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Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1510 - Complaint-resolution process; right to director's review and determination; review of written materials; meeting

Current through Vol. 24-12, July 15, 2024
Rule 10.
(1) If a
				person has reason to believe an insurer or producer has improperly denied him
				or her automobile insurance or home insurance or has charged an incorrect
				premium for that insurance and a private informal managerial-level conference
				fails to resolve the dispute because the person disagrees with the insurer's
				proposed resolution following the conference or the insurer did not provide a
				private informal managerial-level conference and proposed resolution within 30
				days after the date of the person's request, the person has a right to submit a
				complaint to the director and for a review and determination to resolve the
				dispute.
(2) The person making the
				complaint shall submit the complaint and request for the director's review and
				determination in a form and manner approved by the director within 120 days
				after the date the insurer mails or provides the information required under
				R 500.1509 or within 120 days after
				the expiration of the 30-day period that the insurer has to provide a proposed
				resolution to the person making the complaint if no proposed resolution is
				provided during that 30-day period.
(3) The person making the complaint is
				entitled to a review of the dispute by the director either through a review of
				written materials or, upon the person's written request, through a meeting,
				subject to subrule (4) of this rule. A request for a meeting must be made at
				the same time the person submits the complaint and request for the director's
				review and determination.
(4) A
				meeting requested pursuant to subrule (3) of this rule, may, as permitted by
				the director, be held by telephone, video teleconference or other substantially
				similar electronic means, or if requested by the person making the complaint,
				in-person. A request for an in-person meeting must be made at the same time the
				person submits the complaint and request for the director's review and
				determination. Any meeting under this subrule must include the director or his
				or her designee, the person making the complaint or his or her designated
				representative, and a supervisory or higher level representative of the insurer
				authorized to act on behalf of the insurer. If an in-person meeting is held,
				the insurer's authorized representative may participate through telephone or
				video teleconference or other substantially similar electronic means. The
				director shall conduct any meeting under this subrule in a manner that allows
				the person making the complaint and insurer to present relevant facts, records,
				dates, times, and names to substantiate their respective positions regarding
				the dispute.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1511 - Complaint-resolution process; notice of director's review of dispute

Current through Vol. 24-12, July 15, 2024
Rule 11. The director shall do all of the following within 10
				  business days after the director receives a complaint and request for the
				  director's review and determination, as applicable:
(a) For a review and determination conducted
				through a meeting pursuant to
				R
				500.1510(4), set a time for the
				meeting and notify the person making the complaint and the insurer of the time,
				manner, and place of the meeting.
(b) For all review and determinations, notify
				the insurer of the time period within which any reply must be submitted to the
				director and of the disputed issue or issues under consideration. A copy of
				that notification must be provided to the person making the
				complaint.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1512 - Complaint-resolution process; basis for director's determination; failure to supply materials or information

Current through Vol. 24-12, July 15, 2024
Rule 12.
(1) If a
				review and determination is conducted through written materials, the director
				shall base his or her determination upon written materials submitted by the
				person making the complaint and the insurer.
(2) If a review and determination is
				conducted through a meeting pursuant to
				R
				500.1510(4), the director shall base
				his or her determination upon written materials submitted by the person making
				the complaint and the insurer, any statements made at the meeting, or a
				combination of both.
(3) If the
				person making the complaint or the insurer fails to supply any materials or
				information in a timely manner, the director shall base his or her
				determination upon materials and information available to the director at the
				time of the determination.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1513 - Complaint-resolution process; director's decision; contested case

Current through Vol. 24-12, July 15, 2024
Rule 13.
(1) If a
				review and determination is conducted through written materials, the director
				shall issue a written decision of his or her determination of the disputed
				issue or issues within 15 business days after the insurer submits a reply to
				the complaint during the time period established by the director under
				R 500.1511 or, if a reply is not
				submitted to the director during that time period, within 15 business days
				after that time period has expired.
(2) If a review and determination is
				conducted through a meeting pursuant to
				R
				500.1510(4), the director shall issue
				a written decision of his or her determination of the disputed issue or issues
				within 15 business days after the meeting is concluded.
(3) The director shall indicate in the
				written decision that if either the insurer or the person making the complaint
				disagrees with the determination, the director, if requested to do so, shall
				proceed to hear the matter as a contested case under the administrative
				procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.
(4) The director shall provide copies of the
				written decision to the insurer and the person making the complaint.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1514 - Complaint-resolution process; remedies based on director's review and determination

