Which of the following would be protected from financial loss by the guaranty association?

Assessment

Section 631.52, Florida Statutes, explains the lines of business that FIGA will pay a covered claim on and therefore the lines of business deemed assessable.  Section 631.55, Florida Statutes, further divides FIGA into two separate accounts (Auto and All Other) for the purpose of assessment. The 2021 and 2022 Assessments are only for FIGA’s All Other Account and includes the following lines of business:

• Aircraft
• Boiler & Machinery
• Burglary & Theft
• Commercial Multi-peril, Liability and Property (Non-Auto)
• Farm Owners, Private Crop
• Fire, Allied, Earthquake, Homeowners, Personal Liability
• Inland Marine, Watercraft
• Medical Malpractice
• Product Liability
• Private Flood

Exhibit A: Assessable Lines of Business (“LOB”) by Annual Statement Line Number is included to further explain assessable premium written for FIGA’s All Other Account.

That determination is ultimately up to the FIGA Board and is based on current and future cash needs for each of the Auto or All Other Account. Based on our current cash needs for the All Other Account, a pass-through method will be used for both FIGA’s 2021 and 2022 Assessments. Members will first collect a premium surcharge from its policyholders then remit amounts collected to FIGA.

Surcharges are applied on a policy year basis for policies incepting during the Assessment Year.

The OIR orders for the 2021 (.70%) and 2022 (1.3%) assessments indicate that “Member insurers shall first collect, and then remit to FIGA, the assessments levied in this Order on a quarterly basis.”  The OIR order for the 2022B (.70%) assessment indicates “Members shall either: A. first collect, and then remit to FIGA, the assessments levied in this Order on a quarterly basis….or B. make the quarterly payments referenced above, in 5.A., to FIGA equal to the amount of premium written in the previous quarter for the All Other Account multiplied by 0.7% if the member insurers elect not to recoup the assessment.”

FIGA 0.7% Assessment [Levied 10/11/2021]

* OIR Annual Reconciliation due June 30, 2023
** Final settlement will occur March 31, 2024

FIGA 1.3% Assessment [Levied 3/11/2022]

* OIR Annual Reconciliation due September 30, 2023
** Final settlement will occur July 30, 2024

FIGA 2022B 0.7% Assessment [Levied 8/9/2022]

* OIR Annual Reconciliation due January 31, 2024
** Final settlement will occur January 31, 2025

Fourth quarter payment includes a “true-up” of any adjustments or amounts collected and not remitted for prior quarters.

Section 631.64, Florida Statutes, explains disclosure requirements for FIGA assessments.  Members are to separately show assessment surcharge on “premium statements to enable policyholders to determine amount charged for association assessments”. Most members plan to show the assessment surcharge as one line item on the declaration page.  Our recommendation is to show the amount charged on the Declaration Page as “FIGA Assessment Surcharge”.

For 2022, the assessment surcharge is calculated as 1.3% multiplied by direct written premium for new or renewal policies with term effective dates beginning July 1, 2022 through June 30, 2023 (Assessment Year).  MGA, EMPA and other policy fees are not assessable. For 2021, the assessment surcharge is calculated as 0.7% multiplied by direct written premium for new or renewal policies with term effective dates beginning January 1, 2022 through December 31, 2022 (Assessment Year).  MGA, EMPA and other policy fees are not assessable.

The Order instructs members to apply a policy surcharge to All Other Account policies during the Assessment Year.  FIGA recommends that members apply the missing surcharge when the policy is subsequently updated or endorsed during the Assessment Year.

Section 631.57 (3)(g), Florida Statutes, explains that members shall treat the failure to pay the surcharge the same as if the policyholder failed to pay their premium.

No. Assessments levied by FIGA are not premium and are not subject to premium taxes, any policy fees, other taxes or commission.

Members can remit surcharge payments to FIGA by check, Wire, or ACH.

INSTRUCTIONS for the 0.7% ASSESSMENT [Levied 10/11/2021]
Make checks payable and Mail to:
Florida Insurance Guaranty Association, Inc.
P.O. Box 14249
Tallahassee, FL 32317

INSTRUCTIONS for the 1.3% ASSESSMENT [Levied 3/11/2022]
Make checks payable and Mail to:
Florida Insurance Guaranty Association, Inc.
P.O. Box 14249
Tallahassee, FL 32317

When remitting surcharge payments via wire or ACH transfer, PLEASE INCLUDE the NAIC number and COMPANY NAME in the payment remittance details. If remitting ONE PAYMENT for multiple companies in a group, PLEASE PROVIDE the NAIC number and SURCHARGE AMOUNT for each company on the check remittance documentation or in the wire/ACH payment remittance details to ensure payments are received and applied correctly.

