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Chapter 5 Part 3: Commercial Insurance Deregulation

The Commercial Insurance Deregulation Act of 1982

Commercial Insurance Deregulation Act of 1982

This Act was enacted to protect policyholders and the public against the adverse effects of excessive, inadequate, or unfairly discriminatory rates.

The Three Purposes of the Act:

1

Encourage Competition

Encourage independent action by price competition among insurers

2

Prevent Monopoly

Prevent practices that tend to bring about monopoly or destroy competition

3

Efficient Practices

Encourage the most efficient and economic rating and marketing practices

Key Point

All commercial policies issued in New Jersey must be issued in accordance with the provisions of this Act.

Filing Requirements

Rates & Rate Amendments

30 Days

AFTER they become effective

All authorized insurers and rating organizations must file rates and amendments with the Commissioner.

Policy Forms

30 Days

BEFORE they become effective

Policy forms must be filed with the Commissioner before they can be used.

Memory Trick: Rates vs. Forms

Rates = After (like paying a bill after you get it)

Forms = Before (like filling out paperwork before starting something)

Example: Filing Timeline

ABC Insurance wants to use a new commercial policy form starting July 1st. They must file it with the Commissioner by June 1st (30 days before). If they also want to change their rates on July 1st, they have until July 31st to file those rate changes (30 days after).

Public Access

All filings become public information and are open to public inspection at any time. Anyone can request copies by paying a reasonable fee.

Rate Standards

Rates Cannot Be:

Excessive

Too high - gouging consumers

Inadequate

Too low - insurer can't pay claims

Unfairly Discriminatory

Different rates without actuarial basis

Factors to Consider When Setting Rates:

Past and potential loss experiences - including conflagration or catastrophe risks within AND outside the state
All factors relevant to the specific type of insurance being offered
Reasonable profit for the insurer
Policyholders' dividends (if participating insurer)

Example: Rate Factors in Action

XYZ Insurance is setting rates for commercial property insurance in coastal NJ. They must consider: their past hurricane claims (loss experience), the risk of future hurricanes (catastrophe risk), what competing insurers charge, their operating expenses, and enough profit margin to stay in business - but not so much that rates are "excessive."

Insurer Rate Options

Option 1: Set Own Rates

Insurers can develop and set their own rates and supplementary rate information independently.

Example: Large insurers with their own actuaries often develop proprietary rates based on their unique experience.

Option 2: Use Rating Organization

Insurers can use rates provided by a rating organization (like ISO), and may modify them based on their own expense and loss experience.

Example: Smaller insurers often use ISO rates as a baseline, then apply their own modifications (higher or lower).

Commissioner's Powers

Review Authority

  • Can order rates for a particular line of business be submitted for review and approval
  • Can order policy forms for a particular line be submitted for approval before becoming effective

Violation Process

  1. 1 Commissioner suspects a violation
  2. 2 Provides notice of hearing to the suspected party
  3. 3 After hearing, if violation found: can suspend/revoke license

Penalties for Willful Violations

Minimum Penalty

$25

per violation

Maximum Penalty

$500

per violation

Plus potential license suspension or revocation!

Medical Malpractice Liability Insurance - Special Rules

The Commissioner establishes a designated range of annual rate changes specifically for medical malpractice liability insurance.

Minimum Range

5%

Maximum Range

15%

Filing Window

30 Days

One Rate Change Rule: Insurers and rating organizations may only file one rate change within the designated range in a 12-month period without explicit approval of the Commissioner.

Exceeding the Range: Rate changes that exceed the designated range (more than 15%) must be approved by the Commissioner.

Example: Medical Malpractice Rate Changes

Dr. Smith's malpractice insurer wants to raise rates. If they want to increase by 10% (within the 5-15% range), they can do so once per year without approval. But if they want to increase by 20%, they need the Commissioner's explicit approval first.

Special Risks - Exempt from Filing Requirements

The filing of rates statutes do NOT apply to special risks. These are handled differently due to their unique nature.

What Qualifies as a Special Risk?

Commercial Lines Risks That Are:

  • • Unusual in nature
  • • A high loss hazard
  • • Difficult to place or rate
  • • Excess or umbrella coverage
  • • Eligible for export

Premium Threshold:

$10,000+

Minimum annual premium

(Other than medical malpractice liability insurance risks)

Also Considered Special Risks:

Inland Marine Insurance

Fidelity Bonds

Surety Bonds

Forgery Bonds

How to Meet the $10,000 Minimum:

  • Single policy with premium over $10,000
  • Multiple policies by the same insurer or group totaling over $10,000
  • Single policy covering multiple risks generating annual premium over $10,000

Record Keeping Requirements for Special Risks

Insurers must maintain detailed records for special risks:

Detailed underwriting files
Premium statistics
Loss statistics
Expense statistics
Financial records
Other relevant records

The Commissioner determines the level of detail required and can examine these records as frequently as deemed necessary.

Quick Reference: Commercial Deregulation Act

30 Days

Rates: AFTER effective

30 Days

Forms: BEFORE effective

5-15%

Med Mal rate range

$10,000

Special risk threshold

$25-$500

Penalty per violation

1982

Year Act enacted

12 Months

Med Mal: 1 change/year

Public

All filings are public

Rates Cannot Be (Remember: EIU)

Excessive Inadequate Unfairly Discriminatory