Current through Vol. 24-12, July 15, 2024
Rule 14.
(1) Subject
				to subrule (2) of this rule, if the director concludes that the person making
				the complaint was improperly denied automobile insurance or home insurance, the
				director shall order an appropriate remedy.
(2) If the director concludes that the
				automobile insurance or home insurance of the person making the complaint was
				improperly terminated, the person may select any of the following remedies:
(a) The termination is deemed invalid and
				coverage is reinstated effective as of the date of the termination upon payment
				of the applicable premium.
(b) The
				termination is deemed invalid and coverage is reinstated effective as of the
				date of the director's decision issued under
				R
				500.1513 upon payment of the applicable premium,
				subject to the following conditions if the person has secured coverage from an
				insurer other than the insurer that improperly terminated the insurance:
(i) Upon notice from the person, the coverage
				must be canceled and the insurer providing the coverage shall provide the
				person a refund of premium pursuant to the insurer's filed rating
				rules.
(ii) The insurer that
				improperly terminated the insurance shall pay the person any additional premium
				expenditures incurred by the person as a result of seeking additional coverage
				in excess of the pro rata premium the person would have paid for the coverage
				from the improperly terminating insurer for the same period of time.
(c) If the person has secured
				coverage from an insurer other than the insurer that improperly terminated the
				insurance, the person may continue that coverage, and the termination is deemed
				invalid but coverage is not reinstated.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1515 - Collection and reporting of data by insurers

Current through Vol. 24-12, July 15, 2024
Rule 15. For purposes of section 2127 of the code, MCL
				  500.2127, all of the following apply:
(a) Every insurer subject to chapter 21 of
				the code, MCL 500.2101 to 500.2131, underwriting automobile insurance or home
				insurance, or both, in this state shall report data concerning the insurance in
				accordance with statistical plans and reporting forms approved by the director.
				The reporting plans and forms must provide for the collection of only the
				information the director finds necessary to monitor and evaluate the automobile
				and home insurance markets in this state, as provided in section 2127 of the
				code, MCL 500.2127.
(b) Statistical
				plans approved by order of the director for licensed statistical gathering
				agencies are accepted to provide adequate historical premium, exposure, loss,
				and expense information for automobile and home insurance.
(c) Supporting data for automobile and home
				insurance rate filings submitted in accordance with the forms with instructions
				issued by the director are assumed to comply substantially with information
				needs for evaluating overall rate level needs, 1 of the elements in monitoring
				and evaluating markets per section 2127 of the code, MCL 500.2127.
(d) The director shall accept annual
				statement data on 1 element in the process of monitoring competition.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1516 - Exchange of claim information

Current through Vol. 24-12, July 15, 2024
Rule 16. Every insurer subject to chapter 21 of the code, MCL
				  500.2101 to 500.2131, shall exchange claim information for automobile insurance
				  and home insurance as provided in these rules to the extent the information is
				  available from the responding company's data base. The information must not be
				  requested for selected policyholders on the basis of age, sex, or other factor
				  that is discriminatory in nature.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1517 - Exchange of automobile insurance claim information

Current through Vol. 24-12, July 15, 2024
Rule 17.
(1) Every
				insurer subject to chapter 21 of the code, MCL 500.2101 to 500.2131,
				underwriting automobile insurance shall respond, on a form similar to figure 1
				under
				R
				500.1521, within 30 calendar days, to a request by
				another insurer for information concerning the claim history of a specified
				person.
(2) The reporting insurer
				shall report automobile insurance claim information as follows:
(a) The name and address of the
				insured.
(b) The policy number of
				such insured.
(c) The name of the
				driver of the insured vehicle, if known.
(d) The period of time insured, if available,
				but in all cases, the expiration date.
(e) Whether the claim is open or closed at
				the time of the report.
(f) Date or
				dates of loss.
(g) Amount of loss
				paid under each coverage.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1518 - Exchange of home insurance claim information

Current through Vol. 24-12, July 15, 2024
Rule 18.
(1) Every
				insurer subject to chapter 21 of the code, MCL 500.2101 to 500.2131,
				underwriting home insurance shall respond, on a form similar to figure 1 under
				R
				500.1521, within 30 calendar days, to a request by
				another insurer for information concerning the claim history of a specified
				person. The claim information requested or reported must be information as
				described in section 2111(7)(f) of the code, MCL 500.2111.
(2) The reporting insurer shall report home
				insurance information as follows:
(a) Name and
				address of the insured.
(b) Policy
				number of such insured.
(c)
				Location of insured premises.
(d)
				Date of loss or losses.
(e) Amount
				paid.
(f) Coverage
				involved.
(g) Whether or not a fire
				loss was investigated by civil authorities.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1519 - Exchange of claim information; reporting period

