reglab/statecodes huggingface dataset:
2023 Wisconsin Statutes & Annotations › Chapter 628 - Insurance marketing. › 628.90 - Definitions.

628.90
Definitions.
In this subchapter:
(1)
“Exchange" means the American health benefit exchange, as described in 42 USC 18031.
(2)
“Health benefit plan" has the meaning given in s. 632.745 (11).
(3)
(a)
Except as provided in par. (b), “navigator" means a natural person, or an entity that supervises or employs a natural person, who does all of the following:
1.
Performs any of the activities and duties identified in 42 USC 18031 (i) and 45 CFR 155.210 on behalf of the exchange.
2.
Receives funding to perform any of the activities and duties identified in 42 USC 18031 (i) and 45 CFR 155.210 on behalf of the exchange.
(b)
“Navigator" does not include a person acting as an insurance intermediary licensed under subch. II, but an insurance intermediary may apply to be licensed as a navigator under this subchapter.
(4)
“Nonnavigator assister" means a natural person who has been designated by the exchange, or could reasonably be described as working at the behest of the exchange, as a nonnavigator assister, including an in-person assister, enrollment assister, application assister, or certified application counselor.
History:  2013 a. 20.
2023 Wisconsin Statutes & Annotations › Chapter 628 - Insurance marketing. › 628.93 - Other applicable provisions.

628.93
Other applicable provisions.
(1)
Social security and federal employer identification numbers on applications or at time of fee payment. Applicants for individual navigator licensure and navigator entity registration are subject to s. 628.095.
(2)
Refusal to issue license; failure to pay support or to comply with subpoena or warrant; delinquent taxes or unemployment insurance contributions. Applicants for individual navigator licensure and navigator entity registration are subject to s. 628.097.
(3)
Termination of license. Individual navigator licenses are subject to s. 628.10.
History:  2013 a. 20, 276.
2023 Wisconsin Statutes & Annotations › Chapter 628 - Insurance marketing. › 628.95 - Navigator and nonnavigator assister conduct.

628.95
Navigator and nonnavigator assister conduct.
(1)
General. For purposes of this subchapter, a navigator or nonnavigator assister, in the performance of its duties, shall be considered to be transacting the business of insurance.
(2)
Prohibited practices. A navigator or nonnavigator assister may not do any of the following:
(a)
Receive compensation from an insurer who offers a health benefit plan or stop loss insurance or from a 3rd-party administrator.
(b)
Provide any information or services related to enrollment in health benefit plans or other insurance products not offered in the exchange.
(c)
Make or cause to be made any communication relating to the exchange, health benefit plans, an insurance contract, the insurance business, any insurer, any navigator, any nonnavigator assister, or any intermediary that contains false, deceptive, or misleading information, including information that is misleading because of incompleteness.
(d)
Provide advice about which health benefit plan is better or worse for a particular individual or employer.
(e)
Recommend a particular health benefit plan or insurer or advise consumers about which health benefit plan to choose.
(f)
Engage in any unfair method of competition or any other unfair, fraudulent, deceptive, or dishonest act or practice.
(g)
Receive compensation that is dependent, in whole or in part, on whether an individual enrolls in or renews a health benefit plan.
(3)
Restitution. The commissioner may require that any person that violates this subchapter make restitution to any individual who suffers financial injury because of the violation of this subchapter.
History:  2013 a. 20.
2023 Wisconsin Statutes & Annotations › Chapter 628 - Insurance marketing. › 628.96 - Nonnavigator assisters.

628.96
Nonnavigator assisters.
(1)
Registration required. Any entity that employs one or more nonnavigator assisters shall, in a manner prescribed by the commissioner, provide the commissioner with a list of all nonnavigator assisters that it employs, supervises, or is affiliated with upon the nonnavigator assisters first becoming authorized by the exchange to provide nonnavigator assistance. Thereafter, the entity shall provide updates, if any, to the list of nonnavigator assisters on a monthly basis. No nonnavigator assister may act as a nonnavigator assister in this state until registered with the commissioner. The commissioner may refuse to register any nonnavigator assister to which any of the following applies:
(a)
The nonnavigator assister does not possess the requisite character, integrity, competency, and trustworthiness as determined in accordance with the criteria under the rules promulgated under s. 628.04.
(b)
The nonnavigator assister has committed any act that the commissioner finds would warrant the denial, suspension, or revocation of a license or registration under this subchapter.
(2)
Application counselors. In addition to the requirements of this section, certified application counselors, as established by 45 CFR 155.225, shall be required to meet the training and examination requirements set forth in s. 628.92 (7). Certified application counselors may also become licensed as individual navigators.
(3)
Entity liability. An entity that employs, supervises, or is formally affiliated with a nonnavigator assister assumes legal responsibility for the acts of the nonnavigator assister that are performed in this state and that are within the scope of the nonnavigator assister's apparent authority to act as a nonnavigator assister on behalf of that entity.
(4)
Exemption for government entities. This section does not apply to any government entity or any person acting on behalf of a government entity.
History:  2013 a. 20.
2023 Wisconsin Statutes & Annotations › Chapter 628 - Insurance marketing. › 628.98 - Rules.

