DEPARTMENT OF CONSUMER
AND INDUSTRY INSURANCE
AND FINANCIAL
SERVICES
INSURANCE BUREAU
ESSENTIAL INSURANCE
Filed with the secretary of state on
These rules take effect immediately upon filing with the secretary of state unless adopted under section 33, 44, or 45a(6) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after filing with the secretary of state.
(By authority conferred on the commissioner
director
of
the
department of
insurance and
financial services
by section sections 210, 2102, 2113, 2127, and
2130
of Act No. 218 of the Public Acts of 1956, as amended, being S500.210 of
the Michigan Compiled Laws) the insurance code of 1956, 1956 PA 218,
MCL 500.210, 500.2102, 500.2113, 500.2127, 500.2130 and Executive
Reorganization Order No. 2013-1, MCL 550.991)
R 500.1501, R 500.1502, R 500.1503, R 500.1504, R 500.1505, R 500.1506, R 500.1507, R 500.1508, R 500.1509, R 500.1510, R 500.1511, R 500.1512, R 500.1513, R 500.1514, R 500.1515, R 500.1516, R 500.1517, R 500.1518, R 500.1519, R 500.1520, and R 500.1521 of the Michigan Administrative Code are amended, as follows:
R 500.1501 Definitions.
Rule 1. (1) As used in these rules:
(a) "Automobile insurance"
means insurance as defined in section 2102(2) of the code.
(a)(b)
"Classification" means a grouping of individuals or risks on
the basis of 1 or more characteristics for purposes of measuring and
rating differences in anticipated losses or expenses, or both. For
purposes of these rules, a A classification shall does not include a
grouping of individuals or risks solely for statistical data gathering
purposes.
(b)(c) "Code"
means Act No. 218 of the Public Acts of 1956, as amended, being
S500.100 et seq. of the Michigan Compiled Laws.the insurance code
of 1956, 1956 PA 218, MCL 500.100 to 500.8302.
(d) "Commissioner" means
the Michigan commissioner of insurance and the designees of the commissioner.
(c)(e)
"Complaint" means a written statement by a person to an
insurer, an agent, a producer, or the commissioner director claiming that an insurer or
agent producer has improperly
denied him or her automobile insurance or home insurance or has charged
an inappropriate incorrect premium for that automobile
insurance or home
insurance.
(d)(f)
"Denial" or "denied" means both
declination as defined in section 2102(4) of the code and termination. as defined in section
2104(5) of the code.
(g) "Home insurance" means insurance
as defined in section 2103(3) of the code.
(e) "Incorrect premium" means a premium charged for automobile insurance or home insurance that is not consistent with chapter 21 of the code, MCL 500.2101 to 500.2131, or these rules, including, but not limited to, determining a premium using a rate or rating plan or classification that exceeds or otherwise does not comply with a rate or rating plan or classification approved by the department.
(f)(h) "Loss portion"
means that the portion of a rate
which that is attributable
to provisions for incurred losses and allocated loss adjustment expenses.
(g)(i) "Loss ratio,"
for purposes of R 500.1505(b)(v), ratio" means any
of the following ratios for a specified time period, as appropriate
for the context of evaluation:
(i) The ratio of actual incurred losses to total earned premiums at collected rate levels.
(ii) The ratio of actual incurred losses to total earned premiums at current rate levels.
(iii) The ratio of reasonably anticipated incurred losses to total estimated earned premiums at proposed rate levels.
(j) "Meeting" means a
meeting of the commissioner and 1 or both of the following to resolve a complaint:
(i) A person who has made a
complaint or the person's designated representative.
(ii) The insurer about which the
complaint was made.
(k) "Private informal
managerial-level conference" means a personal meeting or a telephone
conference involving the person making the complaint or the person's
designated representative and a representative of the insurer with authority
to decide the contested issues on behalf of the insurer. The conference, if
it involves a personal meeting, shall be held within a reasonably
accessible distance from the Michigan residence of the person or persons
named on the policy as insured or the location of the risk and shall be at a
time reasonably convenient to the person making the complaint or the
person's designated representative.
(l) "Rate differential" means
either the ratio of rates for any 2 rating cells or the absolute
difference in rates for any 2 rating cells, whichever is applicable for
a particular rating system.
(h)(m) "Rating
cell" means a group of individuals or risks for which a single rate
is determined when 2 or more rating classifications are combined to
define a population of individuals or risks for rating purposes.