Current through Vol. 24-12, July 15, 2024
Rule 19. An insurer is responsible for reporting, upon
				  request, automobile insurance and home insurance claim information only for
				  current policies or those that expired 90 days immediately preceding the date
				  of receipt of a request for claim information. The claim information reported
				  must cover the 3 years last preceding the expiration date, including claim
				  information originally reported by another carrier.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Essential Insurance › Section R. 500.1521 - Figure 1

Current through Vol. 24-12, July 15, 2024
Rule 21. Figure 1 reads as follows:
Date Submitted: ______________________
Named Insured _____________________
Address ______________________________
Responding Company
Policy Number ________________________ Period Insured: From
				  ______to ______
We recently received an application for auto property (circle
				  one) insurance from the above individual. As provided for in Section 2130 of
				  the Insurance Code of 1956, 1956 PA 218, MCL 500.2130, please supply the claim
				  experience for the past 3 years as available. If additional space is needed,
				  please complete on the back of this form.
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Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2102 - Interpretation of rules

Current through Vol. 24-12, July 15, 2024
Rule 2. These rules shall be construed to secure a just,
				  speedy, efficient, and fair determination of the issues presented, consistent
				  with due process and the safeguarding of the rights of the
				  parties.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2103 - Petition for a contested case; required information

Current through Vol. 24-12, July 15, 2024
Rule 3. Except as otherwise provided by the commissioner, a
				  person who seeks to have the commissioner commence a contested case shall
				  submit a written petition for a contested case to the commissioner. The
				  petition shall set forth all of the following:
(a) Facts or conduct that warrant a contested
				case.
(b) Specific sections of
				applicable rules and statutes, if known.
(c) The remedies sought.
(d) The identity of the persons involved.This
				rule does not affect the commissioner's authority to commence a contested case
				on the commissioner's own motion.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2104 - Petition for a contested case; determination of commissioner; notice to petitioner

Current through Vol. 24-12, July 15, 2024
Rule 4.
(1) Within
				30 days after receipt of a petition for a contested case, the commissioner
				shall, in conformity with any applicable statute or rule, determine whether to
				take any of the following actions:
(a) Request
				the petitioner to amend the petition.
(b) Demand an answer to the
				petition.
(c) Investigate the
				allegations set forth in the petition.
(d) Issue a notice of opportunity to show
				compliance.
(e) Issue a notice of
				hearing.
(f) Order a public
				hearing.
(g) Decline to take
				further action against the petition.
(h) Take over appropriate action within the
				commissioner's authority.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2132 - Proposal for decision; motion for oral argument; opportunity for rebuttal; service of notice

Current through Vol. 24-12, July 15, 2024
Rule 32. Upon filing exceptions to a proposal for decision, a
				  party may make a motion for oral argument before the commissioner. Oral
				  argument shall be by leave of the commissioner and may be limited in scope and
				  duration. When oral argument is granted, notice shall be served on the parties.
				  All parties shall be given an opportunity for rebuttal. The commissioner may
				  limit the scope and duration of rebuttal.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2133 - Final decisions and orders; date

Current through Vol. 24-12, July 15, 2024
Rule 33. Except as otherwise provided by law, the
				  commissioner shall issue a final decision or order not later than 30 days after
				  the date for the filing of any exceptions or, if oral argument is permitted
				  pursuant to section 81(1) of the act, not later than 30 days after oral
				  argument.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2135 - Presiding officer; designation and authorization

Current through Vol. 24-12, July 15, 2024
Rule 35. The commissioner, a person designated by statute, or
				  1 or more hearing officers designated and authorized by the commissioner to
				  conduct contested cases shall preside in a contested case. Upon commencement of
				  a contested case, the commissioner shall designate the presiding officer in
				  conformity with applicable law.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2139 - Public hearing

Current through Vol. 24-12, July 15, 2024
Rule 39. The commissioner may order a public hearing for the
				  purpose of obtaining information and providing the public with an opportunity
				  to present data, views, and arguments on issues upon which the commissioner is
				  authorized to make a determination.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2140 - Public hearing; notice; advance notice request; publication

