Fla. Stat. 627.426
Claims administration


(1)

Without limitation of any right or defense of an insurer otherwise, none of the following acts by or on behalf of an insurer shall be deemed to constitute a waiver of any provision of a policy or of any defense of the insurer thereunder:Acknowledgment of the receipt of notice of loss or claim under the policy.Furnishing forms for reporting a loss or claim, for giving information relative thereto, or for making proof of loss, or receiving or acknowledging receipt of any such forms or proofs completed or uncompleted.Investigating any loss or claim under any policy or engaging in negotiations looking toward a possible settlement of any such loss or claim.

(a)

Acknowledgment of the receipt of notice of loss or claim under the policy.

(b)

Furnishing forms for reporting a loss or claim, for giving information relative thereto, or for making proof of loss, or receiving or acknowledging receipt of any such forms or proofs completed or uncompleted.

(c)

Investigating any loss or claim under any policy or engaging in negotiations looking toward a possible settlement of any such loss or claim.

(2)

A liability insurer shall not be permitted to deny coverage based on a particular coverage defense unless:Within 30 days after the liability insurer knew or should have known of the coverage defense, written notice of reservation of rights to assert a coverage defense is given to the named insured by United States postal proof of mailing, registered or certified mail, or other mailing using the Intelligent Mail barcode or other similar tracking method used or approved by the United States Postal Service sent to the last known address of the insured or by hand delivery; andWithin 60 days of compliance with paragraph (a) or receipt of a summons and complaint naming the insured as a defendant, whichever is later, but in no case later than 30 days before trial, the insurer:
Gives written notice to the named insured by United States postal proof of mailing, registered or certified mail, or other mailing using the Intelligent Mail barcode or other similar tracking method used or approved by the United States Postal Service of its refusal to defend the insured;
Obtains from the insured a nonwaiver agreement following full disclosure of the specific facts and policy provisions upon which the coverage defense is asserted and the duties, obligations, and liabilities of the insurer during and following the pendency of the subject litigation; or
Retains independent counsel which is mutually agreeable to the parties. Reasonable fees for the counsel may be agreed upon between the parties or, if no agreement is reached, shall be set by the court.

(a)

Within 30 days after the liability insurer knew or should have known of the coverage defense, written notice of reservation of rights to assert a coverage defense is given to the named insured by United States postal proof of mailing, registered or certified mail, or other mailing using the Intelligent Mail barcode or other similar tracking method used or approved by the United States Postal Service sent to the last known address of the insured or by hand delivery; and

(b)

Within 60 days of compliance with paragraph (a) or receipt of a summons and complaint naming the insured as a defendant, whichever is later, but in no case later than 30 days before trial, the insurer:Gives written notice to the named insured by United States postal proof of mailing, registered or certified mail, or other mailing using the Intelligent Mail barcode or other similar tracking method used or approved by the United States Postal Service of its refusal to defend the insured;Obtains from the insured a nonwaiver agreement following full disclosure of the specific facts and policy provisions upon which the coverage defense is asserted and the duties, obligations, and liabilities of the insurer during and following the pendency of the subject litigation; orRetains independent counsel which is mutually agreeable to the parties. Reasonable fees for the counsel may be agreed upon between the parties or, if no agreement is reached, shall be set by the court.
1. Gives written notice to the named insured by United States postal proof of mailing, registered or certified mail, or other mailing using the Intelligent Mail barcode or other similar tracking method used or approved by the United States Postal Service of its refusal to defend the insured;
2. Obtains from the insured a nonwaiver agreement following full disclosure of the specific facts and policy provisions upon which the coverage defense is asserted and the duties, obligations, and liabilities of the insurer during and following the pendency of the subject litigation; or
3. Retains independent counsel which is mutually agreeable to the parties. Reasonable fees for the counsel may be agreed upon between the parties or, if no agreement is reached, shall be set by the court.

Source: Section 627.426 — Claims administration, https://www.­flsenate.­gov/Laws/Statutes/2024/0627.­426 (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

§ 627.426. Claims administration's source at flsenate​.gov