Florida Administrative Code
69 - DEPARTMENT OF FINANCIAL SERVICES
69J - Division of Consumer Services
Chapter 69J-8 - ALTERNATIVE PROCEDURE FOR RESOLUTION OF DISPUTED SINKHOLE INSURANCE CLAIMS
Section 69J-8.009 - Evaluation Process

(1) The neutral evaluator shall, within 14 business days of referral, contact the parties to schedule the evaluation proceeding pursuant to Section 627.7074(7)(c), F.S. If the parties cannot agree to a time and place for the conference, the neutral evaluator may assign a time and place of his or her choosing. If the Department receives a complaint that the contact was not made within the required timeframe, and the neutral evaluator cannot document the contact, the Department will select a new evaluator from the list.

(2) The evaluation proceeding shall take the form of an informal conference, and shall not be subject to rules of procedure or evidence applicable in a court or administrative proceeding. The neutral evaluator, all approved professional utilized in accordance with Section 627.7074(11), F.S., and all representatives of the parties must be allowed reasonable access to the interior and exterior of insured structures to be evaluated or for which a claim has been made.

(3) All parties shall submit to the neutral evaluator copies of all reports related to the claim, including those prepared pursuant to Sections 627.7072 and 627.7073, F.S., at least 7 days prior to the neutral evaluation conference of the property. The neutral evaluator shall give each party the opportunity to submit evidence, testimony, or other information which is reasonably expected to assist the neutral evaluator in determining the existence, nature, and scope of a sinkhole loss, and the nature, extent, and cost of repair and remediation. Any report initiated by policyholder, or an agent of the policyholder, confirming a sinkhole loss or disputing another sinkhole report must be provided to the neutral evaluator prior to his or her physical inspection of the insured property. The neutral evaluator shall not be required to accept or consider any submission of information under this section after the completion of the neutral evaluation conference.

(4) The neutral evaluator shall make inquiry of the parties and conduct such independent investigation as the neutral evaluator finds reasonably necessary to determine the existence, nature, and scope of a sinkhole loss, and the nature, extent, and cost of repair and remediation.

(5) The neutral evaluator may utilize other professionals during the course of the neutral evaluation in accordance with Section 627.7074(11), F.S. The neutral evaluator is to notify the department of the professionals utilized and confirm no known conflicts exist between the professionals and the parties.

(6) The parties may settle the claim at any time. If a settlement is reached prior to the conclusion of the neutral evaluation, the parties will notify the neutral evaluator and the department in writing, and the evaluation will be cancelled. If the settlement is cancelled and either party decides to re-submit their request for neutral evaluation, the previously confirmed evaluator shall continue as the assigned evaluator and complete the neutral evaluation.

(7) The neutral evaluator shall conclude the proceeding upon settlement of the claim or at any point that the neutral evaluator reasonably determines that settlement is not likely to be facilitated by the continuation of the proceeding.

(8) If the proceeding is concluded without reaching a settlement, the neutral evaluator shall prepare and file the report required under Section 627.7074(2), F.S., on the form adopted in Rule 69J-8.011, F.A.C., below.

(9) As neutral evaluators are deemed by statute to be agents of the department, they shall not use any company letterhead on any reports, invoices, or other documents submitted or circulated to the department or the parties in connection with any neutral evaluation.