631.36(5)(c)
(c)
Anniversary alteration. Subject to
par. (d), an insurer may alter the terms or premium of a policy issued for a term longer than one year or for an indefinite term on the anniversary date only if notice of less favorable terms or premiums is sent by 1st class mail or delivered to the policyholder at least 60 days prior to the anniversary date. If the insurer notifies the policyholder within 60 days prior to the anniversary date, the new terms or premiums do not take effect until 60 days after the notice is mailed or delivered, in which case the policyholder may elect to cancel the policy at any time during the 60-day period. The notice shall include a statement of the policyholder's right to cancel. If the policyholder elects to cancel the policy during the 60-day period, return premiums or additional premium charges shall be calculated proportionately on the basis of the old premiums. If the insurer does not notify the policyholder of the new premiums or terms as required by this subsection prior to the anniversary date, the insurer shall continue the policy until the next anniversary date or the renewal date, whichever is earlier, at the same premiums and terms as for the previous period, except as permitted under
sub. (2) or
(3).
631.36(5)(d)
(d)
Estimate. An insurer may give notice under
par. (a) or
(c) of a new premium by stating the actual amount or percentage increase to be charged. If the insurer cannot reasonably determine the actual amount or percentage increase 60 days prior to the renewal or anniversary date, the notice shall include a good faith estimate of the increase based on information that the insurer can reasonably obtain. If an estimate is stated, the insurer shall renew or continue the policy at a premium that does not exceed the increase stated in the notice except as permitted under
sub. (5) (b).
631.36(6)
(6) Information about grounds. A notice of cancellation or nonrenewal under
sub. (2) (b) or
(4) shall state with reasonable precision the facts on which the insurer's decision is based. No such notice is effective unless it so states the facts.
631.36(7)
(7) Cancellation or nonrenewal notice. 631.36(7)(a)2.
2. Unless the notice contains adequate instructions to the policyholder for applying for insurance through a risk-sharing plan under
ch. 619, if a risk-sharing plan exists under
ch. 619 for the kind of coverage being canceled or nonrenewed, except as provided in
par. (b).
631.36(7)(b)
(b) Paragraph (a) 2. does not apply to a notice of cancellation or nonrenewal issued by the mandatory health care liability risk-sharing plan established under
s. 619.04.
631.36(8)
(8) Cancellation for nonpayment of premium. Subsections (6) and
(7) do not apply if the ground for cancellation or nonrenewal is nonpayment of the premium and if the notice so states.
631.36(9)
(9) Immunity. There is no liability on the part of and no cause of action of any nature arises against any insurer, its authorized representatives, its agents, its employees, or any firm, person or corporation furnishing to the insurer information relating to the reasons for cancellation or nonrenewal, for any statement made by them in complying or enabling the insurer to comply with this section, or for the provision of information pertaining thereto.
631.36 Cross-reference
Cross Reference: See also s.
Ins 6.77, Wis. adm. code.
631.36 Annotation
A policy did not lapse as the result of the insured's failure to pay a renewal premium before the policy's expiration date when the insurer failed to notify the insured of the nonrenewal or of the premium due. Sausen v. American Family Mutual Insurance Co.
121 Wis. 2d 653,
360 N.W.2d 565 (Ct. App. 1984).
631.36 Annotation
This section governs cancellation and recision of insurance contracts. WHEDA v. Verex Assurance, Inc.
166 Wis. 2d 636,
480 N.W.2d 490 (1992).
631.36 Annotation
The state was the policyholder of its employee group health policy and it, not the insureds, was entitled to notice of policy changes under sub. (5). Schaefer v. Physicians Plus Insurance Corp.
174 Wis. 2d 488,
497 N.W.2d 776 (Ct. App. 1993).
631.36 Annotation
Sub. (5) requires notice of policy changes effected by the insurer, not changes effected by the legislature or the courts. Roehl v. American Family Mutual Insurance Co.
222 Wis. 2d 136,
585 N.W.2d 893 (Ct. App. 1998).
631.36 Annotation
Under sub. (5), if an insurer offers to renew a policy on less favorable terms within 60 days of the renewal date, the insurer must inform the insured that the terms do not become effective until 60 days after the renewal is sent and that the insured has the same 60 days to cancel. Failure to comply requires the insurer to continue the prior policy terms for an additional period equal to the term of the expiring policy. Hanson v. Prudential Property & Casualty Insurance Co.
