim or
681rejects a claim, the insurer shall provide at the time of the
682partial payment or rejection an itemized specification of each
683item that the insurer had reduced, omitted, or declined to pay
684and any information that the insurer desires the claimant to
685consider related to the medical necessity of the denied
686treatment or to explain the reasonableness of the reduced
687charge, provided that this does shall not limit the introduction
688of evidence at trial.; and The insurer must shall include the
689name and address of the person to whom the claimant should
690respond and a claim number to be referenced in future
691correspondence.
692     (d)  A However, notwithstanding the fact that written
693notice has been furnished to the insurer, Any payment is shall
694not be deemed overdue if when the insurer has reasonable proof
695to establish that the insurer is not responsible for the
696payment. For the purpose of calculating the extent to which any
697benefits are overdue, payment shall be treated as being made on
698the date a draft or other valid instrument which is equivalent
699to payment was placed in the United States mail in a properly
700addressed, postpaid envelope or, if not so posted, on the date
701of delivery. This paragraph does not preclude or limit the
702ability of the insurer to assert that the claim is was
703unrelated, was not medically necessary, or was unreasonable, or
704submitted that the amount of the charge was in excess of that
705permitted under, or in violation of, subsection (6) (5). Such
706assertion by the insurer may be made at any time, including
707after payment of the claim or after the 30-day time period for
708payment set forth in this paragraph (b). The 30-day period for
709payment or denial is tolled with respect to any portion of a
710claim for which the insurer has a reasonable belief that a
711fraudulent insurance act as defined in s. 626.989 has been
712committed while the insurer investigates such act. The insurer
713must notify the claimant in writing that it is investigating a
714fraudulent insurance act within 30 days after the date it has a
715reasonable belief that such act has been committed. The insurer
716must pay or deny the claim, in full or in part, within 120 days
717after the date the written notice of the fact of a covered loss
718and of the amount of the loss was provided to the insurer.
719     (e)(c)  Upon receiving notice of an accident that is
720potentially covered by personal injury protection benefits, the
721insurer must reserve $5,000 of personal injury protection
722benefits for payment to physicians licensed under chapter 458 or
723chapter 459 or dentists licensed under chapter 466 who provide
724emergency services and care, as defined in s. 395.002(9), or who
725provide hospital inpatient care. The amount required to be held
726in reserve may be used only to pay claims from such physicians
727or dentists until 30 days after the date the insurer receives
728notice of the accident. After the 30-day period, any amount of
729the reserve for which the insurer has not received notice of
730such a claim from a physician or dentist who provided emergency
731services and care or who provided hospital inpatient care may
732then be used by the insurer to pay other claims. The time
733periods specified in paragraph (b) for required payment of
734personal injury protection benefits are shall be tolled for the
735period of time that an insurer is required by this paragraph to
736hold payment of a claim that is not from a physician or dentist
737who provided emergency services and care or who provided
738hospital inpatient care to the extent that the personal injury
739protection benefits not held in reserve are insufficient to pay
740the claim. This paragraph does not require an insurer to
741establish a claim reserve for insurance accounting purposes.
742     (f)(d)  All overdue payments shall bear simple interest at
743the rate established under s. 55.03 or the rate established in
744the insurance contract, whichever is greater, for the year in
745which the payment became overdue, calculated from the date the
746insurer was furnished with written notice of the amount of
747covered loss. Interest is shall be due at the time payment of
748the overdue claim is made.
749     (g)(e)  The insurer of the owner of a motor vehicle shall
750pay personal injury protection benefits for:
751     1.  Accidental bodily injury sustained in this state by the
752owner while occupying a motor vehicle, or while not an occupant
753of a self-propelled vehicle if the injury is caused by physical
754contact with a motor vehicle.
755     2.  Accidental bodily injury sustained outside this state,
756but within the United States of America or its territories or
757possessions or Canada, by the owner while occupying the owner's
758motor vehicle.
759     3.  Accidental bodily injury sustained by a relative of the
760owner residing in the same household, under the circumstances
761described in subparagraph 1. or subparagraph 2. if, provided the
762relative at the time of the accident is domiciled in the owner's
763household and is not himself or herself the owner of a motor
764vehicle with respect to which security is required under the no-
765fault law ss. 627.730-627.7405.
766     4.  Accidental bodily injury sustained in this state by any
767other person while occupying the owner's motor vehicle or, if a
768resident of this state, while not an occupant of a self-
769propelled vehicle, if the injury is caused by physical contact
770with such motor vehicle and if, provided the injured person is
771not himself or herself:
772     a.  The owner of a motor vehicle with respect to which
773security is required under the no-fault law ss. 627.730-
774627.7405; or
775     b.  Entitled to personal injury benefits from the insurer
776of the owner or owners of such a motor vehicle.
777     (h)(f)  If two or more insurers are liable to pay personal
778injury protection benefits for the same injury to any one
779person, the maximum payable is shall be as specified in
780subsection (1), and any insurer paying the benefits is shall be
781entitled to recover from each of the other insurers an equitable
782pro rata share of the benefits paid and expenses incurred in
783processing the claim.
784     (i)(g)  It is a violation of the insurance code for an
785insurer to fail to timely provide benefits as required by this
786section with such frequency as to constitute a general business
787practice.
788     (j)(h)  Benefits are shall not be due or payable to or on
789the behalf of a claimant who: an insured person if that person
790has
791     1.  Submits a false or misleading statement, document,
792record, or bill;
793     2.  Submits any other false or misleading information; or
794     3.  Has otherwise committed or attempted to commit a
795fraudulent insurance act as defined in s. 626.989.
796
797A claimant who violates this paragraph is not entitled to any
798personal injury protection benefits or payment for any bills and
799services, regardless of whether a portion of the claim may be
800legitimate.
