Disclosure of group health claims experience.
Restrictions on medical payments insurance.
Minimum standards for certain disability policies.
Renewability of long-term care insurance policies.
Midterm termination of long-term care insurance policy by insured.
Internal grievance procedure.
Independent review of coverage denial determinations.
Benefit appeals under certain policies.
Prohibiting refusal to cover services because liability policy may cover.
Coverage without prior authorization for treatment of an emergency medical condition.
Coverage of drugs and devices.
Requirements if experimental treatment limited.
Explanation required for restriction or termination of coverage.
Restrictions on pharmaceutical services.
Pharmacy benefit managers.
Step therapy protocols.
Oral and injected chemotherapy.
Restrictions on health care services.
Restrictions relating to fees for dental services.
Independent evaluations relating to chiropractic treatment.
Policy extension for handicapped children.
Coverage of dependents.
Coverage of mental disorders, alcoholism, and other diseases.
Mandatory coverage of adopted children.
Hospital and medical coverage for persons insured under individual and group policies.
Prohibiting abortion coverage.
Medical savings accounts study.
The fraternal contract.
Fraud in obtaining membership.
Beneficiaries in fraternal contracts.
Application of proceeds of credit insurance policy.
Portable electronics insurance.
Limited lines travel insurance.
Worker's compensation insurance.
Certifications of disability.
Ch. 632 Cross-reference
See definitions in ss. 600.03
Ch. 632 Cross-reference
See also ch. Ins 3
, Wis. adm. code.
Ch. 632 Note
NOTE: Chapter 375, laws of 1975
, which created subchapters I to VIII of Chapter 632, contains explanatory notes.
FIRE AND OTHER PROPERTY INSURANCE
Indemnity amounts. 632.05(1)(1)
Replacement cost of coverage.
An insurer may agree in a property insurance policy to indemnify the insured for the amount it would cost to repair, rebuild or replace the damaged or destroyed insured property with new materials of like size, kind and quality.
(2) Total loss.
Whenever any policy insures real property that is owned and occupied by the insured primarily as a dwelling and the property is wholly destroyed, without criminal fault on the part of the insured or the insured's assigns, the amount of the loss shall be taken conclusively to be the policy limits of the policy insuring the property.
See also ch. Ins 4
, Wis. adm. code.
Arson by one spouse did not bar the other from recovering fire insurance proceeds under a jointly owned policy that insured jointly owned property. Hedtcke v. Sentry Ins. Co. 109 Wis. 2d 461
, 326 N.W.2d 727
An administrative rule interpretation of sub. (2) that denies benefits solely on the basis of a past rental of the property would be unreasonable. Kohnen v. Wisconsin Mut. Ins. Co. 111 Wis. 2d 584
, 331 N.W.2d 598
(Ct. App. 1983).
To have “occupied" a dwelling under sub. (2) requires actual and physical control. An inanimate entity such as an estate is incapable of occupying a dwelling under sub. (2). Drangstviet v. Auto-Owners Insurance Co. 195 Wis. 2d 592
, 536 N.W.2d 189
(Ct. App. 1995), 95-0053
Sub. (2), the valued policy law, does not provide that an insured is entitled to the limits of all policies insuring a dwelling. Instead, s. 631.43 (1), the pro rata statute, specifically governs situations when two or more policies indemnify against the same loss. Absent the consent of the insurers, insureds are entitled to the full amount of their loss but not to the full amount of both policies if the combined limits exceed the actual loss. Wegner v. West Bend Mutual Insurance Company, 2007 WI App 18
, 298 Wis. 2d 420
, 728 N.W.2d 30
Sub. (2) does not exclude real property that is owned and occupied by the insured primarily as a dwelling solely because it is not the insured's primary residence, but to be covered under the statute the property must be “occupied by the insured primarily as a dwelling." Use is the core meaning of occupy in the context of this statute. The building must be used by the insured primarily as a residence. When the primary use of a building for at least 14 months before a fire had been renting it to others, sub. (2) did not apply. Cambier v. Integrity Mutual Insurance Company, 2007 WI App 200
, 305 Wis. 2d 337
, 738 N.W.2d 181
Sub. (2) requires the insured building be “occupied by the insured primarily as a dwelling." The insured's use must bear a relationship to actually living in the dwelling. The fact that the building was being renovated and refurbished does not affect its status as a dwelling. Whether or not a person ever slept in a house is not dispositive of whether he or she occupied it. A dwelling does not cease to be occupied as a dwelling if the people living there temporarily vacate the dwelling for renovations or if a purchaser engages in renovations before moving in. Johnson v. Mt. Morris Mutual Insurance Company, 2012 WI App 3
, 338 Wis. 2d 327
, 809 N.W.2d 53
Administrative rules provide that real property owned and occupied by the insured that is partially destroyed but ordered razed under a fire ordinance or similar law shall be considered wholly destroyed for purposes of sub. (2). The test is not whether the property has been physically destroyed. Haynes v. American Family Mutual Insurance Company, 2014 WI App 128
, 359 Wis. 2d 87
, 857 N.W.2d 478
Prohibiting requiring property insurance in excess of replacement value.