628.98
Rules.
The commissioner may promulgate any rules necessary to carry out the purposes of this subchapter. Notwithstanding s. 227.24 (1) (a) and (3), the commissioner may promulgate rules under this section as emergency rules under s. 227.24 without providing evidence that promulgating a rule under this section as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and without a finding of emergency.
History:  2013 a. 20.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.01 - Definitions.

629.01
Definitions.
In this chapter:
(1)
“Adjusting service” means an act on behalf of an insured, in exchange for compensation, with the preparation, completion, or filing of a first-party claim, including by negotiating values, damages, or depreciation or by applying the loss circumstances to insurance policy provisions.
(2)
“Compensation” means anything of value received directly or indirectly in return for the performance of an adjusting service.
(3)
“First-party claim” means a claim for damage or loss to real or personal property located in this state that is filed by an insured.
(4)
“Insured” means a person whose real or personal property is insured under an insurance policy against which a claim is or will be made.
(5)
“Public adjuster” means an individual who engages in adjusting services in this state and, in the case of an individual who is not a resident of this state, has registered with the commissioner under s. 629.02 (2), but does not include any of the following:
(a)
An attorney admitted to practice in this state while acting in his or her professional capacity as an attorney.
(b)
An individual who negotiates or settles claims arising under a life insurance policy, a policy of disability insurance, as defined in s. 645.675 (1) (h), or an annuity contract.
(c)
An individual employed solely for the purpose of obtaining facts surrounding a loss or furnishing technical assistance to a public adjuster, including a photographer, estimator, private investigator, engineer, or handwriting expert.
(d)
An individual who settles subrogation claims between insurers.
(e)
An individual who is licensed as an intermediary under s. 628.04 or 628.09 while acting in his or her professional capacity as an intermediary.
(f)
An individual who represents an insurer in negotiations for the settlement of a claim against the insurer arising out of the coverage provided by an insurance policy.
(g)
A travel administrator, as defined in s. 632.977 (1) (g).
History:  2019 a. 129; 2021 a. 111; 2021 a. 240 s. 30.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.02 - Registration.

629.02
Registration.
(1)
List of registered public adjusters. The commissioner shall maintain on the office's Internet site a list of public adjusters who have registered with the commissioner under sub. (2).
(2)
Application. A public adjuster who is not a resident of this state shall register with the commissioner prior to engaging in adjusting services in this state. A public adjuster who is a resident of this state may register with the commissioner. In order to register under this subsection, the public adjuster shall complete an application form prescribed by the commissioner. The form shall request the individual to provide the individual's social security number and all documentation the commissioner determines is necessary and appropriate. The commissioner shall approve the individual's registration application if the commissioner determines the individual satisfies all the following conditions:
(a)
The individual has not committed any act subject to penalty under s. 629.13.
(c)
The individual pays the fee under s. 601.31 (1) (z).
(d)
The individual maintains a home office in the individual's state of residence and is available to the public at that office through reasonable appointment hours or regular business hours.
(e)
The individual is at least 18 years of age.
(f)
The individual meets the requirements of ss. 629.03 and 629.11.
(h)
If the individual is not a resident of this state, the individual agrees to be subject to the jurisdiction of the commissioner and the courts of this state and to the commissioner's rules and orders with service of process as provided under ss. 601.72 and 601.73.
(4)
Term; renewal. A registration under sub. (2) shall remain in effect for 2 years from the date of issuance, unless it is revoked or suspended by the commissioner under s. 629.13. An individual may renew a registration by submitting, prior to the registration's expiration date, a request for renewal to the commissioner in the form prescribed by the commissioner. The request shall include evidence of compliance with s. 629.11 and payment of the fee under s. 601.31 (1) (zb). An individual who fails to renew a registration prior to the expiration date may reapply for registration under sub. (2).
History:  2019 a. 129; 2021 a. 240 s. 30.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.03 - Examination.

629.03
Examination.
(1)
Prior to the commissioner approving an individual's registration under s. 629.02 (2), the individual shall pass a written examination that tests knowledge of the duties and responsibilities of a public adjuster and the insurance laws and regulations of this state. The examination shall be conducted as prescribed by the commissioner and require payment of the fee under s. 601.31 (1) (zc). The commissioner may contract with an outside testing service for administering the examination and collecting the fee.
(2)
An individual who is not a resident of this state and who is a licensed or registered public adjuster in the individual's state of residence and was required to pass a written examination to obtain that license or registration may request the commissioner to accept proof of the examination's passage as fulfilling the requirement under sub. (1). The commissioner may approve the request if the individual's license or registration in that state is in good standing.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.04 - Contract requirements.