801     (k)  Notwithstanding any remedies afforded by law, the
802insurer may recover from a claimant who has violated paragraph
803(j) any sums previously paid to the claimant and may bring any
804available common law and statutory causes of action committed,
805by a material act or omission, any insurance fraud relating to
806personal injury protection coverage under his or her policy, if
807the fraud is admitted to in a sworn statement by the insured or
808if it is established in a court of competent jurisdiction. If a
809physician, hospital, clinic, or other medical institution
810violates paragraph (j), the injured party is not liable for, and
811the physician, hospital, clinic, or other medical institution
812may not bill the insured for, charges that are unpaid because of
813failure to comply with paragraph (j). Any agreement requiring
814the injured person or insured to pay for such charges is
815unenforceable. Any insurance fraud shall void all coverage
816arising from the claim related to such fraud under the personal
817injury protection coverage of the insured person who committed
818the fraud, irrespective of whether a portion of the insured
819person's claim may be legitimate, and any benefits paid prior to
820the discovery of the insured person's insurance fraud shall be
821recoverable by the insurer from the person who committed
822insurance fraud in their entirety. The prevailing party is
823entitled to its costs and attorney's fees in any action in which
824it prevails in an insurer's action to enforce its right of
825recovery under this paragraph.
826     (5)  INSURER INVESTIGATIONS.-An insurer has the right and
827duty to conduct a reasonable investigation of a claim. In the
828course of the investigation, the insurer may require the
829insured, claimant, or medical provider to provide copies of the
830treatment and examination records so that the insurer can
831provide such records to a physician for a records review. A
832records review need not be based on a physical examination and
833may be obtained at any time, including after reduction or denial
834of the claim. The 30-day period for payment under paragraph
835(4)(b) is tolled from the date the insurer sends its request for
836treatment records to the date that the insurer receives the
837treatment records. The claim may be denied or reduced if the
838medical provider fails to keep adequate records such that the
839insurer is unable to obtain a records review.
840     (6)(5)  CHARGES FOR TREATMENT OF INJURED PERSONS.-
841     (a)1.  Any physician, hospital, clinic, or other person or
842institution lawfully rendering treatment to an injured person
843for a bodily injury covered by personal injury protection
844insurance may charge the insurer and injured party only an a
845reasonable amount pursuant to this section for the services and
846supplies rendered, and the insurer providing such coverage may
847pay for such charges directly to such person or institution
848lawfully rendering such treatment, if the insured receiving such
849treatment or his or her guardian has countersigned the properly
850completed invoice, bill, or claim form approved by the office
851upon which such charges are to be paid for as having actually
852been rendered, to the best knowledge of the insured or his or
853her guardian. In no event, However, may such a charge may not
854exceed be in excess of the amount the person or institution
855customarily charges for like services or supplies. When
856determining With respect to a determination of whether a charge
857for a particular service, treatment, or otherwise is reasonable,
858consideration may be given to evidence of usual and customary
859charges and payments accepted by the provider involved in the
860dispute, and reimbursement levels in the community and various
861federal and state medical fee schedules applicable to automobile
862and other insurance coverages, and other information relevant to
863the reasonableness of the reimbursement for the service,
864treatment, or supply.
865     1.2.  The insurer may limit reimbursement to 80 percent of
866the following schedule of maximum charges:
867     a.  For emergency transport and treatment by providers
868licensed under chapter 401, 200 percent of Medicare.
869     b.  For emergency services and care provided by a hospital
870licensed under chapter 395, 75 percent of the hospital's usual
871and customary charges.
872     c.  For emergency services and care as defined by s.
873395.002(9) provided in a facility licensed under chapter 395
874rendered by a physician or dentist, and related hospital
875inpatient services rendered by a physician or dentist, the usual
876and customary charges in the community.
877     d.  For hospital inpatient services, other than emergency
878services and care, 200 percent of the Medicare Part A
879prospective payment applicable to the specific hospital
880providing the inpatient services.
881     e.  For hospital outpatient services, other than emergency
882services and care, 200 percent of the Medicare Part A Ambulatory
883Payment Classification for the specific hospital providing the
884outpatient services.
885     f.  For all other medical services, supplies, and care, 200
886percent of the allowable amount under the participating
887physicians schedule of Medicare Part B. However, if such
888services, supplies, or care is not reimbursable under Medicare
889Part B, the insurer may limit reimbursement to 80 percent of the
890maximum reimbursable allowance under workers' compensation, as
891determined under s. 440.13 and rules adopted thereunder which
892are in effect at the time such services, supplies, or care is
893provided. Services, supplies, or care that is not reimbursable
894under Medicare or workers' compensation is not required to be
895reimbursed by the insurer.
896     2.3.  For purposes of subparagraph 1. 2., the applicable
897fee schedule or payment limitation under Medicare is the fee
898schedule or payment limitation in effect on January 1 of the
899year in which at the time the services, supplies, or care was
900rendered and for the area in which such services were rendered,
901notwithstanding any subsequent changes made to such fee schedule
902or payment limitation, except that it may not be less than the
903allowable amount under the participating physicians schedule of
904Medicare Part B for 2007 for medical services, supplies, and
905care subject to Medicare Part B.
906     3.4.  Subparagraph 1. 2. does not allow the insurer to
907apply any limitation on the number of treatments or other
908utilization limits that apply under Medicare or workers'
909compensation. An insurer that applies the allowable payment
910limitations of subparagraph 1. 2. must reimburse a provider who
911lawfully provided care or treatment under the scope of his or
912her license, regardless of whether such provider is would be
913entitled to reimbursement under Medicare due to restrictions or
914limitations on the types or discipline of health care providers
915who may be reimbursed for particular procedures or procedure
916codes.
917     4.5.  If an insurer limits payment as authorized by
918subparagraph 1. 2., the person providing such services,
919supplies, or care may not bill or attempt to collect from the
920insured any amount in excess of such limits, except for amounts
921that are not covered by the insured's personal injury protection
922coverage due to the coinsurance amount or maximum policy limits.