224 Wis. 2d 356,
591 N.W.2d 619 (Ct. App. 1999).
631.36 Annotation
Sub. (5) does not apply to reducing clause changes that are not initiated by the insurer but come into effect by statutory change, even when the insurer gratuitously sends a renewal notice discussing the altered terms. Sukala v. Heritage Mutual Insurance Co. 2000 WI App 266,
240 Wis. 2d 65,
622 N.W.2d 457.
631.36 Annotation
If notice of nonrenewal is not provided, the policyholder may exercise its right of renewal under sub. (1) (a). This right is limited to one additional period, but the policyholder must take some responsibility and discern whether renewal has occurred in light of evidence to the contrary, such as a failure to receive billing or declarations statements. Magyar v. Wisconsin Health Care Liability Insurance Plan, 2001 WI 41,
242 Wis. 2d 491,
625 N.W.2d 291.
631.37
631.37
Special cancellation provisions. The following cancellation provisions apply to the policies specified, whether or not
s. 631.36 is also applicable to them.
631.37(1)
(1) Cancellation upon request of premium finance company. Section 138.12 (12) applies to cancellation on request of a premium finance company.
631.37(2)
(2) Cancellation upon request of creditor. Section 424.303 applies to cancellation upon request of a creditor.
631.37(3)
(3) Worker's compensation insurance. Section 102.31 (2) applies to the termination of worker's compensation insurance.
631.37(3m)
(3m) Health care liability insurance. Section 655.24 (2) (b),
(3) and
(4) applies to the termination of a health care liability insurance policy.
631.37(4)
(4) Special limitations on cancellation. 631.37(4)(c)
(c)
Driver education motor vehicles. Section 341.267 (6) applies to motor vehicles used for driver education.
631.37(4)(d)
(d)
Insurance of juveniles. Section 343.15 (4) (a) applies to motor vehicle policies covering juveniles as described therein.
631.37(4)(e)
(e)
Motor vehicle liability policy. Section 344.34 applies to motor vehicle liability policies certified under
s. 344.31 and to policies certified under
s. 344.32.
631.37(4)(f)
(f)
Health care liability policy. Section 655.25 applies to insurance issued by the mandatory health care liability risk-sharing plan established under
s. 619.04.
631.41
631.41
Policies jointly issued. Two or more insurers may together issue a policy in which their liability is either several or joint and several. If it is several, the heading of the policy shall conspicuously so state and the policy shall conspicuously state the proportion or amount of premium to be paid to each insurer and the type and the proportion or amount of liability each insurer agrees to assume.
631.41 History
History: 1975 c. 375.
631.43
631.43
Other insurance provisions. 631.43(1)
(1)
General. When 2 or more policies promise to indemnify an insured against the same loss, no "other insurance" provisions of the policy may reduce the aggregate protection of the insured below the lesser of the actual insured loss suffered by the insured or the total indemnification promised by the policies if there were no "other insurance" provisions. The policies may by their terms define the extent to which each is primary and each excess, but if the policies contain inconsistent terms on that point, the insurers shall be jointly and severally liable to the insured on any coverage where the terms are inconsistent, each to the full amount of coverage it provided. Settlement among the insurers shall not alter any rights of the insured.
631.43(2)
(2) Fraud as a defense. Subsection (1) does not affect the right of an insurer to defend against a claim under the policy on the ground of fraudulent misrepresentation.
631.43 Note
NOTE: 1995 Wisconsin Act 21, which became effective on July 15, 1995, made significant changes in the law regarding the "stacking" of insurance policy coverage.
631.43 Annotation
A clause providing that any amount payable under the insurer's policy would be reduced by monies paid by other insurance company's uninsured motorist coverage was not valid; therefore, the plaintiff was entitled to the entire benefits under both uninsured motorist provisions. Landvatter v. Globe Security Insurance Co.
100 Wis. 2d 21,
300 N.W.2d 875 (Ct. App. 1980).
631.43 Annotation
An insurance policy provision that prohibits the stacking of uninsured motorist benefits against the same insurer is prohibited by sub. (1). Tahtinen v. MSI Insurance Co.
122 Wis. 2d 158,
361 N.W.2d 673 (1985).
631.43 Annotation
Sub. (1) only prohibits the use of reducing clauses in indemnity coverages, not in underinsured motorist coverage. Kuehn v. Safeco Insurance Co. of America,
140 Wis. 2d 620,
412 N.W.2d 126 (Ct. App. 1987).
631.43 Annotation
If a single insurance contract incorporates coverage for two vehicles, charging two separate premiums, two policies have been issued under s. 631.43. Krause v. Mass. Bay Insurance Co.
161 Wis. 2d 711,
468 N.W.2d 755 (Ct. App. 1991).
631.43 Annotation
A fleet policy listing individual vehicles and assessing separate premiums for each is a separate policy for each vehicle and a single limit provision contained in the policy violates sub. (1). Carrington v. St. Paul Fire & Marine Insurance
169 Wis. 2d 211,
485 N.W.2d 267 (1992).
631.43 Annotation
Carrington is extended to underinsured motorist coverage. An insured who pays separate premiums for each vehicle under a single policy can stack underinsured motorist coverage even though the policy contains a limit of liability clause. West Bend Mutual Insurance Co. v. Playman,
171 Wis. 2d 37,
489 N.W.2d 915 (1992).
631.43 Annotation
Although a policy's limit of liability language has been held invalid under s. 631.43 for the purpose of preventing stacking, it is still valid for determining each policy's limit of liability. Schaefer v. General Cas. Co.