Here is a copy of FIGA’s W-9 Form.

Yes. Members are still required to submit the initial remittance form [a zero report] and the annual reconciliation even if they do not write assessable lines of business. Per the note on the quarterly remittance form, we will suspend subsequent quarterly reporting once we’ve received and processed the initial filing and have been contacted by the company to do so in writing. Those requests can be sent to .

Yes, but please provide the NAIC number and assessment amount for each company included in the group either on the check remittance documentation or in the wire payment detail fields.

Member companies will only remit surcharge amounts collected from policyholders.  Members will be given the opportunity to “true up” or reconcile amounts following the Assessment Year.

Our recommendation is to round assessment surcharge similar to other premium amounts listed on the declaration page of the policy.

To update member representative contact information, please send your request to FIGA at figafacts.com/contactus/.  Please include the company name, individual representative name and contact information in your request.

Members can reach a FIGA representative at (850) 386-9200 or can submit their questions online at figafacts.com/contactus/.

The assessments are additive.

When you combine all three, policyholders should be surcharged the following rates for new policies issued or renewed starting:

1/1/2022 – 6/30/2022  => 0.70%
7/1/2022 – 6/30/2023  => 2.00%
7/1/2023 – 12/31/2023 => 0.70%

No, the assessment is based on the effective date of the policy.  The effective date in this example is 8/1/2021 and therefore the assessment does not apply.  If the effective date was 8/1/2022 through 8/1/2024, then the assessment would apply to the entire amount of the policy premium for the multi-year term.

No, the FIGA assessment is not considered a sales tax.

Yes.  The assessment applies to endorsements that are made to policies with an effective date within the assessment year.

No, as the assessment is based on a policy year and the annual report is based on a calendar year.

[ABC Member Insurance Company] is receiving a remittance document because it is authorized to write one or more of the assessable lines in the State of Florida according to the Office of Insurance Regulation and must report an initial filing even if it is zero. If it is zero and the company will not write any of the assessable lines in the future, we will suspend the quarterly reporting once the initial filing is received and processed and we receive a request for that suspension in writing via email to . Those instructions are also indicated on the Quarterly Surcharge Remittance document.

NO. The remittance document must be submitted via DocuSign in order for it to be processed and any surcharge payment received applied to the appropriate company properly. Detailed instructions on reporting can be found in the FIGA Quarterly Surcharge Remittance Reporting Guide available on the Assessments page of FIGA’s website [figafacts.com] under Documents & Forms.

Yes. Reporting is still required even if it is zero.

Send an email requesting the contact update to with the new contact’s full name and email address. The remittance document will then be re-routed to the new contact’s email address. Any additional updates needed [name, phone number, address, title, etc.] must be entered on the actual form in order for a permanent update to our system records to occur. Once we’ve received and processed the remittance document, our system will automatically update and all future remittances will be sent to the new contact.

NO, but the contact assigned to it can download or print, and then forward a copy of the remittance document to anyone they choose. The document can also be re-assigned to a different contact by the original signee if someone other than them is responsible for completing and signing it. Instructions on assigning the remittance document to someone else can be found in the FIGA Quarterly Surcharge Remittance Reporting Guide available on the Assessments page of FIGA’s website [figafacts.com] under Documents & Forms.

Suspension of subsequent reporting after the initial filing only applies to the quarterly reporting. Remittance of the Annual Surcharge Reconciliation Affidavit [ASR] is required as it serves as a true-up of what has been previously reported. The ASR affidavit will combine data submitted in prior reports for members to update and or confirm policyholder surcharges reported and collected during the Assessment period.

That decision is up to the member company to determine as it doesn’t matter to us who signs the remittance document.

Email for formal verification of the banking information.

Email so that we can research whether or not the company is subject to the Assessment and or if it was excluded from the distribution and should have been included.

