reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.28 - Status of company

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
						advertisement originating within this Commonwealth, which is intended to be
						seen or heard or which may reasonably be expected to be seen or heard beyond
						the limits of this Commonwealth, may not imply licensing beyond this
						Commonwealth unless the company is so licensed. An advertisement shall
						appropriately indicate that the company is licensed in a specified state or
						states only, or is not licensed in a specified state or states, by a statement
						such as: "This Company is licensed only in . . ." or "This Company is not
						licensed in . . ."
(b) An
						advertisement originating outside this Commonwealth, which may reasonably be
						expected to be seen or heard in this Commonwealth shall comply with this
						chapter or prominently set forth the following disclaimer: "This offer is not
						available to residents of Pennsylvania."
(c) An advertisement may not contain
						statements which are untrue in fact, or by implication misleading, with respect
						to the assets, corporate structure, financial standing, age or relative
						position of the company in the insurance business.
(d) An advertisement may not create the
						impression directly or indirectly that the company, its financial condition or
						status, or the payment of its claims, or the merits, desirability, or
						advisability of its contract forms or kinds or plans of insurance are approved,
						endorsed, or accredited by any division or agency of this Commonwealth or the
						United States Government.
(e) An
						advertisement may not contain a recommendation by a commercial rating system
						unless it clearly indicates the purpose of the recommendation and the
						limitations of the scope and extent of the recommendation.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.29 - Introductory, initial or special offers

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An advertisement may not directly or by
						implication falsely represent that a contract or combination of contracts is an
						introductory, initial or special offer, or that applicants will receive
						substantial advantages not available at a later date or that the offer is
						available only to a specified group of individuals.
(b) An advertisement may not directly or by
						implication falsely represent that only a specific number of policies will be
						sold, or that a time is fixed for the discontinuance of the sale or the
						particular policy advertised.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.30 - Enrollment periods

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
						advertisement which utilizes an enrollment period shall prominently display the
						ending date of that period.
(b) An
						advertisement may not contain phrases such as "special enrollment," "special
						limited enrollment," "enrollment deadline," "acceptance period" or similar
						words or phrases when the words or phrases falsely imply that an application
						must be made by a specific deadline in order to obtain the particular insurance
						product advertised by "any one company." This section is inapplicable to
						solicitations of employes or members of a particular group or association which
						otherwise would be eligible for the coverage under specific provisions of the
						laws or regulations of this Commonwealth governing group, blanket or franchise
						insurance.
(c) An enrollment period
						during which a particular insurance product may be purchased on an individual
						basis may not be offered within this Commonwealth unless there has been a lapse
						of not less than 90 days between the close of the immediately preceding
						enrollment period for the same product and the opening of the new enrollment
						period. The advertisement shall indicate the date by which the applicant must
						mail the application which may not be less than 10 days and not more than 40
						days from the date the enrollment period is advertised for the first time. This
						section applies to advertising media, such as, mail, newspapers, radio,
						television, magazines and periodicals, by "any one company."
(d) The phrase "any one company" in
						subsections (b) and (c) includes affiliated companies or a group of insurance
						companies under common management or control if the companies act in concert in
						such a manner as is primarily intended to make a particular insurance product
						available with less than 90 days between the close of the immediately preceding
						enrollment period and the opening of a new enrollment period.
(e) The phrase "a particular insurance
						product" in subsections (b) and (c) means an insurance contract which provides
						substantially different benefits than those contained in another contract.
						Different terms of renewability; an increase or decrease in the dollar amounts
						of benefits; an increase or decrease in an elimination period or waiting period
						from those available during an enrollment period for another policy may not be
						sufficient to constitute the product being offered as a different product
						eligible for concurrent or overlapping enrollment periods.
This section cited in 31 Pa. Code §
														90c.17 (relating to enrollment
							 period).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.31 - Testimonials or endorsements by third parties