(i)(n) "Relativity"
means either the ratio of rates for any 2 rating classifications or the
absolute difference in rates for any 2 rating classifications,
whichever is applicable for a particular rating system.
(j)(o) "Uncertainty
of loss" means a measure of the nature and the extent of the variability
of actual losses for a group of individuals or risks from the mean
anticipated loss for the group and includes other similar measures
of risk.
(k)(p) "Underwriting"
means the offer or refusal to insure, the offer or refusal to continue to
insure, or the limitation of the amount of coverage available to, an
individual, risk, or class of individuals or risks.
(2) A term defined in the code has the same meaning when used in these rules.
R 500.1502 Other insurance coverages to be considered to be automobile insurance.
Rule 2. In addition to the insurance
coverages described in section 2102(2)(a), (b), and (c) of the code, MCL 500.2102, all of the
following insurance coverages shall be are considered to be automobile
insurance under section 2102(2)(d) of the code, MCL 500.2102:
(a) Insurance coverage commonly known as "uninsured motorist insurance," for both bodily injury and property damage claims.
(b) Insurance coverage for the liability
existing under section 3135(2)(d) 3135(3)(e) of the code, MCL 500.3135.
(c) Insurance coverage commonly known as "underinsured motorist insurance."
R 500.1503 Excessive rates.
Rule 3. For the purposes of section
2109(1)(a) of the code, MCL 500.2109, both of the following provisions shall
apply in
determining whether a rate for automobile insurance or home insurance is excessive:
(a) A rate is unreasonably high for the insurance coverage provided if it is unreasonably high in relation to anticipated losses or expenses, or both, or to the uncertainty of loss for the insurance coverage provided.
(b) A determination regarding the
existence of a reasonable degree of competition shall must give due
consideration to, at a minimum, all of the following:
(i) The relevant market for the coverage or the type of insurance to which the rate applies.
(ii) The number of insurers and the
number of self-insurers actively engaged in writing underwriting or providing the
coverage or type of insurance in the relevant market.
(iii) The distribution of rates and
market shares for such those insurers in the relevant market.
Market shares may be measured either by premiums or exposures.
(iv) Past and prospective trends in the availability of coverage and coverage options for insurance of that type in the relevant market.
(v) Profits attributable to insurance of
that type in relation to the profitability of other types of insurance,
to the uncertainty of loss for that and other types of insurance, and to
the amount of capital and surplus funds available to support premium writings
underwritings for that
and other types of insurance.
(vi) The ability and potential for firms
insurers to enter and
exit the relevant market and for financial capital and surplus funds to be
allocated to, and to be removed from, the relevant market.
R 500.1504 Inadequate rates.
Rule 4. For purposes of section 2109(1)(b)
of the code, MCL
500.2109,
all of the following provisions shall apply in determining
whether a rate for automobile insurance or home insurance is inadequate:
(a) A rate is unreasonably low for the insurance coverage provided if it is unreasonably low in relation to anticipated losses or expenses, or both, or to the uncertainty of loss for the insurance coverage provided.
(b) A rate is inadequate if the use
of the rate has or will have the effect of destroying competition among
insurers or creating a monopoly.
(b)(c) An applicant Applicants who is are in good faith
entitled to procure the insurance through ordinary methods is
an are the persons who
are
eligible person persons, as defined in section 2103(1) or (2) of the code,
MCL 500.2103, with
respect to that insurance., as defined in section 2103(1) of
the code.
R 500.1505 Unfairly discriminatory rates.
Rule 5. (1) For purposes of section 2109(1)(c)
of the code, MCL
500.2109,
a rate for a automobile insurance or home insurance coverage is
unfairly discriminatory in relation to another rate for the same coverage
if the differential between the rates is not reasonably justified by
differences in mean anticipated losses or expenses, or both, or by differences
in the uncertainty of loss, for the individuals or risks to which the rates apply.
A reasonable justification shall must be supported by a reasonable
classification system, by applicable sound actuarial principles, and by
actual and credible loss and expense statistics or, in the case of new
coverages and classifications, by reasonably anticipated loss and expense
experience.
(2) A rate is not unfairly
discriminatory because it reflects differences in anticipated expenses
for classifications of individuals or risks with
similar anticipated losses or because it reflects differences in anticipated
losses for classifications of individuals or risks with
similar anticipated expenses.
