(k) Requirements in case loss occurs.
The insured shall give written notice as soon as reasonably possible to this Company of any loss, protect the property from further damage, forthwith separate the damaged and undamaged personal property, put it in the best possible order, furnish a complete inventory of the destroyed, damaged and undamaged property, showing in detail quantities, costs, actual cash value and amount of loss claimed; and within sixty days after the loss, unless such time is extended in writing by this Company, the insured shall render to this Company a proof of loss signed and sworn to by the insured, stating the knowledge and belief of the insured as to the following: the time and origin of the loss, the interest of the insured and of all others in the property, the actual cash value of each item thereof and the amount of loss thereto, all encumbrances thereon, all other contracts of insurance, whether valid or not, covering any of said property, any changes in the title, use, occupation, location, possession or exposures of said property since the issuing of this property, by whom and for what purpose any building herein described and the several parts thereof were occupied at the time of loss and whether or not it then stood on leased ground, and shall furnish a copy of all the descriptions and schedules in all policies and, if required, verified plans and specifications of any building, fixtures or machinery destroyed or damaged. The insured, as often as may be reasonably required, shall exhibit to any person designated by this Company all that remains of any property herein described, and submit to examinations under oath by any person named by this Company, and subscribe the same; and, as often as may be reasonably required, shall produce for examination all books of account, bills, invoices and other vouchers, or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by this Company or its representative, and shall permit extracts and copies thereof to be made.
In case the insured and this Company shall fail to agree as to the actual cash value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within twenty days of such demand. The appraisers shall first select a competent and disinterested umpire; and failing for fifteen days to agree upon such umpire, then, on request of the insured or this Company, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this Company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting him or her and the expenses of appraisal and umpire shall be paid by the parties equally.
(m) Company's options.
It shall be optional with this Company to take all, or any part, of the property at the agreed or appraised value, and also to repair, rebuild or replace the property destroyed or damaged with other of like kind and quality within a reasonable time, on giving notice of its intention so to do within thirty days after the receipt of the proof of loss herein required.
There can be no abandonment to this Company of any property.
(o) When loss payable.
The amount of loss for which this Company may be liable shall be payable sixty days after proof of loss, as herein provided, is received by this Company and ascertainment of the loss is made either by agreement between the insured and this Company expressed in writing or by the filing with this Company of an award as herein provided.
No suit or action on this policy for the recovery of any claim shall be sustainable in any court of law or equity unless all the requirements of this policy shall have been complied with, and unless commenced within 12 months next after inception of the loss.
This Company may require from the insured an assignment of all right of recovery against any party for loss to the extent that payment therefor is made by this Company.
Ins 6.76 History
Cr. Register, November, 1977, No. 263
, eff. 12-1-77; am. (3) (a), Register, November, 1978, No. 275
, eff. 12-1-78.
Exemption from mid-term cancellation requirements. Ins 6.77(2)
This section applies to all insurers authorized to write umbrella or excess liability insurance policies in Wisconsin and to all insurers authorized to write aircraft insurance policies in Wisconsin.
means a policy form that is designated an application by the insurer and that is filed with the office of the commissioner of insurance under s. 631.20
“Excess liability policy" means an insurance contract providing at least $1,000,000 of liability coverage per person or per occurrence in excess of certain required underlying liability insurance coverage.
“Umbrella liability policy" means an insurance contract providing at least $1,000,000 of liability coverage per person or per occurrence in excess of certain required underlying liability insurance coverage or a specified amount of self-insured retention.
“War risks coverage"
means insurance coverage provided under an aircraft insurance policy for bodily injury, mental anguish, medical expense, or damage or loss to the covered aircraft or a third party's property caused by declared or undeclared war, invasion, rebellion, insurrection or warlike operations or by an attempt to or the actual seizure or detention of an aircraft by any government, military, naval, or usurped power.
An insurer cancelling any umbrella liability policy or excess liability policy shall notify the commissioner of the grounds for such cancellation not later than the time at which the insurer notifies the policyholder of such cancellation. Insurers shall provide notice to the insured as set forth in s. 631.36 (2) (b)
No cancellation under s. 631.36 (2) (a)
, Stats., of any war risks coverage contained in an aircraft insurance policy is effective until at least 7 days after the 1st class mailing or delivery of a written notice to the policyholder.
