State RegulationsFL specificDifficulty 2/5
After receiving a completed proof of loss from a life claimant, what must a Florida insurer do within 30 days under the unfair claim handling rules?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under Fla. Stat. 626.9541(1)(i)3.e, within 30 days after receiving a completed proof of loss, an insurer must confirm or deny coverage and the amount payable; failing to do so is unfair claim handling the DFS can sanction. The rule requires a substantive response, not immediate payment, and nothing in it requires DFS involvement or an autopsy.
Why the other options are wrong
- B) The rule requires a coverage and amount determination within 30 days, not automatic payment without investigation.
- C) Referring claims to the DFS is not part of the insurer's duty; the DFS polices insurers that mishandle claims.
- D) No independent autopsy is required; the duty is to confirm or deny coverage and amount.
Memory hook
30 days: confirm or deny - coverage AND amount.