Current through Vol. 24-12, July 15, 2024
Rule 40.
(1) Notice
				of a public hearing shall be given not less than 10 days before the public
				hearing and shall include all of the following:
(a) A reference to the statutory authority
				under which the determination is to be made.
(b) The time and place of the public hearing
				and a statement of the manner in which data, views, and arguments may be
				submitted to the commissioner at other times by any person.
(c) A description of the subjects and issues
				involved.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2141 - Public hearing; presentation of testimony

Current through Vol. 24-12, July 15, 2024
Rule 41. The commissioner shall determine the order in which
				  testimony is presented and may question those persons who present testimony.
				  Subject to any limitation the commissioner may prescribe, the commissioner may
				  permit persons to question other persons who present testimony. The
				  commissioner may set time limits on testimony.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Hearing Procedures › Section R. 500.2142 - Rescission

Current through Vol. 24-12, July 15, 2024
Rule 42. R 501.301 to R 501.308 of the Michigan
				  Administrative Code, appearing on pages 5053 to 5055 of the 1979 Michigan
				  Administrative Code, are rescinded.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Discretionary Clauses › Section R. 500.2201 - Definitions

Current through Vol. 24-12, July 15, 2024
Rule 1. As used in these rules:
(a) "Appeal" means an appeal by a
				policyholder or other claimant of a claim denial by an insurer. It includes
				appeals to administrative agencies, arbitrators, courts, and
				mediators.
(b) "Commissioner" means
				the commissioner of the office of financial and insurance services.
(c) "Discretionary clause" is a provision in
				a form that purports to bind the claimant to or grant deference in subsequent
				proceedings to the insurer's decision, denial, or interpretation on terms,
				coverage, or eligibility for benefits including, but not limited to, a form
				provision that does any of the following:
(i)
				Provides that a policyholder or other claimant may not appeal a denial of a
				claim.
(ii) Provides that the
				insurer's decision to deny policy coverage is binding upon a policyholder or
				other claimant.
(iii) Provides that
				on appeal the insurer's decision-making power as to policy coverage is
				binding.
(iv) Provides that the
				insurer's interpretation of the terms of a form is binding upon a policyholder
				or other claimant.
(v) Provides
				that on appeal the insurer's interpretation of the terms of a form is
				binding.
(vi) Provides that or
				gives rise to a standard of review on appeal that gives deference to the
				original claim decision.
(vii)
				Provides that or gives rise to a standard of review on appeal other than a de
				novo review.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Discretionary Clauses › Section R. 500.2202 - Discretionary Clauses Prohibited

Current through Vol. 24-12, July 15, 2024
Rule 2.
(a) A
				discretionary clause unreasonably reduces the risk purported to be assumed in
				the general coverage of the policy within the meaning of MCL
				500.2236(5).
(b) On and after the
				first day of the first month following the effective date of these rules, an
				insurer shall not issue, advertise, or deliver to any person in this state a
				policy, contract, rider, indorsement, certificate, or similar contract document
				that contains a discretionary clause. This does not apply to a contract
				document in use before that date, but does apply to any such document revised
				in any respect on or after that date.
(c) On and after the first day of the first
				month following the effective date of these rules, a discretionary clause
				issued or delivered to any person in this state in a policy, contract, rider,
				indorsement, certificate, or similar contract document is void and of no
				effect. This does not apply to contract documents in use before that date, but
				does apply to any such document revised in any respect on or after that
				date.
(d) Nothing in this rule
				limits the commissioner's authority under section 2236 to disapprove or
				withdraw approval of any form that contains a discretionary clause.
(e) By the first day of the second month
				following the effective date of these rules, each insurer transacting insurance
				in this state shall submit to the commissioner a list of all forms in effect in
				Michigan that contain discretionary clauses and shall submit a certification
				that the list is complete and accurate. If an insurer has no such forms in
				effect, it shall submit a letter to the commissioner reporting and certifying
				that fact.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Shortened Limitation of Action Clauses › Section R. 500.2211 - Definitions