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Testimonials used in advertisements shall
						be genuine, represent the current opinion of the author, be applicable to the
						contract advertised and be accurately reproduced. The company, in using a
						testimonial, makes as its own the statements contained therein, and the
						advertisement, including the statement, is subject to this chapter.
(b) If the person making a testimonial, an
						endorsement or an appraisal has a financial interest in the company or a
						related entity as a stockholder, director, officer, employe or otherwise, the
						fact shall be prominently disclosed in the advertisement.
(c) If a person is compensated for making a
						testimonial, endorsement or appraisal, the fact shall be disclosed in the
						advertisement by language substantially as follows: "Paid Endorsement." This
						rule does not require disclosures of union "scale" wages required by union
						rules if the payment is actually for such "scale" for TV or radio performances.
						However, the payment of substantial amounts, directly or indirectly, for travel
						or entertainment, may be sufficient compensation to require prominent
						disclosure as a "Paid Endorsement" in the advertisement.
(d) An advertisement may not represent or
						imply that a company or a contract has been approved or endorsed by an
						individual, group of individuals, society, association or other organizations,
						unless such is the fact, and unless a proprietary relationship between an
						organization and the insurer is disclosed. If the entity making the endorsement
						or testimonial has been formed by the company or is owned or controlled by the
						company or the person or persons who own or control the company, the fact shall
						be disclosed in the advertisement.
(e) If a testimonial refers to benefits
						received under a contract, the specific claim data, including claim number,
						date of loss, and other pertinent information shall be retained by the insurer
						for inspection for a period of 4 years or until the filing of the next regular
						report on examination of the insurer, whichever is the longer period of
						time.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.32 - Use of statistics

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
						advertisement relating to the dollar amounts of claims paid, the number of
						persons insured or similar statistical information relating to an insurer or
						policy may not use irrelevant facts, and may not be used unless it accurately
						reflects the relevant facts. An advertisement may not imply that the statistics
						are derived from the contract advertised unless such is the fact, and when
						applicable to other contracts or plans shall specifically so state.
(b) The source of any statistics used in an
						advertisement shall be identified in the advertisement, if the failure to so
						identify would have the capacity or tendency to mislead purchasers or
						prospective purchasers.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.33 - Identification of plan or number of policies

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a choice of the amount of benefits is
						referred to, an advertisement shall disclose that the amount of benefits
						provided depends upon the plan selected and that the premium will vary with the
						amount of the benefits selected.
(b) When an advertisement refers to various
						benefits which may be contained in two or more policies, other than group
						master policies, the advertisement shall disclose that the benefits are
						provided only through a combination of those policies.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.34 - Disparaging comparisons and statements

Current through Register Vol. 54, No. 28, July 13, 2024
An advertisement may not directly or indirectly make
						  unfair or incomplete comparisons of policies or benefits or comparisons of
						  non-comparable policies of other insurers, and may not disparage competitors,
						  their policies, services or business methods, and may not falsely or unfairly
						  disparage or minimize competing methods of marketing
						  insurance.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.35 - Identity of the company and contracts

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The name of the actual insuring company
						shall be clearly identified in all of its advertisements. The contracts
						advertised shall be identified by form number or other appropriate
						identification, so as to clearly identify the contract or contracts advertised.
						An advertisement may not use a trade name, an insurance group designation, name
						of the parent company of the insurer, name of a particular division of the
						insurer, service mark, slogan, symbol or other device which, without disclosing
						the name of the actual insurer, would have the capacity and tendency to mislead
						or deceive as to the true identity of the company.
(b) An advertisement may not contain an
						address other than that of the company's home office address, unless the "other
						address" is an actual branch or district office of the company and is
						identified as such.
(c) An
						advertisement may not use a combination of words or physical materials which by
						their content, phraseology, shape, color or other characteristics are so
						similar to combinations of words or physical materials used by agencies of the
						Federal government or of this Commonwealth, or otherwise appear to be of a
						nature that the same tend to confuse or mislead prospective insureds into
						believing that the solicitation is in some manner connected with an agency of
						the municipal, State or Federal government. The following are illustrations of
						combinations of words and physical materials which are presumed to mislead and
						confuse prospective insureds:
(1) Use of names
						as follows:
(i) Mailings sent to truck
						drivers living in this Commonwealth bearing the caption indicating that the
						sender is the "Department of Information, Pennsylvania Truckers Division,
						Harrisburg, Pennsylvania."
(ii)
						Mailings sent to employes of this Commonwealth bearing the caption indicating
						that the sender is the "Government Employees Division" and that the mailing is
						an announcement of a "Special Government Employees Health Plan."
(iii) Mailings sent to farmers living in this
						Commonwealth bearing the caption indicating that the sender is the
						"Pennsylvania Farmers Division."
(iv) Other examples include the following:
						"National Health Plan Agency"; "State Health Insurance Service Agency";
						"Pennsylvania Hospital Service Agency, Inc."; "Labor Unions Health &
						Welfare, Inc."; "International Farm Agency Advisory Board"; "Disability
						Division"; "Senior Citizens Division."
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › GENERAL COMPLIANCE STANDARDS › Section 51.36 - Mail-order solicitation