629.04
Contract requirements.
(1)
A public adjuster may not perform any adjusting service for an insured prior to entering into a contract with the insured. The contract shall be in writing, be titled “Public Adjuster Contract,” and be on a form filed with the commissioner under s. 631.20 (1m). The contract shall include all of the following:
(a)
The public adjuster's full name, state of residence, permanent principal business street address, telephone number, and, if applicable, registration number assigned by the commissioner.
(b)
The insured's full name, street address, insurer name, and policy number.
(c)
A description of the loss and its location.
(d)
The date and time the contract was signed by the public adjuster and the insured.
(e)
An attestation by the public adjuster that he or she is fully bonded pursuant to state law.
(f)
A disclosure of the compensation the public adjuster is to receive in accordance with s. 629.05.
(g)
A provision allowing the insured to void the contract in accordance with sub. (3).
(h)
A statement that the contract shall constitute the entire agreement between the public adjuster and the insured.
(2)
A contract under sub. (1) may not require the insured to do any of the following:
(a)
Authorize an insurer to issue a check only in the name of the public adjuster.
(b)
Pay collection costs or a late fee to the public adjuster.
(c)
Limit the insured's right to pursue any civil remedy against the public adjuster.
(3)
At the insured's option, the insured may void a contract under sub. (1) no later than 5 business days after the contract's execution. The insured may void the contract by sending notice by registered or certified mail, return receipt requested, to the public adjuster at the address on the contract or by personally serving notice on the public adjuster at the place of business identified on the contract. The public adjuster shall return anything of value provided under the contract by the insured no later than 15 business days following receipt of the notice. Nothing in this subsection prevents an insured from pursuing any civil remedy against a public adjuster.
(4)
A contract under sub. (1) shall be executed in duplicate with an original provided to the public adjuster and to the insured. The public adjuster shall make the contract available to the commissioner at all times for inspection without notice.
(5)
A public adjuster shall include with the contract under sub. (1) a notice of the insured's right to file a complaint with the commissioner about an insurance problem. The notice shall be on a single piece of paper that is separate from the contract and shall include all of the following:
(a)
The information described in sub. (1) (a).
(b)
A clear statement of the insured's right to file a complaint.
(c)
Information on how the insured may obtain a complaint form by contacting the office of the commissioner or from the office's Internet site.
(d)
The office of the commissioner's mailing address and phone numbers and the address of the office's Internet site.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.05 - Compensation.

629.05
Compensation.
(1)
In this section, “catastrophic disaster” means an event for which the president of the United States or the governor has declared a state of emergency.
(2)
The contract under s. 629.04 shall clearly disclose the compensation the public adjuster is to receive from the insured.
(3)
If an insurer pays, or commits in writing to pay, the policy limit no later than 5 business days after the date the loss is reported to the insurer, the only compensation a public adjuster may receive from the insured shall be compensation at a reasonable hourly rate for the time spent on the claim.
(4)
A public adjuster may not demand compensation from the insured prior to the insured receiving payment from the insurer.
(5)
If an insurer pays a claim in installments, the public adjuster shall receive the compensation in equal amounts prorated over the number of checks issued by the insurer and may not demand to be paid entirely from the first check issued.
(6)
A public adjuster may not receive compensation in excess of 10 percent of an insured's actual recovery under the insurance policy if the claim is due to a catastrophic disaster.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.06 - Additional compensation.

629.06
Additional compensation.
A public adjuster may not directly or indirectly accept compensation or anything else of value from an insured and a person who provides estimates for work or performs work in conjunction with damage or loss under a claim subject to a contract under s. 629.04.
History:  2019 a. 129; 2021 a. 240 s. 30.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.07 - Assignment of proceeds prohibited.

629.07
Assignment of proceeds prohibited.
(1)
A public adjuster may not request or accept an assignment of insurance policy proceeds from an insured with whom the public adjuster has entered into a contract under s. 629.04. An insurer may not be required to honor an assignment of insurance policy proceeds to a public adjuster.
(2)
A public adjuster may request that an insurer include both the public adjuster and the insured on a check paying all or part of the proceeds of an insurance policy if the contract under s. 629.04 permits joint payment of proceeds.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.08 - Escrow of funds.

629.08
Escrow of funds.
A public adjuster who, on behalf of an insured, receives, accepts, or holds any funds for the settlement of a first-party claim shall deposit the funds in a noninterest-bearing escrow account in a federally insured financial institution that is located in the state in which the insured resides or the loss occurred.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.09 - Contractors.

629.09
Contractors.
A public adjuster may not require an insured to use a particular contractor or vendor and may not take any action that vests the effective authority with the public adjuster to choose a person to perform work on the insured's claim. A contract under s. 629.04 shall state that the insured may choose any contractor or vendor.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.10 - Prohibitions.