Current through Vol. 24-12, July 15, 2024
Rule 1. As used in these rules:
(a) "Commissioner" means the commissioner of
				the office of financial and insurance services.
(b) "Form" means a form identified in section
				2236(1) of the insurance code of 1956, 1956 PA 218, MCL 500.2236(1).
(c) "Personal insurance" means all insurance
				policies underwritten and sold on an individual or group basis for personal,
				family, or household use.
(d)
				"Shortened limitation of action clause" is a provision in a form that shortens
				the period of time otherwise provided by statute within which a claimant may
				bring an action in law or equity against an insurer for claims arising under a
				personal insurance policy. It includes any clause, condition, or provision that
				reduces the period of time established by the insurance code of 1956, 1956 PA
				218, MCL 500.100 to MCL 500.8302, by the revised judicature act of 1961, 1961
				PA 236 , MCL 600.101 to MCL 600.9947; or by any other applicable
				statute.
(e) Terms defined in the
				insurance code of 1956, 1956 PA 218, MCL 500.100 to 500.8302, have the same
				meanings when used in these rules.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Shortened Limitation of Action Clauses › Section R. 500.2212 - Shortened limitation of action clauses prohibited

Current through Vol. 24-12, July 15, 2024
Rule 2.
(1) A
				shortened limitation of action clause unreasonably reduces the risk purported
				to be assumed in the general coverage of the policy within the meaning of MCL
				500.2236(5).
(2) On and after the
				first day of the first month following the effective date of these rules, an
				insurer shall not issue, advertise, or deliver to any person in this state a
				policy, contract, rider, indorsement, certificate, or similar contract document
				that contains a shortened limitation of action clause. This does not apply to a
				contract document in use before that date, but does apply to any such document
				revised in any respect on or after that date.
(3) On and after the first day of the first
				month following the effective date of these rules, a shortened limitation of
				action clause issued or delivered to any person in this state in a policy,
				contract, rider, indorsement, certificate, or similar contract document is void
				and of no effect. This does not apply to contract documents in use before that
				date, but does apply to any such document revised in any respect on or after
				that date.
(4) Nothing in this rule
				limits the commissioner's authority under section 2236 of the act to disapprove
				or withdraw approval of any form that contains a shortened limitation of action
				clause.
(5) By the first day of the
				second month following the effective date of these rules, each insurer
				transacting insurance in this state shall submit to the commissioner a list of
				all forms in effect in Michigan that contain shortened limitation of action
				clauses and shall submit a certification that the list is complete and
				accurate. If an insurer has no such forms in effect, it shall submit a letter
				to the commissioner reporting and certifying that fact.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Nonconforming Clauses › Section R. 500.2231 - Definitions

Current through Vol. 24-12, July 15, 2024
Rule 1. As used in these rules:
(a) "Act" means the insurance code of 1956,
				1956 PA 218, MCL 500.100.
(b)
				"Commissioner" means the commissioner of the office of financial and insurance
				regulation.
(c) "Form" means a form
				identified in section 2236 or in any other section of the act that is subject
				to section 2236procedures for approval or disapproval of forms.
(d) "Nonconforming clause" means a clause,
				exception, or condition identified in
				R
				500.2232.
(e) "Personal insurance" means all
				certificates issued or insurance policies underwritten and sold on an
				individual or group basis for personal, family, or household use.
(f) Terms defined in the insurance code of
				1956, 1956 PA 218, MCL 500.100, have the same meanings when used in these
				rules.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Insurance Policy Forms - Nonconforming Clauses › Section R. 500.2232 - Nonconforming clauses

Current through Vol. 24-12, July 15, 2024
Rule 2.
(1) Within
				the meaning of unreasonable in section 3525 of the act or within the meaning of
				section 2236(5) of the act, the following clauses violate a provision of the
				act, or are inconsistent, ambiguous, or misleading, or are exceptions and
				conditions that unreasonably or deceptively affect the risk purported to be
				assumed in the general coverage of a policy:
(a) A definition of disability in a
				disability income policy that is more inclusive than the definition of
				disability used in social security act disability proceedings if the more
				inclusive definition ceases to apply when or if the policyholder is denied
				social security disability benefits.
(b) A blank endorsement in connection with a
				personal insurance policy.
(c) An
				arbitration provision that requires the insured to travel to a location outside
				the county of the insured's residence, unless the insured consents to another
				location after the arbitral dispute occurs.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Written Examination For Health And Accident Agents › Section R. 501.157 - Limited licenses

Current through Vol. 24-12, July 15, 2024
Rule 7.
(1) The
				commissioner of insurance may issue a limited license to an agent who will be
				limiting his or her business to certain specified lines of insurance.
(2) An agent may receive a limited license
				upon qualifying to write the lines of insurance desired under procedures
				established by the commissioner of insurance.
(3) The insurer's request for licensing and
				the application of the prospective agent shall conspicuously indicate that the
				request is for a limited license. An explanation of the reasons for the
				limitation shall accompany the documents.
(4) An agent issued a limited license shall
				not submit, and an insurer shall not accept from that agent, any business
				written for lines of insurance not specifically authorized under the agent's
				license.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Farmers' Mutual Fire Insurance Companies › Section R. 501.201 - Membership fee

