Cases where required.
The following persons or their authorized representatives shall be heard by the bureau upon written request:
Any insurer or employer on any matter affecting the risk in connection with a survey under sub. (2) (a)
Any person aggrieved by the application of the bureau's rating system to the person;
Any member alleging discrimination as to services or charges of the bureau; and
The bureau shall provide within this state a specified procedure for review of the matters under par. (a)
The commissioner may disapprove the procedure specified under subd. 1.
if the commissioner finds that it does not provide adequate notice and fair hearing to the person asking for review.
The person asking for review may appeal to the commissioner under sub. (4)
from a decision of the bureau or from its failure to provide a review and decision within 30 days after a written request therefor.
Cases where appeal is allowed.
The following persons or their authorized representatives may petition the commissioner in writing for review of a bureau action or decision:
Any member aggrieved by an apportionment of costs made by the bureau under sub. (1) (c)
, or by the bureau's failure to make an apportionment;
Any member aggrieved by discrimination in the supplying of services by the bureau;
Any member aggrieved by the bureau's rejection of proposed changes in or additions to its filings that would affect the member;
Any insurer, municipality, as defined under s. 345.05 (1) (c)
, any state department or agency or employer aggrieved by the application of the bureau's rating system to that person or agency.
An appeal is initiated by a written petition to the commissioner, which must be filed within 30 days after the adverse decision of the bureau on review or, if the bureau has not announced a decision within the specified 30 days, within 60 days after the written request for review. If the bureau announces a decision after the specified 30 days but before filing of the petition, the petitioner has 30 days after announcement of the decision to petition the commissioner.
The commissioner shall give not less than 10 days' notice of hearing to the appellant and the bureau, and in cases under par. (a) 1.
, to all other members of the bureau.
Procedure in the hearing shall be as provided for other hearings before the commissioner.
The commissioner shall mail a copy of the commissioner's decision to the appellant and the bureau.
The commissioner's decision shall be by order, with findings of fact and conclusions of law, which order may:
Direct the bureau within a reasonable time the commissioner designates to give further consideration to the matter and to reach a conclusion consistent with the commissioner's order; or
Direct the bureau within a reasonable time the commissioner designates to take specified action consistent with the commissioner's findings.
Development of rates by bureau. 626.32(1)(a)(a)
Every insurer writing any insurance specified under s. 626.03
shall report its insurance in this state to the bureau at least annually, on forms and under rules prescribed by the bureau. The bureau shall file, under rules promulgated by the department of workforce development, a record of such reports with that department. No such information may be made public by the bureau or any of its employees except as required by law and in accordance with its rules. No such information may be made public by the department of workforce development or any of its employees except as authorized by the bureau.
Payroll audits by insurers shall show information classified under the statistical plan and shall be correct as to amount in each classification. The commissioner or the bureau may check any payroll audit and upon written complaint alleging facts that if true would create serious doubt about the accuracy of the payroll audit shall check it.
(2) Classifications and plans.
The commissioner shall promulgate a statistical plan, which shall give due consideration to the rating system on file with the commissioner and seek to make the plan as uniform among the several states as is practicable. The statistical plan may be modified from time to time. It shall be used thereafter by each insurer in the recording and reporting under sub. (1)
of its Wisconsin loss and country-wide expense experience. The rules and statistical plan may also provide for the recording and reporting of expense experience items which are specially applicable to this state. The bureau shall assign each compensation risk to its proper class, and its classification shall be used by all insurers writing any insurance specified under s. 626.03
. On behalf of all members the bureau shall inspect and make a written survey of compensation risks to determine their proper classifications, shall maintain a record of its classification of risks and the written surveys of all risks inspected by it showing such facts as are material in the writing of insurance thereon.
(3) Aids in rate-making.
The commissioner and every insurer and rate service organization may exchange information and experience data with insurance supervisory officials, insurers and rate service organizations in other states and may consult with them with respect to rate-making and the application of rates. The commissioner may designate one or more rate service organizations to assist the commissioner in gathering experience and making compilations thereof, and the compilations shall be made available to insurers and rating organizations.
Worker's compensation insurance contracts. 626.35(1)(1)
An insurer who provides a contract under s. 102.31 (1) (a)
shall file with the bureau a copy of the contract, or other evidence of the contract as designated by the bureau, not more than 60 days after the effective date of the contract.
The bureau may assess a penalty, in accordance with a schedule adopted by the bureau, against an insurer who fails to comply with sub. (1)
History: 1989 a. 64
; 1989 a. 332
; Stats. 1989 s. 626.35.
Other rate service organizations.
Any group, association or other organization which assists the bureau in rate-making by the collection and furnishing of loss and expense statistics or by the submission of recommendations is a rate service organization and shall be governed by ss. 625.31
History: 1975 c. 148