The W-9 can be downloaded from the figafacts.com website via the following link:
W-9 Form

Only the person assigned to the remittance document distributed via DocuSign can view, download, and print it with what has been entered. When the document is assigned or forwarded to another person, any data entered by the original signer will not be saved and therefore the document will be blank.

FIGA is part of a non-profit, state-based, statutorily-created system that pays certain outstanding claims of insolvent insurance companies. By paying these claims, guaranty associations protect policyholders and claimants. Guaranty associations are active in every state, the District of Columbia, Puerto Rico and the Virgin Islands. State laws require that licensed property and casualty insurance companies belong to the guaranty associations in every state where they are licensed to do business. A guaranty association system also exists in Florida for the life, health and annuity insurance industry; but they operate independently from the property and casualty system.

Guaranty associations ease the burden on policyholders and claimants of the insolvent insurer by immediately stepping in to assume responsibility for most policy claims following liquidation. The coverage guaranty associations provide is determined by the insurance policy or state law; they do not offer a “replacement policy.” By virtue of the authority given to the guaranty associations by state law, they are able to provide two important benefits: prompt payment of covered claims and payment of the full value of covered claims up to the limits set by the policy or state law.

FIGA is administered by a board that is elected by the guaranty association members (that is, all companies writing licensed business in that state) and a Chief Financial Officer appointee.  There is oversight authority by the Florida Department of Financial Services, who reviews the association’s plan of operation, and may also audit a guaranty association.  In Florida the appointment to the guaranty association board is subject to the approval of the Chief Financial Officer.

While many of the associations are based on a model set forth by the National Association of Insurance Commissioners (NAIC), there are differences in statutes that govern the associations and their operation from state to state, including the amount of coverage provided by the association.

The potential failure of insurance companies, like the potential failure of all businesses, is an unfortunate, but inevitable, part of doing business in a free-market system.  Since inception of the property and casualty guaranty association system, there have been about 600 insolvencies.  In all, the system has paid out about $24.2 billion.

FIGA is partially funded by assets of insolvent insurers.  Receivers marshal estate assets and reimburse FIGA for paid claims and administrative costs related to the FIGA’s claim paying activities. The other source of funding is member company assessments.  FIGA’s assessments are capped at 2% of a company’s net direct premium for regular assessments, and an additional 2% for emergency assessment for insolvencies relating to hurricanes, on premium written in similar lines of business in Florida. The other source of funding is distributions from receivers of the insolvent insurance companies.

FIGA’s assessments are computed and billed based on the immediate needs of the guaranty association that has claims it needs to pay. Claim files come in from the insolvent insurance company; the adjusters review them, and set appropriate reserves on those files. (Reserves are the projected ultimate liability under terms of a given policy.) In Florida the assessment cap is 2% of net direct-written premium for regular assessments and an additional 2% for emergency assessments for insolvencies relating to hurricanes. FIGA cannot assess an insurance company more than the statutorily set cap on assessments.

Liquidation is similar to bankruptcy. When a company is liquidated, the Liquidator (also referred to as the Receiver), collects the assets of the company and verifies the liabilities such as claim payments and bills. The Liquidator then develops a plan to distribute the company’s assets according to the law and submits the plan to the Court for approval. In most cases, an estate will not yield sufficient money to pay claims in full; and most are not able to pay claims in a timely manner. For this reason, FIGA and other state guaranty associations step in (depending on the number of states in which the failed company wrote business) to cover certain claims. The estate’s creditors not covered by the guaranty associations usually receive only partial payment on their claims.

Yes. Most liquidation orders cancel all policies within a certain time period after liquidation, typically 30 days. You will need to obtain coverage with another insurance company. However, we do not recommend any particular company. You may contact any licensed insurance agent to get the names of other insurers. For homeowner’s insurance information in the State of Florida, you may contact the Florida Market Assistance Plan at 800-524-9023.

The processing and payment of pending covered claims will be made by FIGA (subject to the lesser of policy limits or FIGA’s maximum cap, see "Are there limits on the amount that FIGA will pay?" below). You may contact the Florida Insurance Guaranty Association (FIGA) at:

PO Box 14249
Tallahassee, Florida 32317
(800) 988-1450 Toll Free
(850) 523-1888 FAX

A covered claim is defined in the FIGA statute (F.S.631.54) as “… “Covered claim” means an unpaid claim, including one of unearned premiums, which arises out of, and is within the coverage, and not in excess of, the applicable limits of an insurance policy…”.

