12 mandatory provisions of Florida health insurance

Health insurance is one of the most important investments an individual can make for himself and his family members. With so many health insurance providers offering health insurance, states like Florida have 12 mandatory health insurance provisions that apply to all health insurance providers. The 12 mandatory Florida health insurance provisions are:

1) The contract

Anything apart from the signed application and attached policy riders cannot be considered a part of the health insurance contract. In essence, a customer must receive all the paperwork with the final contract and anything outside the paperwork provided is not considered a part of the contract. This provision has been enforced as a customer protection clause, and is designed to ensure that health insurance providers do not use any annexure to their advantage.

2) Limiting the contestable time period

Any Florida health insurance policy can only be contested and question by the customer within a given time period. In essence, the customer is responsible for understanding all the details involved in the policy and Florida health insurance providers are required to provide their customers a time of around 2 years before the policy is considered ‘incontestable’.

3) Grace period

All Florida health insurance providers have to give their customers a grace period to renew their policy and only after the grace period has expired can a Florida health insurance provider null and void the insurance policy. The grace period is 7 days for industrial policies, 10 days for policies with a monthly premium and 31 days for other policies.

4) Reinstatement of defaulted health insurance payments

Florida health insurance providers are required to continue the health insurance if a customer defaults on the policy but pays the delinquent premium (If the Florida health insurance provider does not require a fresh application). This mandatory provision is ideal for people that might have defaulted on a payment but would like to continue the health insurance without any paperwork.

5) Notice of claim

The policy owner has to inform a Florida health insurance provider with a notification of loss within a stipulated time period of 20 days.

6) Health insurance provider has to provide claim forms

It is the duty of the Florida health insurance provider to provide the customer with the necessary claim forms within 15 days of receiving the notice of loss.

7) Submitting proof of loss

The claimant has 90 days to provide the Florida health insurance provider with the necessary proof of loss. This clause is not applicable when it is not possible to provide the Florida health insurance provider with the necessary documents.

8) Payment of claims

Any Florida health insurance provider has to pay the claimant in 45 days of receiving the necessary claim documents (like a notification and proof of loss).

9) Payment of claims

All Florida health insurance policies are required to mention clearly how the claims will be paid, and who will receive the payment of claims (irrespective of the nature of the Florida health insurance policy).

By: steven raker