Updated 2013−14 Wis. Stats. Published and certified under s. 35.18. January 1, 2015.
INSURANCE CONTRACTS GENERALLY
Updated 13−14 Wis. Stats.
ordered by the commissioner prior to the expiration of the first 30 days.
(b) Subject to s. 655.24 (1), the commissioner may by rule exempt certain classes of policy forms from prior filing and approval.
(c) Subject to sub. (1m), a form first used and not already filed under par. (a) on or after August 1, 2008, is exempt from par. (a) except for any of the following:
A form subject to s. 655.24 (1).
A form for a worker’s compensation policy.
A form for a Medicare replacement policy or a Medicare
4. A form for a long−term care insurance policy, including a form for a nursing home or home health care policy.
6. A form issued by an insurer ordered by the commissioner under s. 601.41 (4) to file forms under par. (a). The commissioner may require an insurer to file forms under par. (a) to secure com- pliance with the law, including if the commissioner determines that the insurer violated sub. (1m).
7. A form that includes an appraisal or arbitration provision not specifically authorized by rule. The entire form, including the appraisal or arbitration provision, is subject to par. (a).
8. A form that contains a clause subject to s. 631.21, but only as to the clause.
9. A form for a policy of insurance to cover a warranty, as defined in s. 100.205 (1) (g).
A warranty contract form.
A form required to be filed under par. (a) by a rule promul-
gated by the commissioner.
(1g) EXEMPT IF APPROVED BY COMMISSION. A form for a prod- uct, as defined in s. 601.58 (2) (k), that is approved by or self− certified to, and not disapproved by, the Interstate Insurance Prod- uct Regulation Commission is exempt from subs. (1) (a) and (1m) (a), unless otherwise provided by a rule promulgated by the com- missioner under s. 601.58.
(1m) USE OF CERTAIN FORMS. (a) Except as exempted under sub. (1g) or s. 631.01 (2), (3), (4), or (5) or by a rule promulgated by the commissioner, an insurer may not, on or after August 1, 2008, use a form that is exempt from sub. (1) (a) under sub. (1) (c) unless the insurer does all of the following:
Files the form with the commissioner 30 days before its use.
Files the form in the manner and format, and with the
attachments, prescribed by the commissioner.
3. Certifies as required under par. (b) that the form complies with chs. 600 to 655 and rules promulgated under chs. 600 to 655. The commissioner may require an insurer to include specific com- pliance certifications.
(b) An insurer shall provide the certification under par. (a) 3. in the form prescribed by the commissioner. The certification shall be executed by a person who is an officer of the insurer and who is responsible for the form that is the subject of the filing. No insurer may file, and no insurer’s officer may execute, a false certi- fication.
(2) GROUNDS FOR DISAPPROVAL. The commissioner may dis- approve a form under sub. (1) (a) or (3) upon a finding:
(a) That it is inequitable, unfairly discriminatory, misleading, deceptive, obscure or encourages misrepresentation, including cases where the form:
1. Is misleading because its benefits are too restricted to achieve the purposes for which the policy is sold;
2. Contains provisions whose natural consequence is to obscure or lessen competition;
Is unnecessarily verbose or complex in language; or
Is misleading, deceptive or obscure because of such physi-
cal aspects as format, typography, style, color, material or orga- nization;
(b) That it provides benefits or contains other provisions that endanger the solidity of the insurer;
(c) That in the case of the policy, though not of riders and endorsements, it fails to provide the exact name of the insurer and the full address of its home office; or
(d) That it violates a statute or a rule promulgated by the com- missioner, or is otherwise contrary to law.
That its use would violate s. 631.22.
SUBSEQUENT DISAPPROVAL. Whenever the commissioner
finds, after a hearing, that a form approved or deemed to be approved under sub. (1) (a), a form filed under sub. (1m), or a form subject to subsequent disapproval under s. 601.58 (14) should be disapproved under sub. (2), the commissioner may order that on or before a date not less than 30 nor more than 90 days after the order the use of the form shall be discontinued or appropriate changes shall be made.
(4) CONTENTS OF ORDER OF DISAPPROVAL. The commissioner’s disapproval must be in writing and constitutes an order. It must state the reasons for disapproval sufficiently explicitly that the insurer is provided reasonable guidance in reformulating its pro- posals.
(5) EXPLICIT APPROVAL OF CERTAIN CLAUSES. General approval of a form under this section, or failure to disapprove, does not constitute approval of clauses specified in s. 631.21.
(6) FORM THAT VIOLATES STATUTE OR RULE. (a) The penalties under s. 601.64 (3) to (5) may not be imposed against an insurer for any of the following:
1. Using a form that does not comply with a statute or rule, including a rule or uniform standard adopted by the Interstate Insurance Product Regulation Commission, if the statute or rule was in effect on the date the form was approved or deemed to be approved under sub. (1) (a) or s. 601.58.
2. The use of a form solely based on a finding of the commis- sioner that the content of the form is misleading under s. 628.34
An insurer’s use of a form that does not comply with a stat-
ute or rule, including a rule or uniform standard adopted by the Interstate Insurance Product Regulation Commission, that takes effect after the date the form was approved or deemed to be approved under sub. (1) (a) or s. 601.58 is a violation of the statute or rule, and the penalties under s. 601.64 may be imposed against the insurer using the form.
(c) Except as provided in par. (a) 2., an insurer’s use of a form filed under sub. (1m) that violates chs. 600 to 655 or rules promul- gated under chs. 600 to 655 is a violation of the statute or rule, regardless of whether the form has been subsequently disap- proved under sub. (3). The insurer is subject to the penalties and remedial orders provided under chs. 600 to 655, including ss.
(4) and 601.64.
SURPLUS LINES INSURANCE. Except as provided in sub. (1)
9. and s. 618.41 (6m), this section does not apply to a surplus
lines insurance form issued under s. 618.41 before, on, or after April 20, 2012.
History: 1975 c. 375, 421; 1979 c. 218; 1987 a. 247; 1999 a. 9; 2005 a. 74; 2007 a. 168; 2011 a. 224; 2013 a. 20. Cross−reference: See also ss. Ins 6.05, 6.07, and 6.76, Wis. adm. code.
Explicit approval required. (1) REQUIRED Despite filing or general approval of a form under s.
631.20, the following clauses may not be used even if contained
in the them:
(a) Expeditious notice. Clauses requiring more expeditious notice than 1st class mail, as provided in s. 631.81 (2).
Reinstatement fees. A schedule of reinstatement fees under
632.74, if made a part of the policy. Such a schedule need not
be included in the contract but may be given approval as a separate document specifically made applicable to particular classes of policies.
2013−14 Wisconsin Statutes updated through 2013 Wis. Act 380 and all Supreme Court Orders entered before Jan. 1, 2015. Pub- lished and certified under s. 35.18. Changes effective after Jan. 1, 2015 are designated by NOTES. (Published 1−1−15)