175 Wis. 2d 80,
498 N.W.2d 859 (Ct. App. 1993).
631.43 Annotation
The lack of underinsured motorist coverage on an accident vehicle was irrelevant when the insured had the coverage on two other vehicles. Under sub. (1), a policy definition amounting to a "drive-other-car" exclusion is invalid. Rodey v. Stoner,
180 Wis. 2d 309,
509 N.W.2d 316 (Ct. App. 1993), Patraw v. American Family Mut. Ins. Co.
185 Wis. 2d 757,
519 N.W.2d 643 (Ct. App. 1994).
631.43 Annotation
Liability coverages insuring against the risk of loss arising out of specified, owned vehicles do not insure against the same loss and thus sub. (1) does not apply to those coverages. Weismer v. Country Mutual Insurance Co.
211 Wis. 2d 845,
565 N.W.2d 595 (Ct. App. 1997).
631.43 Annotation
The applicability of sub. (1) cannot be ascertained by resorting to historical definitions of indemnity and liability insurance. An analysis must be made of whether a particular policy promises to indemnify the insured against the same loss as another policy. Taylor v. Greatway Insurance Co. 2000 WI App 64,
233 Wis. 2d 703,
608 N.W.2d 722.
631.43 Annotation
Sub. (1) did not invalidate a provision excluding coverage for a vehicle not owned by the driver but made regularly available to him, when the owner's policy insured against losses arising from the use of the vehicle. The policies did not insure against the "same loss" within the meaning of sub. (1). Martin v. American Family Mutual Insurance Co. 2002 WI 40,
252 Wis. 2d 103,
643 N.W.2d 452.
631.43 Annotation
Stacking uninsured motorist coverage. Hannula, WBB Oct. 1985.
631.45
631.45
Limitations on loss to be borne by insurer. 631.45(1)(1)
General. An insurance policy indemnifying an insured against loss may by clear language limit the part of the loss to be borne by the insurer to a specified or determinable maximum amount, to loss in excess of a specified or determinable amount, to a specified percentage of the loss, which may vary with the amount of the loss, or by a combination of these methods. If the policy covers various risks, different limitations may be provided separately for each risk if the policy clearly so states.
631.45(2)
(2) Property coinsurance. A policy indemnifying an insured against loss of or damage to property may limit the part of the loss to be borne by the insurer to a percentage of the total loss that corresponds to the ratio of the insured sum to a specified percentage of the value of the insured property.
631.45 History
History: 1975 c. 375.
631.45 Annotation
Public policy does not prohibit insurance coverage for statutorily imposed multiple damages. Cieslewicz v. Mutual Service Casualty Insurance Co.
84 Wis. 2d 91,
267 N.W.2d 595 (1978).
631.45 Annotation
Under the facts of the case, the insurer's tender of the policy limits into court did not relieve the insurer of its duty to defend the insured in the lawsuit. Gross v. Lloyds of London Insurance Co.
121 Wis. 2d 78,
358 N.W.2d 266 (1984).
631.45 Annotation
Although a policy's limit of liability language has been held invalid under s. 631.43 for the purpose of preventing stacking, it is still valid for determining each policy's limit of liability. Schaefer v. General Cas. Co.
175 Wis. 2d 80,
498 N.W.2d 859 (Ct. App. 1993).
631.48
631.48
Nonwaiver clause. An insurer may insert in any insurance policy a provision that no change in the policy is valid unless approved by an executive officer of the insurer, or unless the approval is endorsed on the policy or attached to it, or both, and that no agent has authority to change the policy or waive any of its provisions. This does not preclude a person claiming a right under the policy from relying on waiver or estoppel in an appropriate case.
631.48 History
History: 1975 c. 375.
631.51
631.51
Dividends on policies. 631.51(1)
(1)
Life insurance and annuities. Section 632.62 applies to life insurance and annuities.
631.51(2)
(2) Insurance, other than life insurance and annuities. Any insurer may distribute a portion of surplus attributable to policies other than life insurance or annuities, in amounts and with classifications the board of directors determines to be fair and reasonable. Such distribution may not be made contingent on the continuation of the policy or of premium payments except under
s. 632.75 (2). A schedule explaining the basis for the distribution shall be filed with the commissioner prior to the distribution.
631.51(3)
(3) When not specified in policy. Any insurer may distribute surplus to any class of policyholders even if those policies do not so provide. A schedule explaining the basis for the distribution shall be filed with the commissioner at least 30 days prior to the distribution.
