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:
(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.
(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.
(c) Personal lines dwelling policies shall not
exclude liability coverage for lead.
(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.
(c)
Any person or entity seeking a waiver
shall make a request in writing.
(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 |