Florida/Georgia Personal Injury & Workers Compensation

...g court action against his insurer. We hold that the insured must pursue those administrative remedies. Therefore, we affirm the circuit court's dismissal of the plaintiff's action below. The statutorily-mandated premium discount appears in sections 627.0629 and 627.711, Florida Statutes (2007). Section 627.0629 provides, in pertinent part: (1)(a) It is the intent of the Legislature that insurers must provide savings to consumers who install or implement windstorm damage mitigation techniques, alterations, or solutions to their *653 properties to prevent windstorm losses....

...led or implemented.. . . . . . (2)(c) The premium notice shall specify the amount by which the rate has been adjusted . . . and shall also specify the maximum possible positive and negative adjustments that are approved for use by the insurer. . . . § 627.0629(1)(a), (2)(c), Fla....

...t of loss in a windstorm can be or have been installed or implemented. § 627.711(1), Fla. Stat. (2007). The plaintiff sued his homeowner's insurer, State Farm, in circuit court, alleging in various causes of action that State Farm violated sections 627.0629 and 627.711....

...Thus, under section 627.371's plain language, a request for a "premium adjustment" necessarily must arise from a challenge to the "rate charged." The statutes upon which the plaintiff bases his action further demonstrate on their face that the rate charged and any premium discounts are inextricably linked. Section 627.0629(1)(a) provides that a rate filing for residential property insurance must include "reasonable discounts ... or other rate differentials " for properties on which windstorm mitigation techniques have been installed. (emphasis added) Section 627.0629(2)(c) provides that "[t]he premium notice shall specify the amount by which the rate has been adjusted." (emphasis added) Section 627.711(1) provides that the insurer shall notify the policyholder of the availability and the range of each "premium discount ....

"direct or indirect, wholly or partially." Section 627.629, Florida Statutes (2000), permits an insurance

...reach. Zimmerman v. FWUA, 873 So.2d 411, 412 (Fla. 1st DCA 2004). The First District found it unnecessary to reach Appellants' arguments that: (1) the rate increase was invalid because no public hearing was held on the proposed increase pursuant to section 627.0629(7), Florida Statutes, and Rule 4-166.051, Florida Administrative Code, and (2) that statutes allowing arbitration of proposed rate increases were unconstitutional....

...Based on the foregoing, we are closing our file without further investigation or action. Appellants assert two main arguments in this appeal from OIR's finding of no probable cause. First, they argue that the July 1, 2000 rate increase was invalid because a public hearing was not held on FWUA's rate filing, as provided by section 627.0629(7), Florida Statutes (1999), and Rule 4-166.051(3), Florida Administrative Code (1999)....

...The appellants contend not only that arbitration of proposed rate increases did *414 not comply with FWUA's Plan of Operation; but also that the rate increase was invalid because no public hearing was held on the proposed increase, as allegedly required by section 627.0629(7), Florida Statutes, and Rule 4-166.051, Florida Administrative Code; and that the statutes allowing arbitration of proposed rate increases were unconstitutional because they impermissibly delegated regulatory and legislative author...

...Accordingly, we affirm the trial court's refusal to order refunds and denial of injunctive relief, but reverse the judgment and declaration insofar as it declares that "the arbitration resulted in Department approval as a matter of law," and vacate the judgment and declaration insofar as it construes section 627.0629(7), Florida Statutes, and Rule 4-166.051, Florida Administrative Code, and insofar as it adjudicates the constitutionality of certain provisions of the Florida Insurance Code....

...hallenge Florida Administrative Code Rules 690-170.017 and 690-170.0155 and Forms 1699 and 1655 and in concluding that Rule 69O-17Q.0155(k) and both forms constituted invalid exercises of delegated legislative authority by modifying and contravening section 627.0629(1), Flor *334 ida Statutes. Because we agree with Appellants that the ALJ erred in finding that Appellee had standing to bring the rule challenge, we reverse the Final Order. In 2006, the Legislature amended section 627.0629, entitled “Residential property insurance; rate filings,” to provide: (1) Effective June 1, 2002, a rate filing for residential property insurance must include actuarially reasonable discounts, credits, or other rate differential...

