P&C Commercial Umbrella
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Filing Review Requirements |
Regulatory Reference |
Comments |
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FORMS |
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Applications |
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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 unless it was meant to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer. |
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Abuse |
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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. |
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Alcohol |
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Exclusion not permitted |
Department requirement |
Acts committed under the influence may not be excluded. |
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Appeals |
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Limit of liability may be waived |
Title 8, §4203 |
The Company has unlimited liability should they appeal a case without the insured's consent. |
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Arbitration |
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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. |
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Bankruptcy Provision |
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Bankruptcy of the Insured cannot relieve the company of their liability |
Title 8, §4203 |
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Cancellation & Non-renewal |
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Days' Notice and Cancellation/Nonrenewal Reasons |
Title 8, §4711 - 4715 |
15 days' notice for cancellation for non-pay. |
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Claims Made Requirements |
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See comments |
Department requirement |
We do not allow an umbrella/excess policy to be only claims-made unless it is to be excess only over a claims underlying policy. It is acceptable for the umbrella/excess policy to be excess over a combination of occurrences and claims-made underlying. The umbrella/excess policy must provide for an External Reporting Period at the option of the Insured. If a basic ERP is automatically provided, then any optional or supplemental ERP chosen must begin when elected, rather than at the end of the basic ERP in whole or in part. The optional ERP must reinstate policy limits or have a separate limit equal to the expired or expiring policy. |
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Defense Costs |
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Defense Within Limits not allowed |
Department requirement |
Department will consider separate defense limit equal to the limit of liability. |
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Disclosure |
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Notice Requirements |
Regulation 78-1 (1) |
Insured must be given written notice when coverage has been modified or eliminated. |
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Drugs |
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Exclusion permitted subject to limitations |
Department requirement |
Exclusion must be limited to illegal drugs or legal drugs illegally used. |
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Electromagnetic Radiation |
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May not be excluded |
Department requirement |
No exceptions. |
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Filing Standards |
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Prior Approval |
Regulation I-2010-03 |
Forms must be submitted at least 30 calendar days prior to their proposed effective date. |
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Fraud |
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Guidelines |
Title 8, §4205 and §4711 |
If a policy is obtained through fraud or material misrepresentation, that policy may be voided. If this occurs after the effective date, the company may only deny the claim on that basis, however, has grounds for cancellation. |
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Indemnity |
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Indemnity not generally permitted |
Title 8, §4203 |
Must be "Pay on Behalf of" in Coverage Grant (Indemnity may be permitted on certain specialized coverages.) |
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Liberalization Clause |
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Not required |
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Loss Settlement |
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Loss Settlement and Payment Conditions |
Regulation 79-2; S6 |
The Insurer has 15 days to respond to a properly executed Proof of Loss. After Settlement has been agreed upon, Insurer shall mail in the agreed amount to the claimant and/or loss payee within 10 working days. |
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Pollution |
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May not be excluded except as noted. |
Bulletin 111
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A "following form" pollution liability endorsement may be used so that coverage will track with the applicable underlying policy. If this is not utilized then pollution coverage must be provided unless excluded by means of an approved Consent to Rate Application. |
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Punitive Damages |
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May be excluded |
Bulletin 139 |
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Readability |
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Guidelines |
Regulation I-2010-03 |
Flesh score minimum is 40, not less than 10 point type, one point leaded. |
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Tobacco |
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May not be excluded |
Department requirement |
No exceptions. |
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Uninsured/underinsured Motorists |
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UM/UIM is mandatory on all policies providing automobile coverage. |
Title 23, §800 and §941 |
UM/UIM may only be excluded if the umbrella contains an exclusion of all automobile coverage. Minimum limits for UM/UIM are $50,000 per person, $100,000 per accident, $10,000 per claim property damage. Regardless of Insureds UM/UIM limits choices on the underlying policy, the umbrella must provide either the umbrella policy limit or the $50,000/$100,0000 BI limit option, whichever the Insured chooses. The "Damage to Property Belonging to the Insured" exclusion needs an exception for damage covered under the UM/UIM provisions. |
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RATING |
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Open Competition, Use and File |
Title 8, §4688 Loss Costs - |
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) rates applies is not acceptable. |
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Rating Plan Requirements |
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None specified |
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