923     (b)1.  An insurer or insured is not required to pay a claim
924or charges:
925     a.  Made by a broker or by a person making a claim on
926behalf of a broker;
927     b.  For any service or treatment that was not lawful at the
928time rendered;
929     c.  To any person who knowingly submits a false or
930misleading statement relating to the claim or charges;
931     d.  With respect to a bill or statement that does not
932substantially meet the applicable requirements of paragraphs (c)
933and paragraph (d);
934     e.  For any treatment or service that is upcoded, or that
935is unbundled if when such treatment or services should be
936bundled, in accordance with paragraph (d). To facilitate prompt
937payment of lawful services, an insurer may change codes that it
938determines to have been improperly or incorrectly upcoded or
939unbundled, and may make payment based on the changed codes,
940without affecting the right of the provider to dispute the
941change by the insurer if, provided that before doing so, the
942insurer contacts must contact the health care provider and
943discusses discuss the reasons for the insurer's change and the
944health care provider's reason for the coding, or makes make a
945reasonable good faith effort to do so, as documented in the
946insurer's file; and
947     f.  For medical services or treatment billed by a physician
948and not provided in a hospital unless such services are rendered
949by the physician or are incident to his or her professional
950services and are included on the physician's bill, including
951documentation verifying that the physician is responsible for
952the medical services that were rendered and billed.
953     2.  The Department of Health, in consultation with the
954appropriate professional licensing boards, shall adopt, by rule,
955a list of diagnostic tests deemed not to be medically necessary
956for use in the treatment of persons sustaining bodily injury
957covered by personal injury protection benefits under this
958section. The initial list shall be adopted by January 1, 2004,
959and shall be revised from time to time as determined by the
960Department of Health, in consultation with the respective
961professional licensing boards. Inclusion of a test on the list
962must of invalid diagnostic tests shall be based on lack of
963demonstrated medical value and a level of general acceptance by
964the relevant provider community and may shall not be dependent
965for results entirely upon subjective patient response.
966Notwithstanding its inclusion on a fee schedule in this
967subsection, an insurer or insured is not required to pay any
968charges or reimburse claims for any invalid diagnostic test as
969determined by the Department of Health.
970     (c)1.  With respect to any treatment or service, other than
971medical services billed by a hospital or other provider for
972emergency services as defined in s. 395.002 or inpatient
973services rendered at a hospital-owned facility, the statement of
974charges must be furnished to the insurer by the provider and may
975not include, and the insurer is not required to pay, charges for
976treatment or services rendered more than 35 days before the
977postmark date or electronic transmission date of the statement,
978except for past due amounts previously billed on a timely basis
979under this paragraph, and except that, if the provider submits
980to the insurer a notice of initiation of treatment within 21
981days after its first examination or treatment of the claimant,
982the statement may include charges for treatment or services
983rendered up to, but not more than, 75 days before the postmark
984date of the statement. The injured party is not liable for, and
985the provider may shall not bill the injured party for, charges
986that are unpaid because of the provider's failure to comply with
987this paragraph. Any agreement requiring the injured person or
988insured to pay for such charges is unenforceable.
989     1.2.  If, however, the insured fails to furnish the
990provider with the correct name and address of the insured's
991personal injury protection insurer, the provider has 35 days
992from the date the provider obtains the correct information to
993furnish the insurer with a statement of the charges. The insurer
994is not required to pay for such charges unless the provider
995includes with the statement documentary evidence that was
996provided by the insured during the 35-day period demonstrating
997that the provider reasonably relied on erroneous information
998from the insured and either:
999     a.  A denial letter from the incorrect insurer; or
1000     b.  Proof of mailing, which may include an affidavit under
1001penalty of perjury, reflecting timely mailing to the incorrect
1002address or insurer.
1003     2.3.  For emergency services and care as defined in s.
1004395.002 rendered in a hospital emergency department or for
1005transport and treatment rendered by an ambulance provider
1006licensed pursuant to part III of chapter 401, the provider is
1007not required to furnish the statement of charges within the time
1008periods established by this paragraph,; and the insurer is shall
1009not be considered to have been furnished with notice of the
1010amount of covered loss for purposes of paragraph (4)(b) until it
1011receives a statement complying with paragraph (d), or copy
1012thereof, which specifically identifies the place of service to
1013be a hospital emergency department or an ambulance in accordance
1014with billing standards recognized by the Centers for Medicare
1015and Medicaid Services (CMS) Health Care Finance Administration.
1016     3.4.  Each notice of the insured's rights under s. 627.7401
1017must include the following statement in type no smaller than 12
1018points:
1019
1020BILLING REQUIREMENTS.-Florida Statutes provide that
1021with respect to any treatment or services, other than
1022certain hospital and emergency services, the statement
1023of charges furnished to the insurer by the provider
1024may not include, and the insurer and the injured party
1025are not required to pay, charges for treatment or
1026services rendered more than 35 days before the
1027postmark date of the statement, except for past due
1028amounts previously billed on a timely basis, and
1029except that, if the provider submits to the insurer a
1030notice of initiation of treatment within 21 days after
1031its first examination or treatment of the claimant,
1032the first billing cycle statement may include charges
1033for treatment or services rendered up to, but not more
1034than, 75 days before the postmark date of the
1035statement.