Ins 6.77 History
Emerg. cr. eff. 7-1-77; cr. Register, November, 1977, No. 263
, eff. 12-1-77; am. (1), (4) and (5), Register, May, 1987, No. 377
, eff. 6-1-87; am. (1) and (2), renum. (3) (a), (4) and (5) to be (3) (c), (4) (a) and (5) (a), cr. (3) (a) and (d), (4) (b) and (5) (b), Register, July, 1990, No. 415
, eff. 8-1-90; CR 06-117
: am. (1), (2) and (4) (a), cr. (3) (ac), (ag), (am) and (bm), (4) (b) and (c) and (6), renum. (4) (b) to be (4) (d), Register June 2007 No. 618
, eff. 7-1-07; correction in (1) made under s. 13.92 (4) (b) 7.
, Stats., Register January 2010 No. 649
: emerg. am. (1), (2), (4) (a), (b) and (6), r. (3) (ag) and (4) (c), cr. (4) (am), eff. 11-1-09; CR 09-097
: am. (1), (2), (4) (a) and (6), r. (3) (ag) and (4) (c), cr. (4) (am) Register April 2010 No. 652
, eff. 5-1-10; correction in (1) and (4) (a) made under s. 13.92 (4) (b) 7.
, Stats., Register, January, 2012 No. 673
; CR 15-032
: am. (title), (1), (2), r. (3) (am), (bm), (4) (am), (b), and (6) Register November 2015 No. 719
, eff. 12-1-15; correction in (1), (2) made under s. 35.17
, Stats., Register November 2015 No. 719
Exemption from filing of rates. Ins 6.78(1)(1)
The purpose of this section is to exempt from the filing requirements of s. 625.13
, Stats., those rates for risks which have been customarily written on a consent-to-rate basis and certain title insurance rates, it having been determined that such filing is not necessary to protect policyholders and the public. This rule implements and interprets ss. 625.04
, and 625.15
This section applies to the following lines or classes of insurance:
The classes specified in s. Ins 6.75 (2) (a)
, and (n)
Individual rate modifications that are a reduction from the filed title insurance rate.
(3) Exempt filings.
If a specific risk in a line or class of insurance set forth in sub. (2) (a)
is of the type which is customarily written on a consent-to-rate basis wherein the insured agrees to accept a rate that is different from the insurer's filed rates, the consent-to-rate shall not be filed with the commissioner, provided:
The insurer keeps for at least 1 year after the expiration date of the policy;
The written application signed by the insured stating the insured's reason for requesting the rate.
Prior to entering into such insurance agreements in Wisconsin the insurer has notified the commissioner of insurance of its intention so to do, identifying the contemplated lines and classes of insurance.
(4) Exempt filing.
If a title insurance rate as set forth in sub. (2) (b)
is a downward deviation of an existing filed rate, the rate shall not be filed with the commissioner provided that all of the following apply:
The insurer keeps for at least five years after the inception date of the policy the following information:
The filed rate and premium and the deviated rate and premium;
The effective date of the policy and the location and description of the risk;
Prior to entering into such insurance agreements in Wisconsin, the insurer has notified the commissioner of its intentions to do so, identifying the contemplated rate deviation program.
Ins 6.78 History
Cr. Register, January, 1980, No. 289
, eff. 2-1-80; am. (1), (2) and (3) (intro.), cr. (4), Register, February, 1993, No. 446
, eff. 3-1-93; reprinted to restore dropped copy in (3), Register, May, 1993, No. 449
Exemption from rate filing requirements. Ins 6.785(1)(1)
This section is intended to exempt certain classes of property and casualty rates from the rate filing requirements. This section implements and interprets ss. 625.04
This section applies to the lines or classes of insurance which are listed in s. Ins 6.75 (2) (a)
of direct insurance written on risks or operations in this state subject to s. 625.03
, Stats., and which are exempted under the consent-to-rate provision of s. Ins 6.78
The commissioner of insurance finds that for certain classes of business certain risks within other classes of business and certain situations, the rate filing requirements set forth in s. 625.13
, Stats., are unnecessary to achieve the purposes of ch. 625
, Stats. The commissioner bases this finding on the following reasons:
The manual rate, classification or form is inappropriate because it does not adequately reflect the exposure represented by the risk;
The risk is so different from other risks that no single manual rate or classification could be representative of all such risks;
The risk belongs to a classification that does not develop enough experience to warrant sufficient credibility for rate-making purposes; or
The risk involves a new product or coverage as to which there are no appropriate analogous exposures for rate-making purposes.
(4) Rate filing exemption.
The following rates shall not be filed with the commissioner by the insurer or rate service organization on behalf of the insurer provided the insurer complies with sub. (7)
The rate for an individual risk written under a rating rule class filed with the commissioner which must be accompanied by a certification by a qualified actuary that the rate under the rating rule class cannot be objectively rated for at least one of the following reasons:
The class generates insufficient loss experience to be reliably used in rating;
The class loss experience is so volatile as to make it unreliable;
Prospective losses for this class are likely to change rapidly and unpredictably; or
Risks within the class are so dissimilar that a single rate would not be representative of all risks in the class.
