reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.04 - Initiation of Proceedings

Current through Register 1525, July 5, 2024
(1)
Notice of Hearing.
(a)
Contents of notice of
			 hearing
. Notices of hearing shall contain:
1. A reference to the statutory authority
			 under which the proceedings are held;
2. The date, time, and location of the
			 hearing;
3. A brief statement of
			 the subject of the hearing; and
4.
			 A brief statement of the dates and procedures for submission of advisory
			 filings, notices of appearance by statutory intervenors, petitions to appear as
			 intervenors or participants, and notices of appointment of counsel.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.05 - Schedule of Proceedings, Conferences, and Content of Advisory Filings

Current through Register 1525, July 5, 2024
(1)
Schedule
. The
			 Presiding Officer shall determine the dates for submissions of filings;
			 rebuttal evidence and briefs, if any; the beginning and ending dates of cross-
			 and redirect examination; and the dates for any pre-hearing and
			 preliminaryconferences. Unless otherwise determined by the Presiding Officer,
			 advisory filings shall be submitted in the following order: insurer,
			 intervenors and statutory intervenors, and the State Rating Bureau.
The schedule may be altered by the Presiding Officer on his or
				her own, or upon request by a party upon a showing of good cause. The schedule
				may provide for separate filings, to be submitted at different times, for
				different issues or groups of issues specified by the Presiding Officer.
The schedule and procedures set forth in
				211 CMR 77.00 may be modified
				by the Presiding Officer in proceedings on applications to deviate from the
				fixed-and-established rates.
(2)
Separate
			 Hearings
. The Presiding Officer, in his or her discretion, may
			 direct that certain issues be considered in one or more separate hearing
			 sessions to be conducted according to a schedule set by the Presiding Officer.
			 The Presiding Officer may direct that the sessions proceed
			 concurrently.
(3)
Conferences
. The Presiding Officer may hold one or
			 more pre-hearing conferences to develop the schedule for the conduct of the
			 proceeding. The Presiding Officer may also direct the parties to confer with
			 the Presiding Officer or each other to consider:
(a) simplification of issues;
(b) the possibility of obtaining stipulations
			 or admissions of fact and agreements as to documents;
(c) a limitation on the number of expert
			 witnesses;
(d) stipulations as to
			 the qualifications of experts;
(e)
			 limitations as to the time to be allowed for cross-examination, redirect and
			 recross-e xamination.
(f) rulings
			 as to evidentiary disputes; and
(g)
			 other matters as may aid in the prompt disposition of the proceeding.
After a conference held pursuant to 211 CMR 77.05(3), the
				Presiding Officer may issue an order regarding the subsequent schedule of the
				proceeding, which shall control unless modified by the Presiding
				Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.06 - Discovery

Current through Register 1525, July 5, 2024
(1)
Requests for
			 Discovery
. The parties are encouraged to engage in voluntary
			 discovery. A party may request another party to produce or make available
			 documents or tangible things, not privileged and not previously supplied, which
			 are in the possession, custody or control of the party to whom the request is
			 made. Such requests may be served on a party after submission of its advisory
			 filing and shall set forth the items to be provided with reasonable
			 particularity. Additional forms of discovery may be allowed at the discretion
			 of the Presiding Officer upon a showing of good cause.
(2)
Responses to
			 Discovery
. The party receiving the request shall respond within a
			 period of ten days unless the Presiding Officer establishes a different time
			 period. In the event that the time period between the submission of a filing
			 and the commencement of cross-examination on that filing is less than ten days,
			 and the discovery was requested in a timely fashion, the party receiving the
			 discovery request shall respond no later than twenty-four hours prior to the
			 scheduled hearing. The party receiving the request for discovery may, within
			 five days of service of the request, or such other period as the P residing
			 Officer may prescribe, file objections to the request or move for a protective
			 order. The Presiding Officer may, in his or her discretion, schedule a hearing
			 on the objections or motion. The Presiding Office may issue protective orders
			 to protect a party from annoyance, embarrassment, oppression or undue burden or
			 expense. The Presiding Officer may also order limits on the scope, method, time
			 and place for discovery and provisions for protecting confidential information
			 or documents.
(3)
Motions to Compel Discovery
. A party may file a motion
			 to compel discovery if a request for documents is not honored, in whole or in
			 part.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.08 - Oral Argument and Briefs

