Jimmy Patronis Issues Directive Empowering Insurance Consumer Advocate to Hold NICA Accountable

On Monday, Florida Chief Financial Officer (CFO) Jimmy Patronis issued a directive empowering Florida’s Insurance Consumer Advocate Tasha Carter to engage in advocacy efforts on behalf of families who receive services from the Florida Birth-Related Neurological Injury Compensation Association (NICA).

This action directs the Insurance Consumer Advocate to coordinate directly with families participating in the NICA program and advocate on their behalf before the Division of Administrative Hearings. These direct advocacy efforts will aid NICA families as they navigate the claims process.

The CFO also directed the Insurance Consumer Advocate to represent NICA families before the Office of Insurance Regulation (OIR) during any deliberations on programmatic changes. These efforts will ensure any modifications to the NICA program reflect input from NICA participants.

“I cannot think of a better use of Florida’s Insurance Consumer Advocate than empowering Tasha with the powers she needs to help families in NICA expedite their claims. Not only does Tasha have a great team, I’ve seen Tasha personally fight for what’s right when it came to getting families the support they deserved. Since the Miami Herald broke their important story, my office has already received some requests from families within NICA asking for assistance – and we want to make sure these families have someone they can go to if they feel NICA’s being unfair or dragging their feet on certain claims or requests,” Patronis said on Monday.

“These families have been through so much already, and the idea that they need a doctor’s note for every little request is something Tasha can work with both sides on to fix. Moreover, as I have asked OIR to audit NICA, I want to make sure Tasha and her team have access to whatever information Commissioner Altmaier has access to. Ultimately, reforming NICA is going to require changes to the law. That doesn’t mean, however, we cannot do some good on behalf of these families in the short-term. This directive is an important step in getting immediate relief to some of the families who have not had their needs properly met,” Patronis added.

“I take seriously the responsibility that CFO Patronis has placed upon my office to advocate for NICA recipients through his directive. I look forward to working on behalf of these families who have already endured so much. The stories outlined by the Miami Herald are heartbreaking, and I want to ensure that children in the program have an independent voice to help fight for their needs. I’ll work to address deficiencies, streamline operations and ensure families are serviced with respect and dignity,” Carter said.

CFO DIRECTIVE EMPOWERING FLA. INSURANCE CONSUMER ADVOCATE

WHEREAS, the Legislature created the Florida Birth-Related Neurological Injury Compensation Plan, (hereinafter referred to as “NICA”), in 1989 for the purpose of providing compensation, irrespective of fault, for birth-related neurological injury claims.

WHEREAS, section 627.0613, Florida Statutes, designates the Consumer Advocate as representative of the interests of the general public and the state before the Division of Administrative Hearings and the Office of Insurance Regulation, (herein after referred to as “OIR”), on behalf of the Chief Financial Officer.

WHEREAS, section 766.304, Florida Statutes, grants the Division of Administrative Hearings exclusive authority to determine whether a claim filed with NICA is compensable.

WHEREAS, section 766.315(5)(d), Florida Statutes, requires NICA to annually provide audited financial reports to OIR, and empowers OIR to audit NICA at any time determined to be necessary.

WHEREAS, section 766.314(2)(a) specifies that NICA shall be administered in accordance with a Plan of Operation, which must include provisions specifying the manner in which NICA processes claims.

WHEREAS, section 766.314(2)(b), authorizes the NICA Board of Directors to amend its Plan of Operation and requires such amendments to be approved by OIR.

WHEREAS, participants in the NICA Program have a substantial interest in the provisions of the NICA Plan of Operations and determinations by the Division of Administrative Hearings as to whether claims submitted to NICA are compensable as provided in section 766.304, Florida Statutes.

NOW THEREFORE, BE IT RESOLVED THAT I, JIMMY PATRONIS, in accordance with the authority vested in me by Article IV, Section 4 of the Florida Constitution, and Sections 17.30 and 20.121(1), Florida Statutes, hereby issue the following Directive to the Department of Financial Services’ Office of Insurance Consumer Advocate:

      • Section 1. The Insurance Consumer Advocate shall coordinate with NICA participants to advocate on their behalf before the Division of Administrative Hearings.
      • Section 2. The Insurance Consumer Advocate shall advocate for NICA participants before OIR during deliberations, by OIR, of one or more amendments to the NICA Plan of Operation.
      • Section 3. This Directive shall remain in effect until modified or rescinded by the Chief Financial Officer.

 

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