1036
1037     (d)  All statements and bills for medical services rendered
1038by any physician, hospital, clinic, or other person or
1039institution shall be submitted to the insurer on a properly
1040completed Centers for Medicare and Medicaid Services (CMS) 1500
1041form, UB 92 forms, or any other standard form approved by the
1042office or adopted by the commission for purposes of this
1043paragraph. All billings for such services rendered by providers
1044must shall, to the extent applicable, follow the Physicians'
1045Current Procedural Terminology (CPT) or Healthcare Correct
1046Procedural Coding System (HCPCS), or ICD-9 in effect for the
1047year in which services are rendered and comply with the Centers
1048for Medicare and Medicaid Services (CMS) 1500 form instructions
1049and the American Medical Association Current Procedural
1050Terminology (CPT) Editorial Panel and Healthcare Correct
1051Procedural Coding System (HCPCS). All providers other than
1052hospitals shall include on the applicable claim form the
1053professional license number of the provider in the line or space
1054provided for "Signature of Physician or Supplier, Including
1055Degrees or Credentials." In determining compliance with
1056applicable CPT and HCPCS coding, guidance shall be provided by
1057the Physicians' Current Procedural Terminology (CPT) or the
1058Healthcare Correct Procedural Coding System (HCPCS) in effect
1059for the year in which services were rendered, the Office of the
1060Inspector General (OIG), Physicians Compliance Guidelines, and
1061other authoritative treatises designated by rule by the Agency
1062for Health Care Administration. A No statement of medical
1063services may not include charges for medical services of a
1064person or entity that performed such services without possessing
1065the valid licenses required to perform such services. For
1066purposes of paragraph (4)(b), an insurer is shall not be
1067considered to have been furnished with notice of the amount of
1068covered loss or medical bills due unless the statements or bills
1069comply with this paragraph, and unless the statements or bills
1070are properly completed in their entirety as to all material
1071provisions, with all relevant information being provided
1072therein.
1073     (e)1.  At the initial treatment or service provided, each
1074physician, other licensed professional, clinic, or other medical
1075institution providing medical services upon which a claim for
1076personal injury protection benefits is based shall require an
1077insured person, or his or her guardian, to execute a disclosure
1078and acknowledgment form, which reflects at a minimum that:
1079     a.  The insured, or his or her guardian, must countersign
1080the form attesting to the fact that the services set forth
1081therein were actually rendered;
1082     b.  The insured, or his or her guardian, has both the right
1083and affirmative duty to confirm that the services were actually
1084rendered;
1085     c.  The insured, or his or her guardian, was not solicited
1086by any person to seek any services from the medical provider;
1087     d.  The physician, other licensed professional, clinic, or
1088other medical institution rendering services for which payment
1089is being claimed explained the services to the insured or his or
1090her guardian; and
1091     e.  If the insured notifies the insurer in writing of a
1092billing error, the insured may be entitled to a certain
1093percentage of a reduction in the amounts paid by the insured's
1094motor vehicle insurer.
1095     2.  The physician, other licensed professional, clinic, or
1096other medical institution rendering services for which payment
1097is being claimed has the affirmative duty to explain the
1098services rendered to the insured, or his or her guardian, so
1099that the insured, or his or her guardian, countersigns the form
1100with informed consent.
1101     3.  Countersignature by the insured, or his or her
1102guardian, is not required for the reading of diagnostic tests or
1103other services that are of such a nature that they are not
1104required to be performed in the presence of the insured.
1105     4.  The licensed medical professional rendering treatment
1106for which payment is being claimed must sign, by his or her own
1107hand, the form complying with this paragraph.
1108     5.  The original completed disclosure and acknowledgment
1109form is shall be furnished to the insurer pursuant to paragraph
1110(4)(b) and may not be electronically furnished.
1111     6.  This disclosure and acknowledgment form is not required
1112for services billed by a provider for emergency services as
1113defined in s. 395.002, for emergency services and care as
1114defined in s. 395.002 rendered in a hospital emergency
1115department, or for transport and treatment rendered by an
1116ambulance provider licensed pursuant to part III of chapter 401.
1117     7.  The Financial Services Commission shall adopt, by rule,
1118a standard disclosure and acknowledgment form to that shall be
1119used to fulfill the requirements of this paragraph, effective 90
1120days after such form is adopted and becomes final. The
1121commission shall adopt a proposed rule by October 1, 2003. Until
1122the rule is final, the provider may use a form of its own which
1123otherwise complies with the requirements of this paragraph.
1124     8.  As used in this paragraph, the term "countersigned" or
1125"countersignature" means a second or verifying signature, as on
1126a previously signed document, and is not satisfied by the
1127statement "signature on file" or any similar statement.
1128     9.  The requirements of this paragraph apply only with
1129respect to the initial treatment or service of the insured by a
1130provider. For subsequent treatments or service, the provider
1131must maintain a patient log signed by the patient, in
1132chronological order by date of service, that is consistent with
1133the services being rendered to the patient as claimed. The
1134requirements of this subparagraph for maintaining a patient log
1135signed by the patient may be met by a hospital that maintains
1136medical records as required by s. 395.3025 and applicable rules
1137and makes such records available to the insurer upon request.
1138     (f)  Upon written notification by any person, an insurer
1139shall investigate any claim of improper billing by a physician
1140or other medical provider. The insurer shall determine if the
1141insured was properly billed for only those services and
1142treatments that the insured actually received. If the insurer
1143determines that the insured has been improperly billed, the
1144insurer shall notify the insured, the person making the written
1145notification, and the provider of its findings and shall reduce
1146the amount of payment to the provider by the amount determined
1147to be improperly billed. If a reduction is made due to such
1148written notification by any person, the insurer shall pay to the
1149person 20 percent of the amount of the reduction, up to $500. If
1150the provider is arrested due to the improper billing, then the
1151insurer shall pay to the person 40 percent of the amount of the
1152reduction, up to $500.
1153     (g)  An insurer may not systematically downcode with the
1154intent to deny reimbursement otherwise due. Such action
1155constitutes a material misrepresentation under s.
1156626.9541(1)(i)2.
1157     (7)(6)  DISCOVERY OF FACTS ABOUT AN INJURED PERSON;
1158DISPUTES.-
1159     (a)  An insurer may require a claimant to submit to an
1160examination under oath or sworn statement as often as reasonably
1161requested by an insurer and at any reasonable location
1162designated by the insurer. Submission to an examination under
1163oath or sworn statement is a condition precedent to recovery or
1164filing suit. The insurer is not liable for benefits under the
1165no-fault law if the claimant fails to fully and truthfully
1166answer all questions asked or violates any provision of
1167paragraph (4)(j).
