05 LC 28
2243
House
Bill 683
By:
Representatives Oliver of the
83rd,
Knox of the
24th,
Willard of the
49th,
Ehrhart of the
36th,
Forster of the
3rd,
and others
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 33 of the Official Code of Georgia Annotated, relating to insurance,
so as to provide a short title; to comprehensively revise the rate regulatory
system for property and casualty insurance in this state; to provide legislative
findings; to provide definitions; to provide for the determination of
competitive and noncompetitive markets; to provide for factors to consider in
making such determinations; to provide for rating standards and methods; to
provide for rate regulation in noncompetitive markets; to provide for the filing
of certain rates and information; to provide for the method of disapproving
certain rates; to provide for certain regulation for policies for large
commercial policyholders; to provide for the operation and control of advisory
organizations; to provide for permitted and prohibited activities of advisory
organizations; to authorize the exchange of certain information; to provide for
the keeping of certain records and the making of certain reports; to provide for
joint underwriting, pool, and residual market activities; to provide for
assigned risks; to provide for certain examinations; to provide for certain
exemptions; to provide for penalties; to provide for notice and hearing and
judicial review; to correct certain citations; to provide for related matters;
to amend Title 34 of the Official Code of Georgia Annotated, relating to labor
and industrial relations, so as to correct a reference; to repeal conflicting
laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
This
Act shall be known and may be cited as the "Property/Casualty Insurance
Modernization Act."
SECTION
2.
Title
33 of the Official Code of Georgia Annotated, relating to insurance, is amended
by striking Chapter 9, relating to regulation of rates, underwriting rules, and
related organizations, and inserting in lieu thereof a new Chapter 9 to read as
follows:
"CHAPTER
9
ARTICLE 1
ARTICLE 1
33-9-1.
(a)
The purpose of this chapter is to promote the public welfare by regulating
insurance rates as provided in this chapter to the end that they shall not be
excessive, inadequate, or unfairly discriminatory; to authorize the existence
and operation of qualified rating organizations and advisory organizations and
require that specified rating services of such rating organizations be generally
available to all admitted insurers; and to authorize cooperation between
insurers in rate making and other related matters.
(b)
It is the express intent of this chapter to permit and encourage competition
between insurers on a sound financial basis to the fullest extent possible.
However, nothing in this chapter is intended or should be construed to restrict
the Commissioner in any way, on his own motion or otherwise, to take any
affirmative action by rule, regulation, or administrative determination in a
particular case, cases, or class of cases which he may deem necessary to protect
the
publićs
interest in maintaining the standards prescribed in Code Section 33-9-4; and
Code Sections 33-9-26 through 33-9-29 in particular shall in no way be viewed as
exhaustive or restrictive of the powers or procedures available to the
Commissioner for this purpose
The General
Assembly finds and declares that a modernized and competitive procedure be
employed:
(1) To promote price competition among insurers;
(1) To promote price competition among insurers;
(2)
To protect policyholders and the public against adverse effects of excessive,
inadequate, or unfairly discriminatory rates;
(3)
To prohibit unlawful price fixing agreements by or among insurers;
(4)
To authorize essential cooperative activities among insurers in the rate-making
process and to regulate such activities to prohibit practices that tend to
substantially lessen competition or create monopolies; and
(5)
To provide necessary regulatory authority in the absence of a competitive
marketplace.
33-9-2.
As
used in this chapter, the term:
(1)
'Advisory organization' means
every
any
person
other than
an admitted insurer, whether located within or outside this state, who prepares
policy forms or makes underwriting rules incident to but not including the
making of rates, rating plans, or rating systems, or who collects and furnishes
to admitted insurers or rating organizations loss or expense statistics or other
statistical information and data and acts in an advisory, as distinguished from
a rate-making, capacity. No duly authorized attorney at law acting in the usual
course of his profession shall be deemed to be an advisory
organization
which has five
unrelated members and which assists insurers as authorized by Code Section
33-9-10. It does not include joint underwriting organizations, actuarial or
legal consultants, a single insurer, any employees of an insurer, or insurers
under common control or management of their employees or
managers.
(2)
'Member'
means an insurer who participates in or is entitled to participate in the
management of a rating, advisory, or other
organization
'Classification
system' or 'classification' means the process of grouping risks with similar
risk characteristics so that differences in costs may be
recognized.
(3)
'Rating
organization' means every person other than an admitted insurer, whether located
within or outside this state, who has as his object or purpose the making of
rates, rating plans, or rating systems. Two or more admitted insurers who act
in concert for the purpose of making rates, rating plans, or rating systems and
who do not operate within the specific authorizations contained in Code Sections
33-9-6, 33-9-7, 33-9-11, 33-9-20, and 33-9-22 shall be deemed to be a rating
organization. No single insurer shall be deemed to be a rating
organization
'Commercial
risk' means any kind of risk which is not a personal
risk.
(4)
'Subscriber'
means an insurer which is furnished at its request with rates and rating manuals
by a rating organization of which it is not a member, or with advisory services
by an advisory organization of which it is not a
member
'Commissioner'
means the Commissioner of
Insurance.
(5)
'Competitive market' means any market except those which have been found to be
noncompetitive pursuant to Code Section 33-9-4.
(6)
'Developed losses' means losses, including loss adjustment expenses, adjusted,
using standard actuarial techniques, to eliminate the effect of differences
between current payment or reserve estimates and those which are anticipated to
provide actual ultimate loss, including loss adjustment expense,
payments.
(7)
'Excessive' means a rate that is likely to produce a long-term profit that is
unreasonably high for the insurance provided. No rate in a competitive market
shall be considered excessive.
(8)
'Expenses' means that portion of a rate attributable to acquisition, field
supervision, collection expenses, general expenses, taxes, licenses, and
fees.
(9)
'Experience rating' means a rating procedure utilizing past insurance experience
of the individual policyholder to forecast future losses by measuring the
policyholder!s
loss experience against the loss experience of policyholders in the same
classification to produce a prospective premium credit, debit, or unity
modification.
(10)
'Inadequate' means a rate which is unreasonably low for the insurance provided
and the continued use of which endangers the solvency of the insurers using it
or will have the effect of substantially lessening competition or creating a
monopoly in any market.
(11)
'Joint underwriting' means an arrangement established to provide insurance
coverage for a risk pursuant to which two or more insurers contract with the
insured for a price and policy terms agreed upon between or among the
insurers.
(12)
'Large commercial policyholder' means a commercial policyholder with the size,
sophistication, and insurance-buying expertise to negotiate with insurers in a
largely unregulated environment as determined by rule and regulation of the
Commissioner based upon two or more of the following factors: aggregate premium
on commercial policies held by the insured, including
workers!
compensation; number of employees; annual net revenues or sales; net worth;
annual budgeted expenditures for not for profit organizations or a public body
or agencies; or population for municipalities.
(13)
'Loss adjustment expense' means the expenses incurred by the insurer in the
course of settling claims.
(14)
'Market' means the interaction between buyers and sellers consisting of a
product market component and a geographic component. A product market component
consists of identical or readily substitutable products including, but not
limited to, consideration of coverage, policy terms, rate classifications, and
underwriting. A geographic market component is a geographical area in which
buyers have a reasonable degree of access to insurance sales outlets.
Determination of a geographic market component shall consider existing market
patterns.
(15)
'Noncompetitive market' means a market which is subject to a ruling pursuant to
Code Section 33-9-4 that a reasonable degree of competition does not exist. For
the purposes of this chapter, residual markets and pools are noncompetitive
markets.
(16)
'Personal risk' means homeowners, tenants, nonfleet private passenger
automobiles, mobile homes, and other property and casualty insurance for
personal, family, or household needs. This includes any property and casualty
insurance that is otherwise intended for noncommercial coverage.
(17)
'Pool' means an arrangement pursuant to which two or more insurers participate
in the sharing of risks on a predetermined basis. A pool may operate as an
association, syndicate, or in any other generally recognized
manner.
