CHAPTER Ins 5000 STANDARDS AND PROCEDURES FOR THE FILING OF PROPERTY AND CASUALTY INSURANCE FORMS AND RATES

Statutory Authority: RSA 400-A:15, I; RSA 412:43, I

PART Ins 5001 PROPERTY AND CASUALTY FORM AND RATE FILINGS

Ins 5001.01 Purpose and Scope.

(a) The purpose of Ins 5001 is to establish standards and procedures for the filing of property and casualty insurance forms and rates to be used within this state.

(b) Ins 5001 shall apply to all licensed admitted writers of property and casualty insurance in this state and advisory organizations who are required to make form and rate filings.

Source. #12770, eff 5-5-19

Ins 5001.02 Definitions.

(a) “Commissioner” means the insurance commissioner.

(b) “Department” means the New Hampshire insurance department.

(c) “Mold” means any type or form of fungus, including mold or mildew, and any mycotoxins, spores, scents, or by-products produced or released by a fungus, wet or dry rot, or bacteria.

(d) “National Association of Insurance Commissioners (NAIC)” means the organization of state insurance regulators of the 50 United States, Washington, DC, and the 5 US territories.

(e) “New program” means a new product that a company or advisory organization has not previously offered in New Hampshire.

(f) “Policy” means the written contract effecting insurance, or the certificate thereof, by whatever name called, and including all clauses, endorsements, policy jackets, and papers attached thereto and made a part thereof.

(g) “Rate” means the cost of insurance per exposure unit, prior to any application of individual risk variations based on loss or expense considerations. The term does not include minimum premiums.

(h) “Support” means any data, analysis, considerations, assumptions, manuals, schedules, models, or any other actuarial work product that an insurer uses to justify a rate or rate modification.

(i) “System for Electronic Rate and Form Filing (SERFF)” means the system for electronic rate and form filing supported by the NAIC.

(j) “Type of insurance” means a specific type of insurance listed in the Uniform Property and Casualty Product Coding Matrix published by the NAIC as available in SERFF.

Source. #12770, eff 5-5-19

Ins 5001.03 Form Filing Procedures.

(a) All forms required to be filed pursuant to RSA 412 shall be submitted through SERFF. Forms and rates shall be filed together or separately.

(b) All form filings shall include the following:

(1) A notation in the SERFF general information tab if a filing is a new program; and

(2) A filing description submitted under the SERFF general information tab or the supporting documentation tab and which provides for the following:

a. A detailed description of the program for which the filer seeks approval; and

b. A brief description of each form within the program, including any new features, and a listing of other forms to which it will be attached.

(c) If a form is replacing a prior form, the prior form shall be identified by its SERFF tracking number or the company filing number. If a form is replacing a form filed before January 1, 2008, the filer shall provide the prior approved form along with a statement that the form has been approved. If a form is not replacing a prior form, it shall be so stated.

(d) Where a form is replacing another form, a side-by-side comparison that clearly shows the changes, additions, or deletions for each amended form shall be provided in the SERFF form schedule tab along with the final copy of the form.

(e) Any form submitted for review shall be in the same layout, as permitted by technology, as issued to consumers in New Hampshire.

(f) The declarations page of a policy shall be completed with hypothetical data that is realistic and consistent with the other contents of the policy, so as to provide an example. The declarations page shall also prominently display a space reserved for producer contact information.

(g) With respect to any submission of a company domiciled in a state or country where the state insurance department or comparable agency requires foreign or alien insurers to pay any fees for the filing or examination of forms, the submission shall include an electronic funds transfer (EFT) payment of the retaliatory fee due to the state of New Hampshire, pursuant to RSA 400-A:35.

(h) If filed separately, forms, rate filings, and rate or form rules shall be cross referenced by SERFF tracking numbers in the SERFF general information tab.

(i) All variable language shall be identified by the use of brackets, accompanied by a narrative statement describing the full range of variability. The narrative shall be attached to the SERFF supporting documentation tab or shown on the corresponding manual page for the form and provided with the filing. Variable language that changes the terms and conditions of coverage provided by the policy shall also be explained in the narrative statement.

(j) Any submission of a blank form that is unclear as to its intended use on its face shall in all instances be accompanied by a list of all intended uses attached to the SERFF supporting documentation tab.

(k) In the event that forms submitted to the department by an insurer are not approved and such forms are thereafter corrected and resubmitted, the previous submission's SERFF tracking number shall be provided in the SERFF general information tab. Filings disapproved pursuant to RSA 412:5, I shall not be resubmitted unless and until previously identified form objections are corrected.

(l) When a company withdraws a form from use in this state, written notice of withdrawal shall be provided to the department along with the withdrawal’s effective date.