1168     1.  The insurer may conduct the examination outside the
1169presence of any other person seeking coverage.
1170     2.  If an insurer requests an examination of a claimant
1171that is in a hospital, clinic, or other medical institution,
1172such claimant shall produce the persons with the most knowledge
1173relating to the issues set forth by the insurer in the notice of
1174examination.
1175     3.  The claimant must provide the insurer at the
1176examination with all documents, papers, receipts, invoices,
1177bills, records, or other tangible items requested by the
1178insurer.
1179     4.  The examination may be recorded by audio, video, or
1180court report or any combination thereof. The claimant may record
1181the examination at the claimant's expense.
1182     5.  The claimant may have an attorney present at the
1183examination at the claimant's expense.
1184     6.  An insurer that unreasonably requests an examination
1185without a reasonable basis as a general business practice is
1186engaging in an unfair insurance trade practice pursuant to s.
1187626.9541.
1188     (a)  Every employer shall, if a request is made by an
1189insurer providing personal injury protection benefits under ss.
1190627.730-627.7405 against whom a claim has been made, furnish
1191forthwith, in a form approved by the office, a sworn statement
1192of the earnings, since the time of the bodily injury and for a
1193reasonable period before the injury, of the person upon whose
1194injury the claim is based.
1195     (b)  Every physician, hospital, clinic, or other medical
1196institution providing, before or after bodily injury upon which
1197a claim for personal injury protection insurance benefits is
1198based, any products, services, or accommodations in relation to
1199that or any other injury, or in relation to a condition claimed
1200to be connected with that or any other injury, shall, if
1201requested to do so by the insurer against whom the claim has
1202been made, permit the insurer or the insurer's representative to
1203conduct an onsite physical review and examination of the
1204treatment location, treatment apparatuses, diagnostic devices,
1205and any other medical equipment used for the services rendered
1206within 10 days after the insurer's request and furnish forthwith
1207a written report of the history, condition, treatment, dates,
1208and costs of such treatment of the injured person and why the
1209items identified by the insurer were reasonable in amount and
1210medically necessary, together with a sworn statement that the
1211treatment or services rendered were reasonable and necessary
1212with respect to the bodily injury sustained and identifying
1213which portion of the expenses for such treatment or services was
1214incurred as a result of such bodily injury, and produce
1215forthwith, and permit the inspection and copying of, his or her
1216or its records regarding such history, condition, treatment,
1217dates, and costs of treatment if; provided that this does shall
1218not limit the introduction of evidence at trial. Such sworn
1219statement must shall read as follows: "Under penalty of perjury,
1220I declare that I have read the foregoing, and the facts alleged
1221are true, to the best of my knowledge and belief." A No cause of
1222action for violation of the physician-patient privilege or
1223invasion of the right of privacy may not be brought shall be
1224permitted against any physician, hospital, clinic, or other
1225medical institution complying with the provisions of this
1226section. The person requesting such records and such sworn
1227statement shall pay all reasonable costs connected therewith. If
1228an insurer makes a written request for documentation or
1229information under this paragraph within 30 days after having
1230received notice of the amount of a covered loss under paragraph
1231(4)(a), the amount or the partial amount that which is the
1232subject of the insurer's inquiry is shall become overdue if the
1233insurer does not pay in accordance with paragraph (4)(b) or
1234within 10 days after the insurer's receipt of the requested
1235documentation or information, whichever occurs later. For
1236purposes of this paragraph, the term "receipt" includes, but is
1237not limited to, inspection and copying pursuant to this
1238paragraph. An Any insurer that requests documentation or
1239information pertaining to reasonableness of charges or medical
1240necessity under this paragraph without a reasonable basis for
1241such requests as a general business practice is engaging in an
1242unfair trade practice under the insurance code.
1243     (c)  If a request is made by an insurer, an employer must
1244furnish, in a form approved by the office, a sworn statement of
1245the earnings of the person upon whose injury a claim is based
1246since the time of the bodily injury and for a reasonable period
1247before the injury.
1248     (d)(c)  If there is a In the event of any dispute regarding
1249an insurer's right to discovery of facts under this section, the
1250insurer may petition the a court of competent jurisdiction to
1251enter an order permitting such discovery. The order may be made
1252only on motion for good cause shown and upon notice to all
1253persons having an interest, and must it shall specify the time,
1254place, manner, conditions, and scope of the discovery. The Such
1255court may, in order to protect against annoyance, embarrassment,
1256or oppression, as justice requires, enter an order refusing
1257discovery or specifying conditions of discovery and may order
1258payments of costs and expenses of the proceeding, including
1259reasonable fees for the appearance of attorneys at the
1260proceedings, as justice requires.
1261     (8)(7)  MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON;
1262REPORTS.-
1263     (b)  If requested by the person examined, a party causing
1264an examination to be made shall deliver to him or her a copy of
1265every written report concerning the examination rendered by an
1266examining physician, at least one of which reports must set out
1267the examining physician's findings and conclusions in detail.
1268After such request and delivery, the party causing the
1269examination to be made is entitled, upon request, to receive
1270from the person examined every written report available to him
1271or her or his or her representative concerning any examination,
1272previously or thereafter made, of the same mental or physical
1273condition. By requesting and obtaining a report of the
1274examination so ordered, or by taking the deposition of the
1275examiner, the person examined waives any privilege he or she may
1276have, in relation to the claim for benefits, regarding the
1277testimony of every other person who has examined, or may
1278thereafter examine, him or her in respect to the same mental or
1279physical condition. If a person unreasonably refuses to submit
1280to an examination, the personal injury protection carrier is no
1281longer liable for subsequent personal injury protection benefits
1282incurred after the date of the first request for examination.
1283Failure to appear for an examination raises a rebuttable
1284presumption that such failure was unreasonable. Submission to an
1285examination is a condition precedent to the recovery of
1286benefits.