(18)
'Prospective loss cost' means that portion of a rate that does not include
provisions for expenses, other than loss adjustment expenses, or profit and is
based on historical aggregate losses and loss adjustment expenses adjusted
through development to their ultimate value and projected through trending to a
future point in time.
(19)
'Rate' means that cost of insurance per exposure unit whether expressed as a
single number or as a prospective loss cost with an adjustment to account for
the treatment of expenses, profit, and individual insurer variation in loss
experience, prior to any application of individual risk variations based on loss
or expense considerations, and does not include minimum premiums.
(20)
'Residual market mechanism' means an arrangement, either voluntary or mandated
by law, involving participation by insurers in the equitable apportionment of
risks among insurers for insurance which may be afforded applicants who are
unable to obtain insurance through ordinary methods.
(21)
'Special assessments' means guaranty fund assessments, special indemnity fund
assessments, vocational rehabilitation fund assessments, and other similar
assessments. Special assessments shall not be considered as either expenses or
losses.
(22)
'Supplementary rate information' means any manual or plan of rates,
classification, rating schedule, minimum premium, policy fee, rating rule, and
any other similar information needed to determine an applicable rate in effect
or to be in effect.
(23)
'Supporting information' means the experience and judgment of the filer and the
experience or data of other insurers or organizations relied upon by the filer,
the interpretation of any statistical data relied upon by the filer, a
description of methods used in making the rates, and other similar information
relied upon by the filer.
(24)
'Trending' means any procedure for projecting losses to the average date of
loss, or premiums or exposures to the average date of writing, for the period
during which the policies are to be effective.
(25)
'Unfairly discriminatory' means rates that cannot be actuarially justified. It
does not refer to rates that produce differences in premiums for policyholders
with like loss exposures but different expenses, or like expenses but different
loss exposures, so long as the rate reflects such differences with reasonable
accuracy. A rate is not unfairly discriminatory if it averages broadly among
persons insured under a group, franchise, or blanket policy, or a mass marketing
plan. No rate in a competitive market shall be considered unfairly
discriminatory unless it violates the provisions of subsection (b) of Code
Section 33-9-5 in that they classify, or are based, in whole or in part on the
basis of race, color, creed, or national origin.
33-9-3.
(a)
This chapter shall apply to all
kinds
of insurance
written
on risks or on operations
by any insurer
authorized to do business in this state,
except:
(1)
Reinsurance
other than
joint reinsurance to the extent stated in Code Section
33-9-19;
(2)
Life insurance;
(3)
Disability
income, specified disease, or hospital indemnity
policies
Accident and
sickness insurance;
(4)
Insurance of vessels or craft, their cargoes, marine
builderś
risks, marine protection and indemnity, or other risks commonly insured under
marine, as distinguished from transportation, insurance policies. Inland marine
insurance shall be deemed to include insurance defined by statute, or by
interpretation thereof or, if not so defined or interpreted, by ruling of the
Commissioner or as established by general custom of the business, as inland
marine insurance;
(5)
Insurance against loss of or damage to aircraft, insurance of hulls of aircraft,
including their accessories and equipment, or insurance against liability
arising out of the ownership, maintenance, or use of aircraft;
(6)
Title insurance; or
(7)
Annuities.
(a.1)
The Commissioner may by rule or regulation establish criteria by which defined
commercial risks may be exempted from the filing requirements of this
chapter.
(b)(1)
This chapter shall apply to all insurers, including stock and mutual companies,
Lloyd́s
associations, and reciprocal and interinsurance exchanges, which under any laws
of this state write any of the kinds of insurance to which this chapter
applies.
(2)
The provisions of this chapter regarding rates shall apply to any insurer,
fraternal benefit society, health care plan, nonprofit medical service
corporation, nonprofit hospital service corporation, health maintenance
organization, or preferred provider organization providing any accident or
sickness insurance or health benefit plan issued, delivered, issued for
delivery, or renewed in this state to the extent required by subsection (c) of
this Code section.
(c)
Provisions of this chapter regarding rates shall apply only to a proposed rate
for any insurance or health benefit plan:
(1)
Which alone or in combination with any previous rate change for such insurance
or plan would result in a rate increase of:
(A)
Any amount, but no decrease shall be subject to such provisions; provided,
however,
(B)
The provisions of this chapter shall not apply to accident and sickness
insurance; or
(2)
Made within 36 months after any rate change described by paragraph (1) of this
subsection.
33-9-4.
(a)
The
following standards shall apply to the making and use of rates pertaining to all
classes of insurance to which this chapter is applicable:
(1)
Rates shall not be excessive or inadequate, as defined in this Code section, nor
shall they be unfairly discriminatory;
(2)
No rate shall be held to be excessive unless such rate is unreasonably high for
the insurance provided and a reasonable degree of competition does not exist in
the area with respect to the classification to which such rate is applicable;
provided, however, with respect to rate filings involving an increase in rates,
no rate for personal private passenger motor vehicle insurance shall be held to
be excessive unless such rate is unreasonably high for the insurance
provided;
(3)
No rate shall be held inadequate unless it is unreasonably low for the insurance
provided and continued use of it would endanger solvency of the insurer, or
unless the use of such rate by the insurer using such rate has, or will, if
continued, tend to destroy competition or create a monopoly;
(4)
Consideration shall be given to the extent applicable to past and prospective
loss experience within and outside this state, to conflagration and catastrophe
hazards, to a reasonable margin for underwriting profit and contingencies, to
past and prospective expenses both country wide and those specially applicable
to this state, to the
insureŕs
average yield from investment income, and to all other factors, including
judgment factors, deemed relevant within and outside this state; and, in the
case of fire insurance rates, consideration may be given to the experience of
the fire insurance business during the most recent five-year
period;
(5)
Consideration may also be given, in the making and use of rates, to dividends,
savings, or unabsorbed premium deposits allowed or returned by insurers to their
policyholders, members, or subscribers;
(6)
The systems of expense provisions included in the rates for use by any insurer
or group of insurers may differ from those of other insurers or groups of
insurers to reflect the operating methods of any such insurer or group with
respect to any kind of insurance or with respect to any subdivision or
combination thereof;
(7)
Risks may be grouped by classifications for the establishment of rates and
minimum premiums. Classification rates may be modified to produce rates for
individual risks in accordance with rating plans which establish standards for
measuring variations in hazards or expense provisions, or both. Such standards
may measure any difference among risks that have a probable effect upon losses
or expenses. Classifications or modifications of classifications of risks may
be established based upon size, expense, management, individual experience,
location or dispersion of hazard, or any other reasonable considerations. Such
classifications and modifications shall apply to all risks under the same or
substantially the same circumstances or conditions; provided, however, the
Commissioner shall establish the maximum amount of any such
modification;
(8)
Nothing contained in this Code section or elsewhere in this chapter shall be
construed to repeal or modify Chapter 6 of this title, relating to unfair trade
practices, and any rate, rating classification, rating plan or schedule, or
variation thereof established in violation of Chapter 6 of this title shall, in
addition to the consequences stated in Chapter 6 of this title or elsewhere, be
deemed violative of this Code section;
(9)
No insurer shall base any standard or rating plan on vehicle insurance, in whole
or in part, directly or indirectly, upon race, creed, or ethnic extraction;
and
(10)
No insurer shall base any standard or rating plan on vehicle insurance, in whole
or in part, directly or indirectly, upon any physical disability of an insured
unless the disability directly impairs the ability of the insured to drive a
motor vehicle
A competitive
market is presumed to exist unless the Commissioner, after notice and hearing,
determines that a reasonable degree of competition does not exist within a
market and issues a ruling to that effect. Such ruling shall expire one year
after issue unless rescinded earlier by the Commissioner or unless the
Commissioner renews the ruling after a hearing and a finding as to the continued
lack of a reasonable degree of competition. The Commissioner shall consider all
relevant structural factors in determining the competitiveness of the market
including the number of insurers actively engaged in providing coverage, market
shares, changes in market shares, and ease of entry.
