Ins 6.68(1)(1)
Purpose. The purpose of this rule is to identify specific acts or practices found to be unfair trade practices that are unfairly discriminatory under s.
628.34, Stats.
Ins 6.68(2)
(2) Applicability and scope. This rule shall apply to property and casualty insurance contracts delivered or issued for delivery in Wisconsin on or after the effective date of the rule.
Ins 6.68(3)
(3) Specific examples of unfair trade practices under s. 628.34, Stats. The following are hereby identified as specific acts or practices which are unfairly discriminatory.
Ins 6.68(3)(a)
(a) Making or permitting any unfair discrimination between individuals or risks of the same class and of essentially the same hazards by refusing to issue, refusing to renew, cancelling or limiting the amount of insurance coverage on a property or casualty risk because of the geographic location of the risk, unless:
Ins 6.68(3)(a)1.
1. The refusal, cancellation or limitation is for a business purpose which is not a mere pretext for unfair discrimination, or
Ins 6.68(3)(a)2.
2. The refusal, cancellation or limitation is required by law or regulatory mandate.
Ins 6.68 Note
Note: Paragraph (a) is intended to prohibit insurance underwriting shortcuts which unfairly label risks as poor risks because of their geographic location. A refusal, nonrenewal, cancellation or limitation of insurance coverage is prohibited if the reason for such refusal, nonrenewal, cancellation or limitation is the geographic location of the risk. An exception to this general rule is provided, however, in situations where the refusal, nonrenewal, cancellation or limitation is based upon a legitimate business need and the refusal, nonrenewal, cancellation or limitation is not a mere pretext for unfair discrimination. Examples of such situations include refusals to insure when the risk is located in areas prone to natural catastrophes, i.e., earthquakes, floods, hurricanes, and refusals to insure because the insurer already has a very high concentration of risks in a particular geographic area. It is intended that the person charged with a violation of this rule be given the burden of proof in establishing any “business purpose" exception. The burden of proving that a refusal, nonrenewal, cancellation or limitation of insurance coverage is not subterfuge for unfair discrimination should likewise fall upon the person charged with a violation of this rule.
Ins 6.68(3)(b)
(b) Making or permitting any unfair discrimination between individuals or risks of the same class and of essentially the same hazards by refusing to issue, refusing to renew, cancelling or limiting the amount of insurance coverage on a residential property risk of 4 units or less, or the personal property contained therein, because of the age of the residential property, unless:
Ins 6.68(3)(b)1.
1. The refusal, cancellation or limitation is for a business purpose which is not a mere pretext for unfair discrimination, or
Ins 6.68(3)(b)2.
2. The refusal, cancellation or limitation is required by law or regulatory mandate.
Ins 6.68(3)(c)
(c) Refusing to insure a risk solely because the applicant was previously denied coverage, terminated by another insurer or had obtained coverage in a residual market.
Ins 6.68 History
History: Cr.
Register, September, 1979, No. 285, eff. 10-1-79; r. (4) under s. 13.93 (2m) (b) 16., Stats.,
Register, December, 1984, No. 348.
Ins 6.70
Ins 6.70
Combinations of lines and classes of insurance. This rule defines and delimits the permissible combinations of the lines and classes of insurance defined and delimited by s.
Ins 6.75 which may be written in the same policy. Except as provided in this rule, lines and classes of insurance may not be combined in the same policy.
Ins 6.70(1)
(1) Combination with separate premium charges. Subject to s.
Ins 2.05, any combination of the lines and classes of insurance defined and delimited by s.
Ins 6.75, except for those described in s.
Ins 6.75 (2) (h),
(i) and
(k), may be written in the same policy if a statement of separate premium charge is shown on the declarations page or on the face of the policy or in a separate written statement furnished to the policyholder. The requirement for a statement of separate premium charge does not prohibit such charges equitably reflecting differences in expected losses or expenses as contemplated by s.
625.11 (4), Stats.
Ins 6.70(2)
(2) Combination with or without separate premium charges. Any combination of the lines and classes of insurance defined and delimited by s.
Ins 6.75 (2) (a),
(b),
(d),
(e),
(f) and
(j) may be written in the same policy with or without showing separate premium charges.
Ins 6.70 History
History: Emerg. cr. eff. 6-22-76; cr.
Register, September, 1976, No. 249, eff. 10-1-76; r. and recr.
Register, August, 1977, No. 260, eff. 9-1-77.
Ins 6.72(1)(1)
Except as otherwise provided by law or by order of the commissioner, no single risk assumed by any insurance company shall exceed 10% of surplus as regards policyholders, except that in an assessable mutual company it may be a greater amount not exceeding 3 times the average policy or
1/
4 of 1% of the insurance in force, whichever is the greater. Upon the business mentioned in s.
