| Filing Review Requirements | Regulatory Reference or Source |
Comments |
|---|---|---|
| FORMS | ||
| Applications | ||
| No filing requirement for applications (unless made part of the policy) | Title 8, §3541 and §4205 | Incorrect statements on the application shall not bar the right to recovery unless it was meant to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer. |
| Abuse | ||
| Sexual abuse exclusion permitted | Department requirement | We do not allow the exclusion of "physical" abuse or molestation. Please see that the exclusion is limited to sexual abuse and/or molestation. |
| Alcohol | ||
| Exclusion not permitted | Department requirement | Acts committed under the influence may not be excluded. |
| Appeals | ||
| Limit of liability may be waived | Title 8, §4203 | The Company has unlimited liability should they appeal a case without the insured's consent. |
| Arbitration | ||
| Cannot be both binding and mandatory | Department requirement | Binding arbitration is not permitted if the process can be demanded unilaterally, since it may deprive the insured of access to the court system. |
| Asbestos | ||
| May not be excluded | Department requirement | May be approved by submitting a Individual Risk "Consent to Rate Application" if a known hazard exists. See Bulletin 111.. |
| Bankruptcy Provision | ||
| Bankruptcy of the Insured cannot relieve the company of their liability | Title 8, §4203 | |
| Cancellation & Non-renewal | ||
| Days' Notice and Cancellation/Nonrenewal Reasons | Title 8, §4711 - 4715 | 15 days' notice for cancellation for non-pay. Policy can be cancelled for any reason within first 59 days - specific reasons required if in force 60 days or more. 45 days' notice of non-renewal required. |
| Claims Made Requirements | ||
| See comments | Department requirement | Claims made not permitted for basic CGL policy; with respect to claims made endorsements, please see the "Professional Liability" section of this document |
| Defense Costs | ||
| Defense Within Limits not allowed | Department requirement | Department will consider separate defense limit equal to the limit of liability. |
| Disclosure | ||
| Notice Requirements | Regulation 78-1 (1) | Insured must be given written notice when coverage has been modified or eliminated. |
| Drugs | ||
| Exclusion permitted subject to limitations | Department requirement | Exclusion must be limited to illegal drugs or legal drugs illegally used. |
| Electromagnetic Radiation | ||
| May not be excluded | Department requirement | No exceptions. |
| Filing Standards | ||
| Prior Approval | Regulation I-2010-03 | Forms must be submitted at least 30 calendar days prior to their proposed effective date. |
| Fraud | ||
| Guidelines | Title 8, §4205 and §4711 |
If a policy is obtained through fraud or material misrepresentation, that policy may be voided. |
| Indemnity | ||
| Indemnity not generally permitted | Title 8, §4203 | Must be "Pay on Behalf of" in Coverage Grant (Indemnity may be permitted on certain specialized coverages.) |
| Lead | ||
| May not be excluded | Department requirement | May be approved by submitting an Individual Risk "Consent to Rate Application" if a known hazard exists. See Bulletin 111. |
| Liberalization Clause | ||
| Not required | ||
| Loss Settlement | ||
| Loss Settlement and Payment Conditions | Regulation 79-2; S6 (G) |
After settlement has been agreed upon, insurer shall mail payment in amount agreed to claimant and/or loss payee within ten (10) working days, unless a further delay is mandated under an order by a court of competent jurisdiction or required by law. |
| Pollution | ||
| May not be excluded except as noted. | Bulliten 111 |
All insurers must provide coverage for pollution by endorsement, with limited exceptions. We will consider a "Consent to Rate" application for companies seeking to attach a pollution exclusion to liability coverage claim. We will approve the use of the exclusion only where there is an identifiable pollution exposure. |
| Punitive Damages | ||
| May be excluded | Bulletin 139 | |
| Readability | ||
| Guidelines | Regulation I-2010-03 |
Flesh score minimum is 40, not less than 10 point type, one point leaded. |
| Tobacco | ||
| May not be excluded | Department requirement | No exceptions. |
| RATING | ||
| Open Competition, Use and File |
Title 8, §4688 Loss Costs -Bulletin 99 |
Filing must be received within 15 days of effective date. Rate filing must include verifying material and actuarial backup. Rating guidelines and methodology need to be furnished for (a) rates. Simply stating that (a) rating applies is not acceptable. |
| Rating Plan Requirements | ||
| None specified | ||