(b)
The following factors shall be considered by the Commissioner for purposes of
determining if a reasonable degree of competition does not exist in a particular
line of insurance:
(1)
The number of insurers or groups of affiliated insurers actively engaged in
providing coverage;
(2)
Measures of market concentration and changes of market concentration over
time;
(3)
Ease of entry and the existence of financial or economic barriers that could
prevent new firms from entering the market;
(4)
The extent to which any insurer or group of affiliated insurers controls all or
a portion of the market;
(5)
Whether the total number of companies writing the line of insurance in this
state is sufficient to provide multiple options;
(6)
The disparity among insurance rates and classifications to the extent that such
classifications result in rate differentials;
(7)
The availability of insurance coverage to consumers;
(8)
The opportunities available to consumers in the market to acquire pricing and
other consumer information; and
(9)
Other relevant factors
(c)
The Commissioner shall monitor the degree and continued existence of competition
in this state on an ongoing basis. In doing so, the Commissioner may utilize
existing relevant information, analytical systems, and other sources or rely on
some combination thereof. Such activities may be conducted internally within
the Insurance Department, in cooperation with other state insurance departments,
through outside contractors, in any combination thereof, or in any other
appropriate manner.
33-9-5.
(a)
Subject to
and in compliance with this chapter authorizing insurers to be members or
subscribers of rating or advisory organizations or to engage in joint
underwriting or joint reinsurance, two or more insurers may act in concert with
each other and with others with respect to any matters pertaining to the making
of rates or rating systems, the preparation or making of insurance policy or
bond forms, underwriting rules, surveys, inspections and investigations, the
furnishing of loss or expense statistics or other information and data, or
carrying on of research
Rates shall
not be excessive, inadequate, or unfairly discriminatory.
(b)
Risks may be classified in any way except that no risk may be classified in
whole or in part on the basis of race, color, creed, or national
origin.
(c)
In determining whether rates in a noncompetitive market are excessive,
inadequate, or unfairly discriminatory, consideration may be given to the
following elements:
(1)
BASIC
RATE FACTORS.
Due consideration shall be given to past and prospective loss and expense
experience within and outside of this state, to catastrophe hazards and
contingencies, to events or trends within and outside of this state, to
dividends or savings to policyholders, members, or subscribers, and to all other
factors and judgments deemed relevant by the insurer;
(2)
CLASSIFICATION.
Risks may be grouped by classifications for the establishment of rates and
minimum premiums. Classification rates may be modified for individual risks in
accordance with rating plans or schedules which establish standards for
measuring probable variations in hazards or expenses, or both;
(3)
EXPENSES.
The expense provisions shall reflect the operating methods of the insurer and
its own past expense experience and anticipated future expenses;
(4)
CONTINGENCIES
AND PROFITS.
The rates may contain a provision for contingencies and a provision for a
reasonable underwriting profit and may reflect investment income directly
attributable to unearned premium and loss reserves; and
(5)
OTHER
RELEVANT
FACTORS. Any
other factors available at the time of
hearing.
33-9-6.
(a)
With
respect to any matters pertaining to the making of rates or rating systems, the
preparation or making of insurance policy or bond forms, underwriting rules,
surveys, inspections and investigations, the furnishing of loss or expense
statistics or other information and data, or carrying on of research, two or
more admitted insurers having a common ownership or operating in this state
under common management or control are authorized to act in concert between or
among themselves the same as if they constituted a single insurer; and to the
extent that the matters relate to cosurety bonds, two or more admitted insurers
executing the bonds are authorized to act in concert between or among themselves
the same as if they constituted a single
insurer
If the
Commissioner determines that competition does not exist in a market and issues a
ruling to that effect pursuant to Code Section 33-9-4, the rates applicable to
insurance sold in that market shall be regulated in accordance with the
provisions of Code Sections 33-9-5 through 33-9-8 applicable to noncompetitive
markets.
(b)
Any rate filing in effect at the time the Commissioner determines that
competition does not exist pursuant to Code Section 33-9-4 shall be deemed to be
in compliance with the laws of this state unless disapproved pursuant to the
procedures and rating standards contained in Code Sections 33-9-5 through 33-9-8
applicable to noncompetitive markets.
(c)
Any insurer having a rate filing in effect at the time the Commissioner
determines that competition does not exist pursuant to Code Section 33-9-4 may
be required to furnish supporting information within 30 days of a written
request by the Commissioner.
33-9-7.
(a)
Agreements
may be made among admitted insurers with respect to the equitable apportionment
among them of property and casualty insurance which may be afforded applicants
who are in good faith entitled to but who are unable to procure such insurance
through ordinary methods, and with respect to the use of reasonable rate
modifications for such insurance, such agreements to be subject to the approval
of the Commissioner
Filings
in competitive
markets. For
personal lines, every insurer shall file with the Commissioner all rates and
supplementary rate information to be used in this state no later than 30 days
after the effective date; provided, however, that such rates and supplementary
rate information need not be filed for inland marine risks which by general
custom are not written according to manual rules or rating
plans.
(b)
All such
agreements shall be submitted in writing to the Commissioner for his
consideration and approval together with such information as he may reasonably
require. The Commissioner shall approve only such agreements as are found by
him to contemplate the use of rates which meet the standards prescribed by this
chapter and activities and practices that are not unfair, unreasonable, or
otherwise inconsistent with this chapter
Filings
in noncompetitive markets.
(1)
Every insurer shall file with the Commissioner all rates, supplementary rate
information, and supporting information for noncompetitive markets at least 30
days before the proposed effective date. The Commissioner may give written
notice, within 30 days of the receipt of the filing, that the Commissioner needs
additional time, not to exceed 30 days from the date of such notice, to consider
the filing. Upon written application of the insurer, the Commissioner may
authorize rates to be effective before the expiration of the waiting period or
an extension thereof. A filing shall be deemed to meet the requirements of this
chapter and to become effective unless disapproved pursuant to Code Section
33-9-8 by the Commissioner before the expiration of the waiting period or an
extension thereof. Residual market mechanisms or advisory organizations may
file residual market rates.
(2)
The filing shall be deemed in compliance with the filing provisions of this Code
section unless the Commissioner informs the insurer within 10 days after receipt
of the filing as to what supplementary rate information or supporting
information is required to complete the
filing.
(c)
At any time
after such agreements are in effect, the Commissioner may review the practices
and activities of the adherents to such agreements and, if after a hearing upon
not less than ten
dayś
notice to such adherents he finds that any such practice or activity is unfair
or unreasonable or is otherwise inconsistent with this chapter, he may issue a
written order to the parties to any such agreement specifying in what respect
such act or practice is unfair or unreasonable or otherwise inconsistent with
this chapter and requiring the discontinuance of such activity or practice. For
good cause, and after hearing upon not less than ten
dayś
notice to the adherents to such agreement, the Commissioner may revoke approval
of any such agreement
Reference
Filings. An
insurer may file its rates by either filing its final rates or by filing a
multiplier and, if applicable, an expense constant adjustment to be applied to
prospective loss costs that have been filed by an advisory organization on
behalf of the insurer as permitted by Code Section
33-9-10.
(d)
Filings
open to
inspection.
All rates, supplementary rate information, and any supporting information filed
under this chapter shall be open to public inspection once they have been filed.
Copies may be obtained from the Commissioner upon request and upon payment of a
reasonable fee.
(e)
Consent
to rate.
Notwithstanding any other provisions of this Code section, upon written
application of the insured, stating the reason therefor, a rate in excess of or
below that otherwise applicable may be used on any specific risk.
33-9-8.
(a)
Agreements
shall be made among admitted property and casualty insurers with respect to the
equitable apportionment among them of property and casualty insurance which may
be afforded applicants who are in good faith entitled to but who are unable to
procure such insurance through ordinary methods upon the determination by the
Commissioner in writing that an agreement relative to a given kind or kinds of
property and casualty insurance is necessary to protect the health, property,
and welfare of the citizens of Georgia. All of the agreements shall be subject
to the approval of the Commissioner and upon his approval shall have the effect
of rules and regulations promulgated by the
Commissioner
Bases
for
disapproval.
