Security First Insurance Company appeals the decision of Florida’s regulatory agency overseeing the insurance industry, the Office of Insurance Regulation (“OIR”), which denied its requests to amend a section of its homeowner’s policies that would restrict the ability of policyholders to assign post-loss rights without the company’s consent. We affirm.
Security First is a property and casualty insurance company licensed to transact insurance in Florida. Before delivering or issuing its policy forms, Security First is required by statute to file all forms it intends to use in Florida with the OIR for its approval. It did so on June 24, 2013, filing three proposed forms that would amend the assignment language in its “Homeowner’s, Tenant Homeowner’s, and Dwelling Fire Insurance” policies. Sеcurity First’s proposed language said: “Assignment of this policy or any benefit or post-loss right will not be valid unless we give our written consent.”
On July 22, 2013, OIR issued notices of disapproval of the changes because they would “violate the intent and meaning of Sections 627.411(l)(a), 627.411(l)(b), and 627.411(l)(e), Florida Statutes!, and] contain[ed] language prohibiting the assignment of a post loss claim under the pоlicy, which is contrary to Florida law.” Security First requested an informal hearing, the legal issue being whether post-loss rights under an insurance policy are freely assignable without the consеnt of the insurer, and in turn, whether OIR erred in disapproving the new language, which required that Security First give written
The hearing officer upheld OIR’s decision, reasoning that it was not clearly erroneоus because a “restriction on assignments of post-loss rights in an insurance policy would be misleading as it would lead the policyholder to believe that the validity of such assignment was contingent upon the written consent of the insurer, contrary to Florida law.” Security First appeals from the final order adopting these findings and conclusions.
The gist of this dispute is whether policyholders might be misled by the proposed change to the policy language, believing that Security First’s consent was required for assignment of their post-loss rights, when Florida law holds to the contrary. On this point we find an unbroken string of Florida cases over the past century holding that policyholders have the right to assign such claims without insurer consent. See, e.g., W. Fla. Grocery Co. v. Teutonia Fire Ins. Co.,
That said, we are not unmindful of the concerns that Security First expressed in support of its policy chаnge, providing evidence that inflated or fraudulent post-loss claims filed by remediation companies exceeded by thirty percent comparable services; that policyholders may sign away their rights without understanding the implications; and that a “cottage industry” of “vendors, contractors, and attorneys” exists that use the “assignments of benefits and the threat of litigation” to “extract higher payments from insurers.” These concerns, however, are matters of policy that we are ill-suited to address. As the Fourth District recently wrote:
Turning to the praсtical implications of this case, we note that this issue boils down to two competing public policy considerations. On the one side, the insurance industry argues that assignments of benefits allow contractors to unilaterally set the value of a claim and demand payment for fraudulent or inflated invoices. On the other side, contractors argue that assignments оf benefits allow homeowners to hire con*629 tractors for emergency repairs immediately after a loss, particularly in situations where the homeowners cannot afford tо pay the contractors up front. Our court is not in a position, however, to evaluate these public policy arguments. There is simply insufficient evidence in the record' in this cаse — or in any of the related cases — to decide whether assignments of benefits are significantly increasing the risk to insurers. If studies show that these assignments are inviting fraud and abuse, then the legislаture is in the best position to investigate and undertake comprehensive reform.
One Call Prop. Services,
AFFIRMED.
ON MOTIONS FOR REHEARING AND CERTIFICATION
Security First Insurance Company asks that we rehear this matter and certify conflict with decisions of the Fourth Distriсt
Security First also asks that we certify as a question of great public importance, whether an insurance policy’s prohibition of an insured’s assignment of “any benefit or post-loss right” without the insurer’s consent is “void as contrary to the Florida Statutes or to this state’s ‘public policy’ ”? As recounted in our merits opinion, a century of precedents from Florida’s courts— including, most recently, the Fourth District in One Call — has said that an insured may assign post-loss rights without the insurer’s consent. See, e.g., W. Fla. Grocery Co. v. Teutonia Fire Ins. Co.,
That said, we note one exception from this well-settled legal principle: health care insurance policies that prohibit insureds from using and assigning post-loss rights or benefits to health care providers outside an insurer’s established network. As the Fourth District noted in upholding an anti-assignment provision in a health insuranсe policy: “[i]f a patient could obtain care from a non-participating [provider] and assign it the patient’s right to be reimbursed under a group policy, in the teeth of an аnti-assignment clause, this direct payment inducement to become a participating [provider] would be weak
Notes
. One Call Prop. Servs., Inc. v. Sec. First Ins. Co.,