Fla. Stat. 627.4238
Health insurer examinations

The office may examine each authorized health insurer which transacts health insurance in this state. The purpose of the examination is to ascertain compliance by the insurer with the applicable provisions of this chapter. In lieu of the examination, the office may accept the report of a similar examination made by the insurance supervisory official of this state or another state. The reasonable cost of the examination shall be paid by the person examined, and such person is subject to the provisions of s. 624.320. Any examination is also subject to the applicable provisions of ss. 624.318, 624.319, 624.321, and 624.322. An examination under this section may not exceed 10 working days in length, may not be conducted more often than annually, and may not be conducted during the same calendar year as a market conduct examination conducted by the office, except in a case in which the office has prima facie evidence of a violation of this chapter or of chapter 626, which violation is of a nature so as to provide an immediate danger to the insurance-consuming public.

Source: Section 627.4238 — Health insurer examinations, https://www.­flsenate.­gov/Laws/Statutes/2024/0627.­4238 (accessed Aug. 7, 2025).

627.401
Scope of this part 627.402
Definitions 627.403
“Premium” defined 627.404
Insurable interest 627.405
Insurable interest 627.406
Power to contract 627.407
Alteration of application 627.408
Application as evidence 627.409
Representations in applications 627.410
Filing, approval of forms 627.411
Grounds for disapproval 627.412
Standard provisions, in general 627.413
Contents of policies, in general 627.414
Additional policy contents 627.415
Charter, bylaw provisions 627.416
Execution of policies 627.417
Underwriters’ and combination policies 627.418
Validity of noncomplying contracts 627.419
Construction of policies 627.420
Binders 627.421
Delivery of policy 627.422
Assignment of policies or post-loss benefits 627.423
Payment discharges insurer 627.424
Minor may give acquittance 627.425
Forms for proof of loss to be furnished 627.426
Claims administration 627.427
Payment of judgment by insurer 627.429
Medical tests for HIV infection and AIDS for insurance purposes 627.441
Commercial general liability policies 627.442
Insurance contracts 627.443
Essential health benefits 627.444
Loss run statements for all lines of insurance 627.445
Paid family leave insurance 627.446
Advanced explanation of benefits 627.4025
Residential coverage and hurricane coverage defined 627.4035
Payment of premiums 627.4085
Insurer name, agent name, and license identification number required on application 627.4091
Specific reasons for denial, cancellation, or nonrenewal 627.4101
Credit insurance enrollment forms 627.4102
Informational filing of forms 627.4105
Life and health insurance 627.4107
Government employees exposed to toxic drug chemicals 627.4108
Claims-handling manuals 627.4131
Telephone number required 627.4132
Stacking of coverages prohibited 627.4133
Notice of cancellation, nonrenewal, or renewal premium 627.4135
Casualty insurance contracts subject to general provisions for insurance contracts 627.4136
Nonjoinder of insurers 627.4137
Disclosure of certain information required 627.4138
Wrap-up insurance policies for nonpublic construction projects 627.4143
Outline of coverage 627.4145
Readable language in insurance policies 627.4147
Medical malpractice insurance contracts 627.4148
Medical malpractice insurers 627.4195
Health insurance 627.4205
Coverage identification number required 627.4215
Disclosures to policyholders 627.4232
Health insurance out-of-hospital benefits 627.4233
Total disability defined 627.4234
Health insurance cost containment provisions required 627.4235
Coordination of benefits 627.4236
Coverage for bone marrow transplant procedures 627.4237
Sickness disability or disability due to sickness 627.4238
Health insurer examinations 627.4239
Coverage for use of drugs in treatment of cancer 627.4265
Payment of settlement 627.4295
Dental procedures 627.4301
Genetic information for insurance purposes 627.4302
Identification cards for processing prescription drug claims 627.40951
Standard personal lines residential insurance policy 627.40952
Savings reflections in residential property and motor vehicle insurer rate filings related to specified chapter laws 627.41495
Public notice of medical malpractice rate filings 627.42391
Insurance policies 627.42392
Prior authorization 627.42393
Step-therapy protocol 627.42395
Coverage for certain prescription and nonprescription enteral formulas 627.42396
Reimbursement for telehealth services 627.42397
Coverage for air ambulance services 627.43141
Notice of change in policy terms

Current through Fall 2025

§ 627.4238. Health insurer examinations's source at flsenate​.gov