Current through Vol. 24-12, July 15, 2024
Rule 1. On and after October 1, 195 2, all farmers' mutual
				  fire insurance companies doing business under section 2, chapter IV, of part 4
				  of the insurance code, as latest amended, will not charge a membership fee upon
				  the issuance of a policy to a new member or upon the increase of a policy
				  already in force.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Rescinded - Petition Requesting Promulgation, Amendment, Or Rescission Of Rules

Current through Vol. 24-12, July 15, 2024
DEPARTMENT OF INSURANCE AND FINANCIAL
				SERVICES
INSURANCE
PETITION REQUESTING PROMULGATION, AMENDMENT, OR
				RESCISSION OF RULES
By Authority of 1952 PA 197, MCL S24.101 to
				  24.110.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Rescinded - Procedures For Informal Managerial-level Conferences And Review By Commissioner Of Insurance

Current through Vol. 24-12, July 15, 2024
DEPARTMENT OF INSURANCE AND FINANCIAL
				SERVICES
INSURANCE
PROCEDURES FOR INFORMAL MANAGERIAL-LEVEL CONFERENCES AND
				REVIEW BY COMMISSIONER OF INSURANCE
By Authority conferred on the commissioner of insurance by
				  section 33 of Act No. 306 of the Public Acts of 1969, as amended, and section
				  404 of Act No. 350 of the Public Acts of 1980, as amended, being SS24.233 and
				  550.1404 of the Michigan Compiled Laws
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Certificates - Discretionary Clauses

Current through Vol. 24-12, July 15, 2024
DEPARTMENT OF INSURANC E AND FINANCIAL
				SERVICES
INSURANCE
CERTIFICATES - DISCRETIONARY
				CLAUSES
By Authority conferred on the commissioner of the office of
				  financial and insurance services by sections 422 and 617 of the nonprofit
				  health care corporation reform act, 1980 PA 350, 1969 PA 306, and E.R.O.No
				  2003-1; MCL 550.1422, MCL 550.1617, MCL 24.231 to MCL 24.233, and MCL
				  445.2011
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.201 - Definitions

Current through Vol. 24-12, July 15, 2024
Rule 1.
(1) As used
				in these rules:
(a) "Act" means Act No. 173 of
				the Public Acts of 1958, as amended, being S550.601 et seq. of the Michigan
				Compiled Laws, and known as the credit insurance act.
(b) "Credit insurance" means both credit life
				insurance and credit accident and health insurance.
(c) "Credit transaction" means any
				transaction under which payment may be made at a future date for money loaned
				or goods, services, or properties sold or leased.
(d) "Joint credit life coverage" means credit
				life insurance covering 2 individuals, where the individuals are co-obligated
				on the indebtedness and where the entire sum insured becomes payable upon the
				death of the first debtor to die while the insurance is in force.
(e) "Open-end credit insurance" means credit
				insurance provided in connection with an indebtedness incurred under an
				open-end credit account plan by use of a credit card, check, or other device as
				the plan may provide. Open-end credit account plan includes a revolving charge
				account plan.
(f) "Post-claim
				underwriting" means determining whether an individual meets underwriting
				criteria after the receipt of a claim and voiding coverage or denying the claim
				based upon that determination. The term does not include determinations under
				preexisting conditions exclusion clauses permitted in these rules. The term
				also does not include determinations where knowledge by the insurer of facts
				misrepresented on the application would have led to a refusal by the insurer to
				issue a certificate based upon the insurer's written underwriting criteria on
				the date of application.
(g)
				"Underwrite" means applying standards under which the insurer issues, refuses
				to issue, renews, refuses to renew, or limits coverage. The term includes
				determinations based upon eligibility criteria or evidence of
				insurability.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.203 - Termination of group credit insurance policy

Current through Vol. 24-12, July 15, 2024
Rule 3.
(1) If a
				debtor is covered by a group credit insurance policy providing for the payment
				of single premiums to the insurer, then provision shall be made by the insurer
				that if the policy is terminated for any reason, insurance coverage with
				respect to any debtor insured under such policy shall be continued for the
				entire period for which the single premium has been paid.
(2) If a debtor is covered by a group credit
				insurance policy providing for the payment of premiums to the insurer on a
				monthly outstanding balance basis, then the policy shall provide that if the
				policy is terminated for whatever reason, termination notice thereof shall be
				given to the insured debtor not less than 30 days before the effective date of
				termination, except where replacement of the coverage by the same or another
				insurer in the same or a greater amount takes place without lapse of coverage.
				The notice required in this subrule shall be given by the insurer or, at the
				option of the insurer, by the creditor.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.204 - Remittance of premiums