629.10
Prohibitions.
In addition to the other prohibitions in this chapter, a public adjuster may not do any of the following:
(1)
Solicit, or attempt to solicit, an insured during the progress of a loss-producing occurrence, as defined in the insured's insurance policy.
(3)
Own a direct or indirect financial interest in any aspect of a claim, other than the compensation agreed to under s. 629.04 (1) (f).
(4)
Acquire an interest in salvage of the insured's property unless obtaining written permission from the insured after settlement of the claim.
(5)
Refer the insured to a person in whom the public adjuster has a direct or indirect financial interest or from whom the public adjuster may directly or indirectly receive anything of value.
(6)
Solicit an insured outside the hours of 9 a.m. and 8 p.m. during the first 24 hours after the loss.
(7)
Undertake an adjusting service without being competent and knowledgeable about the terms and conditions of the insured's insurance coverage or if the loss or coverage exceeds the public adjuster's expertise.
(8)
Knowingly make a false material statement regarding any person engaged in the business of insurance to a client or potential client.
(9)
Act as an adjuster for an insurer or independent adjuster.
(10)
Agree to a settlement without the insured's knowledge and written consent.
History:  2019 a. 129; 2021 a. 240 s. 30.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.11 - Continuing education.

629.11
Continuing education.
(1)
Prior to the commissioner approving an individual's registration under s. 629.02 (2), the individual shall certify to the commissioner that the individual will complete, on a biennial basis, a minimum of 15 credits of continuing education, including 3 credits of ethics. Each credit shall consist of at least 50 minutes of instruction and shall be approved by the commissioner. A public adjuster shall report the credits in conjunction with the registration renewal under s. 629.02 (4), if applicable.
(2)
An individual who is not a resident of this state and who is a licensed or registered public adjuster in the individual's state of residence and complies with continuing education requirements in that state that are substantially similar to the requirements under sub. (1) may submit to the commissioner proof of compliance with that state's requirements. If the individual's state of residence provides credit to the residents of this state on a reciprocal basis, the commissioner shall accept the proof of compliance as meeting the requirement under sub. (1).
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.12 - Reporting of administrative and criminal actions.

629.12
Reporting of administrative and criminal actions.
(1)
A public adjuster shall report to the commissioner any administrative action related to the business of insurance that is taken against the public adjuster by a governmental agency or regulatory body. The report shall be made no later than 30 days after the final disposition of the matter and shall include a copy of the order, consent to order, or similar document.
(2)
A public adjuster shall report to the commissioner any criminal prosecution taken against the public adjuster in any jurisdiction. The report shall be made no later then 30 days after the date of the initial pretrial hearing and shall include a copy of the complaint, the order from the hearing, and any other information required by the commissioner.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 629 - Public adjusters. › 629.13 - Penalties.

629.13
Penalties.
Upon a finding that a public adjuster has done any of the following, the commissioner may, after a hearing, notify the public by posting the public adjuster's name and infraction on the office's Internet site, levy a civil penalty, or, if applicable, suspend or revoke the public adjuster's registration under s. 629.02, or do any combination of the 3 actions:
(1)
Provided false, misleading, or incomplete information in the registration application.
(2)
Failed to comply with any provision in this chapter.
(3)
Violated any insurance law or rule or any subpoena or order of the commissioner or insurance regulatory body of another state.
(4)
Obtained, or attempted to obtain, registration as a public adjuster through misrepresentation or fraud.
(5)
Misappropriated or otherwise improperly handled money or property received in the course of doing business as a public adjuster.
(6)
Intentionally misrepresented the terms of an insurance policy.
(7)
Been convicted of a felony related to the duties and obligations of a public adjuster or the business of insurance.
(8)
Admitted to committing, or is found to have committed, any insurance unfair trade practice or insurance fraud.
(9)
Used fraudulent, coercive, or dishonest practices, or demonstrated incompetence or untrustworthiness, in the conduct of business in any jurisdiction.
(10)
Had an intermediary license or public adjuster license or registration denied, suspended, or revoked in any jurisdiction.
(11)
Cheated on an examination for a public adjuster license or registration.
(12)
Misrepresented to a person that the individual represents or is employed by an insurer in any capacity, including as an independent adjuster.
History:  2019 a. 129.
2023 Wisconsin Statutes & Annotations › Chapter 630 - General public policy provisions applicable to insurers and others. › 630.05 - Political contributions.

630.05
Political contributions.
Section 11.1112 applies to:
(1)
All insurers under s. 600.03 (27).
(2)
Service insurance corporations under ch. 613.
(3)
Cooperatives under s. 185.981 and insurers operating under subch. I of ch. 616.
(4)
Motor clubs under ss. 616.71 to 616.82.
History:  1979 c. 102; 1983 a. 189 s. 329 (25); 1983 a. 274; 2015 a. 117.
Legislative Council Note, 1979: This section provides a convenient cross-reference to the general corporate provision and makes clear that it applies to all types of insurers. It replaces s. 610.55 which applied only to life insurance companies. That section was originally enacted by ch. 343, laws of 1906. Apparently, the provision has been generally ignored since that time, except for the filing of a special schedule to annual statements. A reason for ignoring the section appears to be the action of the 1905 legislature in passing a general prohibition against political contributions [ch. 492, laws of 1905]. [Bill 146-S]
2023 Wisconsin Statutes & Annotations › Chapter 630 - General public policy provisions applicable to insurers and others. › 630.10 - Lobbying.

