628.40 628.40 Effect of agent's appointment on insurer. Every insurer is bound by any act of its agent performed in this state that is within the scope of the agent's apparent authority, while the agency contract remains in force and after that time until the insurer has made reasonable efforts to recover from the agent its policy forms and other indicia of agency. Reasonable efforts shall include a formal demand in writing for return of the indicia, and notice to the commissioner if the agent does not comply with the demand promptly.
628.40 History History: 1975 c. 371, 421.
628.46 628.46 Timely payment of claims.
628.46(1) (1) Unless otherwise provided by law, an insurer shall promptly pay every insurance claim. A claim shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of the loss. If such written notice is not furnished to the insurer as to the entire claim, any partial amount supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after written notice is furnished to the insurer. Any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer. For the purpose of calculating the extent to which any claim is overdue, payment shall be treated as being made on the date a draft or other valid instrument which is equivalent to payment was placed in the U.S. mail in a properly addressed, postpaid envelope, or, if not so posted, on the date of delivery. All overdue payments shall bear simple interest at the rate of 12% per year.
628.46(2) (2) Notwithstanding sub. (1), the payment of a claim shall not be overdue until 30 days after the insurer receives the proof of loss required under the policy or equivalent evidence of such loss. The payment of a claim shall not be overdue during any period in which the insurer is unable to pay such claim because there is no recipient who is legally able to give a valid release for such payment, or in which the insurer is unable to determine who is entitled to receive such payment, if the insurer has promptly notified the claimant of such inability and has offered in good faith to promptly pay said claim upon determination of who is entitled to receive such payment.
628.46(3) (3) This section applies only to the classes of claims enumerated in s. 646.31 (2).
628.46 History History: 1975 c. 375; 1979 c. 109 s. 16; 1979 c. 110 s. 60 (13); 1981 c. 38 s. 24; Stats. 1981 s. 628.46.
628.46 Annotation Submission of legally binding offer from claimant is not necessary condition antecedent to maintenance of bad-faith excess liability action against insurer. Alt v. American Family Mut. Ins. Co. 71 W (2d) 340, 237 NW (2d) 706 (1976).
628.46 Annotation Insured may bring tort action against insurer for failure to exercise good faith in settling insured's claim. This section is unrelated to such tort action. Anderson v. Continental Ins. Co. 85 W (2d) 675, 271 NW (2d) 368 (1978).
628.46 Annotation Tort of bad faith handling of claim discussed. Davis v. Allstate Ins. Co. 101 W (2d) 1, 303 NW (2d) 596 (1981).
628.46 Annotation Third party claimant cannot assert bad faith claim against insurer. Kranzush v. Badger State Mut. Cas. Co. 103 W (2d) 56, 307 NW (2d) 256 (1981).
628.46 Annotation This section applies to service insurance corporations. Physicians Serv. Ins. Corp. v. Mitchell, 114 W (2d) 338, 338 NW (2d) 326 (Ct. App. 1983).
628.46 Annotation Jury's imposition of punitive damages and finding of bad faith is adequate to show that insurer did not have reasonable proof that it was not responsible for claim and supports prejudgment interest pursuant to (1). Upthegrove v. Lumbermans Mut. Ins. Co. 146 W (2d) 470, 431 NW (2d) 689 (Ct. App. 1988).
628.46 Annotation See note to 807.01, citing Upthegrove v. Lumbermans Ins. Co. 152 W (2d) 7, 447 NW (2d) 367 (Ct. App. 1989).
628.46 Annotation This section makes no distinction between payment of claims based on judgment and all other claims; a claim may be due under sub. (2) far in advance of a judgment or award. Fritsche v. Ford Motor Credit Co. 171 W (2d) 280, 491 NW (2d) 119 (Ct. App. 1992).
628.46 Annotation Whether to assess 12% interest is dependent on whether insurer had reasonable proof establishing it was not responsible for payment. U.S. Fire Ins. Co. v. Good Humor Corp. 173 W (2d) 804, 496 NW (2d) 730 (Ct. App. 1993).