Rates for excess liability insurance provided in an amount not less than $1,000,000 in excess of a specified retained limit provided such retained limit is not less than:
$350,000 per occurrence as respects those exposures covered by underlying insurance; or
$10,000 per occurrence as respects those exposures not covered by underlying insurance.
Rates for risks developing annual products liability and completed operations insurance premiums of $5,000 or more at the basic limit.
Rates for risks developing annual increased limits written premium determined by customary rating procedures of $5,000 or more.
Rates for risks developing $100,000 or more annual manual basic limit premium individually or in any combination of general liability insurance, commercial automobile, crime or glass.
Rates for liability insurance increased limits if the risk is reinsured on a facultative basis.
Rates for an adjustment of the aggregate limit of general liability insurance at any time during the policy period.
Rates for coverage which is materially broader or more restrictive than the coverage upon which the manual rate is based.
(5) Utilization of rate filing exemption.
An insurer or a rate service organization wishing to utilize the rate filing exemption or modification granted by sub. (4)
shall have on file with the commissioner rating rules pertaining to the situations described in sub. (4)
(6) Disapproval of filed rules.
If the commissioner determines that a rating rule does not meet the rate standards set forth in s. 625.11
, Stats., the commissioner may exercise the authority granted by s. 625.22
, Stats., and disapprove the rate.
(7) Insurer records.
An insurer using a rate subject to the exemption granted by sub. (4)
shall maintain separate records and documentation for a period of 3 years after the rate is no longer used. This documentation shall include all details of the factors used in determining the rate or classification for a particular risk, including conditions used to qualify a rate for an exemption under sub. (4)
. The insurer shall provide these records to the commissioner upon request.
Ins 6.785 History
Emerg. cr. eff. 8-3-92; cr. Register, February, 1993, No. 446
, eff. 3-1-93.
Advisory councils and committees. Ins 6.79(1)(1)
The purpose of this section is to delineate the process by which the commissioner may create advisory councils and committees under s. 15.04 (1) (c)
, Stats., to assist in dealing with regulatory problems pursuant to s. 601.20
, Stats., and may include assistance with rule-making pursuant to s. 227.13
Each council or committee shall advise the commissioner on matters relating to specific issues or subjects presented to the members for study and review by the commissioner of insurance.
(3) Expense reimbursement.
Members of the councils and committees shall receive no salary or compensation for service on the councils or committees but shall be reimbursed for their actual and necessary expenses in attending meetings or while performing other duties as directed by the commissioner.
The councils or committees shall meet as needed or at such times as requested by the commissioner.
For each council or committee created by the commissioner, membership may not exceed 15 members and shall be representative of the various interested parties and include persons who possess expertise or interest on the issue or topic of the council or committee.
The commissioner shall appoint the chair, unless the commissioner authorizes a different process for selection. The commissioner shall appoint an employee of the office as a non-voting member to assist the council or committee with its duties. The commissioner or a designee shall keep a record of all proceedings, transactions, communications, and other official acts of the councils and committees. The commissioner or a designee appointed by the commissioner shall serve as a voting member when the council or committee is convened in accordance with s. 15.04 (1) (c)
, Stats. The files and records of the councils and committees shall be maintained at the office of the commissioner of insurance.
Members of the councils and committees serve at the pleasure of the commissioner.
Ins 6.79 History
Cr. Register, January, 1980, No. 289
, eff. 2-1-80; correction in (1) under s. 13.93 (2m) (b) 7., Stats., Register, September, 1984, No. 348
; r. (2) (c), Register, November, 1991, No. 431
, eff. 12-1-91; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, February, 2000, No. 530
; CR 08-064
: r. and recr. Register December 2008 No. 636
, eff. 1-1-09.
The purpose of this section is to establish standards for record retention by insurers and other persons subject to the regulation of the commissioner.
This section shall apply to all insurers licensed under chs. 611
, and 618
, Stats., and including the Local Property Insurance Fund, the State Life Insurance Fund, and the State Indemnity Fund.
2. Sections Ins 2.07 (5) (a) 2. d. and (b) 2. b.
apply to life insurance.
Ins 6.80 Note
Note: Sections Ins 2.07 (5) (a) 2. d. and (b) 2. b. do not exist. Section Ins 2.07 was repealed and recreated eff. 3-1-82.