Fla. Admin. Code R. 69O-196.021 (2026)
Disclosure Requirements for Insurance Coverages Financed With Personal Injury Protection
(1) Whenever motor vehicle insurance is financed, the agent shall disclose at the time of sale any coverages financed with personal injury protection other than property damage liability, bodily injury, collision, uninsured motorist, or comprehensive coverage for damage of or loss to the vehicle.
(2) The disclosure shall be on Form OIR-A3-1162, “Insurance Premium Financing Disclosure Form,” effective 3/95, hereby incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-13028. The filings shall be submitted electronically via the Office’s system at https://www.floir.com/iportal.
(3) The disclosure shall be signed by the insured.
(4) Copies of the signed disclosure shall be given to the agent, insured, and the premium finance company.
Rulemaking Authority 624.308(1), 627.8405 FS. Law Implemented 624.424, 627.8405 FS. History–New 3-1-95, Amended 8-16-95, Formerly 4-196.021, Amended 7-30-17, 5-24-21.
Effective: 5/24/2021.