Section 2344. Flexible rate limitations in problem markets  


Latest version.
  • (a) As used in
      this section:
        (1) "Market"  means  a  line,  subline or classification (other than a
      classification delineated by geographic location)  of  property/casualty
      insurance  risks  whose  coverages  are not subject to subsection (b) of
      section two thousand three hundred  five,  section  two  thousand  three
      hundred  twenty-eight,  section three thousand four hundred twenty-five,
      or three thousand four hundred forty-six of this chapter.
        (2) "Rate" means charge per unit of exposure  (whether  such  rate  is
      manually generated or based upon judgment) for a particular market.
        (b)   The   superintendent   shall   by  regulation  establish  annual
      limitations upon rate level increases or decreases which may take effect
      without prior approval with respect to a market. The regulation shall be
      designed to restore and  promote  stability  in  such  markets.  Upon  a
      determination  made  that,  as  to  a  particular market, competition is
      either sufficient to assure that rates will not  be  excessive  or  that
      such  market is conducted in a manner not resulting in inadequate rates,
      not destructive  of  competition  or  detrimental  to  the  solvency  of
      insurers,   the   superintendent  shall  exempt  such  market  from  the
      limitations set forth in such regulation.  The  superintendent,  upon  a
      determination  that  annual  limitations  are  necessary  to restore and
      promote stability in such a market, shall thereafter withdraw or  modify
      such   exemption.   The   superintendent  shall  whenever  he  deems  it
      appropriate hold a hearing, on a record and at which representatives  of
      consumers  and other interested parties may participate, for the purpose
      of determining, on the  basis  of  findings  of  fact  and  conclusions,
      whether  an  exemption  (or  withdrawal  or modification thereof) of any
      market is appropriate. The initial hearing for  such  purpose  shall  be
      held  within  sixty  days of the effective date of this section, and the
      superintendent shall act expeditiously in determining whether to  exempt
      any market.
        (c)  Limitations established or modified pursuant to subsection (b) of
      this section may vary by market and, in establishing or  modifying  such
      limitations, the superintendent may consider such factors as: the extent
      and  nature of competition; size and significance of the coverage; level
      and range of rates and  rate  changes  among  insurers;  investment  and
      underwriting experience of insurers; reinsurance availability; extent of
      consumer  complaints  to the insurance department; extent of denials and
      restrictions of coverage; volume of cancellations  and  nonrenewals;  or
      changing conditions in the economic, judicial and social environment.
        (d)  (1)  Notwithstanding any other provisions of this article, in any
      market  governed  by  such  regulation   and   not   exempted   by   the
      superintendent pursuant to this section, filings that produce rate level
      changes within the limitations specified in such regulation shall become
      effective  without  prior approval pursuant to subsection (a) of section
      two thousand three hundred five of this article; filings  which  produce
      rate  level  changes  beyond such limitations shall not become effective
      until approved by the  superintendent  pursuant  to  subsection  (b)  of
      section  two  thousand  three  hundred five of this article, except that
      filings  shall  be   deemed   approved   unless   disapproved   by   the
      superintendent  within  thirty  days,  which the superintendent may with
      cause extend an additional thirty days and with further cause extend  an
      additional fifteen days.
        (2)  No  insurer  shall  cause  an  expiring policy to be renewed with
      another insurer under common control, as defined by paragraph sixteen of
      subsection (a) of section one hundred seven of this chapter in order  to
      avoid  the limitations established by this section. An insurer may renew
    
