Ins 3.11(1)(a)(a) This rule implements and interprets s. Ins 6.70 and chs. 625 and 631, Stats., by enumerating the minimum requirements for the writing of multiple peril insurance contracts. Nothing herein contained is intended to prohibit insurers or groups of insurers from justifying rates or premiums in the manner provided for by the rating laws.

Ins 3.11(1)(b)(b) This rule shall apply to multiple peril insurance contracts permitted by s. Ins 6.70, and which include a type or types of coverage or a kind or kinds of insurance subject to ch. 625, Stats.

Ins 3.11(1)(c)(c) Types of coverage or kinds of insurance which are not subject to ch. 625, Stats., or to the filing requirement provisions thereof, may not be included in multiple peril insurance contracts otherwise subject to said sections unless such entire multiple peril insurance contract is filed as being subject to this rule and said sections and the filing requirements thereof.

Ins 3.11(2)(2) Definition. Multiple peril insurance contracts are contracts combining 2 or more types of coverage or kinds of insurance included in any one or more than one paragraph of s. Ins 6.75. Such contracts may be on the divisible or single (indivisible) rate or premium basis.

Ins 3.11(3)(a)(a) When underwriting experience is not available to support a filing, the information set forth in s. 625.12, Stats., may be furnished as supporting information.

Ins 3.11(3)(b)(b) Premiums or rates may be modified for demonstrated, measurable, or anticipated variation from normal of the loss or expense experience resulting from the combination or types of coverage or kinds of insurance or other factors of the multiple peril insurance contract. Multiple peril contracts may be filed or revised on the basis of sufficient underwriting experience developed by the contract or such experience may be used in support of such filing.

Ins 3.11(3)(c)(c) In the event that more than one rating organization cooperates in a single (indivisible) rate or premium multiple peril insurance filing, one of such cooperating rating organizations shall be designated as the sponsoring organization for such filing by each of the other cooperating rating organizations and evidence of such designation included with the filing.

Ins 3.11(4)(4) Standard policy. The requirements of s. Ins 6.76 shall apply to any multiple peril insurance contract which includes insurance against loss or damage by fire.

Ins 3.11 HistoryHistory: Cr. Register, July, 1958, No. 31, eff. 8-1-58; am. (3) (a), Register, November, 1960, No. 59, eff. 12-1-60; emerg. am. (1), (2), (3) (a) and (4), eff. 6-22-76; am. (1), (2), (3) (a) and (4), Register, September, 1976, No. 249, eff. 10-1-76; am. (1) (a) and (b), (2) and (4), Register, March, 1979, No. 279, eff. 4-1-79.

Ins 3.13(1)(1) Purpose. This section implements and interprets applicable statutes for the purpose of establishing procedures and requirements to expedite the review and approval of individual accident and sickness policies permitted by s. Ins 6.75 (1) (c) or (2) (c), and franchise type accident and sickness policies permitted by s. 600.03 (22), Stats., and s. Ins 6.75 (1) (c) and (2) (c). The requirements in subs. (2), (3), (4) and (6) are to be followed in substance, and wording other than that described may be used provided it is not less favorable to the insured or beneficiary.

Ins 3.13(2)(a)(a) If a policy is not to insure against sickness losses resulting from conditions in existence prior to the effective date of coverage, or in existence prior to a specified period after such effective date, the policy by its terms shall indicate that it covers sickness contracted and commencing (or beginning, or originating, or first manifested or words of similar import) after such effective date or after such specified period. Wording shall not be used that requires the cause of the condition or sickness, as distinguished from the condition or sickness itself, to originate after such effective date or such specified period.

Ins 3.13 NoteNote: It is understood that “sickness” as used herein means the condition or disease from which the disability or loss results. Paragraph (a) shall not apply to nor prohibit the exclusion from coverage of a disease or physical condition by name or specific description.

Ins 3.13(2)(b)(b) Where any “specified period” referred to in par. (a) exceeds 30 days, it shall apply to the occurrence of loss and not to the contracting or commencement of sickness after such period.

Ins 3.13(2)(c)(c) A policy, other than a non-cancellable policy or a non-cancellable and guaranteed renewable policy or a guaranteed renewable policy, shall set forth the conditions under which the policy may be renewed, either by: A brief description of the policy’s renewal conditions, or a separate statement referring to the policy’s renewal conditions, or a separate appropriately captioned renewal provision appearing on or commencing on the first page.

Ins 3.13(2)(c)1.1. The brief description, if used to meet the foregoing requirement, shall be printed, in type more prominent than that used in the policy’s text, at the top or bottom of the policy’s first page and on its filing back, if any, and shall describe its renewal conditions in one of the following ways: “Renewal Subject to Consent of Company,” “Renewal Subject to Company Consent,” “Renewal at Option of Company,” “Renewal at Option of Company as Stated in _________” (refer to appropriate policy provision), or “Renewal May be Refused as Stated in _________” (refer to appropriate policy provision). A company may submit other wording, subject to approval by the commissioner, which it believes is equally clear or more definite as to subject matter.

Ins 3.13(2)(c)2.2. The separate statement, if used to meet the foregoing requirement, shall be printed, in type more prominent than that used in the policy’s text, at the top or bottom of the policy’s first page and on its filing back, if any, and shall describe its renewal conditions in one of the following ways: “Renewal Subject to Consent of Company,” “Renewal Subject to Company Consent,” “Renewal at Option of Company,” “Renewal at Option of Company as Stated in _________” (refer to appropriate policy provision), or “Renewal May be Refused as Stated in _________” (refer to appropriate policy provision). A company may submit other wording, subject to approval by the commissioner, which it believes is equally clear or more definite as to subject matter.

Ins 3.13(2)(c)3.3. The renewal provision appearing on or commencing on the policy’s first page, if used to meet the foregoing requirement, shall be preceded by a caption which describes the policy’s renewal conditions in one of the following ways: “Renewal Subject to Consent of Company,” “Renewal Subject to Company Consent,” “Renewal at Option of Company,” “Renewal at Option of Company as Stated Below,” or “Renewal May be Refused as Stated Herein.” A company may submit other wording, subject to approval by the commissioner, which it believes is equally clear or more definite as to subject matter. The caption shall be in type more prominent than that used in the policy’s text.

Ins 3.13(2)(d)(d) If the policy is not renewable, it shall be so described in the brief description or in a separate statement at the top or bottom of the first page and on the filing back, if any, or it shall be so described in a separate appropriately captioned provision on the first page. The brief description, or the separate statement, or the caption shall be printed in type more prominent than that used in the policy’s text.

Ins 3.13(2)(e)1.1. The terms “non-cancellable” or “non-cancellable and guaranteed renewable” may be used only in a policy which the insured has the right to continue in force by the timely payment of premiums set forth in the policy:

Ins 3.13(2)(e)1.b.b. In the case of a policy issued after age 44, for at least 5 years from its date of issue, during which period the insurer has no right to make unilaterally any change in any provision of the policy while the policy is in force.

Ins 3.13(2)(e)2.2. A non-cancellable or non-cancellable and guaranteed renewable policy form shall disclose, as prominently as and in close conjunction with any prominent use of the terms “non-cancellable” or “non-cancellable and guaranteed renewable:”

Ins 3.13(2)(e)2.b.b. The age or time at which the form’s benefits are reduced, if applicable, (The age or time at which a form’s benefits are reduced need not be so disclosed if such reduction is not effected prior to the age to or term for which the form is non-cancellable or non-cancellable and guaranteed renewable or if regular benefits are payable at least to the age to or term for which the form is non-cancellable or non-cancellable and guaranteed renewable.) and