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
						Mail-order solicitation shall include a complete premium rate
						schedule.
(b) An advertisement of a
						mail-order solicitation may not incorrectly represent or imply that because "no
						insurance agent will call and no commissions will be paid to agents" that it is
						"a low cost plan," or use other similar words or phrases because the cost of
						advertising and servicing the contracts is a substantial cost in the marketing
						of a direct response insurance product.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › SPECIFIC COMPLIANCE STANDARDS FOR ACCIDENT AND HEALTH INSURANCE › Section 51.42 - Exceptions, reductions and limitations

Current through Register Vol. 54, No. 28, July 13, 2024
(a) When an advertisement refers to either a
						dollar amount, or a period of time for which a benefit is payable or the cost
						of the contract, or specific contract benefit, or the loss for which the
						benefit is payable, it shall also disclose those exceptions, reductions and
						limitations affecting the basic provisions of the contract without which the
						advertisement would have the capacity or tendency to mislead or
						deceive.
(b) An advertisement may
						not represent or imply broad insurance coverage when under the terms of the
						contract, the coverage is subject to an exception, reduction or limitation
						without disclosing the applicable exception, reduction or limitation. Words,
						terms or phrases implying the broad coverage include, but are not limited to,
						"all," "full," "complete," "comprehensive," "unlimited," "this policy will pay
						your hospital bill," and "this policy will replace your income," "this policy
						will help fill some of the gaps that Medicare and your present insurance leave
						out."
(c) If a policy contains a
						waiting, elimination, probationary or similar time period between the effective
						date of the policy and the effective date of coverage under the policy or a
						time period between the date a loss occurs and the date benefits begin to
						accrue for the loss, the advertisement shall disclose the existence of such
						periods.
(d) An advertisement may
						not use the words "only," "just," "merely," "minimum" or similar words or
						phrases to describe the applicability of exceptions and reductions, such as
						"This policy is subject to the following minimum exceptions and
						reductions."
(e) An advertisement
						may not contain descriptions of a contract limitation, exception or reduction,
						worded in a positive manner to imply that it is a benefit such as, describing a
						waiting period as a "benefit builder," or stating "even pre-existing conditions
						are covered after 2 years." Words and phrases used in an advertisement to
						describe the policy limitations, exceptions and reductions shall fairly and
						accurately describe the negative features of the limitations, exceptions and
						reductions of the policy offered.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › SPECIFIC COMPLIANCE STANDARDS FOR ACCIDENT AND HEALTH INSURANCE › Section 51.43 - The preexisting condition exclusion in a mail-order solicitation

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A mail-order
						solicitation which contains an exception, reduction or limitation due to a
						disease or health condition existing prior to the effective date of the
						contract or prior to any other particular time specified in the contract shall
						be accompanied by either of the following:
(1)
						An application containing specific questions concerning the medical history of
						a person to be covered under the contract. The questions shall be immediately
						preceded or followed by a statement disclosing what effect the answers to the
						questions may have on the issuance of the contract, and what effect the answer
						to the question may have on the nature or extent of benefits provided by the
						contract.
(2) An application
						containing a question and provision for answer in the following form: "NOTICE:
						The following question must be answered: Do you understand that the company
						will not pay benefits during the first ____________ year(s) of the policy for
						hospitalization caused by any medical condition or illness you may now have or
						have had in the past? YES ____________NO ____________"
(i) This question and provision for answer
						shall be in bold-face or contrasting color type, and shall immediately precede
						the space for the signature of the applicant.
(ii) This question and provision for answer
						may be altered only to the extent to make it consistent with the preexisting
						condition provisions of the contract advertised. In no case may this question
						and provision for answer be altered to eliminate the beginning phrase "Do you
						understand that the company will not pay benefits during . . . ," or to
						eliminate the requirements that a tentative insured be required to make a "yes"
						or "no" answer.
(iii) If an
						individual who has made a "no" response to this question or has failed to make
						any response is issued the advertised contract or a similar contract from the
						same company or a related company before the company has made certain that the
						individual has been made aware of the applicable limitations of the contract,
						the mail-order solicitation may be presumed not to be in accord with the
						compliance standards for advertisements.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart E - Advertising of Insurance › Chapter 51 - GENERAL PROVISIONS › Subchapter B - COMPLIANCE STANDARDS › COMPLIANCE STANDARDS FOR AUTOMOBILE INSURANCE › Section 51.61 - Offer to quote premium rate

