On May 17, 2011, new sinkhole laws went into effect, significantly changing the way sinkhole claims will now
be handled in Florida. Below are brief summaries, as taken from the Florida Senate website, which explain
some of the most drastic changes. In particular, changes have been made to the statutue of limitations (time
frame in which you must file a claim or forever be barred from doing so), rules governing Public Adjuster, and
the definition of structural damage.
Sinkhole and Catastrophic Ground Cover Collapse Insurance
The bill enacts numerous revisions and clarifications to ss. 627.706-627.7074, F.S., governing sinkhole and
catastrophic ground cover collapse insurance. The bill authorizes insurers to restrict catastrophic ground cover
collapse and sinkhole loss coverage to the principal building as defined in the insurance policy. The bill also allows
an insurer to require a property inspection prior to issuing sinkhole loss coverage. The bill clarifies that additional
living expense coverage is only available pursuant to a sinkhole loss if there is structural damage to the covered
The bill changes the definition of “sinkhole loss,” primarily by creating a statutory definition of “structural damage.”
A sinkhole loss is defined in statute as structural damage to the covered building, including the foundation, caused
by sinkhole activity. The bill creates a detailed definition of “structural damage” for purposes of determining whethe
a sinkhole loss has occurred. The definition specifies five distinct types of damage that constitute structural
damage. Each type of damage is tied to standards contained in the Florida Building Code or used in the
construction industry. Accordingly, in order for the policyholder to obtain policy benefits for sinkhole loss, the
insured structure must sustain structural damage as defined by the bill that is caused by sinkhole activity.
Investigation of Sinkhole Claims – The bill creates a substantially new process for an insurer’s investigation of a
sinkhole claim. The process requires the insurer to determine whether: (1) the building has incurred structural
damage that (2) has been caused by sinkhole activity. Coverage for sinkhole loss is not available if structural
damage is not present or sinkhole activity is not the cause of structural damage. The new process is as follows:
- Initial Inspection < Structural Damage Determination: Upon receipt of a claim for sinkhole loss, the insurer
must inspect the policyholder’s premises to determine if there has been structural damage which may be the
result of sinkhole activity. This inspection will often require the insurer to retain a professional engineer to
evaluate whether the insured building has incurred structural damage as defined by statute.
- Sinkhole Testing Initiated by the Insurer: The insurer is required to engage a professional engineer or
professional geologist to conduct sinkhole testing pursuant to s. 627.7072, F.S., if the insurer confirms that
structural damage exists and is either unable to identify a valid cause of the structural damage or discovers
that the structural damage is consistent with sinkhole loss. If coverage is excluded under the policy even if
sinkhole loss is confirmed, then the insurer is not required to conduct sinkhole testing.
- Notice to the Policyholder: The bill maintains the requirement that the insurer must provide written notice to
the policyholder detailing what the insurer has determined to be the cause of damage (if the determination
has been made) and a statement of the circumstances under which the insurer must conduct sinkhole
testing. The policyholder must also be notified of his or her right to demand sinkhole testing and the
circumstances under which the policyholder may incur costs associated with testing.
- Authorization to Deny Sinkhole Claim: Insurers may continue to deny the claim upon a determination that
there is no sinkhole loss.
- Policyholder Demand for Sinkhole Testing: The bill specifies that the policyholder may demand sinkhole
testing in writing within 60 days after receiving a claim denial if the insurer denies the claim without
performing sinkhole testing and coverage would be available if a sinkhole loss is confirmed (i.e. the claim
denial was not issued due to policy conditions or exclusions of coverage and instead was based the failure
of the loss to meet the definition of sinkhole loss). However, if the policyholder requests such testing, it must
pay the insurer 50 percent of the sinkhole testing costs up to $2,500. If the requested testing confirms a
sinkhole loss the insurer must reimburse the testing costs to the policyholder.
Payment of Sinkhole Claims – The insurer continues to be required to pay to stabilize the land and building and
repair the foundation upon the verification of a sinkhole loss. Payment shall be made to conduct such repairs in
accordance with the recommendations of the professional engineer retained by the insurer under s. 627.707(2),
F.S. The bill also clarifies that the insurer is required to give notice to the policyholder regarding payment of the
The bill revises the statutory authorization specifying that the insurer may limit payment to the actual cash value of
the sinkhole loss not including below-ground repair techniques until the policyholder enters into a contract for the
performance of building stabilization repairs. The bill requires the contract for below-ground repairs to be made in
accordance with the recommendations set forth in the insurer’s sinkhole report issued pursuant to s. 627.7073,
F.S., and entered into within 90 days after the policyholder receives notice that the insurer has confirmed coverage
for sinkhole loss. The time period is tolled if either party invokes neutral evaluation. Stabilization and all other
repairs to the structure and contents must be completed within 12 months after the policyholder enters into the
contract for repairs unless the insurer and policyholder mutually agree otherwise, the claim is in litigation, or the
claim is in neutral evaluation, appraisal or mediation.
The bill specifies that if a covered building suffers a sinkhole loss or catastrophic ground cover collapse, the
insured must repair such damage in accordance with the insurer’s professional engineer’s recommended repairs.