(3) A reasonable classification system
is a system designed to group individuals or risks with similar characteristics
into rating classifications which that are likely to
identify significant differences in mean anticipated losses or expenses,
or both, between the groups, as determined by sound actuarial principles
and by actual and credible loss and expense statistics or, in the
case of new coverages or classifications, by reasonably anticipated
loss and expense experience.
(4) Sound actuarial principles shall must include, but are not be limited
to, all of the following principles:
(a) That data used in developing
classifications and rates are derived from the experience of a
population or sample of risks that is sufficiently similar to the
anticipated insured population so that the statistics thereby obtained
can reasonably be expected to produce representative and reliable
estimates of the anticipated loss and expense experience for the insured
population and so that such statistics are calculated in a manner
that is suitable to their intended use.
(b) That a reasonable predictive relationship can be demonstrated to exist between a characteristic used in defining a rating classification and anticipated losses, anticipated expenses, or the uncertainty of loss for the risks to which the classification applies.
(c) That if rates for individual rating cells are calculated by means of arithmetic combinations of relativities for the classifications defining those rating cells, the relativities are combined in a manner that equitably reflects the anticipated loss and expense experience for those rating cells.
(d) That sampling techniques used in developing classifications and in estimating loss and expense experience are suitable to their intended application.
(e) That with regard to private passenger
automobile insurance and private residential property insurance, rates for
an insurance coverage provided are established in a manner that can reasonably
be anticipated to produce loss ratios which that are
substantially uniform among the classifications, kinds, or types of
individuals or risks to which the rates apply. Evaluation of loss ratios
shall must make appropriate
adjustments for differences in deductibles and limits of liability among
insureds, for expense provisions which that are not allocated
to premiums on a percentage-of-premium basis, and for differences
in contingency factors among classifications and shall must give due
consideration to the credibility of experience for groupings of individuals
or risks, to trends in past and prospective loss experience, and to historical
patterns between projected and realized loss ratios. For purposes of this
subdivision, "substantially uniform" means the absence of
significant variations among loss ratios. This subdivision shall not be
construed to does
not
prohibit the use of appropriate pure premium relativities to estimate or
evaluate rate relativities.
(5) Data of an insurer or rating
organization used in calculating actual and credible loss statistics shall
must
be
of sufficient volume, or shall be combined in an appropriate manner
with suitable data of sufficient volume, so that the statistics thereby calculated
are reasonably credible and can reasonably be anticipated to produce reliable
estimates of anticipated loss and expense experience.
(6) Data for reasonably anticipated
experience used in calculating rates for new coverages and in establishing
new classifications shall, must, to the extent possible, be based
on actual experience for similar coverages and for groups of risks similar
to the proposed classification and shall be of sufficient volume so
that statistics thereby produced can reasonably be anticipated to
produce reliable estimates of loss and expense experience.
(7) Relevant external information, including general economic data and other indicators, may be given due consideration in evaluating or projecting loss and expense experience.
R 500.1506 Expense provisions.
Rule 6. (1) The expense portion of a
rate shall, must, with regard
to each category of expense, be examined and evaluated independent of
the loss portion of the rate. Expenses shall must not be presumed
to change by the same percentage as losses are anticipated to change.
(2) Predictions of future expense costs shall
must
give
due consideration to trends and changes in historical expense levels, in
actual or reasonably allocated expenses incurred, and in external expense
indices and indicators.
R 500.1507 Expense allocation.
Rule 7. (1) Expense provisions for each
category of expenses shall must be reasonably allocated among
classifications in a manner that equitably reflects variations, if any,
in the manner in which such those expenses are anticipated to be
incurred with respect to the groups of individuals or risks defined by
those classifications. Expenses, other than allocated loss adjustment
expenses, shall must not be presumed to be incurred
proportionally to classification relativities based on anticipated loss.
(2) Expense provisions for premium
taxes, if any, shall must reflect the applicable premium
tax rate.
(3) Expense provisions for each other
category of expenses shall must be reasonably allocated among classifications
based on losses, coverages, exposures, or other basis that equitably
measures the variations, if any, in the manner in which such those expenses are anticipated
to be incurred with respect to the classifications. Expense allocation
methods may include percentage-of-premium, uniform-per-coverage,
uniform-per-exposure, or other basis, as appropriate and justified.
R 500.1508 Denial;Complaint-resolution
process; notice
of right to appeal.rights; private informal managerial-level conference.