Current through Register Vol. 54, No. 28, July 13, 2024
An advertisement for automobile liability or physical
						  damage insurance coverage may not invite a prospective insured to apply for a
						  quotation of a premium rate which the company would charge for the insurance
						  unless:
(1) It is the company's intent
						and actual practice to render the quotation to each prospective insured who
						applies, to honor the quote with an offer of insurance.
(2) If it is the company's intent and actual
						practice to refuse to render a quote to certain individuals or classes of
						individuals for any reason, the advertisement shall clearly and conspicuously
						disclose in prominent type, "WE RESERVE THE RIGHT TO REFUSE TO QUOTE ANY
						INDIVIDUAL A PREMIUM RATE FOR THE INSURANCE ADVERTISED HEREIN," and on the
						application for such quotation immediately in bold type or contrasting color
						state: "Do you understand that the company reserves the right to refuse to give
						you a quotation for automobile insurance; YES NO ?".
(3) If it is the company's intent and actual
						practice to offer a quotation to applicants who meet its underwriting
						requirements and not to offer a quotation to those who do not appear to meet
						the company's underwriting requirements, the company shall consider such
						refusal to render a quote as a refusal to write as defined in the act of June
						5, 1968 (P. L. 140, No. 78) (40 P. S. §§
													1008.1-1008.11) and comply with the
						act.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 56 - SPECIAL RULES OF ADMINISTRATIVE PRACTICE AND PROCEDURE › Section 56.1 - Applicability of general rules

Current through Register Vol. 54, No. 28, July 13, 2024
Under 1 Pa. Code §
										31.1 (relating to scope of part),
					 1 Pa. Code Part II (relating to general rules of administrative practice and
					 procedure) is applicable to the activities of and proceedings before the
					 Insurance Department except 1 Pa. Code §§
										35.201-35.207,
					 35.211-35.214 and
					 35.221 (relating to proposed
					 reports generally; exceptions to proposed reports; and briefs and oral argument
					 in absence of proposed report).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 56 - SPECIAL RULES OF ADMINISTRATIVE PRACTICE AND PROCEDURE › Section 56.2 - Adjudication procedure

Current through Register Vol. 54, No. 28, July 13, 2024
(a) At the
				  conclusion of an administrative hearing, if submission of briefs is waived by
				  participants with the consent of the presiding officer or the Insurance
				  Commissioner sitting as such or after submission of briefs, the matter will be
				  adjudicated by the Insurance Commissioner. Consequently, notwithstanding any
				  provision of 1 Pa. Code Part II (relating to general rules of administrative
				  practice and procedure) to the contrary, oral argument, certification of the
				  record of hearing or a proposed report by a presiding officer prior to
				  adjudication by the Insurance Commissioner are dispensed with.
(b) The provisions of subsection (a)
				  supersedes 1 Pa. Code §§
										35.201-35.207,
				  35.211-35.214 and
				  35.221 (relating to proposed
				  reports generally; exceptions to proposed reports; and briefs and oral argument
				  in absence of proposed report).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 56 - SPECIAL RULES OF ADMINISTRATIVE PRACTICE AND PROCEDURE › Section 56.3 - Admissions as to facts and documents

