(1) PURPOSE. This
section interprets s.
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.
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.
means the Wisconsin Automobile Insurance Plan, an unincorporated facility
established by s. , 1967 Stats., and continued under s.
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
(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
(c) The limits of
liability which the insurer shall be required to assume;
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.
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.
Note: A petition under subd. 2. shall be filed as
provided in s.
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
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.
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.