Commissioner Yaworsky Fights for Consumers and Brings More Transparency and Accountability for Hurricane Claim Denials

TALLAHASSEE, Fla.—Insurance Commissioner Mike Yaworsky is driving the Office of Insurance Regulation (OIR) to find more transparency for hurricane claim denials. OIR is scouring data and demanding more specific answers for closed claims without payment. OIR is expanding the required reporting and updating the OIR website for recent storms to show all reasons why a claim may be closed without payment. There have been recent questionable allegations of insurance companies refusing to pay valid claims; however, OIR’s enhanced data reporting does not support this narrative. Yet, if OIR finds any suspicious activity from insurance companies, OIR will take additional enforcement action.

Commissioner Mike Yaworsky said, “Floridians deserve full transparency and accountability when it comes to hurricane claim denials. OIR takes any alarming claims of insurer misconduct seriously and I have asked my office to profusely inspect all closed claims without payment data. If we find any suspicious activity, we will hold insurance companies accountable.”

OIR’s website now shows expanded reasons for closed claims without payment for Hurricanes Helene and Milton. Generally, the top reasons for claims closed without payment are the claim damage was below the insurance policy’s deductible, or the claim was denied due to flood coverage that is not covered by the insurance policy. For Hurricane Helene, below deductible claim denials amounted to 33% of closed claims without payment and flood coverage denials amounted to 20% of closed claims without payment. For Hurricane Milton, below deductible claim denials amounted to 41% of closed claims without payment. Other reasons for claims categorized as closed include claims withdrawn by policyholders, claims opened in error, no cooperation from the policyholder and more. To view the expanded data, click here.

Most residential homeowners insurance policies exclude flood damages. The Federal Government provides flood insurance through the National Flood Insurance Program (NFIP). Homeowners in high-risk flood zones (FEMA-designated Special Flood Hazard Areas) are required to purchase NFIP coverage if they have a federally backed mortgage. However, a consumer seeking coverage through the NFIP often has to produce a denial letter from a traditional property insurance carrier, even if fully aware that their property insurance does not cover flood damage, before they are eligible for coverage through the NFIP. This can elevate numbers for closed claims without payment for storms.

Commissioner Yaworsky recently issued an informational memorandum requiring the reporting of information about National Flood Insurance Program’s Write Your Own policies and reminded insurers of the need to properly evaluate claim determinations when damage is caused by the peril of water and the peril of wind, commonly referred to as concurrent causation. OIR is examining data from companies to ensure that there is no abuse with the exemption process when determining total loss claims. Claims that trigger concurrent causation must be well documented and determined in accordance with Florida law. As in all cases, violations of the law, improperly handled claims involving concurrent causation will result in administrative action and restitution to the consumer. For more information about this memorandum, click here.

Weiss Financial Ratings recently reported questionable data suggesting that 14 insurance companies refused to pay out over half of home insurance claims submitted to them. However, news reports state that Weiss could not provide proof of his claims.   OIR, once again, objects this narrative intending to alarm policyholders driven by Weiss.