628.37 History
History: 1975 c. 223,
371,
422.
628.38
628.38
Disclosure requirements. The commissioner may by rule require insurers to deliver to prospective buyers of life or disability insurance, at a time specified in the rule, information consistent with
ss. 601.01 and
628.34 that will improve their ability to select appropriate coverage.
628.38 History
History: 1981 c. 82.
628.39
628.39
Extension of credit on premiums. The extension of credit to the insured upon a premium without interest for not exceeding 60 days from the effective date of the policy, or after that time with interest at not less than the legal rate nor more than 18% per year on the unpaid balance, is permissible. The payment of premiums on policies issued under a mass marketing program on an installment basis through payroll deductions is not an extension of credit.
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(2m)(a)(a) Notwithstanding
subs. (1) and
(2) and except as provided in
par. (b), a claim for payment for chiropractic services is overdue if not paid within 30 days after the insurer receives clinical documentation from the chiropractor that the services were provided unless, within those 30 days, the insurer provides to the insured and to the chiropractor the written statement under
s. 632.875 (2).
628.46(2m)(b)2.
2. Any line of property and casualty insurance except disability insurance. In this subdivision, "disability insurance" does not include uninsured motorist coverage, underinsured motorist coverage, or medical payment coverage.
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;
2001 a. 16,
65.
628.46 Annotation
Receipt of a legally binding offer to settle a claim against the insured is not required for the insured to have a claim against the insurer for bad-faith failure to settle. Alt v. American Family Mutual Insurance Co.
71 Wis. 2d 340,
237 N.W.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 Insurance Co.
85 Wis. 2d 675,
271 N.W.2d 368 (1978).
628.46 AnnotationThe tort of bad faith handling of a claim is discussed. Davis v. Allstate Ins. Co.
101 Wis. 2d 1,
303 N.W.2d 596 (1981).
628.46 Annotation
A third-party claimant cannot assert a bad faith claim against an insurer. Kranzush v. Badger State Mutual Casualty Co.
103 Wis. 2d 56,
307 N.W.2d 256 (1981).
628.46 Annotation
This section applies to service insurance corporations. Physicians Service Insurance Corp. v. Mitchell,
114 Wis. 2d 338,
338 N.W.2d 326 (Ct. App. 1983).
628.46 Annotation
A jury's imposition of punitive damages and finding of bad faith is adequate to show that the insurer did not have reasonable proof that it was not responsible for a claim and supports an award of prejudgment interest under sub. (1). Upthegrove v. Lumbermans Mutual Insurance Co.
146 Wis. 2d 470,
431 N.W.2d 689 (Ct. App. 1988).
628.46 Annotation
Interest under s. 807.01 (4) is not in addition to interest under sub. (1). Upthegrove v. Lumbermans Insurance Co.
152 Wis. 2d 7,
447 N.W.2d 367 (Ct. App. 1989).
628.46 Annotation
This section makes no distinction between the payment of claims based on judgments 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 Wis. 2d 280,
491 N.W.2d 119 (Ct. App. 1992).
628.46 Annotation
Whether to assess 12% interest is dependent on whether the insurer had reasonable proof establishing that it was not responsible for payment. U.S. Fire Insurance Co. v. Good Humor Corp.
173 Wis. 2d 804,
496 N.W.2d 730 (Ct. App. 1993).
628.46 AnnotationThis 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(4)
(4) Intermediaries that control an insurer.
628.49 History
History: 1991 a. 269.
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 Cross-reference
Cross Reference: See also s.
Ins 6.66, Wis. adm. code.
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.