(m) The written notice in (l) above shall further include an explanatory memorandum submitted in SERFF which provides the following information:

(1) For forms filed prior to January 1, 2008, a copy of the form and a statement from the company indicating the year of approval;

(2) For forms filed on or after January 1, 2008, the SERFF tracking number; and

(3) The reason for the withdrawal.

(n) If an insurer delegates its filing authority to a third-party filer, excluding advisory organizations, each filing shall include a signed and dated letter from an authorized representative of the insurer authorizing the third-party filer to make filings on behalf of the insurer.

(o) The letter in (n) above shall be dated within 6 months of the filing, and:

(1) The insurer shall not delegate responsibility for the content of a filing to a third-party filer. Errors and omissions made by a third-party filer shall be errors and omissions by the insurer; and

(2) If a third-party filer has a pattern of making 3 or more filings that do not comply with New Hampshire insurance laws, the commissioner shall deny or approve a delegation of filing authority, pursuant to RSA 412:19.

(p) Individual risk filings shall be submitted via SERFF as a confidential filing type, and the filing shall include:

(1) The department’s “Individual Risk Form Filing” as illustrated in Appendix A and which may be accessed on the department’s website in the property and casualty section, under industry filing guidelines at https://www.nh.gov/insurance/pc/consent.htm. The individual risk filing form shall be fully completed and signed by the policyholder;

(2) A copy of the declarations page; and

(3) All forms to be used with the individual risk filing.

(q) Risk Purchasing Group (RPG) SERFF filings shall include:

(1) All forms intended to be used by the RPG, other than “State Amendatory Endorsements” for states other than New Hampshire, filed in the SERFF forms schedule tab;

(2) A copy of the master policy, filed in the SERFF supporting documentation tab; and

(3) All forms previously approved by the department for use by the RPG, including the corresponding SERFF tracking number(s) listed in a document and included in the SERFF supporting documentation tab.

Source. #12770, eff 5-5-19; ss by #13284, eff 10-26-21

Ins 5001.04 Rate Filing Procedures.

(a) All rates and support required to be filed pursuant to RSA 412 shall be submitted through SERFF. Forms and rates shall be filed together or separately.

(b) All rate filings shall include the following:

(1) A notation in the SERFF general information tab if a filing includes a predictive model or is a new program;

(2) A filing description that is submitted under the SERFF general information tab or in explanatory material contained with the filing and which provides the following:

a. A detailed description of the program which addresses the intent of the program for which the filer seeks approval;

b. A description of each rate or rate change, including any new or unusual features or changes to prior methodology; and

c. A statement at the beginning of the program description, if the filing includes a new or amended predictive or telematics model or changes to how an existing model is used in the rating process;

(3) Proposed effective date(s) for new and renewal business; and

(4) An actuarial memorandum identifying all components of the actuarial review included in the filing, the methodology used to develop an actuarial indication, and the rationale used in selecting a rate change different from the actuarial indication.

(c) Where a filing is modifying an existing rate, a side-by-side comparison that clearly shows the changes, additions, or deletions to the rating manual shall be provided in the SERFF Rate/Rule schedule tab along with the final copy of the rating manual.

(d) With respect to any submission of a company domiciled in a state or country where the state insurance department or comparable agency requires foreign or alien insurers to pay any fees for the filing or examination of rates, the submission shall include an EFT payment of the retaliatory fee due to the state of New Hampshire, pursuant to RSA 400-A:35.

(e) If filed separately, forms, rate filings, and rate or form rules shall be cross referenced by SERFF tracking numbers in the SERFF general information tab.

(f) In the event that rates submitted to the department by an insurer are not approved and such rates are thereafter corrected and resubmitted, the previous submission's SERFF tracking number shall be provided in the SERFF general information tab.

(g) If an insurer delegates its filing authority to a third-party filer, excluding advisory organizations, each filing shall include a signed and dated letter from an authorized representative of the insurer authorizing the third-party filer to make filings on behalf of the insurer. The letter shall be dated within 30 days of the filing, and:

(h) Consent to rate filings shall be submitted via SERFF as a confidential filing type. The filing shall include the department’s “Consent to Rate Form” as illustrated in Appendix B and which can be accessed on the department’s website in the property and casualty section, under industry filing guidelines at https://www.nh.gov/insurance/pc/consent.htm. The consent to rate filing form shall be fully completed and signed by the policyholder.

Source. #12770, eff 5-5-19

Ins 5001.05 Rules Applicable to All Applications. All applications that are attached to a policy and become part of the policy shall be submitted for review under RSA 412:5 and shall comply with the following:

(a) The declarative portion of the application, if any, shall consist of representations of facts made to the best of the applicant’s knowledge; and

(b) No provision shall be permitted in an application that changes the terms of the policy to which it is attached.