Current through Register 1525, July 5, 2024
(1)
Oral Argument
. When, in the opinion of the Presiding
			 Officer, time permits and the nature of the proceedings, the complexity or
			 importance of the issues of fact or law involved, and the public interest
			 warrant, the Presiding Officer may, either on his or her own or at the request
			 of a party, allow and fix a time for the presentation of oral argument subject
			 to limits of time which are deemed appropriate in the proceeding.
(2)
Briefs
. Briefs
			 may be filed by a party either before or during the course of the proceeding
			 and shall be filed at any time as the Presiding Officer shall designate. The
			 order of filing briefs, including any reply briefs, will be designated by the
			 Presiding Officer. A party who files a brief shall submit six copies thereof to
			 the Presiding Officer unless a different number is permitted or directed by the
			 Presiding Officer. The Presiding Officer may require parties to file a copy of
			 briefs on computer disk in a format determined by the Presiding Officer. The
			 Presiding Officer may order that briefs be served on participants.
Briefs shall contain:
(a) a concise statement of the
			 case;
(b) a clear and specific
			 identification of all evidence relied upon by the filing party, with references
			 to the pages in the record where the evidence appears;
(c) arguments and supporting
			 authorities;
(d) a statement of the
			 specific relief requested on each contested issue; and
(e) other information required by the
			 Presiding Officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.09 - Final Decision

Current through Register 1525, July 5, 2024
The Presiding Officer's final decision shall be in writing, and
				shall be accompanied by a statement of reasons including a determination of
				each issue of fact or law necessary to the decision.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 77.00 - Procedures For The Conduct Of Proceedings On Fixed-and-established Private Passenger Motor Vehicle Insurance Rates › Section 77.10 - Appeal of the Decision

Current through Register 1525, July 5, 2024
(1)
Appeal
. The Presiding Officer shall notify all parties
			 of their right to appeal the decision and of the time within which to
			 appeal.
(2)
Appeal of
			 Decision where the Decision is not Rendered or Approved by the
			 Commissioner
. Where the decision is not rendered or approved by
			 the Commissioner, a person aggrieved by a finding, ruling, or decision rendered
			 after the hearing may appeal the finding, order, or decision to the
			 Commissioner who shall review it and may modify, affirm, or reverse the ruling,
			 finding, or decision. A copyof the appeal shall be served on all parties. Upon
			 the docketing of an appeal, the Commissioner shall set a briefing schedule. The
			 brief of the aggrieved party shall state the grounds for the appeal and the
			 remedy requested. The failure to file a brief within the time allotted shall be
			 considered a waiver of the right to appeal. The Commissioner may, in his or her
			 discretion, call all parties to a conference before making a ruling. Where the
			 Commissioner determines after reading the brief of the aggrieved party that the
			 appeal is without substantial merit he or she may dispose of the appeal without
			 requesting briefs from other parties.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.01 - Purpose and Scope

Current through Register 1525, July 5, 2024
(1)
								211 CMR 79.00 shall apply to
			 Rates and Premium charges for all types of coverages under private passenger
			 motor vehicle insurance policies including, but not limited to, the form and
			 content of Rate and Advisory Filings for the Voluntary Market in accordance
			 with M.G.L. c. 175E and M.G.L. c. 175A; Residual Market Rate Filings in
			 accordance with M.G.L. c. 175A; activities of Rating Organizations, and the
			 conduct of hearings and related proceedings under M.G.L. c. 175A and M.G.L. c.
			 175E.
(2) The purposes of
			 211 CMR 79.00 are:
(a) To promote the public welfare by
			 regulating insurance rates so that they are not excessive, inadequate or
			 unfairly discriminatory;
(b) To
			 promote the accuracy and fairness of private passenger motor vehicle insurance
			 rates;
(c) To promote price
			 competition among Insurers so as to provide insurance rates that are responsive
			 to Competitive Market conditions;
(d) To prohibit price-fixing agreements and
			 other anticompetitive behavior by Insurers;
(e) To provide regulatory procedures for the
			 maintenance of appropriate data reporting systems;
(f) To authorize essential cooperative action
			 among Insurers in the ratemaking process and to regulate such activity to
			 prevent practices that tend to lessen competition substantially or to create a
			 monopoly; and
(g) To provide price
			 and other information to consumers to enable them to purchase insurance
			 suitable for their needs.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.03 - Competitive Market

Current through Register 1525, July 5, 2024
(1)
Presumption
. A Competitive Market is presumed to exist
			 unless the Commissioner, after a hearing pursuant to M.G.L. c. 175E, § 5,
			 determines that competition in the private passenger motor vehicle insurance
			 market is, with respect to any territory or to any kind, subdivision or class
			 of insurance, either:
(a) insufficient to
			 assure that Rates will not be excessive; or
(b) so conducted as to be destructive of
			 competition or detrimental to the solvency of Insurers, and the Commissioner
			 issues findings of fact, conclusions and orders to that effect. Any such
			 determination shall expire no later than one year after issuance.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.04 - Rate Standards