1287     (9)(8)  APPLICABILITY OF PROVISION REGULATING ATTORNEY'S
1288FEES.-With respect to any dispute under the provisions of ss.
1289627.730-627.7405 between the insured and the insurer under the
1290no-fault law, or between an assignee of an insured's rights and
1291the insurer, the provisions of s. 627.428 applies shall apply,
1292except as provided in subsections (11) and (16) (10) and (15).
1293     (10)(9)  PREFERRED PROVIDERS.-An insurer may negotiate and
1294enter into contracts with preferred licensed health care
1295providers for the benefits described in this section, referred
1296to in this section as "preferred providers," which shall include
1297health care providers licensed under chapter chapters 458,
1298chapter 459, chapter 460, chapter 461, or chapter and 463.
1299     (a)  The insurer may provide an option to an insured to use
1300a preferred provider at the time of purchase of the policy for
1301personal injury protection benefits, if the requirements of this
1302subsection are met. However, if the insurer offers a preferred
1303provider option, it must also offer a nonpreferred provider
1304policy. If the insured elects to use a provider who is not a
1305preferred provider, whether the insured purchased a preferred
1306provider policy or a nonpreferred provider policy, the medical
1307benefits provided by the insurer shall be as required by this
1308section.
1309     (b)  If the insured elects the to use a provider who is a
1310preferred provider option, the insurer may pay medical benefits
1311in excess of the benefits required by this section and may waive
1312or lower the amount of any deductible that applies to such
1313medical benefits. As an alternative, or in addition to such
1314benefits, waiver, or reduction, the insurer may provide an
1315actuarially appropriate premium discount as specified in an
1316approved rate filing to an insured who selects the preferred
1317provider option. If the preferred provider option provides a
1318premium discount, the policy may provide that charges for
1319nonemergency services provided within this state are payable
1320only if performed by members of the preferred provider network
1321unless there is no member of the preferred provider network
1322located within 15 miles of the insured's place of residence
1323whose scope of practice includes the required services. If the
1324insurer offers a preferred provider policy to a policyholder or
1325applicant, it must also offer a nonpreferred provider policy.
1326     (c)  The insurer shall provide each insured policyholder
1327with a current roster of preferred providers in the county in
1328which the insured resides at the time of purchasing purchase of
1329such policy, and shall make such list available for public
1330inspection during regular business hours at the insurer's
1331principal office of the insurer within the state. The insurer
1332may contract with another health insurer for the right to use an
1333existing preferred provider network to implement the preferred
1334provider option. Any other arrangement is subject to the
1335approval of the Office of Insurance Regulation.
1336     (17)(16)  SECURE ELECTRONIC DATA TRANSFER.-If all parties
1337mutually and expressly agree, a notice, documentation,
1338transmission, or communication of any kind required or
1339authorized under the no-fault law ss. 627.730-627.7405 may be
1340transmitted electronically if it is transmitted by secure
1341electronic data transfer that is consistent with state and
1342federal privacy and security laws.
1343     Section 9.  Paragraph (c) of subsection (7) of section
1344817.234, Florida Statutes, is amended, present subsection (12)
1345of that section is renumbered as subsection (13), and a new
1346subsection (12) is added to that section, to read:
1347     817.234  False and fraudulent insurance claims.-
1348     (7)
1349     (c)  An insurer, or any person acting at the direction of
1350or on behalf of an insurer, may not change an opinion in a
1351mental or physical report prepared under s. 627.736(8)
1352627.736(7) or direct the physician preparing the report to
1353change such opinion; however, this provision does not preclude
1354the insurer from calling to the attention of the physician
1355errors of fact in the report based upon information in the claim
1356file. Any person who violates this paragraph commits a felony of
1357the third degree, punishable as provided in s. 775.082, s.
1358775.083, or s. 775.084.
1359     (12)  In addition to any criminal liability, a person
1360convicted of violating any provision of this section for the
1361purpose of receiving insurance proceeds from a motor vehicle
1362insurance contract is subject to a civil penalty.
1363     (a)  Except for a violation of subsection (9), the civil
1364penalty shall be:
1365     1.  A fine up to $5,000 for a first offense.
1366     2.  A fine greater than $5,000, but not to exceed $10,000,
1367for a second offense.
1368     3.  A fine greater than $10,000, but not to exceed $15,000,
1369for a third or subsequent offense.
1370     (b)  The civil penalty for a violation of subsection
1371(9)_must be at least $15,000 but may not exceed $50,000.
1372     (c)  The civil penalty shall be paid to the Insurance
1373Regulatory Trust Fund within the Department of Financial
1374Services and used by the department for the investigation and
1375prosecution of insurance fraud.
1376     (d)  This subsection does not prohibit a state attorney
1377from entering into a written agreement in which the person
1378charged with the violation does not admit to or deny the charges
1379but consents to payment of the civil penalty.
1380     Section 10.  Subsection (1) of section 324.021, Florida
1381Statutes, is amended to read:
1382     324.021  Definitions; minimum insurance required.-The
1383following words and phrases when used in this chapter shall, for
1384the purpose of this chapter, have the meanings respectively
1385ascribed to them in this section, except in those instances
1386where the context clearly indicates a different meaning:
1387     (1)  MOTOR VEHICLE.-Every self-propelled vehicle that which
1388is designed and required to be licensed for use upon a highway,
1389including trailers and semitrailers designed for use with such
1390vehicles, except traction engines, road rollers, farm tractors,
1391power shovels, and well drillers, and every vehicle that which
1392is propelled by electric power obtained from overhead wires but
1393not operated upon rails, but not including any bicycle or moped.
1394However, the term does "motor vehicle" shall not include a any
1395motor vehicle as defined in s. 627.732(3) if when the owner of
1396such vehicle has complied with the no-fault law requirements of
1397ss. 627.730-627.7405, inclusive, unless the provisions of s.