Source. #12770, eff 5-5-19

Ins 5001.06 Rules Applicable to All Forms.

(a) Each form shall be designated by a form number composed of numbers, letters, or both, and:

(1) The form number shall be sufficient to distinguish the form from all other forms used by the company;

(2) The form number may contain the prefix "Form No.";

(3) The form number shall be placed on every page of the form; and

(4) When a form is replaced, the form shall be resubmitted with a new form number, new edition date, or both.

(b) Each policy shall display:

(1) The legal title of the company;

(2) The company’s home mailing and physical address;

(3) The administrative office address, if different from the address in (2) above; and

(4) A toll-free telephone number, and if it is available, a facsimile number and e-mail address whereby the insured can contact the company.

(c) All forms shall display a minimum of 10 point font text, not including page number, form number, copyright, and edition date.

(d) Any form identifying a group or any other entity shall also clearly identify the name of the company insuring the risk.

(e) Electronic forms or policies shall also be offered in paper medium, upon request by a consumer.

(f) Forms shall have a prominently displayed heading or title which shall accurately reflect the content of the form.

(g) Any life, accident, and health terminology in a property and casualty form used in any way that would cause a reasonable person to believe that the policyholder is receiving a life, accident, and health product shall be prohibited. This shall not preclude actual life, accident, and health products that are permitted by New Hampshire statute or rule to be included in a property and casualty product.

(h) The inclusion of 2 types of insurance within one policy shall be permissible if the policy language fully complies with all applicable statutes and rules.

Source. #12770, eff 5-5-19

Ins 5001.07 Form Provision Rules.

(a) Coverage under a policy may be voided or denied for the insured or insureds who, whether before or after a loss, have intentionally concealed or misrepresented any material fact or circumstance, engaged in fraudulent conduct, or made false statements relating to this insurance. It shall not be void for innocent co-insureds.

(b) Blanket exclusions or limitations on coverage for animal liability shall be prohibited in personal lines except for an endorsement that identifies and excludes an animal by that specific animal’s name.

(d) Personal lines dwelling policies may limit property coverage for mold consistent with the following:

(1) A policy shall not exclude coverage for loss arising out of mold or remediation in which the proximate cause of loss is a peril other than fire or lightning, unless a sub-limit is provided for mold loss in which the proximate cause of loss is a covered loss;

(2) The minimum aggregate sub-limit for mold and remediation coverage shall be $10,000; and

(3) The policy shall not unreasonably restrict the time period for reporting a mold claim.

(e) Personal lines dwelling policies shall not exclude coverage for liability arising out of mold. A policy may include a minimum aggregate sub-limit of $50,000 for loss arising out of mold.

(f) To the extent that a personal lines dwelling policy provides first-party property coverage for a dwelling, personal property, or both, the policy shall provide coverage in instances where the discharge, dispersal, seepage, migration, release, or escape of a pollutant is caused by a named peril.

(g) Named storm deductibles shall be permitted in any policy providing property insurance. The named storm deductible’s application shall begin at the time that the National Weather Service (NWS) names the storm and issues a watch or warning and ends once the storm has been downgraded by the NWS to non-named storm status. The loss at issue shall be related to the named storm in order to trigger the named storm deductible.

(h) Extended reporting periods (ERP) shall:

(1) Be required for claims-made policy terminations;

(2) Apply to termination for any reason, including non-payment of premium;

(3) Include a 60 day “Basic” or “Automatic” ERP at no additional cost;

(4) Provide the insured, within not less than 30 days from termination, the right to purchase an “optional” or “supplemental” ERP of at least 12 months, and:

a. The optional or supplemental ERP shall begin following the end of the Automatic ERP and shall not overlap it, unless the duration of the optional or supplemental ERP purchased is 14 months or longer;

b. The optional or supplemental ERP may be made contingent upon payment of sums due for the period of coverage; and

c. Once paid in full, the optional or supplemental ERP shall not be cancelled; and

(5) Not be used to sub-limit coverages.

(i) Arbitration provisions shall provide for proceedings in New Hampshire unless both the insurer and the insured agree to arbitration in a different location.

(j) Claims-made policies and defense-within-limits policies shall contain a prominently displayed disclaimer stating that they are such policies. This provision shall not apply to optional endorsements attached to a claims-made policy or a defense-within-limits policy.

(k) Sub-limits shall be permitted as follows:

(1) Sub-limiting by type of insured or type of risk shall be permitted for commercial risks if the sub-limit is prominently displayed in the policy; and

(2) Sub-limiting by type of insured shall be permitted for personal lines if the sub-limit is prominently displayed on the declarations page and the insurer demonstrates a corresponding rate reduction based upon the sub-limit.