Current through Register 1525, July 5, 2024
(1) The Commissioner
			 shall disapprove any Rate Filing, or portion thereof, that results in a Rate
			 that is excessive, inadequate or unfairly discriminatory.
(2)
Excessive Rates
.
			 No Rate shall be held to be excessive unless such Rate is unreasonably high for
			 the insurance provided. Evidence that a reasonable degree of competition exists
			 in the area with respect to the Classification to which such Rate is applicable
			 shall be considered as material, but not conclusive, evidence that such Rate is
			 not excessive.
(3)
Inadequate Rates
. No Rate shall be held to be
			 inadequate unless:
(a) such Rate is
			 unreasonably low for the insurance provided; and
(b) the continued use of such Rate endangers
			 the solvency of the Insurer using the same; or unless
(c) such Rate is unreasonably low for the
			 insurance provided and the use of such Rate by the Insurer using the same has,
			 or if continued will have, the effect of destroying competition or creating a
			 monopoly.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.05 - Rate Filings

Current through Register 1525, July 5, 2024
(1)
Time
			 for Rate Filings
.
(a)
Voluntary Market Rate Filings
. Rate Filings for Rates
			 to be used in the Voluntary Market shall be filed in paper and in electronic
			 form with the Commissioner not less than 45 days prior to the proposed
			 effective date. In addition, when a Rate Filing involving a rate adjustment
			 depends upon a change in the relationship between the proposed Rates and the
			 anticipated production expense portion thereof from the relationship
			 anticipated under any Rates previously filed and currently in effect for the
			 Insurer or Rating Organization involved, the Insurer or Rating Organization
			 making such a Rate Filing shall simultaneously give written notice of such
			 filing to every licensed producer of every Insurer on whose behalf such filing
			 is made.
(b)
Residual
			 Market Rate Filings
. The Rate Filings for Rates to be used in the
			 Residual Market shall be filed in paper and electronic form with the
			 Commissioner not less than 15 days prior to the proposed effective
			 date.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.06 - Suspension or Disapproval of Voluntary Market Rate Filings and Rates

Current through Register 1525, July 5, 2024
(1)
Suspension of a Rate
			 Filing
. The Commissioner may suspend the operation of any Rate
			 Filing pursuant to M.G.L. c. 175E, § 7 for not more than 45 days after its
			 effective date. The Commissioner either shall approve such filing or issue an
			 order disapproving it and specifying the grounds for the disapproval within
			 such 45-day period.
(2)
Implementation of Suspended Rate Filing
. An Insurer
			 may implement a suspended Rate Filing that has not been disapproved by the
			 Commissioner on the suspended filing's effective date provided:
(a) The Insurer submits a written agreement
			 to the Commissioner stating that it will adjust the Premiums, including
			 interest at the rate of 8% per annum, of all of its policies that are affected
			 by the filing from the respective effective dates in accordance with the
			 Commissioner's final determination regarding the suspended Rate Filing;
			 and
(b) The Insurer posts
			 sufficient bond with the Commissioner in a form and amount deemed satisfactory
			 to the Commissioner. The Division's approval of the form and the amount of such
			 bond shall be in writing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.07 - Statistical Plan

Current through Register 1525, July 5, 2024
Nothing in
				211 CMR 79.00 shall affect
				the obligations of each Insurer or Insurance Company Group to provide the data
				required by any statistical plans promulgated by the Commissioner for annual
				reporting of motor vehicle insurance experience.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.09 - Consumer Information and Disclosures

Current through Register 1525, July 5, 2024
(1)
			 The Commissioner may establish rules annually by which Insurers shall produce
			 an information guide which outlines in language prescribed or approved by the
			 Commissioner the various choices of private passenger motor vehicle insurance
			 coverage available to insureds and an estimate of differences in cost among
			 various coverages and Insurers. Each Insurer or Insurance Company Group shall
			 bear full responsibility for assuring that the information contained in the
			 guide is accurate and that a copy of the guide is forwarded to every person
			 insured or solicited for insurance by that company or its insurance
			 producers.
(2) Insurers and
			 insurance producers shall disclose in simple language to every person they
			 insure or solicit for insurance that person's private passenger motor vehicle
			 insurance coverage options, including the option to exclude oneself and members
			 of one's household from personal injury protection coverage, as defined by
			 M.G.L. c. 90, § 34A. The Commissioner shall prescribe the form, content,
			 and timing of said disclosures.
(3)
			 Insurers or Insurance Company Groups that host Internet websites shall make
			 available on the websites information setting forth private passenger motor
			 vehicle insurance coverage and price options for private passenger motor
			 vehicle insurance in Massachusetts, or else conspicuously set forth a telephone
			 number(s) at which a consumer may obtain this information.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.10 - Initiation of a Hearing on a Rate Filing

