Ins 6.09(5)(a)1.1. The insurer does not have an acceptable rating with a rating service or publication;
Ins 6.09(5)(a)2.2. The policy of insurance is assessable; or
Ins 6.09(5)(a)3.3. The financial condition of the insurer is unacceptable, unless the condition constitutes a violation of s. Ins 13.06 or 13.09.
Ins 6.09(5)(b)(b) A person may disapprove a policy issued by a town mutual insurer based wholly or partially on the ground that it does not have a mortgagee clause in the form permitted under s. Ins 13.04 (7) (b).
Ins 6.09(6)(6)Nonapplication. The provisions of this rule shall not apply to renewal of any policy of insurance where the obligation of the borrower to procure insurance for the security interest of the lending institution accrued prior to the effective date of this rule.
Ins 6.09 HistoryHistory: Cr. Register, December, 1968, No. 156, eff. 1-1-69; am. (1), Register, May, 1975, No. 233, eff. 6-1-75; emerg. am. (1) and (2) (e), eff. 6-22-76; am. (1) and (2) (e), Register, September, 1976, No. 249, eff. 10-1-76; am. (2) (e), Register, March, 1979, No. 279, eff. 4-1-79; renum. (5) to be (6), cr. (5), Register, May, 1986, No. 365, eff. 6-1-86.
Ins 6.10Ins 6.10Property and casualty premium restrictions.
Ins 6.10(1)(1)Purpose. This section requires insurers who may return a premium that is less than the pro rata unearned premium to disclose this to the insured. This section also establishes prohibitions concerning specified practices relating to premiums. This section implements and interprets ss. 227.10 (1), 601.01 (2), 625.13 (1), 628.34 (1), (3), (11), and (12), 631.20 and 631.36 (2), Stats.
Ins 6.10(2)(2)Scope. This section applies to all lines or classes of insurance classified as property and casualty insurance in s. Ins 6.75 (2), except lines or classes of insurance providing disability insurance under s. Ins 6.75 (2) (c) and (k).
Ins 6.10(3)(3)Definitions. In this section:
Ins 6.10(3)(a)(a) “Pro rata unearned premium” means the pro rata portion of the written premium covering the unexpired portion of the policy term for which the written premium has been charged by the insurer to the policyholder.
Ins 6.10(3)(b)(b) “Written premium” means the entire amount of premium charged a policyholder for the term of the policy.
Ins 6.10(4)(4)Premium in excess of pro rata earned premium: filing, restrictions, disclosures.
Ins 6.10(4)(a)(a) An insurer shall file with the commissioner in accordance with s. 625.13, Stats., and s. Ins 6.06 any schedule of return premium applicable in the event of policy cancellation wherein the return of premium is less than the pro rata unearned premium for that policy form. The rate filing shall include the basis of the premium calculation in the event of a policy cancellation.
Ins 6.10(4)(b)(b) Subject to par. (c), in any policy under which an insurer may return a premium that is less than the pro rata unearned premium, the insurer shall provide the policyholder with a separate written notice that the policyholder may pay a substantial penalty if the policyholder cancels the policy prior to its expiration date. No insurer may return a premium that is less than the pro rata unearned premium until at least 10 days after the insurer mails or delivers this written notice to the policyholder.
Ins 6.10(4)(c)(c) Notwithstanding pars. (a) and (b), no insurer may return to the policyholder a premium that is less than the pro rata unearned premium if the insurer initiates cancellation or for a cancellation due to the nonpayment of premium.
Ins 6.10(5)(5)Miscellaneous premium prohibition. No insurer may initiate cancellation of one policy solely to apply the pro rata unearned premium of that policy to the balance due on another policy.
Ins 6.10 HistoryHistory: Cr. Register, August, 1989, No. 404, eff. 10-1-89; am. (2), Register, April, 1992, No. 436, eff. 5-1-92.
Ins 6.11Ins 6.11Insurance claim settlement practices.
Ins 6.11(1)(1)Purpose. This rule is to promote the fair and equitable treatment of policyholders, claimants and insurers by defining certain claim adjustment practices which are considered to be unfair methods and practices in the business of insurance. The rule implements and interprets applicable statutes including but not limited to ss. 601.04 (3), 601.01 (2), and 645.41 (3), Stats.
Ins 6.11(2)(2)Scope. This rule applies to the kinds of insurance identified in s. Ins 6.75, transacted by insurers as defined in s. 600.03 (27), Stats., and nonprofit service plans subject to ch. 613, Stats.
Ins 6.11(3)(3)Unfair claim settlement practices.
Ins 6.11(3)(a)(a) Any of the following acts, if committed by any person without just cause and performed with such frequency as to indicate general business practice, shall constitute unfair methods and practices in the business of insurance:
Ins 6.11(3)(a)1.1. Failure to promptly acknowledge pertinent communications with respect to claims arising under insurance policies.
Ins 6.11(3)(a)2.2. Failure to initiate and conclude a claims investigation with all reasonable dispatch.
Ins 6.11(3)(a)3.3. Failure to promptly provide necessary claims forms, instructions and reasonable assistance to insureds and claimants under its insurance policies.
Ins 6.11(3)(a)4.4. Failure to attempt in good faith to effectuate fair and equitable settlement of claims submitted in which liability has become reasonably clear.
Ins 6.11(3)(a)5.5. Failure upon request of a claimant, to promptly provide a reasonable explanation of the basis in the policy contract or applicable law for denial of a claim or for the offer of a compromise settlement.
Ins 6.11(3)(a)6.6. Knowingly misrepresenting to claimants pertinent facts or policy provisions relating to coverages involved.