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  A participant may serve upon any participant a written request for the
				  admission by him, for the purpose of the pending hearing only, of the truth of
				  relevant matters of fact set forth in the request or of the genuineness of any
				  writing, document, or record, a copy of which is attached to the request, or of
				  the truth of any fact relating to its authenticity, correctness, execution,
				  delivery, mailing or receipt.
(b) A
				  matter of which an admission is requested is admitted unless the participant,
				  within 10 days after service of the request, serves upon the requesting
				  participant:
(1) A sworn denial or
				  explanation why he cannot admit or deny the matter.
(2) Objections to the relevance or competence
				  of the matter or the scope of the request.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 57 - PUBLICATION OF CITATIONS AND NOTICE OF HEARINGS › Section 57.1 - General requirements

Current through Register Vol. 54, No. 28, July 13, 2024
All notices of hearing pertaining to alleged violations of
					 the insurance laws of the Commonwealth will hereafter be published in the
Pennsylvania Bulletin
for the purpose of informing the
					 respondents, the insurance industry and the public of pending
					 actions.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.1 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This chapter implements section 5(9) of The Unfair
					 Insurance Practices Act (40 P. S. §§
											1171.5(9)).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.2 - Applicability

Current through Register Vol. 54, No. 28, July 13, 2024
This chapter applies to policies of insurance covering
					 owner-occupied private residential properties or personal property owned by
					 individuals that have been in force for 60 days or more, excluding automobiles
					 covered under the act of June 5, 1968 (P. L. 140, No. 78) (40 P. S.
					 §§
											1008.1-1008.11).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.3 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following terms, when used in this chapter, have the
					 following meanings, unless the context clearly indicates otherwise.
Policies covering owner-occupied
					 dwellings
-Policies covering a residential structure consisting of four
					 or less household units, one of which is occupied by the owner of such
					 structure.
Policies covering personal property owned by
					 individuals
-Policies covering a natural person against loss, theft,
					 damage or destruction of personal property, including liability arising out of
					 the ownership or use thereof except policies of automobile insurance covered
					 under the act of June 5, 1968 (P. L. 140, No. 78) (40 P. S. §§
											1008.1-1008.11).
The provisions of this §
												59.3 issued under The Insurance
						Company Law of 1921 (40 P. S. §§
													1-321);
						The Insurance Department Act of 1921 (40 P. S. §§
													344-991); The Administrative Code of 1929
						(71
						P. S. §§
													66,
						186,
						411 and
						412); act of June 5, 1968 (P.
						L. 140, No. 78) (40 P. S. §§
													1008.1-1008.11); and section 5(a)(9) of the
						Unfair Insurance Practices Act (40 P. S. §
													1171.5(a)(9)).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.4 - Separate insurers

Current through Register Vol. 54, No. 28, July 13, 2024
Each member of a group of affiliated insurers shall be
					 considered a separate insurer for purposes of the act. Therefore, if one
					 insurer, which is a member of a group of affiliated insurers, cancels or
					 refuses to renew a particular policy but at the time offers to arrange
					 insurance for the applicant or insured with another member of the same group,
					 there will be deemed to have been a cancellation or refusal to renew by the
					 first insurer.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.4a - Reasons for cancellation of insurance policies

Current through Register Vol. 54, No. 28, July 13, 2024
In addition to the statutorily permitted bases for
					 cancellation of a policy of insurance found at section 5(a)(9) of the Unfair
					 Insurance Practices Act (40 P. S. §
											1171.5(a)(9)), an insurer
					 may cancel any policy other than a policy insuring farm risks when the property
					 insured would not meet the eligibility requirements for insurance of the
					 Insurance Placement Facility of Pennsylvania (Fair Plan) then in
					 effect.
The provisions of this §
												59.4a issued under The Insurance
						Company Law of 1921 (40 P. S. §§
													1-321);
						The Insurance Department Act of 1921 (40 P. S. §§
													344-991); The Administrative Code of 1929
						(71
						P. S. §§
													66,
						186,
						411, and
						412); act of June 5, 1968 (P.
						L. 140, No. 78) (40 P. S. §§
													1008.1-1008.11); and section 5(a)(9) of the
						Unfair Insurance Practices Act (40 P. S. §
													1171.5(a)(9)).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.5 - Notice of cancellation or refusal to renew

