This section is intended to implement and interpret s. 619.01
, Stats., for the purpose of establishing procedures and requirements for a mandatory risk sharing facility for basic property insurance coverage. This section is also intended to encourage improvement of and reasonable loss prevention measures for properties located in Wisconsin and to further orderly community development.
This section shall apply to all insurers included in sub. (3) (d)
except those organized under ch. 612
, Stats., assessment mutual insurance companies and insurers who write reinsurance only.
“Basic property insurance" means the insurance coverages described in subds. 1.
against direct loss to real and tangible property at a fixed location. The Plan may use customary policy forms and endorsements to effect coverage contemplated by this paragraph. Other coverage may be added to the Plan by endorsement or policy provision upon approval by the commissioner.
Coverage at least equivalent to that provided in
a modified coverage form homeowners policy.
“Farm risks" means all buildings and their contents whether occupied by the owner or by an employee or by a tenant, located on or used in connection with land devoted to any one or more of the following purposes and where gross annual receipts from those purposes are in excess of $5,000:
Dwellings, permanent or seasonal, designed for occupancy by not more than 4 families or containing not more than 4 apartments.
Private outbuildings used in connection with any of the foregoing.
Household and personal property in risks described in subds. 1 through 5.
“Insurer" means any insurance company authorized to transact in this state on a direct basis basic property insurance, including the property insurance components of multi-peril policies.
“Location" means a single building and its contents or contiguous buildings and their contents under one ownership.
“Manufacturing risks" means those risks eligible to be written under the customary manufacturing business interruption policy forms approved by the commissioner. The following are not considered manufacturing risks:
Dry cleaning and laundering—Carpet, rug, furniture, or upholstery cleaning; diaper service or infants' apparel laundries; dry cleaning; laundries; linen supply.
Installation, servicing and repair—Electrical equipment; electronic equipment; glazing; household furnishings and appliances; office machines; plumbing, heating and air conditioning; protective systems for premises, vaults and safes.
Laboratories—Blood banks; dental laboratories; medical or x-ray laboratories.
Duplicating and similar services—Blue printing and photocopying services; bookbinding; electrotyping; engraving; letter service (mailing or addressing companies); linotype or hand composition; lithographing; photo engraving; photo finishing; photographers (commercial).
Warehousing—Cold storage (locker establishments); warehouse, cold storage; warehouse, furniture or general merchandise.
Miscellaneous—Barber shops; beauty parlors; cemeteries; dog kennels; electroplating; equipment rental (not contractors' equipment); film and tape rental; funeral directors; galvanizing, tinning, and detinning; radio broadcasting, commercial wireless and television broadcasting; taxidermists; telephone or telegraph companies; textiles (bleaching, dyeing, mercerizing or finishing of property of others); veterinarians and veterinary hospitals.
“Motor vehicles" means vehicles which are self-propelled.
Gross direct premiums less return premiums, dividends paid or credited to policyholders, or the unused or unabsorbed portions of premium deposits, with respect to property in this state excluding premiums on risks insured under the Plan, for basic property insurance, for homeowners multiple peril policies, and for the basic property insurance premium components of all other multiple peril policies.
In addition, 100% of the premiums obtained for homeowners multiple peril policies shall be added to 100% of the premiums obtained for basic property insurance and the basic property insurance premium components of all other multiple peril policies. The basic year for the computation shall be the second preceding calendar year.
“The Wisconsin Insurance Plan," in this section referred to as the Plan, means the nonprofit, unincorporated mandatory risk-sharing facility established by this section to provide for basic property insurance and to assist applicants in securing basic property insurance.
All risks at a fixed location shall be eligible for inspection and considered for insurance under the Plan except motor vehicles, farm risks, and manufacturing risks as defined in sub. (3) (b)
, and (g)
The maximum limits of coverage for the type of basic property insurance defined in sub. (3) (a) 1.
which may be placed under the Plan are $350,000 on the dwelling and $175,000 on personal property for any habitational risk at one location and $500,000 on any other eligible risk.
The maximum limits of coverage for the type of basic property insurance defined in sub. (3) (a) 3.
which may be placed under the Plan are $350,000 on the dwelling with the customary percentage limits for other structures, personal property and loss of use and $100,000 on personal liability and $1,000 medical payments to others for any risk at one location.