Ins 6.75 (2) (h), the maximum single risk may be a greater amount not exceeding 50% of the admitted assets. Any reinsurance taking effect simultaneously with the policy shall be deducted from the original risk assumed in determining compliance with this subsection.
Ins 6.72(2)
(2) In a mutual company organized for the insurance or guaranty of depositors or deposits in banks or trust companies, the maximum single risk may be fixed at a higher amount by the bylaws. Any such company may effect reinsurance in any authorized or unauthorized company that complies with s.
627.23, Stats. Insurance in any unauthorized company shall be reported annually and the same taxes paid upon the premiums as are paid by authorized companies.
Ins 6.72 History
History: Emerg. cr. eff. 6-22-76; cr.
Register, September, 1976, No. 249, eff. 10-1-76; r. and recr.
Register, August, 1981, No. 308, eff. 9-1-81; am. (1),
Register, January, 1992, No. 433, eff. 2-1-92.
Ins 6.74
Ins 6.74
Suretyship and risk limitations of surety obligations. Ins 6.74(1)(1)
Purpose. The purpose of this rule is to establish minimum requirements for the transaction of surety obligations.
Ins 6.74(2)
(2) Scope. This rule shall apply to the limitations on bond penal amounts imposed on insurers engaged in the business of suretyship. This section shall not apply to insurers issuing only that type of surety insurance known as municipal bond insurance.
Ins 6.74(3)(a)
(a) For purposes of this rule suretyship shall be construed to be insurance.
Ins 6.74(3)(b)
(b) An insurance corporation authorized to write fidelity insurance may guarantee the fidelity of, or become the surety for:
Ins 6.74(3)(b)1.1. persons holding positions of public or private trust; 2. the performance of any act, duty or obligation or the refraining from any act; 3. the performance of any contract; 4. bonds of insurance companies required by law as a condition of transacting business; 5. indemnifying banks, brokers and other financial or moneyed associations or corporations, against the loss of documents and money, except against loss caused by marine risks or risks of transportation or navigation; 6. indemnifying any federal land bank against loss by reason of defective title to or incumbrances on real property on which such bank may have a mortgage.
Ins 6.74(3)(c)
(c) As used in this rule any one surety risk shall be equivalent to the penal amount established on the surety bond.
Ins 6.74(4)
(4) Risk limitations on surety obligations. Ins 6.74(4)(a)(a) No corporation shall execute any suretyship obligation or expose itself to any loss on any one surety bond in an amount in excess of one-tenth of its capital and surplus as reported in its most recent filed annual statement, unless it shall be protected in the excess of that amount:
Ins 6.74(4)(a)1.
1. By reinsurance in a corporation licensed to transact surety business where the risk is located; or
Ins 6.74(4)(a)2.
2. By the cosuretyship of a surety corporation likewise licensed.
Ins 6.74(4)(b)
(b) A surety corporation may execute transportation or warehousing bonds for the United States internal revenue taxes to an amount equal to 5 times the underwriting limitation specified in par.
(a) of this rule.
Ins 6.74(4)(c)
(c) No corporation writing surety shall guarantee the deposits of any single financial institution in an aggregate amount in excess of the underwriting limitation set forth in par.
(a) unless it shall be protected in excess of that amount by reinsurance or cosuretyship as specified in par.
(a).
Ins 6.74(4)(d)
(d) A surety corporation shall not issue multiple bonds on a single contract (splitting bonds) and a surety corporation's liability on a single contract shall not be in excess of the limitations established in par.
(a).
Ins 6.74(4)(e)
(e) No domestic corporation writing surety business shall execute, reinsure or be cosurety on a suretyship obligation in favor of the U.S. governments, or any other obligee, whereby a surety issues a bond to an obligee for a penal amount which is 10%, or an amount substantially less than, the total contract amount, unless the surety reinsures or obtains a cosurety for at least 50% of the bond penal amount with a corporation licensed to transact surety business where the risk is located. This is tantamount to a maximum exposure for any single loss on any one surety bond of this type of not more than one-twentieth of a domestic surety corporation's capital and surplus.
Ins 6.74 History
History: Emerg. cr. eff. 6-22-76; cr.
Register, September, 1976, No. 249, eff. 10-1-76; emerg. am. (2), eff. 6-5-84; am. (2)
Register, October, 1984, No. 346, eff. 11-1-84.
Ins 6.75
Ins 6.75
Classifications of insurance. This rule defines and delimits lines and classes of insurance for any purposes within the commissioner's regulatory power unless the language or context of a statute or rule otherwise provides.