(1)
The Commissioner shall disapprove a rate in a competitive market only if the
Commissioner finds pursuant to subsection (b) of this Code section that the rate
is inadequate or unfairly discriminatory.
(2)
The Commissioner may disapprove a rate for use in a noncompetitive market only
if the Commissioner finds pursuant to subsection (b) of this Code section that
the rate is excessive, inadequate, or unfairly
discriminatory.
(b)
All of the
agreements shall be submitted in writing to the Commissioner for his
consideration and approval within the period of time specified by the
Commissioner in his determination, as provided for in this Code section,
together with such information as he may reasonably require. The approval of
the agreements shall comply with the requirements of the rule-making process as
set forth in Code Section 33-2-9, as now or hereafter amended. The Commissioner
shall approve only such agreements as are found by him to contemplate the use of
rates which meet the standards prescribed by this chapter and activities and
practices that are not unfair, unreasonable, or otherwise inconsistent with this
chapter
Procedures
for disapproval.
(1)
Prior to the expiration of the waiting period or an extension thereof of a
filing made pursuant to subsection (b) of Code Section 33-9-7, the Commissioner
may disapprove by written order rates filed pursuant to subsection (b) of Code
Section 33-9-7 without a hearing. The order shall specify in what respects such
filing fails to meet the requirements of this chapter. Any insurer whose rates
are disapproved under this Code section shall be given a hearing upon written
request made within 30 days of disapproval.
(2)
If, at any time, the Commissioner finds that a rate applicable to insurance sold
in a noncompetitive market does not comply with the standards set forth in Code
Section 33-9-5, the Commissioner may, after a hearing held upon not less than 20
dayś
written notice, issue an order pursuant to subsection (c) of this Code section
disapproving such rate. The hearing notice shall be sent to every insurer and
advisory organization which adopted the rate and shall specify the matters to be
considered at the hearing. The disapproval order shall not affect any contract
or policy made or issued prior to the expiration of the period set forth in such
order. However, a policyholder shall have the privilege to cancel the policy
containing the disapproved rates without penalty, including obtaining return
premium calculated according to company pro rata schedules or waiver of minimum
premium earned stipulations.
(3)
If, at any time, the Commissioner finds that a rate applicable to insurance sold
in a competitive market is inadequate,or unfairly discriminatory, the
Commissioner may issue an order pursuant to subsection (c) of this Code section
disapproving the rate. Such order shall not affect any contract or policy made
or issued prior to the expiration period set forth in such order. However, a
policyholder shall have the privilege to cancel the policy containing the
disapproval rates without penalty, including obtaining return premium calculated
according to company pro rata schedules or waiver of minimum premium earned
stipulations.
(c)
If, as
provided in this Code section, the Commissioner determines that it is necessary
to protect the health, property, and welfare of the citizens of this state, in
addition to all other authority granted in this title, the Commissioner shall
also have and may exercise the following authority:
(1)
The Commissioner may require that any rates contemplated to be used under this
Code section shall be approved by him prior to their use;
(2)
The Commissioner may declare that any policies, contracts, or rates used
pursuant to any agreement or plan established under this Code section shall be
the exclusive policies, contracts, or rates authorized to be used in Georgia for
the kind or kinds of insurance; and he may prohibit the use by any person of
policies, contracts, or rates in this state which are different from those
established in accordance with this Code section; and
(3)
The Commissioner may amend or modify in whole or in part and may adopt any
agreement submitted to him in accordance with this Code section. If no
agreement is submitted within the time prescribed by the Commissioner or if
after a hearing the agreement submitted is unacceptable to the Commissioner, the
Commissioner may on his own motion promulgate and adopt a reasonable plan to
implement this Code section which plan shall become effective on a date not
sooner than ten days as specified by the Commissioner in his
order
Order
of
disapproval.
If the Commissioner disapproves a rate pursuant to subsection (b) of this Code
section, the Commissioner shall issue an order within 30 days of the close of
the hearing specifying in what respects such rate fails to meet the requirements
of this chapter. The order shall state an effective date no sooner than 30
business days after the date of the order when the use of such rate shall be
discontinued. This order shall not affect any policy made before the effective
date of the order. However, a policyholder shall have the privilege to cancel
the policy containing the disapproval rates without penalty, including obtaining
return premium calculated according to company pro rata schedules or waiver of
minimum premium earned
stipulations.
(d)
At any time
after the agreements are in effect the Commissioner may review the practices and
activities of the adherents to such agreements and, if after a hearing upon not
less than ten
dayś
notice to such adherents, he finds that any such practice or activity is unfair
or unreasonable, or is otherwise inconsistent with this chapter, he may issue a
written order to the parties of the agreement specifying in what respect the act
or practice is unfair or unreasonable or otherwise inconsistent with this
chapter and requiring the discontinuance of the activity or practice. For good
cause, and after hearing upon not less than ten
dayś
notice to the adherents thereto, the Commissioner may revoke approval of the
agreement
Appeal
of orders; establishment of
reserves. If
an order of disapproval is appealed pursuant to Code Section 33-9-20, the
insurer may implement the disapproved rate upon notification to the court, in
which case any excess of the disapproved rate over a rate previously in effect
shall be placed in a reserve established by the insurer. The court shall have
control over the disbursement of funds from such reserve. Such funds shall be
distributed as determined by the court in its final order except that de minimus
refunds to policyholders shall not be
required.
(e)
Whenever the Commissioner determines that a lack of competition or a lack of
availability exists in this state in either property or casualty insurance, the
Commissioner is authorized to protect the health, property, and welfare of the
citizens of this state by exercising the following authority:
(1)
The Commissioner shall approve all rates contemplated to be used under this Code
section prior to their use;
(2)
The Commissioner shall approve any policies or contracts used pursuant to any
agreement or plan established under this Code section and such policies or
contracts shall be used exclusively in this state for those kinds of insurance.
The use by any person of any policies or contracts which are different from
those established in accordance with this Code section shall be prohibited;
and
(3)
The Commissioner may by order implement a plan or program to provide the
necessary insurance coverages to the citizens of this state by equitable
apportionment among all property and casualty insurers licensed to transact
those kinds of insurance in this state.
(f)
The powers contained in this Code section are cumulative and shall be in
addition to all other powers of the Commissioner contained elsewhere in this
title or under the laws of this state.
33-9-9.
Members
and subscribers of rating or advisory organizations may use the rating systems,
underwriting rules, or policy or bond form of the organizations and the rates
filed by such organizations for all lines of insurance covered by the provisions
of this chapter, either consistently or intermittently, but, except as provided
in Code Sections 33-9-3, 33-9-7, 33-9-19, and 33-9-20, shall not agree with each
other or rating organizations or others to adhere to such rates, rating systems,
underwriting rules, or policy or bond form. The fact that two or more admitted
insurers, whether or not members or subscribers of a rating or advisory
organization, use, either consistently or intermittently, the rates or rating
systems made or adopted by a rating organization, or the underwriting rules or
policy or bond forms prepared by a rating or advisory organization shall not be
sufficient in itself to support a finding that an agreement so to adhere exists
and may be used only for the purpose of supplementing or explaining any
competent evidence of the existence of the
agreement
(a) A policy
of insurance sold to a large commercial policyholder shall not be subject to the
requirements of this chapter, including, but not limited to, Code Sections
33-9-4 through 33-9-8. The forms and endorsements for any policy sold to a
large commercial policyholder shall not be subject to filing and approval
requirements.