628.46 Annotation This section applies to all insurers. Allison v. Ticor Title Ins. Co. 979 F (2d) 1187 (1992).
628.46 Annotation Excess liability insurance. Griffin. 62 MLR 375 (1979).
628.48 628.48 Risk retention groups.
628.48(1) (1)Prohibited marketing. A risk retention group may not do any of the following:
628.48(1)(a) (a) Solicit or sell insurance to any person who is not eligible for membership in the risk retention group.
628.48(1)(b) (b) Solicit or sell insurance or otherwise operate if the risk retention group is in a hazardous financial condition or is financially impaired.
628.48(2) (2)Notice in policies. A risk retention group may not issue an insurance policy unless the following notice, in 10-point type, is included on the front page and declarations page of the policy:
Notice
This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. State insurance insolvency guaranty funds are not available for your risk retention group.
628.48 History History: 1987 a. 247.
628.49 628.49 Regulation of managing general agents, reinsurance brokers and managers and controlling producers. After considering the applicable model acts adopted by the national association of insurance commissioners, the commissioner may promulgate rules that are reasonably necessary to regulate the business practices and transactions of the following:
628.49(1) (1) Managing general agents.
628.49(2) (2) Reinsurance brokers.
628.49(3) (3) Reinsurance managers.
628.49(4) (4) Intermediaries that control an insurer.
628.49 History History: 1991 a. 269.
subch. IV of ch. 628 SUBCHAPTER IV
COMPENSATION OF INTERMEDIARIES
628.51 628.51 Controlled business. No intermediary may receive any compensation from an insurer for effecting insurance upon the intermediary's property, life or other risk unless during the preceding 12 months the intermediary had effected other insurance with the same insurer with aggregate premiums exceeding the premiums on the intermediary's risks.
628.51 History History: 1975 c. 371, 421.
628.61 628.61 Sharing commissions.
628.61(1)(1)Prohibition. No intermediary or insurer may pay any consideration, nor reimburse out-of-pocket expenses, to any natural person for services performed within this state as an intermediary if he or she knows or should know that the payee is not licensed under s. 628.04 or 628.09. No natural person may accept compensation for service performed as an intermediary unless the natural person is licensed under s. 628.04 or 628.09.
628.61(2) (2)Exceptions. This section does not prohibit:
628.61(2)(a) (a) The payment of deferred commissions to formerly licensed agent and broker intermediaries or their assignees; or
628.61(2)(b) (b) The proper exchange of business between agent and broker intermediaries lawfully licensed in this state.
628.61 History History: 1975 c. 371, 421; 1979 c. 102; 1981 c. 38.
628.77 628.77 Bonuses prohibited.
628.77(1)(1)General. No life insurer or representative of a life insurer may provide any bonus, prize or award or similar additional compensation on insurance business transacted in this state, as a result of a contest or competition among intermediaries, except that awards may be given not primarily as compensation but as recognition of merit, if no such award has a cost in excess of $150 and if the aggregate cost of all such awards in any calendar year does not exceed 1.5% of the insurer's total first year life insurance premium income derived from sales in this state, excluding single premium income.
628.77(2) (2)Business or educational conferences. Payment may be made to cover reasonable actually incurred expenses in connection with any educational conference, meeting or training course of an insurer or intermediary held for bona fide business or educational purposes.
628.77 History History: 1975 c. 371.
628.78 628.78 Benefit plans for agents. A domestic insurer may establish retirement, insurance and other benefit plans for agents on an actuarial basis approved by the commissioner.
628.78 History History: 1975 c. 371.
628.81 628.81 Filing of commission rates paid to agents and brokers. Every insurer shall at or prior to the filing of its application for a certificate of authority file such information as the commissioner requests about the percentages and kinds of commissions paid to agents and brokers within this state, as well as the amounts of any fixed salaries if they are supplemented by commissions. It shall supply amended information promptly after any major change, and whenever the commissioner requests by rule or by order.
628.81 History History: 1975 c. 371.
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