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The End of the Florida Workers Compensation System?

Workers Compensation Florida

A recent development in Florida has jumped that state to the front of the age old workers comp debate between employers and their workers. On August 13, Miami-Dade Circuit Judge Jorge Cueto declared the state’s workers’ compensation exclusive remedy statute (440.01 et seq.) unconstitutional on the grounds that the benefits given to injured employees by the law no longer provide a fair exchange for the surrender of an employee’s right to sue the employer for negligence damages. “The benefits in the act have been so decimated that it no longer provides a reasonable alternative,” said Judge Cueto.

For years, workers rights attorneys in Florida have been asking judges to strike down the Florida workers compensation law. They argue that successive state legislatures have continually eroded the benefits that injured employees receive under the workers comp system. Employers and some legislators counter that high workers comp insurance premiums have those changes necessary in order to stabilize the state’s economy.

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For now, Judge Cueto’s ruling will not impact areas outside of Miami-Dade’s judicial circuit. Florida Attorney General Pam Bondi, who has received criticism for not directly intervening in the Miami-Dade case on behalf of the state, has filed an appeal to Judge Cueto for a rehearing. If that appeal is denied, as seems likely, then the case could eventually make its way to the Florida Supreme Court. Should the Supreme Court uphold Judge Cueto’s ruling then workers throughout the state will be able to settle their workers compensation claims, then file a civil claim to recover additional benefits.

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This case will join other cases challenging parts of Florida’s workers comp statutes. The state Supreme Court is considering an appeal from an injured firefighter who was left with no income after his temporary wage-loss benefits expired.

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Florida Looking for NFIP Alternatives

Last week, Florida Insurance Commissioner Kevin McCarty announced that his office is in the process of developing guidelines for insurance companies to request approval to write primary flood insurance in the state. This announcement came just one day after Rebecca Matthews, McCarty’s deputy chief of staff, told the Florida Senate Banking and Insurance Committee that the Florida Office of Insurance Regulation (FLOIR) was in talks with various insurance companies regarding writing primary flood coverage in the state. These developments are in response to continuing concerns about escalating flood insurance rates due to the Bigger-Waters Act of 2012.

The Biggert-Waters Act of 2012 extended the National Flood Insurance Program by several years while also putting in place several reforms meant to make the program more solvent. One of those reforms was a phasing in of actuarial flood insurance rates over time.

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For many the increased premium will be significant, if not severe. In Florida, the biggest hit will be to homes built prior to 1974 in high risk flood zones. At last week’s hearing it was reported that some of those homes could see rates rise from 0 to ,000.

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Current owners of those properties will continue to receive subsidized rates, but those subsidies will discontinue once the property is sold thus hindering the Florida real estate market.

Florida officials hope that the private primary flood coverage can serve as a viable alternative to the NFIP by providing lower premium rates, but there are significant hurdles to overcome. Private insurers will likely be hesitant to cover properties that the federal government has deemed high risk and there are legitimate concerns about the lack of available data and information to properly underwrite the risk.

“The private sector has not written flood insurance because when you start a company you have to have a ‘me, too’ filing of something that already exists,” said Locke Burt, an owner of Security First Insurance. No such company currently exists in Florida.

Florida Rep. Bryan Nelson added that “the big problem we have is we don’t have enough information to base a decision on, and until we have expected-loss ratios, I don’t think the private sector is going to be ready to jump in.”

Another NFIP alternative being considered would be the creation of a Florida flood insurance pool. Sen. David Simmons, chairman of the Florida Senate Banking and Insurance Committee, signaled that this could be an option if the private market is unable to respond fast enough. The hope is that the pool could provide lower rates than the NFIP.

Florida officials also continue to push for delays in NFIP rate hikes.

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Gov. Rick Scott called on President Obama to halt the hikes. “The president signed the bill. He can have an impact by stopping this.”

Where Questionable Insurance Claims Come From

Wanna blame someone for your high insurance premiums?

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Point to the residents of California, Florida, Texas, New York and Michigan.

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Combined, these five states generate half of the nation’s questionable insurance claims — most of which are either suspect auto policy submissions or fake injury claims.

These states account for 49 percent of all “questionable claims” as tabulated by the National Insurance Crime Bureau (NICB).

Questionable claims are those claims that NICB member insurance companies refer to NICB for closer review and investigation based upon one or more indicators of possible fraud.

NICB just released its three-year analysis of questionable claims in the United States from January 1, 2008 through December 31, 2010.

New York, Los Angeles, Houston, Tampa and Detroit are the cities generating the most QCs. Florida has three cities in the top 10 for QCs—Tampa, Miami and Orlando.

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Of course, a large reason that these states have so many fishy claims is that they are so large. Some 110 million people live in the five states mentioned.

But while they do contain about 36% of the nation’s population, that doesn’t actually explain why these locations create 49% of the questionable claims.

Florida Sinkhole Claims Skyrocket

It seems the entire state of Florida is slowly caving in as more and more sinkholes appear throughout the sunshine state, resulting in a tripling of insurance claims in five years. According to a new state report, for the years 2006 through 2010, sinkhole claims have cost Florida property insurers $1.4 billion — a number that could reach $2 billion by the end of this year.

The report, authored by the state’s Office of Insurance Regulation, says sinkhole costs increased from $209 million in 2006 to $409 million in 2009, with the largest share of the total expense coming from structured loss (54%) and land loss (27%). In 2006, open claims totaled more than $3.3 million for expenses paid and $13.6 million for indemnity. By 2009, these numbers increased drastically to $29.5 million and $114.6 million respectively.

“There is no question that the tripling of frequency of claims will have a significant expense associated with adjusting these claims in Florida and will continue to put upward pressure on rates,” [state Insurance Commissioner Kevin McCarty] said Tuesday.

The bulk of the claims come from an area known as the Sinkhole belt — Hernando, Pasco, Hillsborough and Pinellas counties. McCarty has cited sinkholes as one of the major cost drivers of insurance premiums in the state. As a solution to the problem, McCarty is looking into changing policy language regarding the definition of structural damages or possibly creating a sinkhole insurance fund. Though McCarty and his team are brainstorming ways to deal with sinkholes without raising insurance rates, an increase is likely unavoidable. The state’s largest property insurer, Citizens Property Insurance, cited the cost of sinkhole claims in requesting a rate increase for next year. The insurer said it took in $19.6 million in premiums for sinkhole coverage in 2009 but has paid out $97 million in claims cost.

Here’s a well-crafted news clip from a Central Florida station about the growing number of sinkholes and the importance of insurance coverage.