(l) Contractual exclusions shall be permitted. However, contractual exclusions shall state that they do not exclude coverage for tort liability that would exist independent of a contract claim.

Source. #12770, eff 5-5-19

Ins 5001.08 Waiver of Rules.

(a) The commissioner, upon the commissioner’s own initiative or upon request by an insurer, shall waive any requirement of this part if such waiver does not contradict the objective or intent of the rule and:

(1) Applying the rule provision would cause confusion or would be misleading to consumers;

(2) The rule provision is in whole or in part inapplicable to the given circumstances;

(3) There are specific circumstances unique to the situation such that strict compliance with the rule would be onerous without promoting the objective or intent of the rule provision; or

(4) Any other similar extenuating circumstances exist such that application of an alternative standard or procedure better promotes the objective or intent of the rule provision.

(b) No requirement prescribed by statute shall be waived unless expressly authorized by law.

(d) A request for a waiver shall specify the basis for the waiver and proposed alternative, if any.

Source. #12770, eff 5-5-19

APPENDIX A

STATE OF NEW HAMPSHIRE

INSURANCE DEPARTMENT

INDIVIDUAL RISK FORM FILING

NAMED INSURED AND MAILING ADDRESS

INSURANCE COMPANY AND

MAILING ADDRESS

Policy Number_____________________

Policy Term_______________________

REASON FOR INDIVIDUAL RISK FORM

Describe exposure(s) or any other circumstances which would necessitate the use of a form which is not filed by the insurer.

Attach revised form(s) and copy of original form indicating what revisions were made.

I HEREBY CERTIFY THAT I UNDERSTAND THAT THE COVERAGE PROVIDED FOR THIS POLICY IS NOT STANDARD.

I HEREBY CERTIFY AND I UNDERSTAND THAT THE PREMIUM CHARGE FOR THIS POLICY (ENDORSEMENT) IS NOT STANDARD.

____________________________ ______________________________

Policyholder Signature Date

____________________________

Title

The signature by the policyholder or an authorized representative of the policyholder (NOT the insurance agent) must be made after this form has been completed.

Available at https://www.nh.gov/insurance/pc/documents/individualrisk.pdf

APPENDIX B

STATE OF NEW HAMPSHIRE

INSURANCE DEPARTMENT

CONSENT TO RATE FORM

(Must be accompanied by declarations page showing name, location and address.)

NAMED INSURED AND MAILING

ADDRESS

INSURANCE COMPANY AND MAILING ADDRESS

Policy Number_____________________

Policy Term______________________

REASON(S) FOR EXCEPTION TO FILED RATE(S) - RSA 412:16X:

Describe exposure(s) or any substandard, unusual or hazardous conditions which necessitates the use of a rate or premium not filed with the Department. Include any underwriting information in support of the proposed rating. Reasons that merely refer to a policyholder’s inability to obtain coverage at standard rates, or comments that essentially equate to “class of risk” are not acceptable.

_____Unusual hazard involved	_______Unfavorable loss experience
______Other

Explanation of above reason(s)

Premium at filed rate(s)______________

Premium at Consent Rate(s)_____________

I HEREBY CERTIFY AND I UNDERSTAND THAT THE PREMIUM CHARGE FOR THIS POLICY (ENDORSEMENT) IS NOT STANDARD.

____________________________ ______________________________

Policyholder Signature Date

____________________________

Title

The signature by the policyholder or an authorized representative of the policyholder (NOT the insurance agent) must be made after this form has been completed.

Available at https://www.nh.gov/insurance/pc/documents/consenttorate.pdf

APPENDIX C

Rule	Specific State Statute the Rule Implements
Ins 5001.01	RSA 400-A:15, I; RSA 412:1-5; RSA 412:43, I
Ins 5001.02	RSA 400-A:15; RSA 412:43, I
Ins 5001.03	RSA 400-A:15, I; RSA 412:5, I; RSA 412:19; RSA 412:43, I; RSA 417-C:1, I(c); RSA 417-B:3, IV
Ins 5001.04	RSA 400-A:15, I; RSA 412:5, I; RSA 412:19; RSA 412:43, I
Ins 5001.05	RSA 400-A:15, I; RSA 412:5, I; RSA 412:43, I
Ins 5001.06	RSA 400-A:15, I; RSA 412:5, I; RSA 412:43, I
Ins 5001.07	RSA 400-A:15, I; RSA 412:5, I; RSA 412:43, I
Ins 5001.08	RSA 400-A:15, I; RSA 541-A:22, IV