Rule 8. (1) At the time of a
denial of automobile
insurance
as defined in R 500.1501, or home insurance, the insurer or agent
producer making the denial
shall notify a provide the person subject to the denial written
notice
of his or her right to appeal the decision submit a complaint
and to have a private informal managerial-level conference if he or
she has reason to believe the person believes that such the denial is
improper.
(2) If a person informs an insurer or producer that the person believes the insurer or producer has charged the person an incorrect premium, the insurer or producer shall promptly provide the person written notice of his or her right to submit a complaint and to have a private informal managerial-level conference.
(3)(2) The notice of
a person's right to appeal shall written notices
required under subrule (1) and (2) of this rule must be in language
understandable to a person of ordinary intelligence and shall contain, must include, but need not be
limited to, an explanation of all of the following:
(a) The procedure to be followed in
the complaint resolution process, including the option to request a
private informal managerial level conference.person’s right to
submit a complaint and the procedure the person shall follow if he or she
wishes to submit a complaint.
(b) The person's right to request and
receive, be
provided information pertinent to the denial or premium charge upon request, subject to payment of a reasonable
copying charge, copies of information relating to the denial. A charge. An insurer’s reasonable
copying charge
shall
under
this subdivision
must not exceed the
rate charged for copying by the Michigan Insurance Bureau department in accordance with
the
freedom of information act, 1976 PA 442, MCL 15.231 to 15.246. Act No. 442 of
the Public Acts of 1976, as amended, being S15.231 et seq. of the Michigan
Compiled Laws.
The commissioner director shall inform insurers of the that maximum
allowable copying charge on an annual basis.
(c) The person's right to participate
in an informal process for a private informal managerial-level
conference addressing the complaint resolution. This process shall with the insurer, the
procedure the person shall follow if he or she wishes to request a private
informal managerial-level conference, and the process applicable to a
private
informal managerial-level conference. All of the following apply to that process:
(i) The private informal managerial-level
conference must
be concluded
provided by the
insurer
within 30 days of after the complaint to the insurer and
date
of the person’s request.
(ii) Subject to the request of a person making
the complaint that the private informal managerial-level conference be held in a
manner permitted under this paragraph, the private informal managerial-level
conference
may include discussions be held by telephone, by mail, and
by a private, informal, managerial-level conference. video teleconference
or other substantially similar electronic means, or in-person, as long as the following
requirements are met:
(A) If the conference is held by means of
a telephone conference, or video
teleconference or other substantially similar electronic means, the insurer shall
state
at the beginning of the conference that it is a private informal managerial-level
conference and
identify all persons by name and title who are listening to, or otherwise
participating in,
the phone conference. In addition, the insurer shall either provide
a toll-free
telephone service, or other
service at no cost to the person making the complaint, or pay all telephone
charges associated with such telephone conferences. If the private
managerial-level conference is to be conducted by telephone, the notice
shall the
conference.
As
applicable, the written notice must indicate the telephone number which
the insured that
must
call be
called
and inform the insured state that he or she the telephone number may call be called collect if a
toll-free number is not provided or explain in sufficient detail other instructions
for participating in a conference held by video teleconference or other substantially
similar electronic means.
(B) If the conference is held in-person, the conference must be held within a reasonably accessible distance from the Michigan residence of the person or persons named on the policy as insured or the location of the risk and be held at a time reasonably convenient to the person making the complaint or the person's designated representative.
(iii) The private informal managerial-level conference must include the participation of the person making the complaint, or the person's designated representative, and a supervisory or higher level representative of the insurer who is authorized to decide the dispute on behalf of the insurer.
(d) The person's right to bring the
matter before the commissioner for resolution submit a complaint to the
director and for a review and determination if the insurer's internal
complaint resolution process private informal managerial-level
conference
fails to resolve the dispute. The written notice
must explain this right as described in R 500.1510.
(e) The person's right to appoint
another person as
his or her designee to
act on his or her behalf throughout the appeals complaint-resolution process set forth
in these rules.R
500.1508 to R 500.1514.
R 500.1509 Complaint-resolution process; insurer's responsibility
upon conclusion of internal complaint resolution process. information provided
following private informal managerial-level conference.
Rule 9. (1) Upon the conclusion of the
internal complaint resolution process, a private informal
managerial-level conference, the insurer shall provide the person making
the complaint
the following information to the complainant: in writing and in
language understandable to a person of ordinary intelligence:
(a) The action taken by the insurer to resolve the dispute.
