Citizens’ Board Approves Coverage Caps for Florida Customers Who Use Outside Contractors

24 Apr
Florida homeowners and home repairs

Sun-Sentinel – “We must address the abuse related to non-weather water claims, while always ensuring every single Citizens’ policyholder has access to full coverage.”

The state-run Citizens Property Insurance Corp, who deals mainly with hard to insure properties across the state of Florida came a bit closer to finally capping repair costs for non-weather related water damage for customers who refuse to use their preferred contractors.

The Board of Governors recently approved a plan that will put a $10,000 limit on permanent repairs and a $3,000 limit on emergency repairs unless a customer lets Citizens send a member of its trusted contractor network to perform the repairs.

The new rule would take effect on August 1st for all new and renewing policyholders. It is subject to final approval by the Florida Office of Insurance Regulation.

According to the latest data, Citizens Property insures 118,468 homes and condos in Broward, Palm Beach and Miami-Dade counties and a total of 194,088 homes across the state.

Why the Changes are Needed

Citizens Property officials claim the changes are necessary in order to stop less than honest contractors from convincing homeowners to sign an assignment of benefits (AOB) form which allows the contractor to bill the insurance company directly.

Unfortunately, these shifty contractors are overbilling for unnecessary work and then using shady lawyers to sue insurers when they deny the claim. In the end it is often less expensive for the insurers to settle than battle in court. AOB abuse has skyrocketed in recent years, which has pushed up premiums for policyholders.

In a recent Sun-Sentinel article board chairman Chris Gardner explained the need for the change. “We must address the abuse related to non-weather water claims, while always ensuring every single Citizens’ policyholder has access to full coverage. Rather than simply restricting coverage, our proposed solution seeks to protect our customers and provide customer-friendly options.”

The changes do limit emergency damage repair costs to $3,000 and also removes the option for a customer to request any additional money. The $3,000 in emergency money will also be applied to and count against the $10,000 permanent damage limit. These limits only apply to customers who refuse to use the contractor that Citizens Property chooses.

There is a good chance that customers of other insurance companies will be up against the same coverage limits if Citizens Property’s restrictions are fully approved. This is due to the fact that Citizens Property is not the only insurance company who has been a victim of AOB scams.

In the Sun-Sentinel article Jeff Grady, president and CEO of the Florida Association of Insurance Agents said that the coverage caps were “regrettable but understandable.”

Few Options for Citizens Property

Due to the fact that Citizens is a state owned insurer and cannot legally increase rates more than 10 percent a year, they must look at other options for absorbing the costs of AOB abuse and reducing coverage via caps is one of their only options.

While Citizens Property hopes the new coverage caps help reduce AOB fraud and the resulting lawsuits, experts predict that there could be a couple of other outcomes that may not be as positive.

Paul Handerhan, vice president of public policy for the Florida Association for Insurance Reform said in the Sun Sentinel article “Over time, the cost of repairs will be higher than Citizens thinks it will be. Citizens can’t leave until the property is properly repaired. They’re going to have to pay the full indemnity every time this is exercised.”

If Citizens finds that their average cost per claim goes up due to the managed repair program it may indicate that they were not paying out enough on claims before the caps went into place, making some of the AOB lawsuits legitimate.

Another possible issue is that the new caps could lead to disappointed policyholders hiring a lawyer to test out the new restrictions in court. If this ends up being the case it could get expensive for Citizens Property and in many ways defeat the purpose of new coverage caps.

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