Every insurer, as defined in sub. (3) (d)
, licensed to write one or more components of basic property insurance, as defined in sub. (3) (a)
, shall be considered a member of the Plan. Any other insurer may, upon application to and approval by the governing committee, become a member.
An insurer's membership terminates when the insurer is no longer authorized to write basic property insurance in Wisconsin, but the effective date of termination shall be the last day of the fiscal year of the Plan in which termination occurs. Any insurer so terminated shall continue to be governed by the provisions of this section until it completes all of its obligations under the Plan.
Any voluntary insurer member may terminate its membership only as of the last day of the fiscal year of the Plan by giving written notice to the Plan 30 days prior to the last day of the fiscal year of the Plan. The governing committee upon a majority vote may terminate the membership of a voluntary insurer. Any such terminated member shall continue to be governed by the provisions of this section until it completes all of its obligations under the Plan.
Subject to the approval of the commissioner, the governing committee may charge a reasonable annual membership fee.
The Plan shall be administered by the governing committee, subject to the supervision of the commissioner, and operated by a manager appointed by the governing committee.
The governing committee shall consist of 11 members, each of whom shall serve for a period of one year or until a successor is elected or designated. Each shall have one vote.
Four members shall be nominated by national and state associations that represent property and casualty insurers. If more than four members are nominated, the commissioner shall designate the four members from the list of nominations.
All other insurers not members of the associations in subd. 1 shall elect one member by weighted votes based on each insurer's weighted premiums written.
The commissioner shall appoint members to represent:
stock agents—one member
mutual agents—one member
consumers and other persons not affiliated in any way with the insurance industry—4 members
Not more than one insurer in a group under the same management or ownership shall serve on the governing committee at the same time. Nominees for individuals to serve as consumer members and as representatives of other persons not affiliated in any way with the insurance industry shall be sought from community groups, local agencies, and from other members of the governing committee.
The governing committee shall meet as often as may be required to perform the general duties of the administration of the Plan or on the call of the commissioner. Six members of the committee present or by proxy shall constitute a quorum. Members of the committee who choose to appoint a proxy shall give a written proxy to the person elected to act as proxy. The written proxy shall then be filed with the governing committee, thus ensuring the validity of the proxy's actions as the governing committee performs its duties.
The governing committee shall be empowered to appoint a manager, who shall serve at the pleasure of the committee, to budget expenses, levy assessments, disburse funds, and perform all other duties of the Plan. The adoption of or substantive changes in pension plans or employee benefit programs for the manager and staff shall be subject to approval of the governing committee.
The governing committee may designate, with the approval of the commissioner, a rate service organization as defined in s. 625.02 (2)
, Stats., to make inspections as required under the Plan and to perform such other duties as may be authorized by the governing committee.
The manager shall annually prepare an operating budget which shall be subject to approval of the governing committee.
The governing committee shall submit to the commissioner periodic reports setting forth information as the commissioner may request.
The governing committee shall separately code all policies written by the Plan so that appropriate records may be compiled for purposes of performing loss prevention and other studies of the operation of the Plan.
The governing committee shall authorize the manager to file rates, surcharge schedules and forms for prior approval by the commissioner.
The governing committee shall prepare such agreements and contracts as may be necessary for the execution of this section consistent with its provisions.
There shall be an annual meeting of the insurers on a date fixed by the governing committee at which time members may be chosen under sub. (6) (b) 1.
A special meeting shall be called within 40 days by the governing committee after receipt of a written request from any 10 insurers, not more than one of which may be in a group under the same management or ownership.
The time and place of all meetings shall be reasonable. Twenty days' notice of an annual or special meeting shall be given in writing by the governing committee to all insurers as defined by sub. (3) (d)
. Six members present in person or by proxy shall constitute a quorum. Voting by proxy shall be permitted.
Any matter not inconsistent with the law or this section may be proposed and voted upon at any special meeting of the committee. Notice of any such proposal shall be mailed to each insurer not less than 20 days prior to the final date fixed by the committee for voting thereon.