(b) The facts, with supporting and documentation,
upon which supporting
the
action. is based.
(c) The specific section or sections of
the law upon which the action is based.supporting the
action.
(d) A statement explaining the person's
right to appeal the matter to the commissioner submit a complaint
to the director and for a review and determination within 120 days after
the insurer makes or delivers the written statement.date that the information
under this rule is mailed or provided if the person disagrees with the proposed
resolution included in the information. The statement must also provide instructions
regarding how to submit a complaint to the director and request a review and determination,
provide the department’s toll-free number and mailing address, and clearly indicate
the date that the information under this rule is mailed or provided.
(e) A statement describing the status of the automobile or home insurance coverage or coverages involved.
(2) The insurer shall offer to
provide the information in writing. If the insured accepts the offer,
the insurer shall mail the written statement via first-class
mail. within 3 business
days after acceptance. Such a written statement shall be phrased in terms
understandable to a person of ordinary intelligence.information under
subrule (1) of this rule to the person making the complaint, unless the insurer
and the person have previously agreed to another means of communication and
that agreement includes within its scope providing the information contemplated
under this rule and is consistent with any applicable law.
R 500.1510 Complaint-resolution process; appeals to the
commissioner.
right
to director’s review and determination; review of written materials; meeting.
Rule 10. (1) If a person believes an insurer
or
producer has
improperly denied him or her automobile insurance or home insurance
or has charged an incorrect premium for that insurance and if the insurer's
internal complaint resolution process a private informal managerial-level
conference fails
to resolve the dispute because the person disagrees with the insurer’s proposed
resolution following the conference or the insurer did not provide a private
informal managerial-level conference and proposed resolution within 30 days after
the date of the person’s request, the person has a right to bring
the matter before the commissioner for resolution submit a complaint
to the director and for a review and determination to resolve the dispute.
(2) The complainant person making the complaint shall appeal
the denial to the commissioner submit the complaint and request for the
director’s review and determination in a form and manner approved by the director within 120 days of
after
the
date the insurer mails or delivers a proposed resolution provides the information
required under R 500.1509 or within 120 days after the end expiration of the 30-day
period which that
the
insurer has to provide such a proposed resolution to the person
making the complaint, if no proposed resolution is provided during that 30-day
period.
(3) The complainant person making the
complaint
is entitled to a review of the matter dispute by the commissioner
director either by through a review of written
materials or, upon the person’s written request, through a meeting with
the parties involved in the dispute., subject to subrule (4) of this rule.
A request
for a meeting must be made at the same time the person submits the complaint
and request for the director’s review and determination.
(4) A meeting requested pursuant to subrule (3) of this rule, may, as permitted by the director, be held by telephone, video teleconference or other substantially similar electronic means, or if requested by the person making the complaint, in-person. A request for an in-person meeting must be made at the same time the person submits the complaint and request for the director’s review and determination. Any meeting under this subrule must include the director or his or her designee, the person making the complaint or his or her designated representative, and a supervisory or higher level representative of the insurer authorized to act on behalf of the insurer. If an in-person meeting is held, the insurer’s authorized representative may participate through telephone or video teleconference or other substantially similar electronic means. The director shall conduct any meeting under this subrule in a manner that allows the person making the complaint and insurer to present relevant facts, records, dates, times, and names to substantiate their respective positions regarding the dispute.
R 500.1511 Complaint-resolution
process;
Review notice
of director’s review
of dispute.; commissioner's actions.
Rule 11. (1) When conducting a review
of a dispute through written materials, the commissioner director shall, by
first-class mail, notify the insurer of the matter under consideration and
inform the insurer of the time period within which
any reply shall be made. Such notification shall be given within 10 working
days after the commissioner receives the complaint.
(2) When conducting a review of a
dispute through a meeting with the parties involved, the commissioner
The
director shall
do all of the following within 10 working business days after he
or she the
director
receives the a complaint and request for the
director’s review and determination, as applicable:
(a) Set For
a review and determination conducted through a meeting pursuant to R 500.1510(4), set a time for the
meeting and notify the complainant, by first-class mail, the person making the
complaint and the insurer of the time, manner, and place of the
meeting.
(b) Send, by first-class mail, a copy
of the notice of the meeting to the insurer.
(b)(c) Inform For all review and
determinations, notify the insurer of the time period within which any
reply shall must
be
made submitted
to the director and of the disputed issue or issues under consideration. A copy of that notification
must be provided to the person making the complaint.