(b)
All policies issued pursuant to the provisions of this Code section shall
contain a conspicuous disclaimer printed in at least ten-point, boldface type
that states that the policy applied for, including the rates, rating plans,
resulting premiums, and the policy forms, is not subject to the rate and form
requirements of this state and other provisions of the insurance law that apply
to other commercial products and may contain significant differences from a
policy that is subject to all provisions of the insurance law. Such notice
shall set forth possible differences in policy conditions, forms, and
endorsements, as compared to a policy that is subject to all of the provisions
of the insurance law. The format and provisions of such notice shall be
prescribed by the Commissioner. The disclosure notice will also include a
policyholdeŕs
acknowledgment statement, to be signed and dated prior to the effective date of
the coverage, and shall remain on file with the insurer.
(c)
In procuring insurance, a large commercial policyholder shall certify on a form
approved by the department that it meets the eligibility requirements set out in
subsection (a) of this Code section and specify the requirements that the
policyholder has met. This certification is to be completed annually and remain
on file with the insurer.
33-9-10.
(a)
Upon
compliance with this chapter as applicable thereto, any rating organization,
advisory organization, and any group, association, or other organization of
admitted insurers which engages in joint underwriting or joint reinsurance
through such organization or by standing agreement among the members thereof may
conduct operations in this state. With respect to insurance risks or operations
in this state, no insurer shall be a member or subscriber of any such
organization, group, or association that has not complied with this
chapter.
License
required. No
advisory organization shall provide any service relating to the rates of any
insurance subject to this chapter, and no insurer shall utilize the services of
such organization for such purposes, unless the organization obtained a license
under this Code section.
(b)
Availability
of services.
No advisory organization shall refuse to supply any services for which it is
licensed in this state to any insurer authorized to do business in this state
and offering to pay the fair and usual compensation for the
services.
(c)
Licensing.
(1)
APPLICATION.
An advisory organization applying for a license shall include with its
application:
(A)
A copy of its constitution, charter, articles of association or incorporation,
bylaws, and any other rules or regulations governing the conduct of its
business;
(B)
A list of its members and subscribers;
(C)
The name and address of one or more residents of this state upon whom notices,
process affecting it, or orders of the Commissioner may be served;
(D)
A statement showing its technical qualifications for acting in the capacity for
which it seeks a license;
(E)
A biography of the ownership and management of the organization;
and
(F)
Any other relevant information and documents that the Commissioner may
require.
(2)
CHANGE
IN
CIRCUMSTANCES.
Every advisory organization which has applied for a license shall promptly
notify the Commissioner of every material change in the facts or in the
documents on which its application was based.
(3)
GRANTING
OF LICENSE. If
the Commissioner finds that the applicant and the natural persons through which
it acts are competent, trustworthy, and technically qualified to provide the
services proposed and that all requirements of law are met, the Commissioner
shall issue a license specifying the authorized activity of the
applicant.
(4)
DURATION.
Licenses issued pursuant to this Code section shall remain in effect until the
licensee withdraws from the state or until the license is suspended or revoked.
The Commissioner may at any time, after a hearing, revoke or suspend the license
of an advisory organization that does not comply with the requirements and
standards of this chapter.
33-9-11.
Cooperation
among rating organizations or among rating organizations and insurers in rate
making or in other matters within the scope of this chapter is authorized. The
Commissioner may review the cooperative activities and practices and, if after a
hearing he finds that the activity or practice is unfair or unreasonable or
otherwise inconsistent with this chapter, he may issue a written order
specifying in what respects the activity or practice is unfair or unreasonable
or otherwise inconsistent with this chapter and requiring the discontinuance of
the activity or practice.
Any advisory
organization, in addition to other activities not prohibited, is authorized on
behalf of its members and subscribers to:
(1)
Develop statistical plans including, but not limited to, territorial and class
definitions;
(2)
Collect statistical data from members, subscribers, or any other
sources;
(3)
Prepare and distribute prospective loss costs which may include provisions for
special assessments and taxes;
(4)
Prepare and distribute factors, calculations, or formulas pertaining to
classification, territory, increased limits, and other variables;
(5)
Prepare and distribute manuals of rating rules and rating schedules that do not
include final rates, expense provisions, profit provisions, or minimum
premiums;
(6)
Distribute information that is required or directed to be filed with the
Commissioner;
(7)
Conduct research and on-site inspections in order to prepare classifications of
public fire defenses and other exposures;
(8)
Consult with public officials regarding public fire protection as it would
affect members, subscribers, and others;
(9)
Conduct research and collect statistics in order to discover, identify, and
classify information relating to causes or prevention of losses;
(10)
Conduct research and collect information relating to the impact of statutory
changes upon prospective loss costs and special assessments;
(11)
Prepare, file, and distribute policy forms and endorsements and consult with
members, subscribers, and others relative to their use and
application;
(12)
Conduct research and on-site inspections for the purpose of providing risk
information relating to individual risks;
(13)
Conduct on-site inspections to determine rating classifications for individual
insureds;
(14)
Collect, compile, and distribute past and current prices of individual insurers
and publish such information, provided such information, is also made available
to the general public for a reasonable price;
(15)
Collect and compile exposure and loss experience for the purpose of individual
risk experience ratings;
(16)
File final rates, at the direction of the Commissioner, for residual market
mechanisms; and
(17)
Furnish any other services, as approved or directed by the Commissioner, related
to those enumerated in this Code section.
33-9-12.
(a)
No rating
organization shall conduct its operations in this state without first filing
with the Commissioner a written application for and securing a license to act as
a rating organization. Any rating organization may make application for and
obtain a license as a rating organization if it shall meet the requirements for
a license set forth in this chapter. Every rating organization shall file with
its application:
(1)
A copy of its constitution; its articles of incorporation, agreement or
association; and of its bylaws, rules, and regulations governing the conduct of
its business, all duly certified by the custodian of the originals of the
constitution, articles of incorporation, agreement or association, bylaws,
rules, and regulations;
(2)
A list of its members and subscribers;
(3)
The name and address of a resident of this state upon whom notices or orders of
the Commissioner or process affecting the rating organization may be served;
and
(4)
A statement of its qualifications as a rating
organization
Except as
specifically permitted under this chapter, no advisory organization shall
compile or distribute recommendations relating to rates that include expenses,
other than loss adjustment expenses, or
profit.
(b)
The fee for
filing an application for license as a rating organization shall be an amount as
provided in Code Section 33-8-1, payable in advance to the
Commissioner
No insurer or
advisory organization shall attempt to monopolize or combine or conspire with
any other person to monopolize an insurance market in this state. No insurers
or advisory organization shall engage in a boycott, on a concerted basis, of an
insurance market.
(c)
Except as otherwise provided in this chapter, no insurer shall agree with any
other insurer or with an advisory organization to adhere to or use any rate,
supplementary rate information, policy, surveys, inspections, or similar
material except as needed to develop statistical plans or facilitate the
reporting of statistics pursuant to this chapter.
(d)
The fact that two or more insurers, whether or not members or subscribers of any
advisory organization, use consistently or intermittently the same rates,
supplementary rate information policy, or bond forms, surveys, inspections, or
similar materials is not sufficient in itself to support a finding that an
illegal agreement exists and may be used only for the purpose of supplementing
or explaining other direct evidence of the existence of any such
agreement.
(e)
Two or more insurers having a common ownership or operating in this state under
common management or control may act in concert between or among themselves with
respect to any matters pertaining to activities authorized in this chapter as if
they constituted a single insurer.
33-9-13.