Ins 6.75(1)
(1) Life and disability insurance. Life and disability insurance includes the following:
Ins 6.75(1)(a)
(a) Life insurance and annuities — except insurance or annuities included in par.
(b), insurance or annuities upon the lives of persons, and annuity contracts without life contingencies, as provided in s.
632.66, Stats.;
Ins 6.75(1)(a)1.
1. Credit life insurance — insurance on the lives of borrowers or purchasers of goods in connection with specific loans or credit transactions when all or a portion of the insurance is payable to the creditor to reduce or extinguish the debt;
Ins 6.75(1)(b)
(b) Variable life insurance and variable annuities — insurance or annuities which provide for immediate or future benefits, the cost of which is funded and the payment of which is computed on the basis of experience factors derived from one or more segregated investments accounts established and managed as provided in ss.
611.24,
611.25, and
620.02, Stats.;
Ins 6.75(1)(c)
(c) Disability insurance — insurance covering injury or death of persons caused by accident, or insurance covering health of persons;
Ins 6.75(1)(c)1.
1. Credit accident and sickness insurance — insurance in connection with specific loans or credit transactions against loss of time of debtors resulting from accident or sickness when all or a portion of the insurance is payable to the creditor to reduce or extinguish the debt;
Ins 6.75(2)
(2) Property and casualty insurance. Property and casualty includes all lines or classes of insurance which may lawfully be the subject of insurance other than those classes defined in sub.
(1) (a) or
(b), including but not limited to the following:
Ins 6.75(2)(a)
(a) Fire, inland marine and other property insurance — insurance against loss or damage to real and personal property, while stationary or in transit, arising out of fire or any other peril but not including any insurance defined in any other paragraph of this rule;
Ins 6.75(2)(b)
(b) Ocean marine insurance — insurance against the perils of seas and other related perils usually insured against by ocean marine insurance.
Ins 6.75(2)(c)
(c) Disability insurance — insurance covering injury or death of persons caused by accident, or insurance covering health of persons;
Ins 6.75(2)(c)1.
1. Credit accident and sickness insurance — insurance in connection with specific loans or credit transactions against loss of time of debtors resulting from accident or sickness when all or a portion of the insurance is payable to the creditor to reduce or extinguish the debt;
Ins 6.75(2)(d)
(d) Liability and incidental medical expense (other than automobile) insurance — insurance against liability for damages to persons or property, and incidental insurance for medical expenses when written in the same policy, but not including any liability insurance defined in other paragraphs of this rule;
Ins 6.75(2)(e)
(e) Automobile insurance — insurance against loss, medical or other expense, and liability for damages arising out of the ownership, maintenance or use of and automobile or other motor vehicle;
Ins 6.75(2)(f)
(f) Fidelity insurance — insurance against loss arising out of the acts or defaults of persons in positions of trust, excluding commercial bail bond insurance except as a surety under s.
345.61, Stats.
Ins 6.75(2)(g)
(g) Surety insurance — payment for loss arising out of failure to perform contracts or obligations, excluding commercial bail bond insurance except as a surety under s.
345.61, Stats.
Ins 6.75(2)(h)
(h) Title insurance — insurance against loss by reason of defects in titles to property;
Ins 6.75(2)(i)
(i) Mortgage guaranty insurance — insurance against loss arising from failure of:
Ins 6.75(2)(i)1.
1. Debtors to meet financial obligations to creditors under evidences of indebtedness which are secured by either:
Ins 6.75(2)(i)1.a.
a. A first lien or charge on residential real estate designed for occupancy by not more than four families; or
Ins 6.75(2)(i)1.b.
b. i. A first lien or charge on residential real estate designed for occupancy by 5 or more families; or
ii. A first lien or charge on real estate designed for industrial or commercial purposes; or
Ins 6.75(2)(i)1.c.
c. A stock or membership certificate issued to the tenant stockholders or resident members of a completed fee simple cooperative housing corporation as defined in 26 U.S.C. s. 216 (b) (1); or
Ins 6.75(2)(i)2.
2. Lessees to make payment of rentals under leases of real estate in which the lease extends for 3 years or longer.
Ins 6.75(2)(j)
(j) Credit insurance — insurance against loss arising from failure of debtors to meet financial obligations to creditors, except as defined in par.
(i) 1. a.,
b.,
c., and
2.;
Ins 6.75(2)(k)
(k) Worker's compensation insurance — insurance against obligations under ch.