...Florida’s Department of Community Affairs had contracted with ARA to evaluate the effectiveness of wind resistive features in reducing hurricane damage and loss to single family residences in Florida. According to OIR, ARA’s 2002 study was the only loss relativity study available to it when the Legislature directed it in section 627.0629(1) to reevaluate the insurance discounts and credits....

...hat Form 1699 includes an insurance credit for homeowners who upgrade their windows or glazed openings to protect from storm damage but does not include a separate credit for homeowners who upgrade their non-glazed garage doors. Appellee argued that section 627.0629(1) requires that homeowners who upgrade their non-glazed garage doors receive an additional insurance credit....

...As to its standing to challenge the rules and forms, Appellee alleged that it had been substantially and negatively affected because it manufactures a product that would entitle homeowners to a discount on their home insurance policies had OIR properly implemented the statutory requirements of section 627.0629(1)....

...roduct, given its low cost, would mean increased sales; therefore, the absence of such a discount would likely cause [Appellee] economic injury. With respect to whether Appellee’s interests are within the zone of interest protected or regulated by section 627.0629(1), the ALJ reasoned that Appellee’s financial interest was “collaterally” within the zone of interest protected by the statute....

...ulted in a “real or immediate” injury in fact sufficient to satisfy the substantially affected test. We also agree with OIR that the ALJ erred in finding that Appellee’s interest fell within the zone of interest to be protected or regulated by section 627.0629 or the pertinent rules. As section 627.0629(1) expressly provides, the Legislature intended that “insurers provide savings to consumers who install or implement windstorm damage mitigation techniques, alterations, or solutions to their ' properties to prevent windstorm losse...

...hind it was to increase manufacturers’ sales. While such a financial benefit to manufacturers of certain products has presumably resulted from the existence of insurance credits, we do not find that that type of financial interest is the type that section 627.0629(1) was intended to regulate or protect....

...ould prevent or obstruct their practicing ophthalmic medicine. Id. . We note that if Appellee had standing in this case, we would reverse the Final Order on the merits because, in our opinion, the rules and forms at issue do not contravene or modify section 627.0629(1) and, therefore, do not constitute an invalid exercise of delegated legislative authority.

...For the reasons that follow, we reject Appellants’ argument and affirm. Florida insurers are required to provide savings to consumers who “install or implement windstorm damage mitigation techniques, alterations, or solutions to their properties to prevent windstorm losses.” § 627.0629(1), Fla....

...ng the Amended Complaint, the Fourth District explained: The plaintiff [appellant] sued his homeowner’s insurer, State Farm [appellee], in circuit court, alleging in various causes of action that State Farm violated sections 627.0629 and 627.711....

...adjustment” necessarily must arise from a challenge to the “rate charged.” The statutes upon which the plaintiff bases his action further demonstrate on their face that the rate charged and any premium discounts are inextricably linked. Section 627.0629(1)(a) provides that a rate filing for residential property insurance must include “reasonable discounts ... or other rate differentials” for properties on which windstorm mitigation techniques have been installed. (emphasis added) Section 627.0629(2)(c) provides that “[t]he premium notice shall specify the amount by which the rate has been adjusted.” (emphasis added) Section 627.711(1) provides that the insurer shall notify the policyholder of the availability and the range of each “premium discount ......

...each. Zimmerman v. FWUA, 873 So.2d 411, 412 (Fla. 1st DCA 2004). The First District found it unnecessary to reach Appellants’ arguments that: (1) the rate increase was invalid because no public hearing was held on the proposed increase pursuant to section 627.0629(7), Florida Statutes, and Rule 4-166.051, Florida Administrative Code, and (2) that statutes allowing arbitration of proposed rate increases were unconstitutional....

...or action. Appellants assert two main arguments in this appeal from OIR’s finding of no probable cause. First, they argue that the July 1, 2000 rate increase was invalid because a public hearing was not held on FWUA’s rate filing, as provided by section 627.0629(7), Florida Statutes (1999), and Rule 4-166.051(3), Florida Administrative Code (1999)....