Janelle Irwin Taylor
It’s a rare day in the Legislature that lawmakers unanimously agree. But the health of our beloved fur babies seems to be a priority everyone can get behind.
Gov. Ron DeSantis has signed legislation that would create a regulatory framework for pet insurance oversight, ensuring consumer protections through marketing regulations, required disclosures and more.
The Senate, after swapping out Sen. Nick DiCeglie’s bill (SB 1226) for Rep. Kaylee Tuck’s measure (HB 655), cleared it on a 36-0 vote. The Senate version had already moved through all three committee stops by unanimous votes among those present. The House passed its version on a 110-0 vote.
Now signed, the law takes 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 also will 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 will 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 will not be permitted to exceed 30 days for illnesses, diseases or orthopedic conditions not resulting from an accident. Waiting periods for accidents will not be permitted at all.
The bill will 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 will 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 will 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 also requires 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 will “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 will “provide greater regulatory certainty for insurers.”