A lender may not require a borrower, as a condition of receiving or maintaining a loan secured by real property, to insure the property against risks to improvements on the real property in an amount that exceeds the replacement value or market value of the improvements, whichever is greater.
History: 2007 a. 170
A provision for payment to a mortgagee or other owner of a security interest in property may be contained in or added by endorsement to any insurance policy protecting against loss or destruction of or damage to property. If the insurance covers real property, any loss not exceeding $500 shall be paid to the insured mortgagor despite the provision, unless the mortgagee is a named insured.
History: 1975 c. 375
; 1979 c. 102
Choice of law.
Every insurance against loss or destruction of or damage to property in this state or in the use of or income from property in this state is governed by the law of this state.
History: 1975 c. 375
“Building and safety standards" means the requirements of chs. 101
and of any rule promulgated by the department of safety and professional services under ch. 101
, and standards of a 1st class city relating to the health and safety of occupants of buildings.
“Deliver" means delivery in person, or delivery by deposit with the U.S. postal service of certified or 1st class mail addressed to the recipient at the recipient's last-known address.
“Final settlement" means the amount that an insurer owes under a property insurance policy to the named insured and other interests named in the policy for loss to any insured building or other structure affixed to land that is caused by fire or explosion, excluding any amount payable for loss to contents or other personal property, for loss of use or business interruption and any amount payable under liability coverage under the policy, and that is determined by any of the following means:
Acceptance of a proof of loss by the insurer.
Execution of a release by the named insured.
Acceptance of an arbitration award by the insurer and named insured.
Judgment of a court of competent jurisdiction.
Except as provided in sub. (2)
, every property insurance policy issued or delivered in this state, including property insurance policies issued under the mandatory risk-sharing plan operating under s. 619.01
, that insures real property located in a 1st class city against loss caused by fire or explosion shall provide for payment of any final settlement under the policy in the manner described in ss. 632.102
(2) Excluded policies.
do not apply to property insurance policies issued in any of the following circumstances:
By the local government property insurance fund under ch. 605
On a one- or 2-family dwelling that is occupied by the named insured as a principal residence, if any of the following is satisfied:
The named insured gives proof of occupancy to the insurer by a valid Wisconsin operator's license.
If the named insured does not possess a valid Wisconsin operator's license, the named insured gives proof of occupancy to the 1st class city by documentation approved by the 1st class city. Upon acceptance of the proof, the 1st class city shall immediately notify the insurer that a policy issued on the property is exempt from ss. 632.10
History: 1989 a. 347
; 1991 a. 315
Payment of final settlement. 632.102(1)(1)
An insurer shall withhold from payment a portion of the final settlement as determined under sub. (2)
, if all of the following apply:
The amount of the final settlement exceeds 50 percent of the total of all limits under all insurance policies covering the building and any other structure affixed to land that sustained the loss.
The total amount of all insurance covering the building and any other structure affixed to land that sustained the loss is at least $5,000.
(2) Amount withheld.
The insurer shall withhold from payment of the final settlement an amount that is equal to the greater of the following: