Florida Statute 627.6044 - Full Text and Legal Analysis

The 2025 Florida Statutes

Title XXXVII
INSURANCE

Chapter 627
INSURANCE RATES AND CONTRACTS

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627.6044 Use of a specific methodology for payment of claims.—

(1) Each insurance policy that provides for payment of claims based on a specific methodology, including, but not limited to, usual and customary charges, reasonable and customary charges, or charges based upon the prevailing rate in the community, shall specify the formula or criteria used by the insurer in determining the amount to be paid.

(2) Each insurer issuing a policy that provides for payment of claims based on a specific methodology shall provide to an insured, upon her or his written request, an estimate of the amount the insurer will pay for a particular medical procedure or service. The estimate may be in the form of a range of payments or an average payment. The insurer may require the insured to provide detailed information regarding the procedure or service to be performed, including the procedure or service code number provided by the health care provider and the health care provider’s estimated charge. An insurer that provides an insured with a good faith estimate is not bound by the estimate. However, a pattern of providing estimates that vary significantly from the ultimate insurance payment constitutes a violation of this code.

History.—ss. 9, 12, ch. 91-296; ss. 55, 114, ch. 92-318; s. 340, ch. 97-102.

Note.—Former s. 627.6145.

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Amendments to 627.6044

Annotations, Discussions, Cases:

Cases Citing Statute 627.6044

Total Results: 2

Geico General Insurance Co. v. Virtual Imaging Services, Inc.

141 So. 3d 147, 38 Fla. L. Weekly Supp. 517, 2013 WL 3332385, 2013 Fla. LEXIS 1387

Supreme Court of Florida | Filed: Jul 3, 2013 | Docket: 60241811

Cited 9 times | Published

Virtual Imaging's argument, however, that section 627.6044, Florida Statutes (2008), is relevant to our

MRI Scan Center, Inc. v. Allstate Insurance

273 F. App'x 835

Court of Appeals for the Eleventh Circuit | Filed: Apr 14, 2008 | Docket: 65927387

Published

adjusted claims in violation of Florida Statute § 627.6044(1), which requires insurance policies to specify

This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. Attorney Syfert regularly works with Chapter 627 in the context of insurance coverage law and represents clients throughout Northeast Florida. For legal consultation, call 904-383-7448.