However, if repairs cannot be completed within policy limits, the insurer has the option to either pay to complete the
recommended repairs or tender policy limits.
Prohibition Against Rebates – The policyholder is prohibited from accepting a rebate from a person performing
sinkhole repairs. If the policyholder does receive a rebate, coverage under the insurance policy is rendered void
and the policyholder must refund the amount of the rebate to the insurer. Furthermore, a person who offers a
rebate commits insurance fraud punishable as a third degree felony as provided in s. 775.082, F.S. (up to 5 years
imprisonment), s. 775.083, F.S. (up to a $5,000 fine), and s. 775.084, F.S. (for a habitual felony offender up to 10
years imprisonment with no eligibility for release for 5 years).
Nonrenewal of Policy Due to Sinkhole Claims – The circumstances that allow an insurer to nonrenew a policy
on the basis of filing a sinkhole claim are modified. The policy may only be nonrenewed if the insurer makes
payments for sinkhole loss that equal or exceed policy limits for damage to the covered building or the policyholder
does not repair the structure in accordance with the engineering recommendations.
Sinkhole Testing Reports – The bill requires a sinkhole testing report to verify whether the structural damage to
the covered building has been identified within a reasonable professional probability.
Filing of Reports With The Clerk of Courts – In addition to filing the sinkhole testing report with the Clerk of
Court after paying a sinkhole loss claim, the bill requires the insurer to also file the neutral evaluator’s report (if
any), a copy of the certification indicating that stabilization has been completed (if applicable), and the amount of
the claim payment. The policyholder must file a copy of any sinkhole report prepared on behalf of the policyholder
as a precondition to accepting a sinkhole loss payment.
Certification of Proper Completion of Sinkhole Repairs – Once building stabilization or foundation repairs of a
sinkhole loss are completed, the professional engineer responsible for monitoring the repairs must issue a report to the property owner detailing the repairs performed and certifying that the repairs were performed properly. The
professional engineer must file with the Clerk of Court a copy of the report and certification, the legal description of
the real property, and the name of the county clerk of court.
Neutral Evaluation of Disputed Sinkhole Claims – The bill specifies that neutral evaluation must determine
causation (whether a sinkhole loss has occurred and, if so, whether the observed damage was caused by sinkhole
activity); all methods of stabilization and repair both above and below ground; the costs for stabilization and all
repairs; and all information needed to determine whether a sinkhole loss has been verified and render an opinion
on all matters at dispute in the neutral evaluation.
The neutral evaluator must be provided with information necessary to perform his or her duties. The bill requires
that the neutral evaluator must be allowed reasonable access to the interior and exterior of the insured structures
to be evaluated or for which a claim has been made. The policyholder must provide the neutral evaluator with all
reports initiated on behalf of the policyholder that confirm a sinkhole loss or dispute the insurer’s sinkhole testing
report. Such materials must be provided prior to the neutral evaluator’s physical inspection of the property.
The bill revises the procedures and time frames for conducting the neutral evaluation. The parties are provided 14
business days to agree to a neutral evaluator. If an agreement cannot be reached, the Department of Financial
Services (DFS) shall appoint a certified neutral evaluator. Each party may disqualify two neutral evaluators without
cause; a reduction from 3 disqualifications under current law. The neutral evaluator has 14 business days after the
referral to notify the parties of the date, time and place of the neutral evaluation conference; an increase from 5
business days in current law. The neutral evaluator must make a reasonable effort to hold the conference within 90
days after the DFS has received the request for neutral evaluation. Failure to conduct the conference within 90
days does not invalidate either party’s right to neutral evaluation. Current law requires that the neutral evaluation
conference be held within 45 days. The neutral evaluator’s report must be provided to the parties within 14 days
after the completion of the neutral evaluation conference. A court proceeding related to the neutral evaluation must
be stayed until 5 days after the filing of the neutral evaluator’s report with the court.
If the neutral evaluator is not qualified to determine a disputed issue, he or she may enlist the assistance of anothe
certified neutral evaluator, a professional engineer or professional geologist who is not a certified neutral evaluator,
or a licensed general contractor to provide an opinion on that issue. Such person may be disqualified for cause in
the same fashion as a neutral evaluator. The neutral evaluator may also request that the entity that performed the
sinkhole investigation perform additional and reasonable testing that the neutral evaluator deems necessary.
If the insurer agrees to comply with the neutral evaluator’s report, payments shall be made in accordance with the
terms of the applicable insurance policy and s. 627.707(5), F.S.
The bill also makes the following changes related to the neutral evaluation process:
Time Limits for Claims and Statute of Limitations
- Specifies that neutral evaluation does not invalidate an insurance policy’s appraisal clause.
- Allows the parties to disqualify a neutral evaluator for cause based on specified familial or professional
- Requires admission of the neutral evaluator’s oral testimony and full report in any action, litigation or
proceeding related to the claim.
- Specifies that the actions of the insurer in neutral evaluation are not a confession of judgment or an
admission of liability.