Current through Register Vol. 54, No. 28, July 13, 2024
Forms of notices of cancellation or refusal to renew shall
					 be filed with and approved by the Insurance Commissioner prior to
					 use.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.6 - Notice of cancellation or refusal to renew; requirements

Current through Register Vol. 54, No. 28, July 13, 2024
Notices of cancellation or refusal to renew shall meet the
					 following requirements:
(1) The form
				  shall be clearly labeled: "Notice of Cancellation or Refusal to
				  Renew."
(2) The form shall be given
				  to the insured in duplicate.
(3)
				  The date, not less than 30 days after the date of delivery or mailing, on which
				  such cancellation or refusal to renew is to become effective shall be clearly
				  indicated.
(4) Space must be
				  provided for the insurer to provide the specific reason or reasons for the
				  cancellation or refusal to renew.
(5) The reasons given for cancellation or
				  refusal to renew shall be clear and complete. If the reason is a material
				  misrepresentation, fraudulent statement, omission or concealment of fact
				  material to the acceptance of the risk, or to the hazard assumed by the
				  company, made by the insured, the insurer shall specify what statements,
				  omissions or concealments it relied on for its action.
(6) If the reason is a substantial change or
				  increase in the hazard, the insurer shall specify the changes or increased
				  hazards it relied on for its actions. If the reason is the failure to pay a
				  premium, the insurer shall specify the amount due, and the date when it was
				  due.
(7) The form shall include
				  that advice that the insured has a right to request review of the insurer's
				  action as provided in §
										59.7 (relating to appeal
				  procedure), within ten days of receipt of the notice. In so doing the notice
				  shall include:
(i) Advice that review may be
				  requested by signing a copy of the form in a space provided and sending it to
				  one of the regional offices of the Insurance Department.
(ii) The addresses of the four regional
				  offices of the Insurance Department.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.7 - Appeal procedure

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
				  insured may request review by the Insurance Commissioner of the action of the
				  insurer in cancelling or refusing to renew his or her policy by making written
				  request therefor. This may be done by signing a copy of the "Notice of
				  Cancellation or Refusal to Renew," and sending it to one of the regional
				  offices of the Insurance Department at one of the addresses given on the
				  notice.
(b) Upon receipt of such
				  request, both the insured and the insurer will be notified that an
				  investigation has been undertaken and they may be contacted to secure
				  additional information as required.
(c) Upon completion of the investigation, a
				  copy of the investigative report will be supplied to both the insured and the
				  insurer. Within ten days of receipt of the report either party may submit
				  written comments for consideration by the Insurance Commissioner.
(d) If either insurer or insured desires a
				  formal administrative hearing, such request shall be made at the time written
				  comments are submitted. If so, a hearing will be scheduled as soon as possible.
				  If not, the matter will be decided on the basis of the written comments and
				  investigative report.
(e) Hearings
				  will be held in accordance with the following procedures:
(1) Upon receipt of a request for a formal
				  administrative hearing, notice of the time and place of such hearing will be
				  sent by certified mail to the insurer and insured, not less than five days
				  prior to the hearing.
(2) The
				  hearing will be recorded on tape with a stenographer. The tape and
				  stenographer's notes must be prepared such that a full verbatim transcription
				  may thereafter be made. Such tape will be retained for a period of 90 days
				  following issuance of the Insurance Commissioner's final order in the
				  case.
(3) Parties will be afforded
				  a reasonable time following the hearing to submit written briefs in support of
				  their position.
(4) All relevant
				  evidence of reasonable probative value will be admitted into the record of the
				  proceeding and reasonable examination and cross-examination shall be
				  permitted.
(5) The regulations in 1
				  Pa. Code Part II (relating to general rules of administrative practice and
				  procedure) may be used where conducive to speedy and fair
				  proceedings.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.8 - Residence

Current through Register Vol. 54, No. 28, July 13, 2024
If an insurer determines not to renew a policy of insurance
					 because the insured no longer resides in this Commonwealth, the insurer shall
					 not be required to comply with the requirement of section 5(a)(9) of The Unfair
					 Insurance Practices Act (40 P. S. §
											1171.5).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.10 - Notice of representative