630.10
Lobbying.
Subchapter III of ch. 13 applies to all persons subject to regulation under chs. 600 to 655.
History:  1979 c. 102; 1981 c. 314; 1989 a. 187 s. 29.
Legislative Council Note, 1979: This section provides a convenient cross-reference to the laws regulating lobbying generally and makes clear that it applies to persons regulated under the insurance code.
It replaces s. 610.57 which applied only to life insurance companies. Section 610.57 has been a part of the statutes since passage of ch. 131, laws of 1907. It has been largely ignored in the belief that the general lobbying laws applied to insurance companies and others concerned with insurance matters, especially since adoption of ch. 609, laws of 1947, creating ss. 13.60 to 13.73. [Bill 146-S]
2023 Wisconsin Statutes & Annotations › Chapter 630 - General public policy provisions applicable to insurers and others. › 630.15 - Prohibited relationships between life insurers and funeral directors or cemeteries.

630.15
Prohibited relationships between life insurers and funeral directors or cemeteries.
No life insurer may invest directly in or, except as a loan secured by a mortgage on real estate or as a policy loan, lend money to a funeral director or cemetery or any association of funeral directors or cemeteries. No funeral director or cemetery or association of funeral directors or cemeteries may control a life insurer.
History:  1979 c. 102.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.02 - Definition.

631.02
Definition.
“Interest of the insured," when used in an insurance policy, includes the interest of the named insured and of any other person with whom the named insured holds the insured property in joint tenancy or as marital property.
History:  1979 c. 102; 1983 a. 186; 2015 a. 196.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.03 - Insurance in mutuals.

631.03
Insurance in mutuals.
Any mutual under ch. 611 or 612 and any service corporation under ch. 613 may issue policies to any public or private corporation, board or association or to any unit of government, in any place in this state or elsewhere where it is authorized to do an insurance business. Any public or private corporation, board or association or unit of government in this state that is authorized to acquire insurance may make applications, enter into agreements for and hold policies in any mutual insurer or service corporation authorized under ch. 611, 612, 613 or 618.
History:  1975 c. 375.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.05 - Oral contracts of insurance and binders.

631.05
Oral contracts of insurance and binders.
No provision of chs. 600 to 646 and 655 may be interpreted to forbid an oral contract of insurance or issuance of a written binder. The insurer shall issue a policy as soon as reasonably possible after issuance of any binder or negotiation of an oral contract.
History:  1975 c. 375; 1979 c. 89; 1989 a. 187 s. 29.
The insurer's delay in issuing the title insurance policy did not preclude the insurer from denying coverage per the policy's terms. Columb v. Cox, 2022 WI App 32, 404 Wis. 2d 50, 978 N.W.2d 481, 20-1593.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.08 - Mistakes in contracts.

631.08
Mistakes in contracts.
(1)
General. Except as otherwise provided in chs. 600 to 646 and 655, general contract law applies to mistakes in insurance contracts.
(2)
Person to whom proceeds payable in property insurance. Mistake in designating the person to whom the insurance is payable in a policy of property insurance does not void the policy nor constitute a defense for the insurer unless the mistake was due to misrepresentation or concealment by the owner of the property or someone representing the owner in procuring the policy, or unless the company would not have issued or continued the policy if it had known the truth.
History:  1975 c. 375, 421; 1979 c. 89; 1989 a. 187 s. 29.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.09 - Knowledge and acts of agents.