(3) The commissioner shall conduct
meetings in a manner which allows the disputing parties to present relevant
facts, records, dates, times, and names to substantiate their positions.
R 500.1512 Basis Complaint-resolution
process;
basis for decisions.director’s determination;
failure to supply materials or information.
Rule 12. (1) The
commissioner If
a review and determination is conducted through written materials, the director shall base his or
her decision determination upon written materials submitted by the
parties and the person making the complaint and the insurer.
(2) If a review and determination is conducted
through
a
meeting pursuant to R 500.1510(4), the director shall base his or her determination
upon written materials submitted by the person making the complaint and the insurer,
any
statements of the parties made at the meeting, if any. Failure
of either party or
a combination of both.
(3) If the person making the complaint or
the insurer fails
to supply any materials
or
information in a timely manner, the director shall result
in a decision based base his or her determination upon materials and information
available to the commissioner director at the time of the
decision.determination.
R 500.1513 Decision.Complaint-resolution
process; director’s decision; contested case.
Rule 13. (1) The commissioner If a review and
determination is conducted through written materials, the director shall prepare issue a written decision
of
his or her determination of the disputed issue or issues within 10
working 15
business
days after the insurer submits a reply to a the complaint during the time period
established by the director under R 500.1511 or, if a reply is not submitted
to the director
during that time period, within 10 working 15 business days after the
that
time
period for submitting
a reply has expired.
(2) If a review and
determination is conducted through a meeting is held, pursuant to R
500.1510(4), the
commissioner director
shall
prepare issue a written
decision of
his or her determination of the disputed issue or issues within 10
working 15
business
days after the meeting is concluded.
(3) The commissioner director shall indicate in
the written decision that if either the insurer or the complainant person making the complaint disagrees
with the determination, the commissioner, director, if requested to
do so by either party, shall proceed to hear the matter as a contested
case under Act No. 306 of the Public Acts of 1969, as amended, being
S24.201 et seq. of the Michigan Compiled Laws.the administrative
procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.
(4) The commissioner director shall send provide copies of the written
decision to the parties by first-class mail.insurer and the
person making the complaint.
R 500.1514 Improper termination;
status of coverage.Complaint-resolution process; remedies based on director’s
review and determination.
Rule 14. (1) Subject to subrule (2) of this rule, if the director concludes that the person making the complaint was improperly denied automobile insurance or home insurance, the director shall order an appropriate remedy.
(2) If the commissioner's decision indicates
director
concludes
that the complainant's automobile insurance or home insurance of the person
making the complaint was
improperly terminated, the complainant person may select any
of the following remedies:
(a) The termination may be is deemed invalid
and coverage shall be is reinstated effective as of the date of
the termination upon payment of the applicable premium.
(b) Coverage may be The termination is
deemed invalid and coverage is reinstated with the terminating insurer effective as of the
date of the commissioner's director’s decision issued under R
500.1513
upon payment of the applicable premium, subject to the following conditions
if
the person has secured coverage from an insurer other than the insurer that improperly
terminated the insurance:
(i) If the complainant has secured
coverage from another insurer, upon Upon notice from the complainant,
such person, the coverage shall
must be canceled
and the insurer providing the coverage shall provide the complainant with person a refund of premium
pursuant to the insurer's filed rating rules.
(ii) If the complainant has secured
coverage from another insurer, the improperly terminating The insurer that improperly
terminated the insurance shall pay the insured person any additional premium
expenditures incurred by the insured person as a result
of seeking additional coverage which are in excess of the pro rata
premium the complainant person would have paid for the
coverage from the improperly terminating insurer for the same period of
time.
(c) If the complainant person has secured
coverage from another an insurer other than the insurer that
improperly terminated the insurance, the complainant person may continue that
coverage, and the
termination shall be is deemed invalid but coverage shall is not be
reinstated.
(3) If the director concludes that the person making the complaint was charged an incorrect premium, the director shall order an appropriate remedy. If the director orders a refund of an incorrect premium charged to the person making the complaint, the insurer shall, within 10 business days after the director’s order, provide the refund to the person and provide documentation to the director showing how the refund amount was calculated.
R 500.1515 Collection and reporting of data by insurers.
