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Updated 2013−14 Wis. Stats. Published and certified under s. 35.18. January 1, 2015.

631.36

INSURANCE CONTRACTS GENERALLY

Updated 13−14 Wis. Stats.

6

(2)

MIDTERM

CANCELLATION.

(a)

Permissible

grounds.

Except as provided by par. (c) and sub. (3) and s. 655.24 (2) (b), no insurance policy may be canceled by the insurer prior to the expiration of the agreed term except for failure to pay a premium when due or on grounds stated in the policy, which must be com-

prehended within one of the following classes:

  • 1.

    Material misrepresentation;

  • 2.

    Substantial change in the risk assumed, except to the extent

that the insurer should reasonably have foreseen the change or contemplated the risk in writing the contract;

3. Substantial breaches of contractual duties, conditions or warranties; or

4. Attainment of the age specified as the terminal age for cov- erage, in which case the insurer may cancel by notice under par.

  • (b)

    accompanied by a tender of a proportional return of premium.

  • (b)

    Notice. No cancellation under par. (a) is effective until at

least 10 days after the 1st class mailing or delivery of a written notice to the policyholder.

(c) New policies. Paragraphs (a) and (b) do not apply to any insurance policy that has not been previously renewed if the policy has been in effect less than 60 days at the time the notice of cancellation is mailed or delivered. No cancellation under this paragraph is effective until at least 10 days after the 1st class mail- ing or delivery of a written notice to the policyholder. Subsections

  • (6)

    and (7) do not apply to such a policy.

  • (3)

    ANNIVERSARY CANCELLATION OR ALTERATION. A policy

may be issued for a term longer than one year or for an indefinite term with a clause providing for cancellation by the insurer in the manner provided in sub. (4) (a) for nonrenewals, except the notice must be given at least 60 days prior to any anniversary date and an insurer may not cancel a policy solely because of the termina- tion of an insurance marketing intermediary’s contract with the insurer unless the insurer complies with sub. (4m). The clause may also provide for alteration of the terms or premium by the insurer as provided in sub. (5) (c), except the clause must then per- mit cancellation by the policyholders as provided in sub. (5) (c).

(4) NONRENEWAL. (a) Notice required. Subject to subs. (2) and (3), a policyholder has a right to have the policy renewed, on the terms then being applied by the insurer to similar risks, for an additional period of time equivalent to the expiring term if the agreed term is one year or less, or for one year if the agreed term is longer than one year, unless at least 60 days prior to the date of expiration provided in the policy a notice of intention not to renew the policy beyond the agreed expiration date is mailed or delivered to the policyholder, or with respect to failure timely to pay a renewal premium a notice is given, not more than 75 days nor less than 10 days prior to the due date of the premium, which states clearly the effect of nonpayment of premium by the due date.

(am) Prohibited nonrenewals. Notwithstanding par. (a) an insurer may not refuse to renew a policy solely because of the ter- mination of an insurance marketing intermediary’s contract with the insurer unless the insurer complies with sub. (4m).

(b) Exceptions. This subsection does not apply if the policy- holder has insured elsewhere, has accepted replacement coverage or has requested or agreed to nonrenewal, or if the policy is expressly designated as nonrenewable.

(4m) POLICY CANCELLATION. An insurer may refuse to renew or may cancel a policy under sub. (3) or (4) solely because of the termination of an insurance marketing intermediary’s contract with the insurer only if the notice of nonrenewal or cancellation contains an offer to continue or renew the policy with the insurer if the insurer receives a written request from the policyholder prior to the cancellation or renewal date. The insurer shall continue or renew the policy if a timely request is received unless the policy- holder does not meet normal underwriting criteria.

(5) RENEWAL WITH ALTERED TERMS. (a) General. Subject to pars. (b) and (d), if the insurer offers or purports to renew the policy but on less favorable terms or at higher premiums, the new

terms or premiums take effect on the renewal date if the insurer sent by 1st class mail or delivered to the policyholder notice of the new terms or premiums at least 60 days prior to the renewal date. If the insurer notifies the policyholder within 60 days prior to the renewal date, the new terms or premiums do not take effect until 60 days after the notice is mailed or delivered, in which case the policyholder may elect to cancel the renewal policy at any time during the 60−day period. The notice shall include a statement of the policyholder’s right to cancel. If the policyholder elects to cancel the renewal policy during the 60−day period, return pre- miums or additional premium charges shall be calculated propor- tionately on the basis of the old premiums. If the insurer does not notify the policyholder of the new premiums or terms as required by this subsection prior to the renewal date, the insurer shall con- tinue the policy for an additional period of time equivalent to the expiring term and at the same premiums and terms of the expiring policy, except as permitted under sub. (2) or (3).

(b) Exception. Paragraph (a) does not apply if the only change that is adverse to the policyholder is a premium increase and if either of the following applies to the premium increase:

1. The premium increase is less than 25% and is generally applicable to the class of business to which the policy belongs.

2. The premium increase results from a change based on action by the insured that alters the nature or extent of the risk insured against, including but not limited to a change in the classi- fication or the units of exposure or increased policy coverage.

(c) Anniversary alteration. Subject to par. (d), an insurer may alter the terms or premium of a policy issued for a term longer than one year or for an indefinite term on the anniversary date only if notice of less favorable terms or premiums is sent by 1st class mail or delivered to the policyholder at least 60 days prior to the anni- versary date. If the insurer notifies the policyholder within 60 days prior to the anniversary date, the new terms or premiums do not take effect until 60 days after the notice is mailed or delivered, in which case the policyholder may elect to cancel the policy at any time during the 60−day period. The notice shall include a statement of the policyholder’s right to cancel. If the policyholder elects to cancel the policy during the 60−day period, return pre- miums or additional premium charges shall be calculated propor- tionately on the basis of the old premiums. If the insurer does not notify the policyholder of the new premiums or terms as required by this subsection prior to the anniversary date, the insurer shall continue the policy until the next anniversary date or the renewal date, whichever is earlier, at the same premiums and terms as for the previous period, except as permitted under sub. (2) or (3).

(d) Estimate. An insurer may give notice under par. (a) or (c) of a new premium by stating the actual amount or percentage increase to be charged. If the insurer cannot reasonably determine the actual amount or percentage increase 60 days prior to the renewal or anniversary date, the notice shall include a good faith estimate of the increase based on information that the insurer can reasonably obtain. If an estimate is stated, the insurer shall renew or continue the policy at a premium that does not exceed the increase stated in the notice except as permitted under sub. (5) (b).

(6) INFORMATION ABOUT GROUNDS. A notice of cancellation or nonrenewal under sub. (2) (b) or (4) shall state with reasonable precision the facts on which the insurer’s decision is based. No such notice is effective unless it so states the facts.

(7) CANCELLATION OR NONRENEWAL NOTICE. (a) Except as pro- vided in par. (b), notice of cancellation or nonrenewal required under sub. (2) (b) or (4) is not effective unless the notice contains adequate instructions to the policyholder for applying for insur- ance through a risk−sharing plan under ch. 619, if a risk−sharing plan exists under ch. 619 for the kind of coverage being canceled or nonrenewed.

(b) Paragraph (a) does not apply to a notice of cancellation or nonrenewal issued by the mandatory health care liability risk− sharing plan established under s. 619.04.

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)

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