Current through Register 1525, July 5, 2024
(1)
Adjudicatory Proceeding
. A hearing on a Rate Filing is
			 an adjudicatory proceeding.
(2)
Initiation by the Commissioner
. The Commissioner
			 unilaterally may initiate a hearing on a Rate Filing prior to its effective
			 date after at least ten days' notice.
(3)
Motion by the Attorney
			 General
. The Commissioner shall initiate a hearing on a Rate
			 Filing under M.G.L. c. 175E, § 7 if the Commissioner receives a written
			 motion to do so from the Attorney General dated no later than 20 days after the
			 submission of the Rate Filing. The Attorney General must serve simultaneously a
			 copy of such motion on the Filer.
(4)
Motion by Insurance
			 Producer
. The Commissioner shall call a hearing on a Rate Filing
			 under M.G.L. c. 175E, § 7 if the Commissioner receives a written motion to
			 do so from any insurance producer of any Insurer to which such Rate Filing is
			 applicable or from any association representing insurance producers no later
			 than ten days after the submission of the Rate Filing, provided:
(a) the Rate Filing proposes a change in the
			 relationship between the proposed Rates and the commission expense provisions
			 in the Rates from the relationship in the rates previously in effect for the
			 Insurer or Insurance Company Group involved; and
(b) the Commissioner determines that any such
			 request is in good faith and is supported by reasonable grounds; and
(c) The producer serves a copy of such motion
			 simultaneously on the Filer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.11 - Pre-hearing Procedures

Current through Register 1525, July 5, 2024
Submission of Lists of Witnesses and
				Documents
. No less than seven days prior to the scheduled date of
				a hearing, each Party shall submit to the Presiding Officer and serve on the
				other Parties a list of witnesses which it intends to call to testify. This
				list shall include the occupation and qualifications of each witness, a
				statement of the subject matter and a summary of the witness's expected
				testimony, and an estimate of the time required for such testimony. Each Party
				also shall submit a list of documents it intends to introduce at the hearing. A
				Party who objects to any witness or document must submit the objections in
				writing within three business days after receiving such information from the
				other Party. The Presiding Officer may, in his or her discretion, require
				additional submissions from the Parties prior to the hearing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.13 - Decisions and Remedies

Current through Register 1525, July 5, 2024
(1) The decision of
			 the Commissioner or Presiding Officer shall be in writing. It shall be
			 accompanied by a statement of reasons, including determinations of each issue
			 of fact or law necessary to the decision. The Presiding Officer shall notify
			 all Parties of the decision, of their right to appeal the decision, and of the
			 time within which such right may be enforced.
(2) If, after a bad-faith hearing conducted
			 under M.G.L. c. 175E, § 9, the Commissioner finds that the Filer has
			 failed to justify its Rate Filing, the Commissioner may order that all policies
			 written under such bad-faith Rate Filing be rewritten at Rates meeting the
			 requirements of
			 211 CMR 79.00 from the date
			 of inception of such policies, or that all such policies be cancelled on a
pro rata
basis.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.14 - Use of Unauthorized Rates

Current through Register 1525, July 5, 2024
No Insurer or Insurance Company Group shall make or issue a
				contract or policy for private passenger motor vehicle insurance in the
				Voluntary or Residual Market except in accordance with Rate Filings made by or
				on behalf of the Insurer or Insurance Company Group as provided in the relevant
				provisions of M.G.L. c. 175A; M.G.L. c. 175E; and
				211 CMR 79.00. Violation of
				211 CMR
				79.15 and
				211
				CMR 79.06(3)(d) and (4)(d) 
				shall be subject to the penalties provided in M.G.L. c. 175E, §
				12.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.15 - False or Misleading Information

Current through Register 1525, July 5, 2024
No person or organization shall willfully withhold information
				from, or knowingly give false or misleading information to the Commissioner,
				any statistical agent, any Rating Organization or any Insurer that will affect
				the Rates or Premiums charged under M.G.L. c. 175A or M.G.L. c. 175E. Violation
				of 211 CMR 79.15 shall be subject to the penalties provided in M.G.L. c. 175E,
				§ 12.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.16 - Examinations

Current through Register 1525, July 5, 2024
(1)
Insurers and Insurance
			 Company Groups
. Pursuant to M.G.L. c. 175, § 4 and M.G.L. c.
			 175E, § 8, the Commissioner may examine any Insurer to ascertain whether
			 its rating and underwriting practices comply with the law. Final reports on
			 examinations shall be available for public inspection
(2)
Rating
			 Organizations
. Pursuant to M.G.L. c. 175A, § 14 and M.G.L. c.
			 175E, § 8, the Commissioner may examine any Rating Organization to
			 ascertain whether its rating and underwriting practices comply with the law.
			 Final reports on examinations shall be available for public
			 inspection.
(3)
CAR
. Pursuant to M.G.L. c. 175, § 4, the
			 Commissioner may examine CAR to ascertain whether its rating practices comply
			 with the law. Final reports on examinations shall be available for public
			 inspection.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.17 - Penalties