631.09
Knowledge and acts of agents.
(1)
Imputation of knowledge. An insurer is deemed to know any fact material to the risk or which breaches a condition of the policy, if the agent who bound the insurer or issued the policy or transmitted the application to the insurer knew it at the time the agent acted, or if thereafter any of the insurer's agents with whom the policyholder is then dealing as agent of the insurer learns it in the course of the agent's dealing with the policyholder, and knows that it pertains to a policy written by the insurer.
(2)
Acts of agent. A failure by any policyholder or insured to perform an act required to perfect his or her rights under the policy, or failure to perform the act in the time and manner prescribed, does not affect the insurer's obligations under the policy if the failure was caused by an act, statement or representation or omission to perform a duty by an agent of the insurer who has apparent authority, whether or not the agent was within the actual scope of the agent's authority.
(3)
Effect of notice to agent. Notice given by or on behalf of the policyholder or insured to any authorized agent of the insurer with particulars sufficient to identify the policy is notice to the insurer.
(4)
Collusion. Subsections (1) and (2) do not apply if the agent and the policyholder or insured acted in collusion to deceive or defraud the insurer, or if the policyholder or insured knew the agent was acting beyond the scope of the agent's authority.
(5)
Group policyholder not agent. No person is an agent of an insurer merely because the person is a policyholder of a group insurance policy.
(6)
Liability under common law. This section does not diminish any liability of the insurer that would exist under common law.
History:  1975 c. 375, 421.
Absent proof that an agent knew, or should have known, of financial problems of a reinsurer from whom the agent procured insurance, the agent is not liable when the reinsurer later becomes insolvent. Master Plumbers Ltd. Mutual Liability Co. v. Cormany & Bird, Inc., 79 Wis. 2d 308, 255 N.W.2d 533 (1977).
When an insured elected to have open heart surgery after an agent indicated that the insurer would probably pay the bills, that action was sufficient reliance to estop the insurer from denying coverage. Nolden v. Mutual Benefit Life Insurance Co., 80 Wis. 2d 353, 259 N.W.2d 75 (1977).
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.13 - Incorporation by reference.

631.13
Incorporation by reference.
No insurance contract may contain any agreement or incorporate any provision not fully set forth in the policy or in an application or other document attached to and made a part of the policy at the time of its delivery except that:
(1)
Rates. Any policy may by reference incorporate rate schedules and classifications of risks and short-rate tables filed with the commissioner; and
(2)
Complex contracts. By rule or order or by approval of a form the commissioner may authorize for complex contracts incorporation by reference of provisions for administrative arrangements, premium schedules and payment procedures.
History:  1975 c. 375.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.15 - Contract rights under noncomplying policies.

631.15
Contract rights under noncomplying policies.
(1)
Enforcement of policy terms. Except as otherwise specifically provided by statute, a policy is enforceable against the insurer according to its terms, even if it exceeds the authority of the insurer.
(3m)
Enforcement of statute and rule requirements. A policy that violates a statute or rule is enforceable against the insurer as if it conformed to the statute or rule.
(4)
Reformation of contract. Upon written request of the policyholder or an insured whose rights under the policy are continuing and not transitory, an insurer shall reform and reissue its written policy to comply with the requirements of the law existing at the date of issue or last renewal of the policy.
History:  1975 c. 375; 1987 a. 247.
When uninsured motorist coverage in the amount of $25,000 was contracted for, in violation of the requirement for $50,000 coverage under s. 632.32 (4m) (d), the higher level of coverage was read into the policy under sub. (3m), even though it was not reflected in the premium paid. Brunson v. Ward, 2001 WI 89, 245 Wis. 2d 163, 629 N.W.2d 140, 98-3002.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.17 - Written reason for coverage denial.

631.17
Written reason for coverage denial.
(1)
In this section, “disability insurance policy" has the meaning given in s. 632.895 (1) (a).
(2)
An insurer that denies coverage under an individual or group life or disability insurance policy or a certificate of group life or disability insurance shall advise the applicant or proposed insured in writing of the reasons for the denial.
History:  1999 a. 95.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.21 - Explicit approval required.

631.21
Explicit approval required.
(1)
Required approval. Despite filing or general approval of a form under s. 631.20, the following clauses may not be used even if contained in the form unless the commissioner gives explicit approval to them:
(a)
Expeditious notice. Clauses requiring more expeditious notice than 1st class mail, as provided in s. 631.81 (2).
(c)
Reinstatement fees. A schedule of reinstatement fees under s. 632.74, if made a part of the policy. Such a schedule need not be included in the contract but may be given approval as a separate document specifically made applicable to particular classes of policies.
(2)
Effect of failure to obtain explicit approval. If an insurer fails to obtain explicit approval from the commissioner for the clauses under sub. (1), the clauses shall be null and void.
History:  1975 c. 375; 1985 a. 280; 2007 a. 168.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.22 - Consumer insurance policy readability.

631.22
Consumer insurance policy readability.
(1)
In this section “consumer insurance policy" means a life, disability, property or casualty insurance policy, or a certificate or a substitute for a certificate for group life, disability, property or casualty insurance coverage, which is issued to a person for a personal, family or household purpose and a copy of which is customarily, in the insurance industry, delivered or is required by law, rule or agreement to be delivered to the person obtaining insurance coverage.
(2)
An insurer may provide a consumer insurance policy which is delivered to a person obtaining insurance coverage and is not exempt under sub. (5) only if the consumer insurance policy is coherent, written in commonly understood language, legible, appropriately divided and captioned by its various sections and presented in a meaningful sequence. The commissioner shall promulgate rules establishing standards for the determination of compliance with this subsection.
(3)
This section does not apply to specific language or format required by state or federal law, rule or regulation.
(4)
This section applies only to consumer insurance policies delivered on or after the date which is 6 months after May 8, 1980 except the commissioner may provide by rule that this section will not apply to specific types of consumer insurance policies until a later date which is not later than the date which is 2 years after May 8, 1980 if the commissioner determines that delayed application is necessary to prevent an unreasonable burden upon insurers issuing those types of consumer insurance policies.
(5)
The commissioner may by rule exempt a type of consumer insurance policy from the application of this section if the commissioner finds that type of consumer insurance policy is generally understood by persons to whom it is delivered or that those persons are otherwise adequately protected.
(6)
A violation of this section does not void or render voidable any portion of an insurance policy and is not a defense to an action under the insurance policy.
History:  1979 c. 218.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.23 - Authorized clauses for insurance forms.