(a)
To obtain
and retain a license, a rating organization shall provide satisfactory evidence
to the Commissioner that it will:
(1)
Permit any admitted insurer to become a member of or a subscriber to such rating
organization at a reasonable cost and without discrimination, or withdraw
therefrom;
(2)
Neither have nor adopt any rule or exact any agreement the effect of which would
be to require any member or subscriber, as a condition to membership or
subscribership, to adhere to its rates, rating plans, rating systems,
underwriting rules, or policy or bond forms;
(3)
Neither adopt any rule nor exact any agreement the effect of which would be to
prohibit or regulate the payment of dividends, savings, or unabsorbed premium
deposits allowed or returned by insurers to their policyholders, members, or
subscribers;
(4)
Neither practice nor sanction any plan or act of boycott, coercion, or
intimidation;
(5)
Neither enter into nor sanction any contract or act by which any person is
restrained from lawfully engaging in the insurance business;
(6)
Notify the Commissioner promptly of every change in its constitution, its
articles of incorporation, agreement or association, and of its bylaws, rules,
and regulations governing the conduct of its business; its list of members and
subscribers; and the name and address of the resident of this state designated
by it upon whom notices or orders of the Commissioner or process affecting such
organization may be served; and
(7)
Comply with Code Section 33-9-20
Insurers and
advisory organizations shall file with the Commissioner, and the Commissioner
shall review, reasonable rules and plans for recording and reporting of loss and
expense experience. The Commissioner may designate one or more advisory
organizations to assist in gathering such experience and making compilations
thereof. Except as provided in subsection (c) of this Code section, no insurer
shall be required to record or report its experience in a manner inconsistent
with its own rating system.
(b)
The Commissioner and every insurer and advisory organization may exchange
information and experience data with insurance regulatory officials, insurers,
and advisory organizations, in this and other states and may consult with them
with respect to the collection of statistical data and the application of rating
systems.
(c)
Each
workerś
compensation insurer shall adhere to the uniform classification system and
uniform experience rating plan as submitted to the Commissioner by the advisory
organization. An insurer may develop subclassifications of the uniform
classification system, upon which a rate may be made; provided, however, that
such subclassifications must be filed on an informational basis only with the
Commissioner 30 days prior to their use. The Commissioner shall disapprove
subclassifications only if the insurer fails to demonstrate that the data
thereby produced can be reported consistent with the uniform statistical plan
and classification system. Each
workerś
compensation insurer shall report its experience in accordance with the
statistical plans and other reporting requirements in use by the advisory
organization designated by the Commissioner. The advisory organization shall
develop and file rules reasonably related to the recording and reporting of data
pursuant to the uniform statistical plan, uniform experience rating plan, and
the uniform classification system.
33-9-14.
(a)
The
Commissioner shall examine each application for license to act as a rating
organization and the documents filed therewith and may make such further
investigation of the applicant, its affairs, and its proposed plan of business
as he deems desirable
Acting
in concert.
Notwithstanding the provisions of Code Section 33-9-11, insurers participating
in joint underwriting, pools, or residual market mechanisms may act in
cooperation with each other in the making of rates, rating systems,
supplementary rate information, policy or bond forms, underwriting rules,
surveys, inspections, and investigations, the furnishing of loss and expense
statistics or other information, and conducting research. Joint underwriting,
pools, and residual market mechanisms shall not be deemed advisory
organizations.
(b)
The
Commissioner shall issue the license applied for within 60 days of its filing
with him, if from such examination and investigation he is satisfied
that:
Regulation.
(1)
The
business reputation of the applicant and its officers is
good;
If, after
notice and hearing, the Commissioner finds that any activity or practice of an
insurer participating in a joint underwriting or pooling mechanism is unfair or
unreasonable, will tend to substantially lessen competition in any market, or is
otherwise inconsistent with the provisions or purposes of this chapter and all
other applicable statutes, the Commissioner may issue a written order specifying
in what respects such activity or practice is unfair, unreasonable,
anticompetitive, or otherwise inconsistent with the provisions of this chapter
and all other applicable statutes and require the discontinuance of such
activity or practice.
(2)
The
facilities of the applicant are adequate to enable it to furnish the services it
proposes to furnish; and
Every pool
shall file with the Commissioner a copy of its constitution, articles of
incorporation, agreement, or association, bylaws, rules and regulations
governing its activities, its members, the name and address of a resident of
this state upon whom notices, process, and orders of the Commissioner may be
served, and any changes or modifications thereof.
(3)
The
applicant and its proposed plan of operation conform to the requirements of this
chapter.
Any residual
market mechanism, plan, or agreement to implement such a mechanism, and any
changes or amendments thereto, shall be submitted in writing to the Commissioner
for approval, together with such information as may be reasonably required. The
Commissioner shall approve such agreements if they foster:
(A)
The use of rates which meet the standards prescribed by this chapter and all
other applicable statutes; and
(B)
Activities and practices not inconsistent with the provisions of this chapter
and all other applicable statutes.
(4)
The Commissioner may review the operations of all residual market mechanisms to
determine compliance with the provisions of this chapter and all other
applicable statutes. If, after notice and hearing, the Commissioner finds that
such mechanisms are violating the provisions of this chapter or any other
applicable statutes, the Commissioner may issue a written order to the parties
involved specifying in what respects such operations violate the provisions of
this chapter or any other applicable statutes. The Commissioner may further
order the discontinuance or elimination of any such operation.
(c)
Otherwise, but only after hearing upon notice, the Commissioner shall in writing
deny the application and notify the applicant of his decision and his reasons
therefor.
(d)
The Commissioner may grant an application in part only and issue a license to
act as a rating organization for one or more of the classes of insurance or
subdivisions thereof or class of risk or a part or combination thereof as are
specified in the application if the applicant qualifies for only a portion of
the classes applied for.
(e)
Licenses issued pursuant to this Code section shall remain in effect until
revoked as provided in this chapter.
33-9-15.
(a)
Notwithstanding
Code Section 33-9-14, each rating organization possessing a license of
indefinite term pursuant to such Code section shall owe and pay to the
Commissioner an annual fee as provided in Code Section 33-8-1 in advance on
account of such license until its final termination. Such fee shall be for
periods commencing on July 1 of each year and ending on June 30 and shall be due
and payable on March 1 of each year and shall be delinquent on April 1 of each
year
Agreements
shall be made among admitted property and casualty insurers with respect to the
equitable apportionment among them of property and casualty insurance which may
be afforded applicants who are in good faith entitled to but who are unable to
procure such insurance through ordinary methods upon the determination by the
Commissioner in writing that an agreement relative to a given kind or kinds of
property and casualty insurance is necessary to protect the health, property,
and welfare of the citizens of Georgia. All of the agreements shall be subject
to the approval of the Commissioner and upon his or her approval shall have the
effect of rules and regulations promulgated by the
Commissioner.
(b)
All of the agreements shall be submitted in writing to the Commissioner for his
or her consideration and approval within the period of time specified by the
Commissioner in his or her determination, as provided for in this Code section,
together with such information as he or she may reasonably require. The
approval of the agreements shall comply with the requirements of the rule-making
process as set forth in Code Section 33-2-9, as now or hereafter amended. The
Commissioner shall approve only such agreements as are found by him or her to
contemplate the use of rates which meet the standards prescribed by this chapter
and activities and practices that are not unfair, unreasonable, or otherwise
inconsistent with this chapter.
(c)
If, as provided in this Code section, the Commissioner determines that it is
necessary to protect the health, property, and welfare of the citizens of this
state, in addition to all other authority granted in this title, the
Commissioner shall also have and may exercise the following
authority:
(1)
The Commissioner may require that any rates contemplated to be used under this
Code section shall be approved by him or her prior to their use;
(2)
The Commissioner may declare that any policies, contracts, or rates used
pursuant to any agreement or plan established under this Code section shall be
the exclusive policies, contracts, or rates authorized to be used in Georgia for
the kind or kinds of property and casualty insurance; and he or she may prohibit
the use by any person of policies, contracts, or rates in this state which are
different from those established in accordance with this Code section;
and
(3)
The Commissioner may amend or modify in whole or in part and may adopt any
agreement submitted to him or her in accordance with this Code section. If no
agreement is submitted within the time prescribed by the Commissioner or if
after a hearing the agreement submitted is unacceptable to the Commissioner, the
Commissioner may on his or her own motion promulgate and adopt a reasonable plan
to implement this Code section which plan shall become effective on a date not
sooner than ten days after such motion as specified by the Commissioner in his
or her order.