Current through Register 1525, July 5, 2024
In addition to the penalties set forth in M.G.L. c. 175A,
				§ 18 and M.G.L. c. 175E, § 12, the Commissioner may suspend the
				certificate of authority or license of any Insurer or Rating Organization which
				fails to comply with an order of the Commissioner under M.G.L. c. 175A; M.G.L.
				c. 175E; or
				211 CMR 79.00 within the time
				limited by such order, or any extension thereof which the Commissioner may
				grant. The Commissioner shall not suspend the certificate of authority or
				license of any Insurer or Rating Organization for failure to comply with an
				order until the time prescribed for an appeal therefrom has expired or, if an
				appeal has been taken, until such order has been affirmed. The Commissioner may
				determine when a suspension of certificate of authority or license shall become
				effective and it shall remain in effect for the period fixed by the
				Commissioner, unless the Commissioner modifies or rescinds such suspension or
				until the order upon which such suspension is based is modified, rescinded or
				reversed. No certificate of authority or license shall be suspended or revoked
				except upon a written order of the Commissioner, stating the findings, made
				after a hearing held upon not less than ten days written notice to such
				organization specifying the alleged violation.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 79.00 - Private Passenger Motor Vehicle Insurance Rates › Section 79.18 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				211 CMR 79.00 are severable.
				If any section, subsection, division, subdivision, paragraph, sentence or
				clause of
				211 CMR 79.00 is held invalid
				or unconstitutional, such decision shall not affect the remaining portions of
				211 CMR
				79.00.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.01 - Purpose and Scope

Current through Register 1525, July 5, 2024
211 CMR 88.00 governs the
				filing and review, and the conduct of hearings, on an Appeal of an Insurer's
				determination that an Operator is at fault in an Accident in accordance with
				the Insurer's Merit Rating Plan in a Competitive Market or with the Safe Driver
				Insurance Plan (SDIP) in a Fixed-and-established Market.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.04 - Effect of Appeal on Insurer's At-fault Accident Determination

Current through Register 1525, July 5, 2024
An Appeal and any subsequent court proceedings shall not stay
				the Insurer's imposition of a Surcharge as a result of an At-fault Accident
				Determination. The Insurer may assess or collect any additional Private
				Passenger Motor Vehicle insurance premiums that result from its At-fault
				Accident Determination under the Insurer's Merit Rating Plan or the Safe Driver
				Insurance Plan unless and until the Board or a court of competent jurisdiction
				makes a final decision to vacate the Insurer's determination.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.05 - Incomplete Appeal Filings

Current through Register 1525, July 5, 2024
(1) Upon receipt of
			 an Appeal, the Board shall make an initial review to determine whether it is
			 complete. An Appeal shall be deemed incomplete if:
(a) The filing fee is in an incorrect amount
			 or has not been received by the Board.
(b) The Appeal Form has not been received by
			 the Board.
(c) The Appeal Form is
			 not completed by the Appellant.
(d)
			 The Appeal is in such a condition (
i.e
., illegible, damaged)
			 that it cannot be processed.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.06 - Administrative Resolution of Appeals Prior to an Appeal Hearing

Current through Register 1525, July 5, 2024
(1)
Administrative
			 Review
. The Board at its discretion may conduct an administrative
			 review to determine whether the information on an Appeal Form and any documents
			 submitted with it provide persuasive evidence that the At-fault Accident
			 Determination should be vacated, and, based upon such a review, the Board may
			 vacate an At-fault Accident Determination when an Accident results from a
			 Special Hazardous Driving Condition. Appeals of At-fault Accident
			 Determinations that are not vacated based on an Administrative Review will be
			 scheduled for an Appeal Hearing.
(2)
Documentary
			 Review
. The Board at its discretion may conduct an administrative
			 review to resolve those Appeals of At-fault Accident Determinations that can be
			 vacated based upon document submissions. The Board will notify Insurers of the
			 Appeals pending for their companies and will request copies of the documents or
			 other information that resulted in their At-fault Accident Determinations. The
			 insurer may choose not to submit the documents and request a hearing be
			 scheduled. The Board will review these Appeals based upon the documents
			 submitted by an Insurer, the Appeal Form, and information filed by the
			 Appellant. The Board will vacate the At-fault Accident Determination if the
			 record provides sufficient information to determine that the Appellant is not
			 more than 50% at fault for the Accident at issue. Appeals of At-fault Accident
			 Determinations that are not vacated will be scheduled for an Appeal
			 Hearing.
(3)
Findings
			 and Order
. The Board shall notify the Merit Rating Board of its
			 decision to vacate an At-fault Accident Determination based on an
			 Administrative Review or Documentary Review, and shall provide a copy of its
			 Findings and Order to the Parties.
(4)
Insurer
			 Obligations
. If the Board vacates an At-fault Accident
			 Determination based on an Administrative Review or Documentary Review, the
			 Board shall notify the Merit Rating Board, and the Insurer promptly shall
			 notify any other data collection agency to which the Insurer reported the
			 At-fault Accident Determination. If the Insurer, based on the claim underlying
			 the Appeal, has imposed a Surcharge for an At-fault Accident on the policy
			 insuring the Involved Operator, it shall promptly rescind the Surcharge and
			 return any premium paid as a result of the Surcharge. No Insurer shall
			 thereafter include such Accident for the purpose of calculating a Surcharge for
			 a Private Passenger Motor Vehicle insurance policy covering the Involved
			 Operator unless the Board's Findings and Order are reversed by a court of
			 competent jurisdiction.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.07 - Notice of Appeal Hearing