Yes. If your insurance company has been declared insolvent, covered claims will be paid by FIGA.  The maximum amount FIGA will cover is $300,000 with special limits applying to (1) damages to structure and contents on homeowners’ claims and (2) on condominium and homeowners’ association claims.  For damages to structure and contents on homeowners’ claims the FIGA cap is an additional $200,000.  For condominium and homeowners’ association claims the cap will be the lesser of policy limits or $200,000 multiplied by the number of units in the association.  No claim will be paid in excess of this cap. All claims for companies liquidated prior to July 1, 2021, are subject to a $100 FIGA deductible in addition to any deductible identified in your policy.  You may file a claim against the assets of the insurance company estate for the $100 deductible and for amounts over the cap.  The Receiver will send proof of claim forms and instructions for filing a claim. The Florida Legislature passed a law to remove the $100 FIGA deductible on any claim received from companies liquidated on or after July 1, 2021. Claims not covered by FIGA may be claims against the remaining assets (estate) of the insurance company and will be considered by the Receiver after all covered claims have been processed.

It varies, but claim payments usually begin as soon as possible once a company is ordered liquidated.  FIGA, coordinating with the receivers of the liquidating companies, work hard to avoid delays but it is not uncommon for delays of 30-60 days after the order of liquidation.

No. FIGA is designed as a safety net to pay certain claims arising out of policies issued by licensed insurance companies. FIGA does not pay non-policy claims or claims of self-insured groups, or other entities that are exempt from participation in the guaranty association system. FIGA coverage is limited to licensed insurers (the members of the guaranty associations that, in turn, pay insolvency-related assessments.) When a licensed insurance company becomes insolvent, the FIGA pays eligible claims; but a company does not have guaranty association coverage if it is writing non-admitted or unlicensed products, such as surplus lines or is a self-insurer covered in the non-admitted market. These limits on guaranty association coverage are necessary to balance the need to provide a safety net to those who would be most harmed by the insolvency of their insurance company and keep the burden of providing the safety net at an acceptable level.

a.  As soon as possible, report damage to your agent or FIGA, even if the cause of the damage is unknown;
b.  Make temporary repairs to prevent further damage, and remember to keep receipts for any supplies necessary for those repairs;
c.  Save damaged items until the adjuster inspects them; additionally, take pictures and/or video, if possible, of all damages and damaged items;
d.  Make your property easily identifiable by displaying the house address and insurance company;
e.  Seek long term shelter if the property is uninhabitable and has sustained major damage. Reasonable expenses are generally reimbursed. The limits of your policy may determine your “Loss of Use” coverage;
f.   Be patient, after disasters, especially larger ones, the company’s immediate response time may take longer than usual;
g.  Prepare an inventory with receipts or other evidence of value and ownership, as necessary, to assist in the claim settlement process;
h.  On smaller losses start getting repair estimates, if possible;
i.   If you disagree with the settlement offer, you may wish to elect mediation or arbitration; however, first try to negotiate with the adjuster or company.

Yes. You will receive a form from the Receiver called a “Proof of Claim” form. In order for your claim to be considered by the Receiver you must complete the form and return it to the Receiver by the filing deadline.

You should contact FIGA immediately at 800-988-1450. They will determine if you are entitled to receive a legal defense just as the insurance company would have done if it were still in business. You will need to cooperate with FIGA and the defense counsel just as you would have had to with your company.

(Your policy controls what is covered.) Consult your policy for this coverage.  Generally, voluntary evacuation expenses will not be covered by your insurance policy, and only under certain conditions will mandatory evacuation expenses be covered.

If a dwelling is deemed uninhabitable due to a covered loss and the insured must move, or if a civil authority prevents access to the dwelling, following a covered loss, the Additional Living Expense (ALE) provision of your homeowner’s policy may pay reasonable additional expenses. (Your policy controls this.) Consult your policy for this coverage.

Most policies will pay for food spoilage when the interruption of power is caused by direct damage to the insured premises, not if the power goes out in the general area.

Replacement cost coverage is triggered when you actually replace the item. The company will initially pay the depreciated value (ACV) and will pay the difference between depreciated value and the replacement cost upon evidence that the items have been replaced. This applies to the structure and contents. Some companies will release replacement cost payment for the dwelling when you produce a signed repair contract from a licensed contractor. In the case of a dwelling’s total loss, the structure portion of the claim is usually paid in full. The legislature changed this in 2005 and hold back no longer applies.