631.23
Authorized clauses for insurance forms.
(1)
Promulgation of clauses. The commissioner may not promulgate mandatory uniform clauses that preclude an insurer from filing its own forms under s. 631.20; the commissioner may only disapprove such forms on the basis of the criteria stated in that section. Subject thereto, the commissioner may promulgate authorized clauses by rule upon a finding that:
(a)
Price or coverage competition is ineffective because diversity in language or content makes comparison difficult;
(b)
Provision of language, content or form of specific clauses is necessary to provide certainty of meaning of those clauses;
(c)
Regulation of contract forms would be more effective or litigation would be substantially reduced if there were increased standardization of certain clauses; or
(d)
Reasonable minimum standards of insurance protection are needed for policies to serve a useful purpose.
(2)
Degree of specificity. Any rule creating an authorized clause may prescribe that to be treated as an authorized clause there must be verbatim or substantial adherence to prescribed language, that certain standards or criteria must be met, or that certain drafting principles must be followed. The rules may also permit liberalization of prescribed language. If the proposed rule prescribed verbatim adherence, the commissioner shall make a finding that substantial adherence to the prescribed language is not sufficient and that liberalization of prescribed language will frustrate the purposes of the prescription. If an insurer uses authorized clauses as part of filed forms the commissioner may only disapprove those clauses under s. 631.20 upon a finding that improper combination of clauses makes them violate the criteria of s. 631.20.
History:  1975 c. 375, 421; 1979 c. 221; 2007 a. 168.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.27 - Rules of law as provisions of contracts.

631.27
Rules of law as provisions of contracts.
By rule, the commissioner may require an insurer to insert in a policy any rule of law stated in chs. 600 to 646 and 655 that is applicable to the contents or interpretation of an insurance contract.
History:  1975 c. 375; 1979 c. 89; 1989 a. 187 s. 29.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.28 - Notice of right to file complaint.

631.28
Notice of right to file complaint.
(1)
Requirement to provide notice. Every insurer shall provide notice to its policyholders and its insureds of the right to file a complaint with the office in the manner prescribed by rule under sub. (2).
(2)
Contents by rule. The commissioner shall promulgate rules specifying the contents of a notice that insurers must disseminate under sub. (1), and when and in what manner the notice must be provided. The rules shall describe how a policyholder, insured or other person may make a complaint with the office about an insurer, an intermediary or other insurance matter. The rules may also specify the form, including the type size, in which insurers must present the notice.
History:  1991 a. 154.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.31 - Clauses required to be on first page.

631.31
Clauses required to be on first page.
(1)
List of clauses. The following clauses of insurance policies shall appear on the first page of the policy:
(a)
Corporate name. The name of the insurer as required by s. 631.64;
(b)
Several liability. Information that 2 or more insurers undertake only several liability, as required by s. 631.41;
(c)
Assessability. That the policy is assessable as required by s. 631.65;
(d)
Variable benefits. A statement that benefits are variable, as required by s. 632.45 (1); and
(e)
Right to return policy. The right to return a disability insurance policy under s. 632.73, except that this clause may be conspicuously attached to the first page rather than printed on it.
(2)
Manner of display. Clauses listed in sub. (1) shall be displayed conspicuously and separately from any other clauses.
History:  1975 c. 375; 1981 c. 218.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.37 - Special cancellation provisions.

631.37
Special cancellation provisions.
The following cancellation provisions apply to the policies specified, whether or not s. 631.36 is also applicable to them.
(1)
Cancellation upon request of premium finance company. Section 138.12 (12) applies to cancellation on request of a premium finance company.
(2)
Cancellation upon request of creditor. Section 424.303 applies to cancellation upon request of a creditor.
(3)
Worker's compensation insurance. Sections 102.31 (2) and 102.315 (10) apply to the termination of worker's compensation insurance.
(3m)
Health care liability insurance. Section 655.24 (2) (b), (3) and (4) applies to the termination of a health care liability insurance policy.
(4)
Special limitations on cancellation.
(a)
School bus insurance. Section 121.53 (4) applies to school bus insurance.
(b)
Insurance on common carriers. Section 194.41 (2) applies to insurance on common carriers.
(c)
Driver education motor vehicles. Section 341.267 (6) applies to motor vehicles used for driver education.
(d)
Insurance of juveniles. Section 343.15 (4) (a) applies to motor vehicle policies covering juveniles as described therein.
(e)
Motor vehicle liability policy. Section 344.34 applies to motor vehicle liability policies certified under s. 344.31.
(f)
Health care liability policy. Section 655.25 applies to insurance issued by the mandatory health care liability risk-sharing plan established under s. 619.04.
(g)
Warranty reimbursement insurance policy. Section 632.185 (2) (e) applies to warranty reimbursement insurance policies.
History:  1979 c. 102 ss. 165, 166; 1985 a. 83; 1989 a. 187; 1991 a. 315; 1993 a. 363; 2003 a. 302; 2007 a. 185; 2009 a. 245.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.39 - Renewals in affiliates.

