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2023 Form Changes and DOAH
December 06, 2022
The Florida Office of Insurance Regulation (OIR) has approved updates to Citizens Personal Lines policy forms with an effective date of February 1, 2023. Citizens is amending its new and renewal business policy forms to current industry standards and to address emerging issues and new laws. The major updates are outlined below and in the Notice of Change in Policy Terms.
Division of Administrative Hearings (DOAH)
A new endorsement that attaches to Personal Lines policies offers a new alternative dispute resolution option. The endorsement allows either the policyholder or Citizens to demand resolution of a disputed claim, other than a sinkhole claim or a claim within Citizens’ Managed Repair Contractor Network Program, by the State of Florida Division of Administrative Hearings (DOAH). This new process will benefit the policyholder by reducing the time it takes to resolve a dispute.
- The endorsement will provide details regarding the process, notice and resolution of a disputed claim.
- For more information, visit the DOAH website after the February 1, 2023, effective date of the endorsement.
The format of the endorsement varies as necessary to permit attachment to the specific policy form, but the substantive provisions of the endorsement are the same for each policy type.
Overview of Updated Forms
The following updates have been made to the policies and endorsements for all Personal Lines policies unless it is indicated for a specific policy type. All policy and endorsement edits are made to better express and amend policy provisions.
- Property coverages have been amended to describe different types of personal property that are not covered.
- Property coverages are amended to express sublimits on property in self-storage facilities, drones and other personal property.
- The Fungi, Wet Or Dry Rot, Yeast Or Bacteria coverage is edited to better express the coverage does not include the transmission of disease or the exposure to a disease.
- An Ordinance Or Law coverage provision is added to better express that when there are multiple methods of compliance with the building, zoning or land use ordinance(s) or law(s), the limit of liability will be up to the least amount of the available methods of compliance.
- Home sharing enabled through a home-sharing network platform is not covered.
- Exclusions are edited to expand and align terms across lines of business, as relevant for each excluded cause of loss.
- An exclusion for criminal acts or illegal activity is added.
- The earth movement and settlement exclusion is amended to better express earthquake including land shock waves or tremors – regardless of whether the earthquake, land shock waves or tremors were caused by or occurred before, during or after a volcanic eruption – is excluded from coverage.
- The earth movement and settlement exclusion is amended to better express that blasting and subsidence are excluded from coverage and that the exclusion applies to walls and ceilings in addition to foundations and floors.
- The earth movement and settlement exclusion is amended to express shrinking, bulging, expansion or disarrangement of walls, floors, ceilings, pavements and patios are excluded and that other types of earth movement are also excluded.
- The animal exclusion is amended to better express various types of damage from animals.
- The scope of actual cash value (ACV) calculation in the Loss Settlement condition is expanded to include labor, overhead and profit, taxes, fees, etc.
- The loss settlement penalty for covered loss while the residence is vacant is expanded across all policy types.
- Language is introduced to require that the insured must incur the cost for matching damaged and undamaged items that are included in the claim estimate before payment will be made for those items.
- Duties of an insured after a loss include but are not limited to:
- Provisions are amended to express requirements for any insured to cooperate, including allowing inspection of property for any loss, submitting to examinations under oath and providing any available information.
- Requirements to provide information are expanded to include videos, corporate and board documents, damaged property, any other property contributing to loss and other relevant items or information.
- A requirement that theft, attempted theft, vandalism or malicious mischief must be reported to police within 14 days of the date of the discovery is added.
Notice of Change in Policy Terms
Citizens will send policyholders a Notice of Change in Policy Terms with renewal offers. The content of each notice varies by policy form. These notices are available in the Policyholder Notices section for each policy form on the Personal section of the Agents site.
For more information, log in to the Agent site, go to the Personal section, click on PR-M or PR-W on the left side of the page, then choose the policy type.
Citizens provides agent communications online for historical purposes only, and the communications have not been updated to include any changes that may have been made after publication. Agents can find the latest information by reviewing the applicable underwriting manuals, and by logging in and accessing our FAQs, which are available from the top of any page on our website.