Current through Register 1525, July 5, 2024
(1)
Notice of Hearing
. The Board shall issue written
			 notice of the Appeal Hearing to the Parties, or to their Authorized
			 Representatives, at least 14 days prior to the Appeal Hearing date.
(2)
Continuance of
			 Hearing
. The Board may grant a continuance of an Appeal Hearing at
			 the written request of a Party in advance of the Appeal Hearing for good cause
			 shown. Notice will be issued to both Parties notifying them as to the time,
			 date and location of the rescheduled Appeal Hearing.
(3)
Emergency
			 Scheduling
. The Board may, at its own discretion or at the request
			 of a Party for good cause shown, schedule an Appeal Hearing on an accelerated
			 basis.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.08 - Appeal Hearing Procedures

Current through Register 1525, July 5, 2024
(1)
Conduct of Persons Present
. All parties, Authorized
			 Representatives, counsel, witnesses and other persons present at an Appeal
			 Hearing shall conduct themselves in a manner consistent with the standards of
			 decorum commonly observed in the courts of the Commonwealth. Where such
			 standards are not observed, the Hearing Officer may take action as he or she
			 deems appropriate to maintain order at the hearing, including the exclusion of
			 any person from the hearing. If the person so excluded is a Party or his or her
			 counsel or Authorized Representative, the Hearing Officer may decide the Appeal
			 against such Party with prejudice.
(2)
Appellant's Statement in
Lieu
of Personal Appearance
. After an Appellant
			 receives a notice of an Appeal Hearing, he or she may elect to waive an Appeal
			 Hearing and to submit to the Board a written Statement in
Lieu
of Personal Appearance. The Appellant must sign the Statement under the pains
			 and penalties of perjury. The Appellant must submit with such Statement copies
			 of all documents supporting the Appellant's allegations or defenses, except for
			 those that have already been supplied to the Board. The Statement must be
			 submitted to the Board's Boston office at least five business days prior to the
			 Appeal Hearing date.
(3)
Rights and Duties of the Parties
.
(a)
Appellant's
			 Rights
. The Appellant may present his or her own case at the
			 Appeal Hearing, or may be assisted by an Authorized Representative. The
			 Appellant is responsible for paying the cost of representation, if any. The
			 Appellant, or his or her Authorized Representative, shall have the following
			 rights at the Appeal Hearing:
1. to examine
			 the Insurer's Claim Record at the Appeal Hearing;
2. to present and establish all relevant
			 facts and circumstances by oral testimony, documentary evidence or other
			 evidence;
3. to testify and to
			 present witnesses;
4. to introduce
			 exhibits;
5. to advance pertinent
			 arguments without undue interference;
6. to challenge any testimony and
			 cross-examine the witnesses of the Insurer; and
7. to submit rebuttal evidence.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.09 - Findings and Orders of the Board

