P&C Professional Liability

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.

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. 

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.

Asbestos

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

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.

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.

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. If this occurs after the effective date, the company may only deny the claim on that basis, however, has grounds for cancellation.

Indemnity Wording

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 filing 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

 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. 

Pollution

May not be excluded except as noted.

Bulletin 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 when there is a high probability of a pollution 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) rates applies is not acceptable. 

Rating Plan Requirements

None specified