In most insurance policies, the removal of a tree and its debris is generally limited to $500 per tree and a maximum payout of $1,000 for the entire property. Furthermore, it only applies if a covered structure (i.e., house, fence, utility building) is damaged, or if it blocks driveway access or a ramp that provides disability access.

Since policies vary you should review your coverage with your agent.

Generally, Condo Associations may assess individual units for damage to common areas which aren’t covered by the Association’s policy. Your unit owner’s policy may provide limited coverage. The standard ISO homeowners program does cover an assessment due to an association deductible but only up to $1,000. This is the case even if the policy has been endorsed to provide loss assessment coverage above the $1,000 limit that is built in. Damage must be to covered property due to a covered peril.

Yes. FIGA provides property and casualty coverage up to $300,000 for non-residential commercial policies.

Yes. For policies covering condominium associations or homeowners’ associations, which associations have a responsibility to provide insurance coverage on residential units within the association, shall include that amount of each covered property insurance claim which is less than $200,000 multiplied by the number of condominium units or other residential units; however, as to homeowners’ associations, this sub-subparagraph applies only to claims for damage or loss to residential units and structures attached to residential units.

If your auto policy includes Comprehensive coverage (a.k.a. “Other than Collision”) at the time of a disaster, then wind and flood damages are covered. For example, auto glass broken by windblown objects, vehicles overturned by the force of the wind, or auto glass that pops out due to a sudden drop in atmospheric pressure, are all covered losses. Windshield glass claims are subject to the statutory deductible but not to your comprehensive deductible.

Homeowner’s insurance hurricane deductibles are determined by the insured’s Dwelling Value as stated in Coverage A. For most homes, deductibles can range from a minimum of $250 to a maximum of 10 % of the home’s value.

Individual policies have different deductibles, different coverages and specific amounts. You must read your policy to determine more specific answers.

All medical invoices should be mailed to:

Florida Insurance Guaranty Association
PO Box 14249
Tallahassee, FL 32317

FIGA will pay unearned premium claims after the Receiver completes its processing of the policy records and sends the unearned premium record to FIGA.  This may take several weeks or several months depending on the condition of the data at the insolvent insurance company.

FIGA will pay unearned premium claims for covered lines of business after the Florida Receiver completes its processing of the policy records and sends the unearned premium records to FIGA. Policyholders will be refunded only for the portion of unearned premium collected by the insolvent company.

No, the Receiver deems claims for unearned premium as automatically filed so no action is required by the policyholder. FIGA will process return premium payments after receiving policy information from the Receiver which they traditionally deliver after the policy cancellation date.

After an order of liquidation is entered by the Court, the Receiver assumes responsibility for marshalling all of the assets of the insolvent company, liquidating the assets and recommending to the Court payment of liabilities as those assets allow. In Florida, the Receiver is the Florida Department of Financial Services. All “covered claims” which are amounts payable under an insurance policy of an insolvent company (see complete definition in Florida Statute 631.54 (4)) are transferred to FIGA for the express purpose of avoiding excessive delay in the payment to claimants or policyholders (Florida Statute 631.51). Therefore, FIGA is not responsible for outstanding service provider or vendor invoices as these liabilities of the insolvent entity are not “covered claims” under the statute. You are, however, not without recourse as these outstanding invoices will be evaluated for payment by the Receiver. If you provided goods or services to the insolvent company prior to the date of liquidation you should contact the Receiver for additional instructions. Generally the Receiver requires a listing of outstanding amounts owed, along with a description of the services provided so that the request can be fairly evaluated. A Proof of Claim will need to be submitted and these can be obtained through the Receiver’s office. For a Florida insolvency you may find the web site http://www.myfloridacfo.com/Division/Receiver/ helpful. You should not continue to provide services after the date of liquidation with the expectation of being paid by FIGA without the express written permission of FIGA. FIGA’s statutory authority is to pay claims and to retain persons necessary to handle those claims. There is no statutory authority for FIGA to pay expenses incurred prior to the liquidation as they are not "Covered Claims" – these are the responsibility of the estate and will be evaluated by the Receiver for payment following Florida Statute 631.271 under the supervision of the Court.