Current through Register Vol. 54, No. 28, July 13, 2024
Each insurer shall file within 30 days of the effective
					 date of this Chapter, with the Department, the names of its representatives who
					 are to be notified in the event that an insured or an applicant requests the
					 Insurance Department to review a cancellation or refusal to renew, involving
					 that insurer.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.11 - Records; cancellation, refusal to write or renew

Current through Register Vol. 54, No. 28, July 13, 2024
Each insurer shall maintain records of the numbers of
					 cancellations and refusals to renew policies and the reasons therefor. These
					 records shall be made available to the Insurance Commissioner upon his
					 request.
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.12 - Records; complaints

Current through Register Vol. 54, No. 28, July 13, 2024
Each insurer shall maintain records of the number of
					 complaints received during the previous four years in conformance with section
					 5(a)(11) of The Unfair Insurance Practices Act (40 P. S. §
											1171.5(a)(11)).
Pennsylvania Code › Title 31 - INSURANCE › Part I - General Provisions › Subpart F - Rules of Procedure › Chapter 59 - REASONS FOR CANCELLATIONS AND REFUSAL TO RENEW; NOTICE AND APPEAL PROCEDURES › Section 59.13 - Foreign language requirement

Current through Register Vol. 54, No. 28, July 13, 2024
Each insurer shall assure that the notice required by
					 §
										59.6 (relating to notice of
					 cancellation or refusal to renew; requirements) shall be given to each
					 policyholder affected. In the event the insurer, or its agent, knows or has
					 reason to believe that any policyholder will be unable to read such notice, the
					 insurer shall assure that the notice is communicated to the policyholder by an
					 appropriate foreign language equivalent or oral communication in a language
					 understood by the policyholder.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.1 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
The purpose of this chapter is to implement the provisions of
				  the act of June 5, 1968 (P. L. 140, No. 78) (40 P. S. §§
										1008.1-1008.11).
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.2 - Applicability

Current through Register Vol. 54, No. 28, July 13, 2024
The provisions of this chapter apply to all policies of
				  insurance delivered or issued for delivery in this Commonwealth insuring a
				  natural person as named insured or one or more related individuals resident of
				  the same household, and under which the insured vehicles therein designated are
				  of the following types only:
(1) A
				motor vehicle of the private passenger or station wagon type that is not rented
				to others.
(2) Another four-wheel
				motor vehicle with a gross weight not exceeding 9,000 pounds which is not
				principally used in the occupation, profession, or business of the insured
				other than farming. However, this may not apply to any policy issued under an
				automobile assigned risk plan, nor to any policy insuring more than four
				automobiles, nor to any policy covering garage, automobile sales agency, repair
				shop, service station, or public parking place operation hazards.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.3 - Separate insurers

Current through Register Vol. 54, No. 28, July 13, 2024
Each member of a group of affiliated insurers shall be
				  considered a separate insurer for purposes of the act. Therefore, if one
				  insurer, which is a member of a group of affiliated insurers, cancels or
				  refuses to renew a particular policy but at the same time offers to arrange
				  insurance for the applicant or insured with another member of the same group,
				  there will be considered to have been a cancellation or refusal to renew by the
				  first insurer.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.4 - Notice of cancellation or refusal to renew

Current through Register Vol. 54, No. 28, July 13, 2024
Forms of notices of cancellation or refusal to renew shall be
				  filed with and approved by the Insurance Commissioner prior to
				  use.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.5 - Notice of cancellation or refusal to renew; requirements

