Florida insurance regulators have revised the state’s complaint methodology to exclude mediation requests from the official complaint count, a change that will substantially lower the complaint indices used to measure insurer conduct and trigger regulatory examinations.
Under Rule 69O-138.003, published last week by the Florida Office of Insurance Regulation, requests for claims-dispute mediation or other alternative dispute resolution processes will no longer be included when calculating a carrier’s complaint index—a metric that can trigger market conduct examinations of insurers. Only complaints made by named insureds will now be counted, according to the new rule.
The complaint index is determined by comparing the number of claims-handling complaints to the number of an insurer’s open claims. An insurer is considered to have a disproportionate number of complaints when its complaint index is elevated in three of the last four quarters, which triggers the Office’s required market conduct examinations, according to the rule language.
The change addresses a longstanding criticism from the insurance industry. From 2020 to 2024, during the depths of Florida’s property insurance crisis, official complaint numbers appeared to more than double, rising to about 23,400. But if requests for alternative dispute resolution are excluded from the count, the total number of complaints was much smaller: about 4,000 in 2020, rising only slightly by 2024, according to data from the Department of Financial Services.
Industry representatives argued the old methodology created a distorted picture of insurer conduct. “Few, if any, other states consider requests for mediation or arbitration to be the same thing as consumer complaints about carriers’ conduct,” said Travis Miller, an attorney for Universal Property & Casualty Insurance. “This has the effect of creating unwarranted perceptions of the Florida market, which we unfortunately must explain from time to time to other states or organizations.”
Melissa Burt DeVriese, president of Security First Insurance, said the rule change “makes sense because it ensures that the Office’s required market conduct exams are based off of consumer complaints made to the FLOIR—and not based on service requests to DFS.” She added that the change will put the methodology in line with the intent of the governing statute, which emphasizes actual complaints from policyholders.
The Office of Insurance Regulation did not receive a request for a hearing on the rule and expects it to be adopted by the end of July 2026.
Sources
- Insurance Journal — Rule 69O-138.003 details, complaint data from 2020-2024, industry commentary from Travis Miller and Melissa Burt DeVriese, adoption timeline
- Florida Department of Financial Services — Historical complaint data comparing total complaints to mediation-excluded counts
