West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-03 - Administration Of The Employers' Excess Liability Fund › Section 85-3-9 - Transition

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1. The commission
				will continue to operate under these rules until the termination of the
				commission.
9.2. Upon novation of
				the employers' excess liability fund to the successor to the commission:
a. The successor to the commission shall
				continue to offer employers' excess liability coverage until at least June 30.
				2008. Nothing in these rules shall prevent the successor to the commission from
				offering employers' excess liability coverage beyond June 30. 2008.
b. The application for coverage process and
				application for coverage information required by the successor to the
				commission or other private carrier shall be governed by the business practices
				of the successor to the commission or other private carrier.
c. Policy terms, including, but not limited
				to. payment, exclusions, and conditions of an employers' excess liability
				contract of insurance coverage between the successor to the commission and an
				employer are not governed by the provisions of this rule, except an insofar as
				the coverage terms include the elements of "deliberate intention" as contained
				within the provisions of W. Va. Code §
										23-4-2(d)(2)(ii).
d. Nothing in these provisions will require
				the successor to the commission or other private carrier to provide employers'
				excess liability coverage to an employer. The issuance of a employers' excess
				liability policy is entirely within the discretion of the successor to the
				commission or other private carrier.
e. The successor to the commission or other
				private carrier may decline coverage, or cancel or refuse to renew with sixty
				(60) days notice: in addition, the successor to the commission or other private
				carrier may cancel a policy for failure to pay with (fifteen) 15 days
				notice.
f. Within thirty (30) days
				prior to the novation of the employers' excess liability fund to the successor
				to the commission, the successor to the commission and all private carriers of
				employers' excess liability insurance shall submit to the insurance
				commissioner their proposed rates, which may be higher than the base rates
				established by the board of managers or. upon termination of the commission,
				the industrial council. The insurance commissioner retains authority to
				disapprove rates in effect if it is determined that the rates are not in
				compliance with the following:
1. Rates must
				not be excessive, inadequate or unfairly discriminatory, nor may an insurer
				charge any rate which if continued will have or tend to have the effect of
				destroying competition or creating a monopoly.
2. The insurance commissioner may disapprove
				rates if there is not a reasonable degree of price competition at the consumer
				level with respect to the class of business to which they apply. In determining
				whether a reasonable degree of price competition exists, the insurance
				commissioner shall consider all relevant tests, including:
A. The number of insurers actively engaged in
				the class of business and their shares of the market:
B. The existence of differentials in rates in
				that class of business:
C. Whether
				long-run profitability for private carriers generally of the class of business
				is unreasonably high in relation to its risk:
D. Consumers' knowledge in regard to the
				market in question: and
E. Whether
				price competition is a result of the market or is artificial. If competition
				does not exist, rates are excessive if they are likely to produce a long-run
				profit that is unreasonably high in relation to the risk of the class of
				business, or if expenses are unreasonably high in relation to the services
				rendered.
3. Rates are
				inadequate if they are clearly insufficient, together with the income from
				investments attributable to them, to sustain projected losses and expenses in
				the class of business to which they apply.
4. One rate is unfairly discriminatory in
				relation to another in the same class if it clearly fails to reflect equitably
				the differences in expected losses and expenses. Rates are not unfairly
				discriminatory because different premiums result for policyholders with similar
				exposure to loss but different expense factors, or similar expense factors but
				different exposure to loss, so long as the rates reflect the differences with
				reasonable accuracy. Rates are not unfairly discriminatory if they are averaged
				broadly among persons insured under a group, franchise or blanket policy.
5. The successor to the commission and all private carriers
				  shall thereafter file their rates on an annual basis subject to the approval of
				  the insurance commissioner.