Any person having an insurable interest in an eligible risk under sub. (4) (a)
, and who has received within the last 6 months a notice of rejection or cancellation from an insurer, may apply for insurance by the Plan. The notice of rejection or cancellation shall accompany the application.
An inspection need not be made if the governing committee determines that insurance can be provided for specified classes of risks on the basis of representations of the applicant or the insurance agent.
The Plan may bind coverage. The Plan may wait until receipt of the inspection report or receipt of additional underwriting information before determining whether to bind coverage.
The inspection by the Plan shall be without cost for the applicant.
The manner and scope of the inspection shall be prescribed by the Plan with the approval of the commissioner.
An inspection report shall be made for each property inspected covering pertinent structural and occupancy features as well as the general condition of the building and surrounding structures. Representative photographs may be taken during the inspection to indicate the pertinent features of building, construction, maintenance, occupancy, and surrounding property.
After the inspection, a copy of the completed inspection report and any relevant photographs shall be kept on file by the Plan. The report shall include a description of any deficient physical condition charges proposed by the inspector. A copy of the inspection report shall be made available to the applicant or agent upon request.
(11) Procedure after inspection and receipt of application. Ins 4.10(11)(a)(a)
After receipt of the application, the inspection report, and any additional underwriting information requested from the applicant, and the application, the Plan shall within 5 business days complete and send to the applicant an action report advising him or her of one of the following:
That the risk is acceptable. If the inspection reveals substandard conditions, appropriate charges may be imposed but the report shall specify the improvements necessary for removal of each such charge.
That the risk is declined unless reasonable improvements noted in the action report are made by the applicant and confirmed by reinspection.
That the risk is declined because it fails to meet reasonable underwriting standards as set forth in sub. (12)
. Reasonable underwriting standards as set forth in sub. (12)
shall not include neighborhood or area location or any environment hazard beyond the control of the property owner.
If the risk is accepted, the action report shall advise the applicant of:
The amount of coverage the Plan agrees to write, if specified improvements are made.
The amount of coverage the Plan agrees to write only if a large or special deductible is agreed to by the applicant.
If the risk is accepted, the Plan, upon receipt of the premium, shall deliver the policy to the applicant or to the licensed agent designated by the applicant for delivery to the applicant. The Plan shall remit the commissions to the licensed agent designated by the applicant. If no licensed agent is so designated, the policy shall be delivered to the applicant and the commission shall be retained by the Plan.
If the risk is conditionally declined under par. (a) 2.
but can be improved to meet reasonable standards the Plan shall promptly advise the applicant what improvements noted in the action report should be made to the property. Upon completion of the improvements by the applicant or property owner, the Plan when so notified, shall have the property promptly reinspected under sub. (10)
and shall send a new action report to the applicant.
If a risk is declined under par. (a) 3.
, the Plan shall promptly send copies of the inspection and action reports to the applicant and shall advise the applicant of the right to a hearing set forth in sub. (16) (a)
(12) Reasonable underwriting standards for property coverage.
The following characteristics may be used in determining whether a risk is acceptable for property coverage. Where there is more than one cause for declination, all shall be listed and complied with before the property may be accepted for insurance purposes.
Physical condition of property; however, the mere fact that a property does not satisfy all current building code specifications will not, of itself, suffice as a reason for declination.
The property's present use such as extended vacancy or extended unoccupancy of the property for 60 consecutive days. Properties that are vacant or unoccupied for more than 60 days may be insured while rehabilitation or reconstruction work is actively in process meaning that the insured or owner should make monthly progress in order to complete the rehabilitation or reconstruction within a one year time frame.
Other specific characteristics of ownership, condition, occupancy or maintenance, that violate the law and that result in substantial increased exposure to a loss. Any circumstance considered under this paragraph must relate to the peril insured against.
Characteristics of ownership or maintenance of building including any 2 of the following conditions:
Failure to pay real estate taxes on the property after the taxes have been delinquent for one year or more. Real estate taxes shall not be deemed to be delinquent for this purpose even if they are due and constitute a lien so long as a grace period remains under local law during which such taxes may be paid without penalty.
Failure, within the insured's control, to furnish water for 30 consecutive days or more.
Failure, within the insured's control, to furnish heat for 30 consecutive days or more during the heating season.