1398324.051 apply; and, in such case, the applicable proof of
1399insurance provisions of s. 320.02 apply.
1400     Section 11.  Paragraph (k) of subsection (2) of section
1401456.057, Florida Statutes, is amended to read:
1402     456.057  Ownership and control of patient records; report
1403or copies of records to be furnished.-
1404     (2)  As used in this section, the terms "records owner,"
1405"health care practitioner," and "health care practitioner's
1406employer" do not include any of the following persons or
1407entities; furthermore, the following persons or entities are not
1408authorized to acquire or own medical records, but are authorized
1409under the confidentiality and disclosure requirements of this
1410section to maintain those documents required by the part or
1411chapter under which they are licensed or regulated:
1412     (k)  Persons or entities practicing under s. 627.736(8)
1413627.736(7).
1414     Section 12.  Subsection (7) of section 627.7295, Florida
1415Statutes, is amended to read:
1416     627.7295  Motor vehicle insurance contracts.-
1417     (7)  A policy of private passenger motor vehicle insurance
1418or a binder for such a policy may be initially issued in this
1419state only if the insurer or agent has collected from the
1420insured an amount equal to 2 months' premium. An insurer, agent,
1421or premium finance company may not, directly or indirectly, take
1422any action resulting in the insured having paid from the
1423insured's own funds an amount less than the 2 months' premium
1424required by this subsection. This subsection applies without
1425regard to whether the premium is financed by a premium finance
1426company or is paid pursuant to a periodic payment plan of an
1427insurer or an insurance agent. This subsection does not apply if
1428an insured or member of the insured's family is renewing or
1429replacing a policy or a binder for such policy written by the
1430same insurer or a member of the same insurer group. This
1431subsection does not apply to an insurer that issues private
1432passenger motor vehicle coverage primarily to active duty or
1433former military personnel or their dependents. This subsection
1434does not apply if all policy payments are paid pursuant to a
1435payroll deduction plan or an automatic electronic funds transfer
1436payment plan from the policyholder, provided that the first
1437policy payment is made by cash, cashier's check, check, or a
1438money order. This subsection and subsection (4) do not apply if
1439all policy payments to an insurer are paid pursuant to an
1440automatic electronic funds transfer payment plan from an agent,
1441a managing general agent, or a premium finance company and if
1442the policy includes, at a minimum, personal injury protection
1443pursuant to ss. 627.730-627.7407 627.730-627.7405; motor vehicle
1444property damage liability pursuant to s. 627.7275; and bodily
1445injury liability in at least the amount of $10,000 because of
1446bodily injury to, or death of, one person in any one accident
1447and in the amount of $20,000 because of bodily injury to, or
1448death of, two or more persons in any one accident. This
1449subsection and subsection (4) do not apply if an insured has had
1450a policy in effect for at least 6 months, the insured's agent is
1451terminated by the insurer that issued the policy, and the
1452insured obtains coverage on the policy's renewal date with a new
1453company through the terminated agent.
1454     Section 13.  Subsections (3) and (4) of section 627.733,
1455Florida Statutes, are amended to read:
1456     627.733  Required security.-
1457     (3)  Such security shall be provided:
1458     (a)  By an insurance policy delivered or issued for
1459delivery in this state by an authorized or eligible motor
1460vehicle liability insurer which provides the benefits and
1461exemptions contained in the no-fault law ss. 627.730-627.7405.
1462Any policy of insurance represented or sold as providing the
1463security required hereunder shall be deemed to provide insurance
1464for the payment of the required benefits; or
1465     (b)  By any other method authorized by s. 324.031(2), (3),
1466or (4) and approved by the Department of Highway Safety and
1467Motor Vehicles as affording security equivalent to that afforded
1468by a policy of insurance or by self-insuring as authorized by s.
1469768.28(16). The person filing such security shall have all of
1470the obligations and rights of an insurer under the no-fault law
1471ss. 627.730-627.7405.
1472     (4)  An owner of a motor vehicle with respect to which
1473security is required by this section who fails to have such
1474security in effect at the time of an accident shall have no
1475immunity from tort liability, but shall be personally liable for
1476the payment of benefits under s. 627.736. With respect to such
1477benefits, such an owner shall have all of the rights and
1478obligations of an insurer under the no-fault law ss. 627.730-
1479627.7405.
1480     Section 14.  Section 627.734, Florida Statutes, is amended
1481to read:
1482     627.734  Proof of security; security requirements;
1483penalties.-
1484     (1)  The provisions of chapter 324 that which pertain to
1485the method of giving and maintaining proof of financial
1486responsibility and that which govern and define a motor vehicle
1487liability policy shall apply to filing and maintaining proof of
1488security required by the no-fault law ss. 627.730-627.7405.
1489     (2)  Any person who:
1490     (a)  Gives information required in a report or otherwise as
1491provided for in the no-fault law ss. 627.730-627.7405, knowing
1492or having reason to believe that such information is false;
1493     (b)  Forges or, without authority, signs any evidence of
1494proof of security; or
1495     (c)  Files, or offers for filing, any such evidence of
1496proof, knowing or having reason to believe that it is forged or
1497signed without authority,
1498
1499commits is guilty of a misdemeanor of the first degree,
1500punishable as provided in s. 775.082 or s. 775.083.
1501     Section 15.  Subsections (1), (2), and (3) of section
1502627.737, Florida Statutes, are amended to read:
1503     627.737  Tort exemption; limitation on right to damages;
1504punitive damages.-
1505     (1)  Every owner, registrant, operator, or occupant of a
1506motor vehicle with respect to which security has been provided
1507as required by the no-fault law ss. 627.730-627.7405, and every
1508person or organization legally responsible for her or his acts
1509or omissions, is hereby exempted from tort liability for damages
1510because of bodily injury, sickness, or disease arising out of
1511the ownership, operation, maintenance, or use of such motor
1512vehicle in this state to the extent that the benefits described
1513in s. 627.736(1) are payable for such injury, or would be
1514payable but for any exclusion authorized by the no-fault law ss.