631.51(4)
(4) Combined dividends. It is permissible to provide an indivisible dividend to classes of policyholders having more than one type of policy, including a combination of life or annuities with other types of insurance.
631.51 History
History: 1975 c. 375.
631.61
631.61
Group and blanket insurance. 631.61(1)(a)(a)
General. Except under
par. (d), an insurer issuing a group insurance policy other than blanket shall, as soon as practicable after the coverage is effective, provide a certificate for each member of the insured group, except that only one certificate need be provided for the members of a family unit. The certificate shall contain a summary of the essential features of the insurance coverage, including any rights of conversion to an individual policy. Upon receiving a written request therefor, the insurer shall also inform any insured how the insured may inspect a copy of the policy during normal business hours at a place reasonably convenient to the insured.
631.61(1)(b)
(b)
Blanket insurance. The commissioner may by rule impose a similar requirement for any class of blanket insurance policies for which the commissioner finds that the group of persons covered is constant enough for such action to be practicable and not unreasonably expensive.
631.61(1)(c)
(c)
Method of providing certificates. The certificate shall be provided in a manner reasonably calculated to bring it to the attention of the certificate holder. The insurer may deliver or mail it directly to the certificate holder or may deliver or mail the certificates in bulk to the policyholder to transmit to certificate holders, unless the insurer has reason to believe that the policyholder will not promptly transmit the certificates. An affidavit by the insurer that it has mailed the certificates in the usual course of business creates a rebuttable presumption that it has done so.
631.61(1)(d)
(d)
Substitutes. The commissioner may by rule or order prescribe substitutes for delivery or mailing of certificates, including booklets describing the coverage, the posting of notices in the place of business, or publication in a house organ, if the substitutes are reasonably calculated to inform certificate holders of their rights.
631.61(2)
(2) Effect of failure to issue certificates. Unless a certificate or an authorized substitute has been made available to the certificate holder as required by this section, no act or omission by the certificate holder after the coverage has become effective as to the certificate holder, other than intentionally causing the loss insured against, affects the insurer's obligations under the insurance contract.
631.61 History
History: 1975 c. 375,
421.
631.64
631.64
Corporate name. Every insurance policy or annuity contract shall conspicuously display the name of the insurer on its first page.
631.64 History
History: 1975 c. 375.
631.65
631.65
Assessable policies. Every assessable policy shall conspicuously display on the first page, separately from any other provision and in type at least as large as any used in the body of the policy, the words "This policy is assessable".
631.65 History
History: 1975 c. 375;
1981 c. 218.
631.69
631.69
Insurance written in connection with finance plans. Any insurance contract written in connection with a finance plan or other credit transaction shall contain provisions to protect the insured from overreaching by the insurer or by the creditor in connection with the insurance, including a provision that a copy of the complete policy or a certificate containing all of the essential terms be furnished to the debtor and that there shall be an appropriate surrender value or refund of unearned premium to the debtor calculated on a basis approved by the commissioner if the debt is paid or if the insurance contract is rewritten because the original finance plan or credit transaction is altered or a new plan or transaction is entered into with the same or an affiliated lender. This section is satisfied by compliance with the terms of
ch. 424, if they are applicable.
631.69 History
History: 1975 c. 375.
631.81
631.81
Notice and proof of loss. 631.81(1)
(1)
Timeliness of notice. Provided notice or proof of loss is furnished as soon as reasonably possible and within one year after the time it was required by the policy, failure to furnish such notice or proof within the time required by the policy does not invalidate or reduce a claim unless the insurer is prejudiced thereby and it was reasonably possible to meet the time limit.
631.81(2)
(2) Method of giving notice. It is a sufficient service of notice or proof of loss if a 1st class postage prepaid envelope addressed to the insurer and containing the proper notice or proof is deposited in any U.S. post office within the time prescribed. The commissioner may expressly approve clauses requiring more expeditious methods of notice where that is reasonable.
631.81(3)
(3) Meaning of insurer's acts. The acknowledgment by the insurer of the receipt of notice, the furnishing of forms for filing proofs of loss, the acceptance of such proofs, or the investigation of any claim are not alone sufficient to waive any of the rights of the insurer in defense of any claim arising under the insurance contract.
631.81 History
History: 1975 c. 375.
631.81 Annotation
An insured's contradictory statements constituted a breach of the contractual duties of notice and cooperation. Dietz v. Hardware Dealers Mutual Fire Insurance Co.
88 Wis. 2d 496,
276 N.W.2d 808 (1979).
631.81 Annotation
When the insured fails to give notice within one year after the time required in the policy, there is a rebuttable presumption of prejudice, and the burden of proof shifts to the claimant to prove that the insurer was not prejudiced. Neff v. Pierzina, 2001 WI 95,
245 Wis. 2d 285,
629 N.W.2d 177.