Current through Vol. 24-12, July 15, 2024
Rule 4. If the creditor adds identifiable insurance charges
				  or premiums for credit insurance to the indebtedness, and any direct or
				  indirect finance, carrying, credit, or service charge is made to the debtor on
				  such insurance charges or premiums, the creditor shall remit, and the insurer
				  shall collect, such premium within 60 days after it is added to the
				  indebtedness. However, this time limit may be extended a reasonable amount of
				  time, not to exceed 60 days if, due to the processing of the premium data, the
				  creditor is unable to remit such premium to the insurer within the 60
				  days.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.205 - Renewal or refinancing of indebtedness

Current through Vol. 24-12, July 15, 2024
Rule 5. If the indebtedness is discharged due to renewal or
				  refinancing before the scheduled maturity date, the insurance in force shall be
				  terminated before any new insurance may be issued in connection with the
				  renewed or refinanced indebtedness. In all cases of such termination before the
				  scheduled maturity, a refund shall be made promptly as provided in R
				  550.113.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.206 - Maximum aggregate provisions

Current through Vol. 24-12, July 15, 2024
Rule 6. A provision in an individual policy or a certificate
				  that sets a maximum limit on total insurance benefits is operative only if a
				  refund of premium charges has been made on the amount of insurance in excess of
				  the maximum limit, if any, issued to the debtor within 90 days of the effective
				  date of coverage.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.207 - Voluntary prepayment of indebtedness

Current through Vol. 24-12, July 15, 2024
Rule 7. If a debtor prepays his or her indebtedness other
				  than as a result of his or her death or through a lump sum disability payment
				  under a credit insurance policy covering the debtor, both of the following
				  provisions apply:
(a) Any credit life
				insurance covering such indebtedness shall be terminated and an appropriate
				refund of the credit life insurance premium shall be made in accordance with R
				550.113.
(b) Any credit accident
				and health insurance covering such indebtedness shall be terminated and an
				appropriate refund of the credit accident and health insurance premium shall be
				made in accordance with R 550.113. If a claim under such coverage is in process
				at the time of prepayment, the amount of refund may be determined as if the
				prepayment did not occur until the payment of benefits terminates. No refund
				need be made during any period of disability for which credit accident and
				health benefits are payable. A refund shall be computed as if prepayment
				occurred at the end of the disability period.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.208 - Involuntary prepayment of indebtedness

Current through Vol. 24-12, July 15, 2024
Rule 8. If an indebtedness is prepaid by the proceeds of a
				  credit life insurance policy covering the debtor or by a lump sum payment of a
				  disability claim under a credit insurance policy covering the debtor, then it
				  shall be the responsibility of the insurer to see that the following are paid
				  to the insured debtor, if living, to the beneficiary, other than the creditor,
				  named by the debtor, or to the debtor's estate:
(a) In the case of prepayment by the proceeds
				of a credit life insurance policy, or by the proceeds of a lump sum total and
				permanent disability benefit under credit life coverage, an appropriate refund
				of the credit accident and health insurance premium in accordance with R
				550.113.
(b) In the case of
				prepayment by a lump sum disability claim, an appropriate refund of the credit
				life insurance premium in accordance with R 550.113.
(c) In either case, the amount of the
				benefits in excess of the amount required to repay the indebtedness after
				crediting any unearned interest or finance charges.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.209 - Policy forms; filing; and reserves

Current through Vol. 24-12, July 15, 2024
Rule 9.
(1) Credit
				life and credit accident and health insurance shall be issued only in the forms
				described in section 4 of the act.
(2) All policy forms, certificates of
				insurance, notices of proposed insurance, applications for insurance, binders,
				endorsements, and riders to be delivered or issued for delivery in this state
				and the schedules of maximum premium rates pertaining thereto shall be filed
				with the commissioner as required by sections 12 and 18 of the act.
(3) For policies and certificates issued
				after January 1, 1987, the minimum reserve basis for credit life insurance
				shall be determined in accordance with the 1980 commissioner's extended term
				table with interest at 5 1/2%.
(4)
				The minimum reserve basis for active lives on credit accident and health
				insurance shall be the amount of the premium refund available to the
				insured.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.210 - Rates generally