Rule 15. For purposes of section 2127 of
the code, MCL 500.2127, all of the
following shall apply:
(a) Every insurer subject to chapter 21 of
the code, writing MCL 500.2101 to 500.2131, underwriting automobile
insurance or home insurance, or both, in Michigan this state shall report
data concerning such the insurance in accordance with statistical
plans and reporting forms approved by the commissioner. director. The reporting plans
and forms shall must provide for the collection of only such
the
information
as the commissioner director finds necessary to
monitor and evaluate the automobile and home insurance markets in this
state, as provided in section 2127 of the code, MCL 500.2127.
(b) Statistical plans approved by order
of the commissioner director for licensed statistical
gathering agencies will be are accepted as providing to provide adequate
historical premium, exposure, loss, and expense information for automobile
and home insurance.
(c) Supporting data for automobile
and home insurance rate filings submitted in accordance with the forms
with instructions as issued by the commissioner will be director are assumed to
comply substantially with information needs for evaluating overall rate
level needs, 1 of the elements in monitoring and evaluating markets
per section 2127 of the code, MCL 500.2127.
(d) The commissioner director shall accept
annual statement data on 1 element in the process of monitoring competition.
R 500.1516 Exchange of claim information.
Rule 16. Every insurer subject to
chapter 21 of the code, MCL 500.2101 to 500.2131, shall exchange
claim information for automobile insurance and home insurance as provided in
these rules to the extent such the information is
available from the responding company's data base. Such The information shall
must not be requested
for selected policyholders on the basis of age, sex, or other factor so as
to be that
is
discriminatory in nature.
R 500.1517 Exchange of automobile insurance claim information.
Rule 17. (1) Every insurer subject to
chapter 21 of the code writing , MCL 500.2101 to 500.2131, underwriting automobile
insurance shall respond, on a form similar to figure 1 under
R
500.1521,
within 30 calendar days, to a request by another insurer for
information concerning the claim history of a specified person.
(2) The reporting insurer shall report automobile insurance claim information as follows:
(a) The name and address of the insured.
(b) The policy number of such insured.
(c) The name of the driver of the insured vehicle, if known.
(d) The period of time insured, if available, but in all cases, the expiration date.
(e) Whether the claim is open or closed at the time of the report.
(f) Date or dates of loss.
(g) Amount of loss paid under each coverage.
(3) The requesting insurer shall specify in its request for claim information the name, address, and responding company's policy number of the insured who is the subject of the request. The requesting insurer shall also provide with the request a stamped, addressed envelope for the return of the completed claim information form.
R 500.1518 Exchange of home insurance claim information.
Rule 18. (1) Every insurer subject to
chapter 21 of the code writing , MCL 500.2101 to 500.2131, underwriting
home
insurance shall respond, on a form similar to figure 1 under R 500.1521, within 30
calendar days, to a request by another insurer for information concerning
the claim history of a specified person. The claim information which may be
requested and or reported shall must be information
as described in section 2111(12)(f) 2111(7)(f) of the code, MCL 500.2111.
(2) The reporting insurer shall report home insurance information as follows:
(a) Name and address of the insured.
(b) Policy number of such insured.
(c) Location of insured premises.
(d) Date of loss or losses.
(e) Amount paid.
(f) Coverage involved.
(g) Whether or not a fire loss was investigated by civil authorities.
(3) The requesting insurer shall specify in its request the name, address, and responding company's policy number of the insured who is the subject of the request. The requesting insurer shall also provide with the request a stamped, addressed envelope for the return of the completed claim information form.
R 500.1519 Exchange of claim information; reporting period.
Rule 19. An insurer shall be is responsible for
reporting, upon request, automobile insurance and home insurance claim
information only for current policies or those which that expired 90 days
immediately preceding the date of receipt of a request for claim information.
The claim information reported shall must cover the 3 years
last preceding the expiration date, including claim information
originally reported by another carrier.
R 500.1520 Fee for providing claim data prohibited.
Rule 20. A fee shall must not be charged by
an insurer for providing the claim information required by these rules
for the first 12 calendar months immediately following the effective date
of this rule.October
30, 1981.
R 500.1521 Figure 1.
Rule 21. Figure 1 reads as follows:
We recently received an application
for auto property (circle one) insurance from the above individual. As
provided for in Section 2130 of P.A. 145, of the Insurance Code
of 1956, 1956 PA 218, MCL 500.2130, please supply the claim experience for
the past three 3 years as available. If additional space
is needed, please complete on the back of this form.