631.39
Renewals in affiliates.
(1)
Scope. This section applies to property and casualty lines of insurance, excluding disability insurance, as defined in s. 645.675 (1) (h).
(2)
Renewal requirements. An insurer may renew a policy in an affiliate without having to comply with s. 102.31 (2) (a) or 631.36 (4) or s. INS 21.01 (6), Wis. Adm. Code, if all of the following are satisfied:
(a)
All of the stock of, interest in, or control of the affiliate is held by one or more persons in the same insurance holding company system, as defined in s. 622.03 (2), that includes the insurer.
(b)
The affiliate holds a valid certificate of authority in this state for the kind of business necessary to write the policy being renewed.
(c)
If the policy renewed in the affiliate contains terms and conditions, except for the rates and rating plan, that are less advantageous to the policyholder than the policyholder's current policy, the insurer complies with the requirements of s. 631.36 (5).
(d)
The insurer provides notice to the policyholder at least 60 days before the renewal date that the policy will be renewed in an affiliate.
(e)
The notice under par. (d) includes or states all of the following information:
1.
The name and contact information of the company in which the policy will be renewed and that it is affiliated with the insurer.
2.
That there will be no interruption of coverage.
3.
That the premium for the renewal policy will be determined according to the rates and rating plan of the affiliate.
4.
If the policy currently held by the policyholder is written by a mutual company and will be renewed in an affiliate that is a stock insurance company, that the policy will be renewed in an affiliate that is a stock insurance company and the policyholder will no longer have the rights that are granted to a mutual policyholder.
5.
The A.M. Best or similar rating of the affiliate, if that rating is lower than the current A.M. Best or similar rating of the insurer.
6.
If the amount of the premium for the policy after it is renewed in the affiliate will increase 25 percent or more from the amount of the premium prior to being renewed in the affiliate, notice of the increased premium.
(f)
If the policy is a worker's compensation insurance policy under ch. 102, the insurer provides notice to the department of workforce development at least 60 days prior to renewal of the policy in an affiliate notifying the department of the name of the affiliate in which the policy is to be renewed.
(3)
Applicability of other law. Sections 611.78 and 618.32 do not apply to renewals under this section.
History:  2017 a. 241.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.41 - Policies jointly issued.

631.41
Policies jointly issued.
Two or more insurers may together issue a policy in which their liability is either several or joint and several. If it is several, the heading of the policy shall conspicuously so state and the policy shall conspicuously state the proportion or amount of premium to be paid to each insurer and the type and the proportion or amount of liability each insurer agrees to assume.
History:  1975 c. 375.
2023 Wisconsin Statutes & Annotations › Chapter 631 - Insurance contracts generally. › 631.45 - Limitations on loss to be borne by insurer.

631.45
Limitations on loss to be borne by insurer.
(1)
General. An insurance policy indemnifying an insured against loss may by clear language limit the part of the loss to be borne by the insurer to a specified or determinable maximum amount, to loss in excess of a specified or determinable amount, to a specified percentage of the loss, which may vary with the amount of the loss, or by a combination of these methods. If the policy covers various risks, different limitations may be provided separately for each risk if the policy clearly so states.
(2)
Property coinsurance. A policy indemnifying an insured against loss of or damage to property may limit the part of the loss to be borne by the insurer to a percentage of the total loss that corresponds to the ratio of the insured sum to a specified percentage of the value of the insured property.
History:  1975 c. 375.
Public policy does not prohibit insurance coverage for statutorily imposed multiple damages. Cieslewicz v. Mutual Service Casualty Insurance Co., 84 Wis. 2d 91, 267 N.W.2d 595 (1978).
Under the facts of the case, the insurer's tender of the policy limits into court did not relieve the insurer of its duty to defend the insured in the lawsuit. Gross v. Lloyds of London Insurance Co., 121 Wis. 2d 78, 358 N.W.2d 266 (1984).
Although a policy's limit of liability language has been held invalid under s. 631.43 for the purpose of preventing stacking, it is still valid for determining each policy's limit of liability. Schaefer v. General Casualty Co. of Wisconsin, 175 Wis. 2d 80, 498 N.W.2d 855 (Ct. App. 1993).