Current through Vol. 24-12, July 15, 2024
Rule 10.
(1) Under
				section 13 of the act, benefits provided by credit insurance policies shall be
				reasonable in relation to the premium charged. This requirement is deemed to be
				satisfied if a premium rate not exceeding the prima facie rate is
				charged.
(2) If any insurer files
				for approval of any form providing coverage other than that described in
				R
				550.111 and
				R
				550.112, the insurer shall demonstrate that the rates
				to be charged for such coverage are actuarially consistent with the applicable
				prima facie rates.
(3) If no
				specific charge is made to the debtor for credit insurance, the deviation
				standards of R 550.114 are not required to be used, but any premium rates
				resulting from such standards as are used which exceed the premium rate
				standards set out in
				R
				550.111 and
				R
				550.112 shall be filed with the commissioner. For
				purposes of this subrule, it will be considered that the debtor is charged a
				specific amount for insurance if an identifiable charge for insurance is
				disclosed in the credit or other instrument furnished the debtor which sets out
				the financial elements of the credit transactions or if there is a differential
				in finance, interest, service, or other similar charge made to debtors who are
				in like circumstances, except for their insured or noninsured status.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.211 - Credit life insurance prima facie rates

Current through Vol. 24-12, July 15, 2024
Rule 11.
(1) Single
				life credit life insurance prima facie premium rates for the insured portion of
				an indebtedness repayable in equal monthly installments, where the insured
				portion of the indebtedness decreases uniformly by the amount of the monthly
				installment paid, shall be as set forth in subdivisions (a) and (b) of this
				subrule. Single life credit life insurance prima facie premium rates, when the
				benefit provided is level term, shall be as set forth in subdivisions (a) and
				(c) of this subrule. Subdivisions (e) and (f) of this subrule refer to prima
				facie premium rates for other types of benefits either alone or in combination
				with the types of benefits applicable to subdivisions (a), (b), and (c) of this
				subrule. Subdivisions (a) to (g) read as follows:
(a) If premiums are payable on the monthly
				outstanding balance basis, the premium rate shall be the following amounts per
				month per $1,000.00 of outstanding balance:
(i) .8000 commencing September 1,
				1987.
(ii) .7692 commencing
				September 1, 1988.
(iii) .7385
				commencing September 1, 1989, and continuing thereafter.
Michigan Administrative Code › Department - Insurance and Financial Services › Insurance › Credit Insurance Rates, Forms, And Standards › Section R. 550.212 - Credit accident and health insurance prima facie rates

Current through Vol. 24-12, July 15, 2024
Rule 12.
(1) Credit
				accident and health insurance prima facie premium rates for the insured portion
				of an indebtedness repayable in equal monthly installments, where the insured
				portion of the indebtedness decreases uniformly by the amount of the monthly
				installment paid, shall be as set forth in subdivisions (a) and (b) of this
				subrule. Subdivisions (c), (d), and (e) of this subrule refer to prima facie
				premium rates for other types of benefits either alone or in combination with
				the type of benefits applicable to subdivisions (a) and (b) of this subrule.
				Subdivisions (a) to (f) read as follows:
(a)
				If premiums are payable on a single premium basis for the duration of the
				coverage, the premium rates shall be those set forth in appendix A of R
				550.117.
(b) If premiums are paid
				on the basis of the premium rate per month per thousand of outstanding insured
				indebtedness, the premium rates shall be those set forth in appendix B of R
				550.118.
(c) The actuarial
				equivalent of subdivision (b) of this subrule shall be used if the coverage
				provided is a constant maximum indemnity for a given period of time.
(d) An appropriate combination of the premium
				rate for a constant maximum indemnity for a given period of time and the
				premium rate for a maximum indemnity which decreases in equal amounts per month
				shall be used if the coverage provided is a combination of a constant maximum
				indemnity for a given period of time after which the maximum indemnity begins
				to decrease in equal amounts per month.
(e) If the benefits provided are other than
				those described in subdivisions (a) to (d) of this subrule, rates for such
				benefits shall be actuarially consistent with rates provided in subdivisions
				(b) and (c) of this subrule.
(f)
				The outstanding balance rate for credit accident and health insurance may be
				either a term specified rate or may be a single composite term outstanding
				balance rate applicable to all loans made under an open-end credit
				plan.