(d)
At any time after the agreements are in effect, the Commissioner may review the
practices and activities of the adherents to such agreements and, if after a
hearing upon not less than ten
dayś
notice to such adherents, he or she finds that any such practice or activity is
unfair or unreasonable, or is otherwise inconsistent with this chapter, he or
she may issue a written order to the parties of the agreement specifying in what
respect the practice or act is unfair or unreasonable or otherwise inconsistent
with this chapter and requiring the discontinuance of the practice or activity.
For good cause, and after hearing upon not less than ten
dayś
notice to the adherents thereto, the Commissioner may revoke approval of the
agreement.
(e)
Whenever the Commissioner determines that a lack of competition or a lack of
availability exists in this state in either property or casualty insurance, the
Commissioner is authorized to protect the health, property, and welfare of the
citizens of this state by exercising the following authority:
(1)
The Commissioner shall approve all rates contemplated to be used under this Code
section prior to their use;
(2)
The Commissioner shall approve any policies or contracts used pursuant to any
agreement or plan established under this Code section, and such policies or
contracts shall be used exclusively in this state for those kinds of insurance.
The use by any person of any policies or contracts which are different from
those established in accordance with this Code section shall be prohibited;
and
(3)
The Commissioner may by order implement a plan or program to provide the
necessary insurance coverages to the citizens of this state by equitable
apportionment among all property and casualty insurers licensed to transact
those kinds of insurance in this state.
(f)
The powers contained in this Code section are cumulative and shall be in
addition to all other powers of the Commissioner contained elsewhere in this
title or under the laws of this state.
33-9-16.
(a)
Subject to
the approval of the Commissioner, licensed rating organizations may make
reasonable rules governing eligibility for
membership
The
Commissioner may examine any insurer, pool, advisory organization, or residual
market mechanism to ascertain compliance with this
chapter.
(b)
Every insurer, pool, advisory organization, and residual market mechanism shall
maintain adequate records from which Commissioner may determine compliance with
the provisions of this chapter. Such records shall contain the experience,
data, statistics, and other information collected or used and shall be available
to the Commissioner for examination or inspection upon reasonable
notice.
(c)
The reasonable cost of an examination made pursuant to this Code section shall
be paid by the examined party upon presentation to it of a detailed account of
such costs.
(d)
The Commissioner may accept the report of an examination made by the insurance
supervisory official of another state in lieu of an examination under this Code
section.
33-9-17.
If
two or more insurers having a common ownership or operating in this state under
common management are admitted for the classes or types of insurance for which a
rating organization is licensed to make rates, the rating organization may
require as a condition to membership or subscribership of one or more that all
the insurers shall become members or
subscribers
The
Commissioner may, after public notice and hearing, exempt any line of insurance
from any or all of the provisions of this chapter for the purpose of relieving
such line of insurance from filing or any otherwise applicable provisions of
this chapter.
33-9-18.
(a)
No advisory organization shall conduct its operations in this state unless and
until it has filed with the Commissioner a copy of its constitution, articles of
incorporation, agreement, or association, and of its bylaws or rules and
regulations governing its activities, all duly certified by the custodian of the
originals of the constitution, articles of incorporation, agreement or
association, and bylaws or rules and regulations; a list of its members and
subscribers; and the name and address of a resident of this state upon whom
notices or orders of the Commissioner or process may be
served
Nothing in
this chapter shall be construed to prohibit or regulate the payment of
dividends, savings, or unabsorbed premium deposits allowed or returned by
insurers to their policyholders, members, or subscribers. A plan for the
payment of dividends, savings, or unabsorbed premium deposits allowed or
returned by insurers to their policyholders, members, or subscribers shall not
be deemed a rating plan or
system.
(b)
Each advisory organization shall notify the Commissioner promptly of every
change in its constitution, its articles of incorporation, agreement, or
association, and of its bylaws or rules and regulations governing the conduct of
its business; its list of members and subscribers; and the name and address of
the resident of this state designated by it upon whom notices or orders of the
Commissioner or process affecting the organization may be served.
(c)
No advisory organization shall engage in any unfair or unreasonable practice
with respect to its activities.
(d)
Each advisory organization shall pay an annual fee as provided in Code Section
33-8-1.
33-9-19.
(a)
Every
group, association, or other organization of insurers which engages in joint
underwriting or joint reinsurance through the group, association, or
organization or by standing agreement among the members of the group,
association, or organization shall file with the Commissioner a copy of its
constitution, its articles of incorporation, agreement, or association, and of
its bylaws or rules and regulations governing its activities, all duly certified
by the custodian of the originals of such constitution, articles of
incorporation, agreement or association, bylaws or rules and regulations; a list
of its members; and the name and address of a resident of this state upon whom
notices or orders of the Commissioner or process may be
served
The
Commissioner may impose, after notice and hearing, a penalty determined in
accordance with Code Section
33-2-24.
(b)
Each group,
association, or other organization shall notify the Commissioner promptly of
every change in its constitution, its articles of incorporation, agreement, or
association, and its bylaws, rules, and regulations governing the conduct of its
business; its list of members; and the name and address of the resident of this
state designated by it upon whom notices or orders of the Commissioner or
process affecting the group, association, or organization may be
served
Technical
violations arising from systems or computer errors of the same type shall be
treated as a single violation. In the event of an overcharge, if the insurer
makes restitution including payment of interest, no penalty shall be
imposed.
(c)
No group,
association, or organization shall engage in any unfair or unreasonable practice
with respect to its activities
The
Commissioner may suspend or revoke the license of any insurer, advisory
organization, or statistical agent which fails to comply with an order of the
Commissioner within the time prescribed by such order or any extension thereof
which the Commissioner may
grant.
(d)
Each joint
underwriting and joint reinsurance organization shall pay an annual fee as
provided in Code Section 33-8-1
The
Commissioner may determine when a suspension of license shall become effective
and the period of such suspension, which the Commissioner may modify or rescind
in any reasonable manner.
(e)
No penalty shall be imposed and no license shall be suspended or revoked except
upon a written order of the Commissioner, stating his or her findings, made
after notice and hearing.
33-9-20.
(a)
Every insurer, rating organization, or advisory organization and every group,
association, or other organization of insurers which engages in joint
underwriting or joint reinsurance shall maintain reasonable records of the type
and kind reasonably adapted to its method of operation, of its experience or the
experience of its members, and of the data, statistics, or information collected
or used by it in connection with the rates, rating plans, rating systems,
underwriting rules, policy or bond forms, surveys, or inspections made or used
by it so that the records will be available at all reasonable times to enable
the Commissioner to determine whether the organization, insurer, group, or
association and, in the case of an insurer or rating organization, every rate,
rating plan, and rating system made or used by it complies with this chapter as
applicable to it. The maintenance of the records in the office of a licensed
rating organization of which an insurer is a member or subscriber will be
sufficient compliance with this Code section for any insurer maintaining
membership or subscribership in the organization to the extent that the insurer
uses the rates, rating plans, rating systems, or underwriting rules of the
organization. Such records shall be maintained in an office within this state
and shall be made available for examination or inspection by the Commissioner at
any time.
(b)
Each insurer shall maintain statistics under statistical plans compatible with
the rating plans used. An insurer shall report its statistics through a
recognized statistical agency or advisory organization. No insurer shall be
required to report its statistics through such agencies or organizations with
respect to any unique or unusual risks or with respect to any risks rated in
accordance with Code Section 33-9-32 or any lines or sublines of insurance for
which such agencies or organizations do not promulgate rates or rating systems.
Moreover, the Commissioner shall withhold from public inspection any proprietary
information of any insurer, agency, or
organization
Any order,
ruling, finding, decision, or other act of the Commissioner made pursuant to
this chapter shall be subject to judicial review in accordance with Chapter 2 of
this title.
33-9-21.