1515627.730-627.7405, under any insurance policy or other method of
1516security complying with the requirements of s. 627.733, or by an
1517owner personally liable under s. 627.733 for the payment of such
1518benefits, unless a person is entitled to maintain an action for
1519pain, suffering, mental anguish, and inconvenience for such
1520injury under the provisions of subsection (2).
1521     (2)  In any action of tort brought against the owner,
1522registrant, operator, or occupant of a motor vehicle with
1523respect to which security has been provided as required by the
1524no-fault law ss. 627.730-627.7405, or against any person or
1525organization legally responsible for her or his acts or
1526omissions, a plaintiff may recover damages in tort for pain,
1527suffering, mental anguish, and inconvenience because of bodily
1528injury, sickness, or disease arising out of the ownership,
1529maintenance, operation, or use of such motor vehicle only in the
1530event that the injury or disease consists in whole or in part
1531of:
1532     (a)  Significant and permanent loss of an important bodily
1533function.
1534     (b)  Permanent injury within a reasonable degree of medical
1535probability, other than scarring or disfigurement.
1536     (c)  Significant and permanent scarring or disfigurement.
1537     (d)  Death.
1538     (3)  When a defendant, in a proceeding brought pursuant to
1539the no-fault law ss. 627.730-627.7405, questions whether the
1540plaintiff has met the requirements of subsection (2), then the
1541defendant may file an appropriate motion with the court, and the
1542court shall, on a one-time basis only, 30 days before the date
1543set for the trial or the pretrial hearing, whichever is first,
1544by examining the pleadings and the evidence before it, ascertain
1545whether the plaintiff will be able to submit some evidence that
1546the plaintiff will meet the requirements of subsection (2). If
1547the court finds that the plaintiff will not be able to submit
1548such evidence, then the court shall dismiss the plaintiff's
1549claim without prejudice.
1550     Section 16.  Subsection (1) of section 627.7401, Florida
1551Statutes, is amended to read:
1552     627.7401  Notification of insured's rights.-
1553     (1)  The commission, by rule, shall adopt a form for the
1554notification of insureds of their right to receive personal
1555injury protection benefits under the Florida Motor Vehicle no-
1556fault law. Such notice shall include:
1557     (a)  A description of the benefits provided by personal
1558injury protection, including, but not limited to, the specific
1559types of services for which medical benefits are paid,
1560disability benefits, death benefits, significant exclusions from
1561and limitations on personal injury protection benefits, when
1562payments are due, how benefits are coordinated with other
1563insurance benefits that the insured may have, penalties and
1564interest that may be imposed on insurers for failure to make
1565timely payments of benefits, and rights of parties regarding
1566disputes as to benefits.
1567     (b)  An advisory informing insureds that:
1568     1.  Pursuant to s. 626.9892, the Department of Financial
1569Services may pay rewards of up to $25,000 to persons providing
1570information leading to the arrest and conviction of persons
1571committing crimes investigated by the Division of Insurance
1572Fraud arising from violations of s. 440.105, s. 624.15, s.
1573626.9541, s. 626.989, or s. 817.234.
1574     2.  Pursuant to s. 627.736(6)(e)1. 627.736(5)(e)1., if the
1575insured notifies the insurer of a billing error, the insured may
1576be entitled to a certain percentage of a reduction in the amount
1577paid by the insured's motor vehicle insurer.
1578     (c)  A notice that solicitation of a person injured in a
1579motor vehicle crash for purposes of filing personal injury
1580protection or tort claims could be a violation of s. 817.234, s
1581817.505, or the rules regulating The Florida Bar and should be
1582immediately reported to the Division of Insurance Fraud if such
1583conduct has taken place.
1584     Section 17.  Section 627.7405, Florida Statutes, is amended
1585to read:
1586     627.7405  Insurers' right of reimbursement.-Notwithstanding
1587any other provisions of the no-fault law ss. 627.730-627.7405,
1588any insurer providing personal injury protection benefits on a
1589private passenger motor vehicle has shall have, to the extent of
1590any personal injury protection benefits paid to any person as a
1591benefit arising out of such private passenger motor vehicle
1592insurance, a right of reimbursement against the owner or the
1593insurer of the owner of a commercial motor vehicle, if the
1594benefits paid result from such person having been an occupant of
1595the commercial motor vehicle or having been struck by the
1596commercial motor vehicle while not an occupant of any self-
1597propelled vehicle.
1598     Section 18.  Subsection (1) of section 627.7407, Florida
1599Statutes, is amended to read:
1600     627.7407  Application of the Florida Motor Vehicle No-Fault
1601Law.-
1602     (1)  Any person subject to the requirements of ss. 627.730-
1603627.7405, the Florida Motor Vehicle No-Fault Law, as revived and
1604amended by this act, must maintain security for personal injury
1605protection as required by the Florida Motor Vehicle No-Fault
1606Law, as revived and amended by this act, beginning on January 1,
16072008.
1608     Section 19.  Paragraph (d) of subsection (2) and paragraph
1609(d) of subsection (3) of section 628.909, Florida Statutes, are
1610amended to read:
1611     628.909  Applicability of other laws.-
1612     (2)  The following provisions of the Florida Insurance Code
1613shall apply to captive insurers who are not industrial insured
1614captive insurers to the extent that such provisions are not
1615inconsistent with this part:
1616     (d)  Sections 627.730-627.7407 627.730-627.7405, when no-
1617fault coverage is provided.
1618     (3)  The following provisions of the Florida Insurance Code
1619shall apply to industrial insured captive insurers to the extent
1620that such provisions are not inconsistent with this part:
1621     (d)  Sections 627.730-627.7407 627.730-627.7405 when no-
1622fault coverage is provided.
1623     Section 20.  This act shall take effect July 1, 2011.


CODING: Words stricken are deletions; words underlined are additions.
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