Janelle Irwin Taylor
A bill that would create a regulatory framework for pet insurance oversight, ensuring consumer protections through marketing regulations, required disclosures and more, has cleared the Legislature with broad support.
The Senate swapped Sen. Nick DiCeglie’s bill (SB 1226) for Rep. Kaylee Tuck’s measure (HB 655), passing it on a 36-0 vote. The Senate version had already cleared all three committee stops by unanimous votes among all present. The House passed its version last week on a 110-0 vote.
The measure now awaits Gov. Ron DeSantis’ signature and, if signed, it would take effect Jan. 1.
The measure would define unfair methods of competition and deceptive acts within pet wellness programs offered by pet insurance agents to include marketing a wellness program as pet insurance; requiring a wellness program to obtain pet insurance; duplicating products or coverage in wellness programs that are also available in pet insurance coverage; misleading advertising of wellness programs; and other provisions ensuring wellness programs are clearly delineated from pet insurance.
The bill would also require pet insurers to disclose certain details to policyholders, including whether the policy excludes coverage due to a chronic condition, congenital anomaly, hereditary disorder or preexisting condition; whether other exclusions exist; any policy provision limiting coverage through a waiting period, deductible, coinsurance or policy limits; whether coverage is reduced due to pet age, claim history or geographic location; and whether the underwriting company differs from the brand name used in marketing the pet insurance product.
It would allow coverage exclusion based on one or more preexisting conditions as long as there is a written disclosure to the policyholder or applicant, and it is the insurer’s burden to prove whether the preexisting condition exclusion is applicable to a claim.
Waiting periods for coverage could not exceed 30 days for illnesses, diseases or orthopedic conditions not resulting from an accident. Waiting periods for accidents would not be permitted under the bill.
The bill would also require a pet insurer to provide a clear and conspicuous link on the main page of its website to information describing the insurer’s formula or basis for determining claim payments under the pet’s policy.
If that formula uses a benefit schedule to determine claim payments, the insurer would be required to clearly disclose details. If the insurer uses a customary payments method to determine claims, it must clearly describe any fee limitation provisions and how payments are calculated.
When requiring a medical examination before issuing coverage, the pet insurer would be required to disclose clearly and conspicuously what is required in the exam and whether such documentation could result in coverage exclusion due to a preexisting condition.
The bill would also require a pet insurance policy to include a right to return the policy within 30 days, with a refund issued within 30 days of the return request.
A Senate bill analysis found that the increased transparency offered under the bill would “provide consumers with greater information to use in comparing the costs of premiums and benefits of various pet insurance policies,” which “may reduce the out of pocket costs” pet owners incur for unexpected medical emergencies. The analysis also said the bill would “provide greater regulatory certainty for insurers.”