Current through Register Vol. 54, No. 28, July 13, 2024
Notices of cancellation or refusal to renew shall meet the
				  following requirements:
(1) The form
				shall be clearly labeled: "Notice of Cancellation or Refusal to
				Renew."
(2) The form shall be given
				to the insured.
(3) The date, not
				less than 30 days after the date of delivery or mailing, on which the
				cancellation or refusal to renew is to become effective shall be clearly
				indicated. If the cancellation or nonrenewal is due to nonpayment of premium
				the effective date may be 15 days from the date of delivery or
				mailing.
(4) Space shall be
				provided for the insurer to provide the specific reasons for the cancellation
				or refusal to renew. In the alternative, the insurer may include a statement
				that the reasons will be supplied upon the written request of the insured. The
				statement shall specify that the request shall be mailed or delivered to the
				insurer not less than 20 days prior to the effective date. The statement shall
				further indicate that the insurer will supply the reasons within 5 days of its
				receipt of the request.
(5) If the
				cancellation or refusal to renew is based upon nonpayment of premium and the
				insurer notifies the insured less than 30 days prior to the effective date of
				the cancellation or nonrenewal, the insurer shall give the insured a period of
				at least 10 days to request the specific details of the reason for such
				cancellation or nonrenewal.
(6) The
				reasons for the cancellation shall be clear and complete. Upon request of the
				insured if the cancellation is for nonpayment of premium the insurer shall
				specify the amount of premium due, the date when it was due and to whom it was
				to be paid. If the premium was financed, the name and address of the
				organization financing the premium shall also be given. If the cancellation is
				because the driver's license or motor vehicle registration of the named insured
				has been under suspension or revocation the notice shall specify the date of
				such revocation or suspension and the name of the administrative or judicial
				body ordering such action. The reasons for nonrenewal shall be clear and
				complete. They shall be stated such that a person of average intelligence and
				education can understand them.
(7)
				The form shall include advice that the insured has a right to request review of
				the insurer's action as provided in §
									61.6 (relating to appeal
				procedures) within 10 days of receipt of the reasons for cancellation or
				nonrenewal. In so doing the notice shall include the following:
(i) Advice that review may be requested by
				signing a copy of the form in a space provided and sending it to one of the
				regional offices of the Insurance Department.
(ii) The addresses of the four regional
				offices of the Insurance Department.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.6 - Appeal procedures

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
				insured may request review by the Insurance Commissioner of the action of the
				insurer in cancelling or refusing to renew his policy by making written request
				therefore. This may be done by signing a copy of the "Notice of Cancellation or
				Refusal to Renew," and sending it to one of the regional offices of the
				Insurance Department at one of the addresses given on the notice.
(b) Upon receipt of the request both the
				insured and the insurer will be notified that an investigation has been
				undertaken and they may be contacted to secure additional information as
				required.
(c) Upon completion of
				the investigation a copy of the investigative report will be supplied to both
				the insured and the insurer. Within 10 days of receipt of the report either
				party may submit written comments for consideration by the Insurance
				Commissioner.
(d) At the time
				written comments are submitted, if either the insured or the insurer desires a
				formal administrative hearing, the request shall be made. If so, a hearing will
				be scheduled as soon as possible. If not, the matter will be decided on the
				basis of the written comments and the investigative report.
(e) Hearings will be held in accordance with
				the following procedures:
(1) Upon receipt of
				a request for a formal administrative hearing, notice of the time and place of
				the hearing will be sent by certified mail to the insurer and insured, not less
				than 5 days prior to the hearing.
(2) The hearing will be recorded on tape with
				a stenographer. The tape and stenographer's notes shall be prepared such that a
				full verbatim transcription may thereafter be made. The tape will be retained
				for a period of 90 days following issuance of the Insurance Commissioner's
				final order in the case.
(3)
				Parties will be afforded a reasonable time following the hearing to submit
				written briefs in support of their position.
(4) Relevant evidence of reasonable probative
				value will be admitted into the record of the proceeding and reasonable
				examination and cross-examination will be permitted.
(5) The provisions of 1 Pa. Code Part II
				(relating to general rules of administrative practice and procedure) may be
				used where conducive to speedy and fair proceedings.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.7 - Policies in effect during review by Insurance Commissioner of cancellation, or refusal to renew and refusal to write auto insurance policies

Current through Register Vol. 54, No. 28, July 13, 2024
Policies of automobile insurance subject to its provisions
				  shall remain in effect until the conclusion of the review by the Insurance
				  Commissioner, unless the action of the insurers was taken because of nonpayment
				  of premium.
Pennsylvania Code › Title 31 - INSURANCE › Part II - Automobile Insurance › Chapter 61 - NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES › Section 61.8 - Car pools

Current through Register Vol. 54, No. 28, July 13, 2024
A motor vehicle which is used for car pool purposes may not
				  be considered to be used as a public or livery conveyance for passengers,
				  provided that the owner of the motor vehicle does not receive any remuneration
				  from his passengers for the service other than a reasonable reimbursement for
				  expenses.