Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69J - Division of Consumer Services › Chapter 69J-8 - ALTERNATIVE PROCEDURE FOR RESOLUTION OF DISPUTED SINKHOLE INSURANCE CLAIMS › Section 69J-8.009 - Evaluation Process

Current through Reg. 50, No. 138; July 16, 2024
(1) The neutral
				evaluator shall, within 14 business days of referral, contact the parties to
				schedule the evaluation proceeding pursuant to Section
				 627.7074(7)(c),
				F.S. If the parties cannot agree to a time and place for the conference, the
				neutral evaluator may assign a time and place of his or her choosing. If the
				Department receives a complaint that the contact was not made within the
				required timeframe, and the neutral evaluator cannot document the contact, the
				Department will select a new evaluator from the list.
(2) The evaluation proceeding shall take the
				form of an informal conference, and shall not be subject to rules of procedure
				or evidence applicable in a court or administrative proceeding. The neutral
				evaluator, all approved professional utilized in accordance with Section
				 627.7074(11),
				F.S., and all representatives of the parties must be allowed reasonable access
				to the interior and exterior of insured structures to be evaluated or for which
				a claim has been made.
(3) All
				parties shall submit to the neutral evaluator copies of all reports related to
				the claim, including those prepared pursuant to Sections
				 627.7072 and
				 627.7073, F.S., at least 7 days
				prior to the neutral evaluation conference of the property. The neutral
				evaluator shall give each party the opportunity to submit evidence, testimony,
				or other information which is reasonably expected to assist the neutral
				evaluator in determining the existence, nature, and scope of a sinkhole loss,
				and the nature, extent, and cost of repair and remediation. Any report
				initiated by policyholder, or an agent of the policyholder, confirming a
				sinkhole loss or disputing another sinkhole report must be provided to the
				neutral evaluator prior to his or her physical inspection of the insured
				property. The neutral evaluator shall not be required to accept or consider any
				submission of information under this section after the completion of the
				neutral evaluation conference.
(4)
				The neutral evaluator shall make inquiry of the parties and conduct such
				independent investigation as the neutral evaluator finds reasonably necessary
				to determine the existence, nature, and scope of a sinkhole loss, and the
				nature, extent, and cost of repair and remediation.
(5) The neutral evaluator may utilize other
				professionals during the course of the neutral evaluation in accordance with
				Section  627.7074(11),
				F.S. The neutral evaluator is to notify the department of the professionals
				utilized and confirm no known conflicts exist between the professionals and the
				parties.
(6) The parties may settle
				the claim at any time. If a settlement is reached prior to the conclusion of
				the neutral evaluation, the parties will notify the neutral evaluator and the
				department in writing, and the evaluation will be cancelled. If the settlement
				is cancelled and either party decides to re-submit their request for neutral
				evaluation, the previously confirmed evaluator shall continue as the assigned
				evaluator and complete the neutral evaluation.
(7) The neutral evaluator shall conclude the
				proceeding upon settlement of the claim or at any point that the neutral
				evaluator reasonably determines that settlement is not likely to be facilitated
				by the continuation of the proceeding.
(8) If the proceeding is concluded without
				reaching a settlement, the neutral evaluator shall prepare and file the report
				required under Section
				 627.7074(2),
				F.S., on the form adopted in Rule
				 69J-8.011, F.A.C.,
				below.
(9) As neutral evaluators
				are deemed by statute to be agents of the department, they shall not use any
				company letterhead on any reports, invoices, or other documents submitted or
				circulated to the department or the parties in connection with any neutral
				evaluation.
Rulemaking Authority
					 627.7074(18)
					 FS. Law Implemented 627.7074
					 FS.
New 11-4-07, Amended 12-26-13, 7-27-15,
					 4-4-16.