§431:10B-108 - Filing, approval, and withdrawal of forms and premium rates.

§431:10B-108 Filing, approval, and
withdrawal of forms and premium rates. (a) All policies, certificates of
insurance, notices of proposed insurance, applications for insurance,
endorsements, and riders delivered or issued for delivery in this State and the
schedules of premium rates pertaining thereto shall be filed with the
commissioner for approval. Each filing shall be accompanied by a $20 fee
payable to the commissioner, which fee shall be deposited in the commissioner's
education and training fund. Forms and rates so filed shall be approved at the
expiration of forty-five days after filing, unless earlier approved or
disapproved by the commissioner. The commissioner by written notice to the
insurer, within the forty-five-day period, may extend the period for an
additional thirty days.

(b) The commissioner, within the waiting
period or any extension thereof after the filing of the policies, certificates
of insurance, notices of proposed insurance, applications for insurance,
endorsements, and riders and premium rates, shall disapprove any form or any
premium rates if:

(1) The benefits provided are not reasonable in
relation to the premium charge; or

(2) The form contains provisions that are:

(A) Unjust, unfair, inequitable, misleading,
or deceptive;

(B) Encourage misrepresentation of the
coverage; or

(c) The benefits provided by the policy form
shall not be deemed reasonable in relation to the premium charged or to be
charged if the ratio of losses incurred to premiums earned is not at least
sixty per cent. The commissioner may adopt by rules prima facie acceptable
premium rates that shall reasonably be expected to produce a sixty per cent
loss ratio. The prima facie rates shall be usable without actuarial or
statistical justification when filed together with an otherwise acceptable
policy form; provided that the ratio of losses for the most recent three years
is at least sixty per cent. The rules shall specify the plans of benefits to
which the premium rates shall apply.

(d) The commissioner shall approve deviations
to rates higher than the prima facie acceptable rates upon filing of reasonable
evidence that loss experience for a creditor or a class of creditors exceeds
the average loss experience used to determine the prima facie rates if the
commissioner determines the use of the higher rates will result in a ratio of
claims incurred to premiums earned that is not less than sixty per cent.
Except where the deviated rate exceeds the prima facie rate for reducing term
credit life insurance and its actuarial equivalent for other forms of credit
life insurance, a reasonable variance from the sixty per cent loss ratio
standard may be required. The deviation may be limited to the debtors or
creditors whose experience was the statistical basis for the filing.

(e) Whenever the commissioner determines it to
be prudent, the commissioner may require insurers to file information as the
commissioner deems necessary to determine whether the approved deviation from
prima facie rates is still justified. If the commissioner determines the
insurer's loss experience no longer justifies a deviation from the prima facie
rates, then, upon giving notice as required in subsection (g), the commissioner
shall disapprove the deviation and any form including the rate set forth
therein.

(f) Credit life insurance policies for which
premium rates vary by individual ages or by age brackets shall be filed as
provided in this section. The commissioner shall approve or disapprove the
filings in accordance with the sixty per cent loss ratio standard and the other
applicable provisions of law.

(g) If the commissioner notifies the insurer
that the form or premium rate is disapproved, it shall be unlawful thereafter
for the insurer to issue or use the form or premium rate. In the notice, the
commissioner shall specify the reason for the commissioner's disapproval and
state that a hearing will be granted within twenty days after request in
writing by the insurer. No policy, certificate of insurance, or notice of
proposed insurance, nor any application, endorsement, or rider, or premium
rate, shall be issued or used until the expiration of forty-five days after it
has been so filed, unless the commissioner gives the commissioner's prior
written approval.

(h) The commissioner at any time after hearing
held not less than twenty days after written notice to the insurer, may
withdraw the commissioner's approval of a form or premium rate on any ground
set forth in subsection (b). The written notice of the hearing shall state the
reason for the proposed withdrawal.

(i) It shall be unlawful for the insurer to
issue or use forms or premium rates after the effective date of their
withdrawal.

(j) If a group policy of credit life insurance
or credit disability insurance:

(1) Has been delivered in this State before July 1,
1969, or

(2) Has been or is delivered in another state before
or after July 1, 1969, the insurer shall be required to file only the group
certificate and notice of proposed insurance delivered or issued for delivery
in this State as specified in subsections (b) and (e) of section 431:10B-107.
The forms shall be approved by the commissioner if:

(i) They conform with the requirements
specified in those subsections;

(ii) They are accompanied by a certification in
a form satisfactory to the commissioner that the substance of the forms are in
substantial conformity with the master policy; and

(iii) The schedules of premium rates applicable
to the insurance evidenced by the certificate or notice are not in excess of
the insurer's schedules of premium rates filed with and approved by the
commissioner;

provided the premium rate in effect on existing
group policies may be continued until the first policy anniversary date
following July 1, 1969.

(k) Any order or final determination of the
commissioner under this section shall be subject to chapter 91. [L 1987, c 347,
pt of §2 as superseded by c 348, §16; am L 1988, c 363, §3; am L 1989, c 207,
§12; am L 2000, c 182, §10; am L 2004, c 122, §38]