102, Stats., or any similar law, and including employers' liability insurance when written in the same policy;
Ins 6.75(2)(L)
(L) Legal expense insurance — insurance against expense for the professional services of licensed lawyers;
Ins 6.75(2)(m)
(m) Credit unemployment insurance — insurance against loss of income of debtors resulting from either labor disputes or involuntary unemployment;
Ins 6.75(2)(n)
(n) Miscellaneous — insurance against any other property or casualty insurance risk which lawfully may be the subject of insurance not specifically defined in any other paragraph of this rule;
Ins 6.75(2)(o)
(o) Aircraft insurance — insurance against loss, medical or other expense, and liability for damages arising out of the ownership, maintenance or use of any aircraft.
Ins 6.75 History
History: Cr.
Register, August, 1977, No. 260, eff. 9-1-77; am. (2) (f) and (g),
Register, March, 1980, No. 291, eff. 4-1-80; am. (2) (i) and (j),
Register, October, 1982, No. 322, eff. 11-1-82; emerg. am. (1) (a), eff. 10-4-88, am. (1) (a) (intro.),
Register, December, 1988, No. 396, eff. 1-1-89;
CR 01-074: am. (2) (e) and (n), cr. (2) (o),
Register January 2002 No. 553, eff. 2-1-02.
Ins 6.76
Ins 6.76
Grounds for disapproval of and authorized clauses for fire, inland marine and other property insurance forms. Ins 6.76(1)(1)
Purpose. The purpose of this rule is to set out characteristics and provision of fire, inland marine and other property insurance forms, as defined by s.
Ins 6.75 (2) (a), which may constitute grounds for disapproval of such forms under the provisions of s.
631.20 (2), Stats., and to promulgate authorized clauses for such forms under s.
631.23, Stats., because it has been found that:
Ins 6.76(1)(a)
(a) Price or coverage competition is ineffective because diversity in language or content makes comparison difficult;
Ins 6.76(1)(b)
(b) Provision of language, content or form of these specific clauses is necessary to provide certainty of meaning of them;
Ins 6.76(1)(c)
(c) Regulation of contract forms will be more effective and litigation will be substantially reduced if there is increased standardization of certain clauses; and
Ins 6.76(1)(d)
(d) Reasonable minimum standards of insurance protection are needed for policies to serve a useful purpose.
Ins 6.76(2)
(2) Grounds for disapproval. A fire, inland marine or other property insurance form may be considered misleading, deceptive or obscure within the meaning of s.
631.20 (2), Stats., if it does not clearly state the perils covered, the limitations, and the conditions, or if it contains provisions contrary to the law, or if it does not include clauses covering the following provisions where appropriate:
Ins 6.76(2)(b)
(b) Effect of other insurance on the coverage provided;
Ins 6.76(2)(c)
(c) Conditions suspending, restricting or voiding the coverage provided;
Ins 6.76(3)
(3) Authorized clauses. The following clauses, or any of them, shall be considered authorized clauses pursuant to s.
631.23, Stats. Appropriate liberalization of the prescribed language shall also be permitted.
IN CONSIDERATION OF THE PROVISIONS AND
STIPULATIONS HEREIN OR ADDED HERETO
and of the premium above specified this Company, for the term of
from at noon (12:01 a.m.) [choose one] Standard Time to at location of property involved, to an amount not exceeding the amount(s) above specified does insure
and legal representatives, to the extent of the actual cash value of the property at the time of loss, but not exceeding the amount which it would cost to repair or replace the property with material of like kind and quality within a reasonable time after such loss, without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest of the insured against all DIRECT LOSS BY FIRE, LIGHTNING AND BY REMOVAL FROM PREMISES ENDANGERED BY THE PERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy, or pro rata for 5 days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but not elsewhere. Assignment of this policy shall not be valid except with the written consent of this Company. This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy.
Ins 6.76(3)(b)
(b) Uninsurable and excepted property. This policy shall not cover accounts, bills, currency, deeds, evidences of debt, money or securities; nor, unless specifically named hereon in writing, bullion or manuscripts.
Ins 6.76(3)(c)
(c) Perils not included. This company shall not be liable for loss by fire or other perils insured against in this policy caused, directly or indirectly, by:
Ins 6.76(3)(c)1.1. enemy attack by armed forces, including action taken by military, naval or air forces in resisting an actual or an immediately impending enemy attack; 2. invasion; 3. insurrection; 4. rebellion; 5. revolution; 6. civil war; 7. usurped power; 8. order of any civil authority except acts of destruction at the time of and for the purpose of preventing the spread of fire, provided that such fire did not originate from any of the perils excluded by this policy; 9. neglect of the insured to use all reasonable means to save and preserve the property at and after a loss, or when the property is endangered by fire in neighboring premises; 10. nor shall this company be liable for loss by theft.
