Mich. Admin. Code R. 500.1352 - Premium dispute; appeal to commissioner

Current through Vol. 22-05, April 1, 2022

Rule 2.

(1) If the personal meeting involving the insured and the insurer fails to resolve the dispute, the insured is entitled to bring the matter before the commissioner for resolution. The commissioner shall rule on the reasonableness of reserves or redemptions only with respect to their application in an insurer's rating system. In making a ruling on the reasonableness of a reserve calculation used in applying an insurer's rating system, the commissioner shall take into account the following factors:
(a) Whether or not the initial reserve amount is consistent with the information about the claim available to the insurer at the time the initial case reserve was created.
(b) The presence or absence of reasonable adjustments to the reserve as additional information becomes available.
(2) The insured shall appeal the matter to the commissioner within 30 days of the date the insured receives the information provided pursuant to R 500.1351.
(3) The insured is entitled to a review of the matter by the commissioner either by a review of written materials or through a meeting with the parties involved in the dispute.

Notes

Mich. Admin. Code R. 500.1352
1983 AACS

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