Wis. Admin. Code Office of the Commissioner of Insurance § Ins 3.49 - Wisconsin automobile insurance plan

Current through November 29, 2021

(1) PURPOSE. This section interprets s. 619.01(6), Stats., to continue a plan to make automobile insurance available to those who are unable to obtain it in the voluntary market by providing for the equitable distribution of applicants among insurers and outlines access and grievance procedures for such a plan.
(2)DEFINITIONS. In this section:
(a) "Committee" means the governing committee of the Wisconsin Automobile Insurance Plan which is the group of companies administering the Plan.
(b) "Plan" means the Wisconsin Automobile Insurance Plan, an unincorporated facility established by s. , 1967 Stats., and continued under s. 619.01(6), Stats.
(3)FILING AND ACCESS. The committee shall submit revisions to its rules, rates and forms for the Plan to the commissioner. Prior approval by the commissioner of the documents is required before they may become effective. The documents shall provide:
(a) Reasonable rules governing the equitable distribution of risks by direct insurance, reinsurance or otherwise and their assignment to insurers;
(b) Rates and rate modifications applicable to such risks which shall not be excessive, inadequate or unfairly discriminatory;
(c) The limits of liability which the insurer shall be required to assume;
(d)
1. A method by which an applicant to the Plan denied insurance or an insured under the Plan whose insurance is terminated may request the committee to review the denial or termination and by which an insurer subscribing to the Plan may request the committee to review actions or decisions of the Plan which adversely affect the insurer. The method shall specify that requests for review must be made in writing to the Plan and that the decision of the committee in regard to the review may be appealed by the applicant, insured or insurer to the commissioner of insurance as provided for in ch. Ins 5. A request for review does stay the termination of coverage.
2. The committee's decision under subd. 1. shall be in writing and shall include notice of the right to a hearing under ch. Ins 5 if the person files a petition for a hearing with the commissioner of insurance not later than 30 days after the notice is mailed. The notice shall describe the requirements of s. Ins 5.11(1).

Note: A petition under subd. 2. shall be filed as provided in s. Ins 5.17.

3. The office of the commissioner of insurance shall hold a hearing within 30 days after receipt of a complete petition under subd. 2., unless the petitioner waives the right to a hearing within 30 days. At the hearing, the petitioner has the burden of proving by a preponderance of the evidence that the committee's decision is erroneous under the policy terms or the plan's rules.
4. Filing a petition under subd. 2. does not stay the action of the plan with respect to termination of coverage. The plan shall comply with the final decision and order in the contested case proceeding.
(e) The commissioner shall maintain files of the Plan's approved rules, rates, and forms and such documents must be made available for public inspection at the office of the commissioner of insurance.

Notes

Wis. Admin. Code Office of the Commissioner of Insurance § Ins 3.49
Cr. Register, November, 1984, No. 347, eff. 12-1-84; renum. (3) (d) to be (3) (d) 1. and am., cr. (3) (d) 2. to 4., Register, March, 1996, No. 483, eff. 4-1-96.

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