The 2023 Florida Statutes (including Special Session C)

Title XXXVII
INSURANCE

Chapter 627
INSURANCE RATES AND CONTRACTS

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F.S. 627.411

627.411 Grounds for disapproval.—

(1) The office shall disapprove any form filed under s. 627.410, or withdraw any previous approval thereof, only if the form:

(a) Is in any respect in violation of, or does not comply with, this code.

(b) Contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.

(d) Is printed or otherwise reproduced in such manner as to render any material provision of the form substantially illegible.

(e) Is for residential property insurance and contains provisions that are unfair or inequitable or encourage misrepresentation.

(f) Is for health insurance, and:

1. Provides benefits that are unreasonable in relation to the premium charged.

2. Contains provisions that are unfair or inequitable or contrary to the public policy of this state or that encourage misrepresentation.

3. Contains provisions that apply rating practices that result in unfair discrimination pursuant to s. 626.9541(1)(g)2.

(g) Excludes coverage for human immunodeficiency virus infection or acquired immune deficiency syndrome or contains limitations in the benefits payable, or in the terms or conditions of such contract, for human immunodeficiency virus infection or acquired immune deficiency syndrome which are different than those which apply to any other sickness or medical condition.

(2) In determining whether the benefits are reasonable in relation to the premium charged, the office, in accordance with reasonable actuarial techniques, shall consider:

(a) Past loss experience and prospective loss experience within and without this state.

(b) Allocation of expenses.

(d) Acquisition costs.

History.—s. 460, ch. 59-205; ss. 13, 35, 69-106; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 366, 377, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 48, ch. 88-380; s. 114, ch. 92-318; s. 63, ch. 93-129; s. 1, ch. 2003-139; s. 1115, ch. 2003-261; s. 9, ch. 2005-111; s. 16, ch. 2013-101; s. 12, ch. 2016-11; s. 7, ch. 2016-194.

F.S. 627.411 on Google Scholar

F.S. 627.411 on Casetext

Amendments to 627.411

Arrestable Offenses / Crimes under Fla. Stat. 627.411

Level: Degree
Misdemeanor/Felony: First/Second/Third

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 627.411.

Annotations, Discussions, Cases:

Cases from cite.case.law:

SECURITY FIRST INSURANCE COMPANY, v. FLORIDA OFFICE OF INSURANCE REGULATION,, 232 So. 3d 1157 (Fla. Dist. Ct. App. 2017)

. . . The disapproval letter stated that “the forms violate the intent and meaning of [s]ections 627.411(a) . . .

JOHNSON, v. CATAMARAN HEALTH SOLUTIONS, LLC, f. k. a. f. k. a., 687 F. App'x 825 (11th Cir. 2017)

. . . that if § 627.6515 didn’t require premiums to be reasonable in relation to benefits, then §§ 627.410, 627.411 . . . Thus, although §§. 627.410, 627.411, and 627.640 do seem to embody a requirement that insurance products . . . Based on this comparison, it is clear that §§ 627.410, 627.411, and 627.640 do not serve the same direct . . . Thus, we decline to incorporate §§ 627.410, 627.411, and 627.640 into the insurance contracts at issue . . . Stat. §§ 627.6515, 627.410, 627.411,.and 627.640. . . .

SECURITY FIRST INSURANCE COMPANY, v. STATE OFFICE OF INSURANCE REGULATION,, 177 So. 3d 627 (Fla. Dist. Ct. App. 2015)

. . . notices of disapproval of the changes because they would “violate the intent and meaning of Sections 627.411 . . . (l)(a), 627.411(l)(b), and 627.411(l)(e), Florida Statutes! . . .

UNITED INSURANCE COMPANY OF AMERICA, v. OFFICE OF INSURANCE REGULATION, Of, 985 So. 2d 665 (Fla. Dist. Ct. App. 2008)

. . . The request was disapproved by the Office of Insurance Regulation, pursuant to sections 627.411(l)(a) . . .

FLORIDA DEPARTMENT OF INSURANCE v. GUARANTEE TRUST LIFE INSURANCE COMPANY, 812 So. 2d 459 (Fla. Dist. Ct. App. 2002)

. . . Department of Insurance (DOI) appeals the trial court’s entry of declaratory judgment which held section 627.411 . . . However, only that portion of section 627.411(l)(e), Florida Statutes, which provides “... or which apply . . . and DOI may disapprove a future rate filing based on the “viability provision” contained in section 627.411 . . .

ALLSTATE INDEMNITY COMPANY, v. WISE a k a Jr., 818 So. 2d 524 (Fla. Dist. Ct. App. 2001)

. . . See § 627.411, Fla. Stat. (2000). . . .

SECURITY MUTUAL LIFE INSURANCE COMPANY OF LINCOLN, NEBRASKA, v. DEPARTMENT OF INSURANCE AND STATE TREASURER,, 707 So. 2d 929 (Fla. Dist. Ct. App. 1998)

. . . the forms] does not create new law but represents the Department’s enforcing existing laws, Sections 627.411 . . .

EXCELSIOR INSURANCE COMPANY, v. POMONA PARK BAR PACKAGE STORE,, 369 So. 2d 938 (Fla. 1979)

. . . Department of Insurance does not disapprove an insurance policy form which is defective under Section 627.411 . . . Pomona Park has also asserted that Excelsior’s policy form violates Section 627.411, Florida Statutes . . . Section 627.411 requires the Department of Insurance to disapprove inconsistent, ambiguous, misleading . . . We do not view the policy form in issue here as violative of Section 627.411. . . . freewheeling judicial revision of insurance contracts that might be considered defective under Section 627.411 . . .