Current through Register 1525, July 5, 2024
(1)
General
. The Board shall issue its Findings and Order
			 as promptly as administratively feasible after the completion of the Appeal
			 Hearing.
(2)
Findings
			 and Order
. The Findings and Order issued following an Appeal
			 Hearing either shall vacate or uphold the Insurer's At-fault Accident
			 Determination.
(a)
Vacate
			 At-fault Accident Determination
. If the Board finds that the
			 Insurer's At-fault Accident Determination was not in accordance with the
			 Standards of Fault promulgated under
			 211 CMR 74.00:
Standards of Fault to Be Used by the Board of Appeal on Motor Vehicle
			 Liability Policies and Bonds and Insurers in Presuming Fault When Making at
			 Fault Determinations
, it shall vacate the Insurer's At-fault Accident
			 Determination. The Board shall notify the Appellant, the Insurer, and the Merit
			 Rating Board of its decision. The Insurer promptly shall notify any other data
			 collection agency to which the Insurer reported the At-fault Accident
			 Determination that the Board has vacated the determination. If the Insurer,
			 based on the claim underlying the Appeal, has imposed a Surcharge for At-fault
			 Accidents on the policy insuring the Involved Operator, it shall promptly
			 rescind the Surcharge and return any premium paid as a result of the Surcharge.
			 No Insurer shall thereafter include such accident for the purpose of
			 calculating a premium for a Private Passenger Motor Vehicle insurance policy
			 covering the Involved Operator unless the Board's Findings and Order are
			 reversed by a court of competent jurisdiction.
(b)
Uphold At-fault Accident
			 Determination
. If the Board finds that the Insurer correctly
			 determined the Appellant's fault in accordance with the Standards of Fault
			 promulgated under
			 211 CMR 74.00:
Standards of Fault to Be Used by the Board of Appeal on Motor Vehicle
			 Liability Policies and Bonds and Insurers in Presuming Fault When Making at
			 Fault Determinations
, it shall uphold the Insurer's At-fault Accident
			 Determination. The Board shall notify the Appellant and the Insurer of its
			 decision.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.10 - Judicial Appeal Procedure

Current through Register 1525, July 5, 2024
The Party appealing the Board's Findings and Order must:
(1) obtain from the Board certified copies of
			 the Appeal Form and of the Board's Findings and Order;
(2) file with the appropriate court a
			 Petition for Judicial Review (forms may be obtained in the Clerks' Offices of
			 the respective court), certified copies of the original Appeal Form and the
			 Board's Findings and Order and the filing fee required by the court;
			 and
(3) serve a copy of the
			 Petition for Judicial Review filed with the court upon the Board and the Office
			 of the Attorney General.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.11 - Retention of Sound Recordings

Current through Register 1525, July 5, 2024
The Board will retain the sound recording of the Appeal Hearing
				for a minimum of four months from the date of the Board's Findings and Order on
				the Appeal. If a Party appeals the Board's Findings and Order to a court of
				competent jurisdiction, and properly notifies the Board of such appeal, the
				sound recording of the Appeal Hearing will be retained for a minimum of four
				months from the date of judicial disposition of the judicial
				appeal.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 88.00 - Procedures for the Appeal of Insurer At-fault Accident Determinations and the Conduct of Hearings on Insurer At-fault Accident Determinations › Section 88.12 - Severability

Current through Register 1525, July 5, 2024
If any section or portion of a section of
				211 CMR 88.00 or the
				applicability thereof to any person, entity, or circumstance is held invalid by
				a court of competent jurisdiction, the remainder of
				211 CMR 88.00 or the
				applicability of such provision to other persons, entities or circumstances,
				shall not be affected thereby.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 90.00 - Legal Services Plans › Section 90.01 - Purpose and Authority

Current through Register 1525, July 5, 2024
St. 1977, c. 774 authorizes the establishment of legal services
				plans in Massachusetts.
				211 CMR
				90.00 implementsthestatute and creates guidelines and
				procedures for theestablishmentand operation of these plans.
211 CMR 90.00 promulgated
				under the authority of M.G.L. c. 175, §§ 4, 25, 47, 48; M.G.L. c.
				175A, § 15(d); M.G.L. 176H, § 17; and M.G.L. c. 176D.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 90.00 - Legal Services Plans › Section 90.02 - Definitions

Current through Register 1525, July 5, 2024
Insurer
means a corporation licensed
				under M.G.L. c. 175 to write legal services insurance under an insured legal
				services plan.
Legal Services Plan
means a
				risk-spreading program under which the cost of legal services is not allocated
				individually to those who actually use the services but instead is pooled and
				distributed among all those who potentially can use the services. The terms
				does not include the provision of legal services incidental to other insurance
				coverages, such as the defense of lawsuits provided under automobile liability
				insurance, nor the arrangements specifically excluded by M.G.L. c. 176H, §
				7. There are three types of legal services plans: insured indemnity; insured
				service; and membership. The characteristics of each are described in M.G.L. c.
				176H.
Membership Plan Sponsor
means a
				corporation formed under M.G.L. c. 180, a corporation formed under general or
				special law for any of the purposes set forth in M.G.L. c. 180 § 4, or a
				lab o r organization, which establishes and operates a membership legal
				services plan.
Subscriber
means a person who has
				signed an individual contract, or is covered under a group contract, with an
				insurer or membership plan sponsor.
The terms
covered dependents
,
covered legal services
, and
participating
				attorney
are defined in M.G.L. c. 176H, §
				1.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 90.00 - Legal Services Plans › Section 90.03 - Applicability

