Attorney General Opinions
Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.
§431:10A-406 Forms; rates; approval. (a) The forms of the policies, applications, certificates, or other evidence of insurance coverage, commission schedules, and applicable premium rates relating thereto shall be filed with the commissioner.
(b) No policy, contract, certificate, or other evidence of insurance, application, or other form shall be sold, issued, or used and no endorsement shall be attached to or printed or stamped thereon unless its form has been approved by the commissioner or thirty days have expired after such filing without written notice from the commissioner of disapproval. The commissioner shall disapprove the forms for such insurance if the commissioner finds:
(1) That they are unjust, inequitable, misleading, or deceptive; or
(2) That the rates are by reasonable assumptions excessive in relation to the benefits provided.
In determining whether the rates by reasonable assumptions are excessive in relation to the benefits provided, the commissioner shall give due consideration to past and prospective claim experience, within and outside this State, and to fluctuations in such claim experience, to a reasonable risk charge, to contribution to surplus and contingency funds, to past and prospective expenses, both within and outside this State, and to all other relevant factors within and outside this State, including any differing operating methods of the insurers joining in the issue of the policy. In exercising the powers conferred by this part, the commissioner shall not be bound by any other requirement of this code with respect to standard provisions to be included in accident and health or sickness policies or forms.
(c) After hearing, upon written notice, the commissioner may withdraw an approval previously given if the commissioner is of the opinion that an original submission would have been disapproved. Such withdrawal of approval shall be effective not less than ninety days after the giving of notice of withdrawal. [L 1987, c 347, pt of §2; am L 2003, c 212, §80]
Section: Previous 431-10a-312 431-10a-401 431-10a-402 431-10a-403 431-10a-404 431-10a-404.5 431-10a-405 431-10a-406 431-10a-407 431-10a-408 431-10a-409 431-10a-410 431-10a-521-to-531 431-10a-601 431-10a-602 NextLast modified: October 27, 2016