- Deems neutral evaluators agents of the Department of Financial Services and grants them immunity from
suit pursuant to s. 44.107, F.S.
The bill places time limits for bringing a hurricane or sinkhole claim and also creates a statute of limitations for
bringing a breach of contract property insurance action in court. A claim, supplemental claim, or reopened
windstorm or hurricane claim must be given to the insurer within 3 years after the hurricane first makes landfall or
the windstorm causes covered damage. An initial, supplemental or reopened sinkhole claim must be given to the
insurer within 2 years after the policyholder knew or reasonably should have known about the sinkhole loss. The
bill also enacts a 5 year statute of limitations for bringing an action for the breach of a property insurance contract
that runs from the date of loss.
The bill limits public adjuster fees related to reopened or supplemental claims to a maximum of 20 percent of the
reopened or supplemental claim payment. The bill also limits public adjuster fees to 20 percent of an insurance
claim payment made by the insurer more than one year after events that are the subject of a declaration of a state
of emergency by the governor. A public adjuster fee related to a policy issued by Citizens Property Insurance
Corporation may not exceed 10 percent of the additional amount actually paid in excess of the amount originally
offered by Citizens on the claim.
Public adjusters are prohibited from making deceptive or misleading advertisements or solicitations. Written
solicitations must include a disclaimer notifying the consumer that a solicitation is being made. A public adjuster
contract related to a property and casualty insurance claim must contain the full name of the public adjuster and
public adjusting firm, the business address, license number, and other specified information.
Public adjusters must give prompt notice of a property loss claim to the insurer and include with the notice the
public adjuster’s employment contract. The public adjuster must also ensure that the insurer has access to inspect
the property, can interview the insured directly about the loss and claim, and allow the insurer to obtain information
necessary to investigate and respond to the claim. The insurance company’s adjuster or other persons acting on
the insurer’s behalf must provide at least 48 hours notice before scheduling an inspection of the property or a
meeting with the claimant. The insurer also must allow the public adjuster to be present during the insurer’s
in-person meetings with the insured.
The bill requires licensed contractors to be licensed as a public adjuster in order to adjust a claim on behalf of the
Citizens Property Insurance Corporation
Citizens policies issued or renewed on or after January 1, 2012, which cover sinkhole loss may not include
coverage for losses to appurtenant structures, sidewalks, decks, or patios that are caused by sinkhole activity.
Citizens must exclude such coverage using a notice of coverage change, which may be included with the policy
Notice of Cancellation
The bill revises the notice of cancellation, nonrenewal or termination requirements for personal lines and
commercial lines residential property insurance policies. At least 120 days notice must be given to a named
insured whose residential structure has been insured by the insurer or its affiliate for at least 5-years. Under curren
law 180 days notice must be provided for the cancellation, nonrenewal, or termination of such policies. The bill
authorizes the nonrenewal of a policy that covers both a home and a motor vehicle for any reason applicable to
either the property or motor vehicle insurance, so long as the insurer provides 90 days notice of the nonrenewal.
The notice of cancellation requirement for a Citizens policy that has been assumed by an authorized “take out”
insurer is reduced to 45 days.
The bill also authorizes an insurer to cancel or nonrenew a property insurance policy if the Office of Insurance
Regulation finds that the early cancellation is necessary to protect the best interests of the public or policyholders.
The Office may base its finding upon the financial condition of the insurer, the insurer’s lack of adequate
reinsurance coverage for hurricane risk, or other relevant factors. The nonrenewal may be conditioned upon the
insurer being placed under administrative supervision or to the appointment of a receiver.
Notice of Change in Policy Terms
The bill authorizes insurers to renew a property and casualty insurance policy under different policy terms by
providing to the policyholder a written “Notice of Change in Policy Terms” instead of a written “Notice of
Non-Renewal.” The Notice must be titled “Notice of Change in Policy Terms,” give the insured written notice of the
change, and be enclosed with the written notice of renewal premium. The insured is deemed to have accepted the
change in policy terms upon the insurer’s receipt of the premium payment for the renewal policy. If the insurer fails
to provide the Notice of Change in Policy Terms the original policy terms remain in effect.
Replacement Cost Coverage
The bill modifies how insurers must pay dwelling or personal property losses on a replacement cost basis. For a
dwelling loss, the insurer must initially pay the actual cash value, minus the deductible. Subsequently the insurer
must pay any amounts necessary to perform repairs as work is performed. If a total loss of a dwelling occurs, the
insurer must pay the entire replacement cost coverage without holdback of depreciation in value pursuant to the
Valued Policy Law.
For personal property losses insured on a replacement cost basis, the insurer must offer two claim payment
options. The first option requires the insurer to pay the replacement cost without holdback of depreciation,
regardless of whether the insured replaces the property. The second option allows the insurer to limit the initial
payment to the actual cash value of the personal property to be replaced. To receive payment from the insurer for
the full replacement value of the personal property, the insured must provide a receipt for the replaced property to
the insurer. A policy authorizing the insurer to require replacement of personal property prior to paying the full
replacement cost must provide the policyholder with a premium credit or discount and the insurer must provide
clear notice of the payment process before the policy is bound.