(a)
Every
insurer shall maintain with the Commissioner copies of the rates, rating plans,
rating systems, underwriting rules, and policy or bond forms used by it. The
maintenance of rates, rating plans, rating systems, underwriting rules, and
policy or bond forms with the Commissioner by a licensed rating organization of
which an insurer is a member or subscriber will be sufficient compliance with
this Code section for any insurer maintaining membership or subscriberships in
such organization, to the extent that the insurer uses the rates, rating plans,
rating systems, underwriting rules, and policy or bond forms of such
organization; provided, however, the Commissioner, when he or she deems it
necessary, without compliance with the rule-making procedures of this title or
Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act':
(1)
May require any domestic, foreign, and alien insurer to file the required rates,
rating plans, rating systems, underwriting rules, and policy or bond forms used
independent of any filing made on its behalf or as a member of a licensed rating
organization, as the Commissioner shall deem to be necessary to ensure
compliance with the standards of this chapter and Code Section 34-9-130 and for
the best interests of the citizens of this state;
(2)
Shall require, not later than July 30, 1990, each domestic, foreign, and alien
insurer, writing or authorized to write
workerś
compensation insurance in this state, to file such
insureŕs
own individual rate filing for premium rates to be charged for
workerś
compensation insurance coverage written in this state. Such premium rates shall
be developed and established based upon each individual
insureŕs
experience in the State of Georgia to the extent actuarially credible. The
experience filed shall include the loss ratios, reserves, reserve development
information, expenses including commissions paid and dividends paid, investment
income, pure premium data adjusted for loss development and loss trending,
profits, and all other data and information used by that insurer in formulating
its
workerś
compensation premium rates which are used in this state and any other
information or data required by the Commissioner. In establishing and
maintaining loss reserves, no
workerś
compensation insurer shall be allowed to maintain any excess loss reserve for
any claim or potential claim for more than 90 days after the amount of liability
for such claim or potential claim has been established, whether by final
judgment, by settlement agreement, or otherwise. This limitation on the
maintenance of loss reserves shall be enforced through this Code section, as
well as through Code Section 33-9-23, relating to examination of insurers, Code
Section 34-9-135, relating to required disclosure of costs by
workerś
compensation insurers, and any other appropriate enforcement procedures. The
Commissioner is authorized to accept such rate classifications as are reasonable
and necessary for compliance with this chapter. A rate filing required by this
paragraph shall be updated by the insurer at least once every two years, the
initial two-year period to be calculated from July 30, 1990; and
(3)
As used in paragraph (2) of this subsection, the term 'excess loss reserve'
means any reserve amount in excess of the reserve required by
law
Notice
requirements.
All notices rendered pursuant to the provisions of this chapter shall be in
writing and shall state clearly the nature and purpose of the hearing. All
relevant facts, statutes, and rules shall be specified so that respondent is
fully informed of the scope of the hearing including specific allegations, if
any. If a hearing is required, all notices shall designate a hearing date at
least 14 days from the date of the notice unless such minimum notice period is
waived by the respondent.
(b)
Any
domestic, foreign, or alien insurer that is authorized to write insurance in
this state must file with the Commissioner any rate, rating plan, rating system,
or underwriting rule for all personal private passenger motor vehicle insurance.
No such rate, rating plan, rating system, or underwriting rule will become
effective, nor may any premium be collected by any insurer thereunder, unless
the filing has been received by the Commissioner in his or her office and such
filing has been approved by the Commissioner or a period of 45 days has elapsed
from the date such filing was received by the Commissioner during which time
such filing has not been disapproved by the Commissioner. The Commissioner
shall be authorized to extend such 45 day period by no more than 55 days at his
or her discretion. If a filing is disapproved, notice of such disapproval order
shall be given within 100 days of receipt of filing by the Commissioner,
specifying in what respects such filing fails to meet the requirements of this
chapter. The filer shall be given a hearing upon written request made within 30
days after the issuance of the disapproval order, and such hearing shall
commence within 30 days after such request unless postponed by mutual consent.
Such hearing, once commenced, may be postponed or recessed by the Commissioner
only for weekends, holidays, or after normal working hours or at any time by
mutual consent of all parties to the hearing. The Commissioner may also, at his
or her discretion, recess any hearing for not more than two recess periods of up
to 15 consecutive days each. In connection with any hearing or judicial review
with respect to the approval or disapproval of such rates, the burden of
persuasion shall fall upon the affected insurer or insurers to establish that
the challenged rates are adequate, not excessive, and not unfairly
discriminatory. After such a hearing, the Commissioner must affirm, modify, or
reverse his or her previous action within the time period provided in subsection
(a) of Code Section 33-2-23 relative to orders of the Commissioner. The
requirement of approval or disapproval of a rate filing by the Commissioner
under this subsection shall not prohibit actions by the Commissioner regarding
compliance of such rate filing with the requirements of Code Section 33-9-4
brought after such approval or disapproval
Hearings.
All hearings
pursuant to the provisions of this chapter shall be conducted in accordance with
Chapter 13 of Title 50, the Georgia Administrative Procedures Act, to the extent
such provisions are consistent with the procedural requirements contained in
this chapter.
(c)
When a rate filing of an insurer required under subsection (b) of this Code
section is not accompanied by the information upon which the insurer supports
the filing and the Commissioner does not have sufficient information to
determine whether the filing meets the requirements of this chapter, then the
Commissioner must request in writing, within 20 days of the date he or she
receives the filing, the specifics of such additional information as he or she
requires and the insurer shall be required to furnish such information and in
such event the 45 day period provided for in subsection (b) of this Code section
shall commence as of the date such information is furnished.
(d)
Any domestic, foreign, or alien insurer that is authorized to write insurance in
this state must file with the Commissioner any rate, rating plan, rating system,
or underwriting rule at least 45 days prior to any indicated effective date for
all insurance other than personal private passenger motor vehicle insurance. No
rate, rating plan, rating system, or underwriting rule required to be filed
under this subsection will become effective, nor may any premium be collected by
any insurer thereunder, unless the filing has been received by the Commissioner
in his office not less than 45 days prior to its effective date.
(e)
When a rate filing of an insurer required under subsection (d) of this Code
section results in any overall rate increase of 10 percent or more within any 12
month period, the Commissioner shall order an examination of that insurer to
determine the accuracy of the claim reserves, the applicability of the claim
reserve practices for the loss data used in support of such filing, and any
other component of the rate filing; provided, however, that in the event the
overall increase is less than 25 percent within any 12 month period and the
Commissioner affirmatively determines that he or she has sufficient information
to evaluate such rate increase and that the cost thereof would not be justified,
he or she may waive all or part of such examination. In all other rate filings
required under subsection (d) of this Code section, the Commissioner may order
an examination of that insurer as provided in this subsection. Such examination
shall be conducted in accordance with the provisions of Chapter 2 of this title.
Upon notification by the Commissioner of his or her intent to conduct such
examination, the insurer shall be prohibited from placing the rates so filed in
effect until such examination has been reviewed and certified by the
Commissioner as being complete. Such examination, if conducted by the
Commissioner, shall be reviewed and certified within 90 days of the date such
rate, rating plan, rating system, or underwriting rule is filed; provided,
however, if the Commissioner makes an affirmative finding that the examination
may not be completed within the 90 day period, he or she may extend such time
for one additional 60 day period. Any examination required under this Code
section shall be conducted in accordance with Chapter 2 of this
title.
(f)
Notwithstanding the provisions of subsection (d) of this Code section, in the
event the filing of any rate, rating plan, rating system, or underwriting rule
under subsection (d) of this Code section is not necessary, in the judgment of
the Commissioner, to accomplish the purposes of this chapter as set forth in
Code Section 33-9-1, then the Commissioner may exempt all domestic, foreign, and
alien insurers from being required to file such rate, rating plan, rating
system, or underwriting rule.
(g)
Filings required pursuant to this Code section shall be accompanied by a fee or
fees as provided in Code Section 33-8-1.
33-9-21.1.
In
order to facilitate the handling of form and rate filings of certain types of
miscellaneous casualty insurance which prior to July 1, 1995, has been filed
generally under paragraph (10) of Code Section 33-7-3, the following types of
casualty insurance shall be