      an expiring policy with another insurer under common control based  upon
      underwriting criteria or other valid business reasons.
        (e)  The  superintendent  shall  by  regulation  establish  reasonable
      standards for rating plans (including experience rating plans,  schedule
      rating  plans,  individual  risk  premium modification plans and expense
      reduction plans) designed to modify rates in the development of premiums
      for  individual  risks  insured  in  a  property/casualty  market.  Such
      standards  shall  permit  recognition of expected differences in loss or
      expense characteristics, and shall be designed so that  such  plans  are
      reasonable  and  equitable  in  their  application, and are not unfairly
      discriminatory, violative of public policy or otherwise contrary to  the
      best  interests  of  the  people of this state. Such standards shall not
      prevent the development  of  new  or  innovative  rating  methods  which
      otherwise  comply with this article. Such rating plans shall be filed or
      refiled  by  insurers   in   compliance   with   the   regulation.   The
      superintendent  shall  review  such  plans,  and  may  without a hearing
      disapprove a  plan  that  does  not  comply  with  the  regulation.  The
      regulation  shall  establish  maximum debits and credits that may result
      from the application of a rating plan,  shall  encourage  loss  control,
      safety  programs and other methods of risk management, and shall require
      insurers to maintain documentation  of  the  basis  for  the  debits  or
      credits applied under any plan. Once it has been filed and approved, use
      of the rating plan shall become mandatory and such plan shall be applied
      uniformly   for  eligible  risks  in  a  manner  that  is  not  unfairly
      discriminatory.
        (f) The superintendent shall  review  all  rates  filed  between  June
      first,  nineteen  hundred  eighty-six,  and  the  effective  date of the
      regulation promulgated pursuant to subsection (b) of this  section,  and
      shall,  on  a  selective  basis,  review rates established prior to June
      first, nineteen hundred eighty-six, including rates not manually  rated,
      to   determine   whether  they  comply  with  the  applicable  standards
      prescribed by this  article  for  purposes  of  the  annual  limitations
      established  or  modified pursuant to subsection (b) of this section. In
      establishing priorities for such selective  review,  the  superintendent
      shall  give  consideration  to  markets  which  have been subject to the
      largest rate changes in the twelve month period  prior  to  June  first,
      nineteen hundred eighty-six and to markets affecting the greatest number
      of  risks;  the  superintendent  shall  to the extent material also give
      consideration to the criteria  set  forth  in  subsection  (c)  of  this
      section.  In  addition,  the  superintendent shall to the fullest extent
      possible  review  markets  not  manually  rated,  for  the  purpose   of
      determining  whether  a  manual  rate  is  appropriate and shall, upon a
      determination  of  appropriateness,  require  that  a  manual  rate   be
      developed  for  such  market.  If the superintendent determines that the
      reviewed rate pursuant to the mandatory or selective review specified by
      this subsection does not comply with the applicable standards prescribed
      by this article, the insurer shall be  afforded  an  opportunity  to  be
      heard  and  shall file in accordance with such determination prospective
      rates applicable to  new  and  renewal  policies.    Except  as  to  the
      procedures  set  forth  in  this  subsection,  nothing contained in this
      subsection shall be  construed  to  alter,  limit,  modify,  enlarge  or
      abrogate  any  right  of  any  insurer  or any power or authority of the
      superintendent under any other provision of this chapter.
        (g) (1) Within ninety days after the effective date  of  this  section
      every insurer licensed to write property/casualty coverages in regard to
      a  market  not  exempted  pursuant to subsection (b) of this section and
      affected by the statutory provisions specified in this  paragraph  shall
      file  with the superintendent rates, for each such market written by the
    
      insurer, appropriately modified to reflect  the  likely  reductive  cost
      effects   reasonably   attributable   to  any  newly  enacted  statutory
      provisions of the civil practice law and rules, court of claims act  and
      not-for-profit  corporation  law.  Such filings shall contain a specific
      explanation of the reductive cost effects (which shall also be expressed
      in amounts or percentages) ascribed to such statutory provisions,  in  a
      form prescribed by the superintendent. In regard to a market not subject
      to this section or exempted pursuant to this section, subsequent filings
      shall  reflect  likely reductive cost effects reasonably attributable to
      such statutory provisions appropriate to such market.
        (2)  The  superintendent  shall  determine  whether  the  rates  filed
      pursuant  to  paragraph  one  of  this subsection reasonably reflect the
      likely reductive cost effects attributable to the  statutory  provisions
      specified in paragraph one of this subsection.
        (3)  In  the  event that the superintendent determines that the likely
      reductive cost effects are not properly reflected  in  such  rates,  the
      basis  for  such  determination  shall be stated and, within thirty days
      after receipt of such determination, the affected insurer may request  a
      hearing.  All policies written or renewed on or after the effective date
      of  the  statutory  provisions  specified  in  paragraph  one  of   this
      subsection  shall  be  subject to appropriate premium adjustments in the
      event the superintendent's determination is sustained, and  the  insurer
      shall maintain its records in regard to each such policy for a period of
      no  less  than six years in order to verify that appropriate adjustments
      have been made.
        (4) For purposes of the annual  limitations  established  pursuant  to
      subsection   (b)   of   this   section,  the  rates  determined  by  the
      superintendent to reasonably reflect the likely reductive  cost  effects
      of the provisions specified in paragraph one of this subsection shall be
      treated  as if they had been in effect for the twelve month period prior
      to the date of such determination.
        (h) This section shall cease to be of any force or effect  during  the
      period  August  third,  two  thousand  one  through  the  day before the
      effective date of the property/casualty insurance availability act,  and
      after  June  thirtieth,  two  thousand  eleven,  except that rates shall
      reflect the likely reductive cost effects reasonably attributable to the
      statutory provisions specified in paragraph one  of  subsection  (g)  of
      this section.
        * NB Expires July 1, 2011