Current through Register 1525, July 5, 2024
Except as provided below,
				211 CMR
				90.00 applies to all legal services plans established,
				operated, or sold in Massachusetts. No legal services plan benefits may be
				offered for sale unless the plan of operation, the benefit contracts, and the
				rates have been approved by the Commissioner of Insurance.
211 CMR
				90.00 does not apply to:
(1) An automobile club providing legal fee
			 reimbursement services in conformity with M.G.L. c. 174B.
(2) A labor organization providing legal
			 services to its members and their dependents.
(3) A corporation formed under M.G.L. c. 180
			 providing legal services that do not exceed a limited amount of consultation
			 and advise either alone or in combination with referral services.
(4) An employee organization or employer
			 which sponsors or co-sponsors an employee benefit welfare plan subject to the
			 provisions of the Employee Retirement Income Security Act of 1974. This
			 exemption does not apply to an insurance company associated with a plan under
			 which benefits of prepaid legal services are provided in whole or in part
			 through the purchase of insurance.
(5) A program of student-supported legal
			 services established pursuant to M.G.L. c. 175. An organization relying on one
			 or more of the above exemptions must file a statement with the Commissioner
			 which demonstrates that it qualifies for the exemption or exemptions.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 90.00 - Legal Services Plans › Section 90.04 - Plan of Operation and Benefit Contracts Approval

Current through Register 1525, July 5, 2024
Each insurer and membership plan sponsor must file two copies
				of its plan of operation and benefit contracts with the Commissioner and one
				copy with each member of the Advisory Committee on Prepaid Legal Services. An
				insurer may not file before it has been licensed under M.G.L. c. 175 to write
				legal services insurance.
In the event the Commissioner determines that a filing is
				incomplete or that additional information is needed to properly evaluate a
				filing, he or she will notify the applicant in writing within 14 calendar days
				of the filing's submission concerning the additional documents or information
				that is required. Within 30 calendar days after the submission of a complete
				filing, the Commissioner will review it in accordance with
				211 CMR
				90.00 and either approve the plan of operation and the
				benefit contracts in writing or hold a hearing after not less than 15 calendar
				days written notice to all interested parties. In the event a hearing is held,
				the Commissioner will within 30 calendar days after the submission of briefs
				either approve the plan of operation and the benefit contracts in writing or
				notify the applicant of his or her disapproval and the ground or grounds for
				disapproval.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 90.00 - Legal Services Plans › Section 90.06 - Benefit Contracts

Current through Register 1525, July 5, 2024
Each insurer and membership plan sponsor must submit a copy of
				its group and individual contract forms along with the plan of operation. Each
				group contract form must be accompanied by the certificate that summarizes the
				provisions of the contract for the group subscribers. Each certificate and
				individual contract form must be accompanied by its Flesch scale readability
				score, computed by the procedure specified in M.G.L. c. 175, § 2B.
The Commissioner will disapprove any certificate or group or
				individual contract form that contains any provisions which are unfair,
				inequitable, misleading or deceptive. The Commissioner will disapprove a
				certificate or contract form under this standard if it permits the insurer or
				membership plan sponsor to reduce the level of benefits or assess subscribers
				during the coverage period.
The Commissioner will disapprove any certificate or individual
				contract form that does not meet the standards set out in M.G.L. c. 175, §
				2B or that does not state clearly and in understandable style and language
				:
(1) The benefits available to the
			 subscriber and his or her covered dependents.
(2) The limitations and exclusions on the
			 benefits, including an explanation of any deductible, coinsurance, or copayment
			 features and any waiting periods.
(3) The manner of obtaining benefits,
			 including the type of attorneys that may be used, the procedures, including
			 those of appeal, that must be followed before nonparticipating attorneys may be
			 used and the claims procedure.
(4)
			 The organization's procedure for the use of the subscriber satisfaction form
			 and its procedure for resolving complaints concerning the operations of the
			 legal services plan and the quality of participating attorneys, including a
			 telephone number for registering grievances.
(5) The role of the Board of Bar Overseers in
			 regulating attorney conduct and the procedure for submitting complaints to the
			 Board.
(6) The statutory procedure
			 for obtaining a Division of Insurance hearing on any dispute or controversy
			 arising between the insurer or sponsor and any subscriber or between any
			 attorney and subscriber.
(7) The
			 conditions upon which the certificate maybe extended, renewed, amended,
			 canceled or otherwise terminated.
(8) The premium which must be paid by or on
			 behalf of the subscriber and the coverage period.
(9) The number of days of grace (minimum of
			 30) which will be allowed for making any payment due under the certificate or
			 individual contract.
(10) A general
			 information telephone number.