140 LEARNING WORKBOOK 2026 CLAIMS
HANDLING AND POLICY INTERPRETATION
SKILLS
◉ True or False: Both mediation and sinkhole neutral evaluation are
non-binding. Neither the insured nor the insurance company is
legally obligated to accept the outcome of the mediation conference.
Answer: True
◉ The ______________ is intended for use by parties who are beginning
the process of filing suit against an insurer, when a party feels they
have been damaged by specific acts of the insurer. The Notice is
intended to meet a portion of legal requirements set forth in Section
624.155, Florida Statutes, which requires a party to file Notice with
both the insurer and the Department of Financial Services (DFS) at
least 60 days prior to bringing an action against the insurer. The DFS
does not involve itself in the pre-suit negotiations or
communications related to Notices as such actions are not within
the scope of its statutory authority.
Answer: Civil Remedies Notice
◉ Mediation Statute 627.7015
,Answer: The department shall adopt by rule a property insurance
mediation program to be administered by the department or its
designee. The department may also adopt special rules which are
applicable in cases of an emergency within the state. The rules shall
be modeled after practices and procedures set forth in mediation
rules of procedure adopted by the Supreme Court. The rules shall
provide for:(a) Reasonable requirement for processing and
scheduling of requests for mediation.(b) Qualifications, denial of
application, suspension, revocation of approval, and other penalties
for mediators as provided in s. 627.745 and the Florida Rules for
Certified and Court-Appointed Mediators.(c) Provisions governing
who may attend mediation conferences.(d) Selection of
mediators.(e) Criteria for the conduct of mediation conferences.(f)
Right to legal counsel.
(5) All statements made and documents produced at a mediation
conference shall be deemed to be settlement negotiations in
anticipation of litigation within the scope of s. 90.408. All parties to
the mediation must negotiate in good faith and must have the
authority to immediately settle the claim. Mediators are deemed to
be agents of the department and shall have the immunity from suit
provided in s. 44.107.
(6)(a) Mediation is nonbinding; however, if a written settlement is
reached, the policyholder has 3 business days within which the
policyholder may rescind the settlement unless the policyholder has
cashed or deposited any check or draft disbursed to the policyholder
for the disputed matters as a result of the conference. If a settlement
agreement is reached and is not rescinded, it is binding and acts as a
release of all specific claims that were presented in that mediation
conference.
, (b) At the conclusion of the mediation, the mediator shall provide a
written report of the re
◉ Code of ethics (FAC 69B-220.201)
Answer: The work of adjusting insurance claims engages the public
trust. An adjuster shall put the duty for fair and honest treatment of
the claimant above the adjuster's own interests in every instance. ...
(b) An adjuster shall treat all claimants equally.
◉ Florida Insurance Guaranty Association
Answer: establishes and maintains a service-oriented operation for
processing covered claims of insolvent members. FIGA is a nonprofit
corporation created by the Florida Legislature in 1970. FIGA
services pending claims by or against Florida policyholders of
member insurance companies which become insolvent and are
ordered liquidated.
◉ The Residential Property and Casualty Joint Underwriting
Association originally created by this statute shall be known as the
Citizens Property Insurance Corporation
Answer: The corporation shall provide insurance for residential and
commercial property, for applicants who are entitled, but, in good
faith, are unable to procure insurance through the voluntary market.
◉ Business auto coverage form Section 3 Physical Damage Coverage