Chapter Ins 5
ADMINISTRATIVE ACTIONS; RULES OF PROCEDURE FOR CONTESTED CASES
Subchapter I — Scope; Definitions
Ins 5.01 Purpose; applicability. Subchapter II — Declaratory Ruling
Ins 5.05 Petition for declaratory ruling. Ins 5.06 Response to petition. Subchapter III — Investigations; Orders Issued by Office; Form Filing Disapprovals
Ins 5.07 Complaint; investigation. Subchapter IV — Adverse Decision of Office, Board, Plan, Fund or Council; Right to Hearing; Petition
Ins 5.09 Right to hearing before commissioner. Ins 5.10 Right to hearing before PCF board. Ins 5.11 Petition; response; effect. Subchapter V — Notice of Hearing Pleadings; Form and Filing of Documents
Ins 5.12 Notice of hearing. Ins 5.15 Amendment of pleadings. Ins 5.17 Papers; identification; form; filing; service. Subchapter VI — Administrative Law Judge Authority; Sanctions
Ins 5.19 Administrative law judges. Ins 5.21 Failure to appear, answer or comply with administrative law judge’s order. Subchapter VII — Motions; Subpoenas; Record; Miscellaneous Provisions
Ins 5.29 Record of oral proceedings; transcripts. Ins 5.31 Proceedings open to public; exceptions. Subchapter VIII — Prehearings; Hearing Procedure
Ins 5.33 Prehearing conference. Ins 5.37 Stipulations; settlement. Ins 5.40 Costs to prevailing party. Ins 5.41 Arguments; briefing. Subchapter IX — Decisions
Ins 5.43 Proposed decision. Ch. Ins 5 NoteNote: Chapter Ins 5 as it existed on March 31, 1996 was repealed and a new chapter Ins 5 was created effective April 1, 1996.
Ins 5.01Ins 5.01 Purpose; applicability. Ins 5.01(3)(3) This chapter does not require a contested case proceeding before the issuance of a declaratory order under s. 601.41 (4) (b), Stats. Ins 5.01 HistoryHistory: Cr. Register, March, 1996, No. 483, eff. 4-1-96; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register January 2011 No. 661; CR 18-092: am. (1) Register March 2020 No. 771, eff. 4-1-20. Ins 5.03Ins 5.03 Definitions. In this chapter: Ins 5.03(1)(1) “Commissioner” means the commissioner of insurance or the deputy commissioner of insurance acting under s. 601.11 (1) (b), Stats. Ins 5.03(3)(3) “Declaratory ruling” means an administrative decision by the commissioner or a board which, after a contested case proceeding, determines the applicability of a statute or rule enforced by the commissioner to any person, property or state of facts. Ins 5.03(4)(4) “Hearing” means the trial of the issues in a contested case. Ins 5.03(6)(6) “License” means any license, permit, approval, certificate of authority, certificate of registration or similar form of permission required by law and issued under chs. 601 to 655, Stats. Ins 5.03(7)(7) “Office” means the office of the commissioner. Ins 5.03(8)(8) “PCF board” means the board of governors of the Wisconsin health care liability insurance plan and patients compensation fund established under s. 619.04 (3), Stats. Ins 5.03(9)(9) “Person” means a natural person, corporation, limited liability company, partnership, cooperative, association, trust, other business entity or government entity. Ins 5.03(10)(10) “Subpoena” means a command to give testimony or provide evidence. Ins 5.03 HistoryHistory: Cr. Register, March, 1996, No. 483, eff. 4-1-96; correction in (5) made under s. 13.93 (2m) (b) 7., Stats., Register June 2005 No. 594; CR 18-092: r. (5) Register March 2020 No. 771, eff. 4-1-20. Ins 5.05Ins 5.05 Petition for declaratory ruling. An interested person may file with the commissioner or a board a petition for a declaratory ruling under s. 227.41, Stats. The petition shall comply with s. 227.41 (2), Stats., and shall state how the petitioner may be affected by the statute or rule referenced in the petition. Ins 5.05 HistoryHistory: Cr. Register, March, 1996, No. 483, eff. 4-1-96. Ins 5.06Ins 5.06 Response to petition. Within a reasonable time after a petition is filed under s. Ins 5.05, the commissioner or board shall grant or deny the petition. If the petition is granted, the commissioner or board shall initiate a contested case under s. 227.41 (1), Stats., by issuing a notice of hearing in the form specified in s. Ins 5.12. If the petition is denied, the commissioner or board shall issue a denial notice in writing, specifying the reason for the denial. The commissioner or board may permit the petitioner to amend the petition if it does not fully comply with s. 227.41 (2), Stats., or s. Ins 5.05. Ins 5.06 HistoryHistory: Cr. Register, March, 1996, No. 483, eff. 4-1-96. Ins 5.07Ins 5.07 Complaint; investigation. Ins 5.07(1)(1) Any person may file with the office a complaint about any person subject to regulation under ch. 153, Stats., or chs. 600 to 655, Stats. Ins 5.07(2)(2) Based on a complaint under sub. (1) or other information available, the office may investigate to determine whether there is probable cause to take action against a person subject to regulation under ch. 153, Stats., or chs. 600 to 655, Stats. Ins 5.07 HistoryHistory: Cr. Register, March, 1996, No. 483, eff. 4-1-96. Ins 5.08(1)(1) Issuance. If the office determines, based on its examination or investigation of a person regulated under ch. 153, Stats., or chs. 600 to 655, Stats., that there is probable cause to believe that a person has violated any provisions of those chapters, a rule promulgated under those chapters or an order under s. 601.41 (4) (a) and 601.63, 601.64 or 601.65, Stats., the office may issue an order under s. 153.78 or 601.41 (4) (a), Stats., or issue a notice of hearing under s. 601.62, Stats., and s. Ins 5.12, or both. Ins 5.08(2)(a)1.1. The identity and, if known, the address of each respondent to whom the order is directed. Ins 5.08(2)(a)2.2. A statement of the facts constituting the basis for the order. Ins 5.08(2)(a)3.3. A reference to each statute, rule or order which each respondent allegedly violated. Ins 5.08(2)(a)4.4. A description of what the order requires each respondent to do. Ins 5.08(2)(a)5.5. The signature and title of the designated employee of the office who issued the order. Ins 5.08(2)(b)(b) An order under s. 631.20 (4), Stats., disapproving a form filing shall be accompanied by notice of the right to a hearing under s. 601.62 (3) (a), Stats., and shall include all of the following: Ins 5.08(2)(b)2.2. A reference to each statute or administrative rule relied on for the disapproval. Ins 5.08(2)(b)3.3. The signature of the employee of the office issuing the disapproval. Ins 5.08(3)(a)1.1. A summary order under ss. 227.51 (3) and 628.10 (2) (b), Stats., suspending an intermediary agent’s license and ordering the agent to cease and desist from all activities of a licensed intermediary. Ins 5.08(3)(a)3.3. A summary order under any other section of the statutes suspending a license issued by the office. Ins 5.08(3)(b)(b) A summary order shall take effect upon service under s. Ins 5.17 (3) or upon actual notice of the order to the respondent or the respondent’s attorney, whichever is sooner, and shall continue in effect until the effective date of the final decision and order in any contested case proceeding arising out of the order. Ins 5.08(3)(c)(c) In addition to the requirements of sub. (2), a summary order shall include all of the following: Ins 5.08(3)(c)1.1. A finding either that the public health, safety or welfare requires emergency action or that irreparable harm to the property or business of the insurer or to the interests of its policyholders, creditors or the public may occur unless the summary order is issued.
