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Part 5: Commercial Insurance Deregulation

Letting the Market Work - With Some Guardrails

Start Here: 5 Things You MUST Know About Commercial Insurance Deregulation

1

Deregulation Act of 1982 - lets insurers compete on price

2

Rates filed 30 days AFTER becoming effective (not before!)

3

Policy forms filed 30 days BEFORE they become effective

4

Special risks ($10,000+ premium) are exempt from rate filing rules

5

Rates cannot be excessive, inadequate, or unfairly discriminatory

What is Commercial Insurance Deregulation?

Before 1982: The Old Way

Before the Deregulation Act, insurance was heavily regulated:

  • - Insurers had to get approval BEFORE changing rates
  • - Less competition - prices were similar across companies
  • - Businesses had fewer choices
  • - Slow to respond to market changes

The Commercial Insurance Deregulation Act of 1982

This law lets insurers compete more freely while still protecting consumers. Think of it as taking off some of the training wheels, but keeping guardrails in place.

The Three Main Goals:

1

Encourage competition - Let insurers compete on price

2

Prevent monopolies - Stop practices that destroy competition

3

Encourage efficiency - Promote better rating and marketing practices

Think of it Like This...

Imagine if every car dealer had to get government approval before setting their prices. Car shopping would be slow and prices would be similar everywhere. Deregulation is like letting dealers set their own prices - they compete for your business, which usually means better deals for you. But there are still rules: they can't price-gouge during emergencies or collude to fix prices.

Rate Filing Requirements - Key Numbers!

The 30-Day Rules - Know the Difference!

There are TWO different 30-day rules - one for RATES and one for FORMS. The exam LOVES to test this!

30

Days AFTER for Rates

File AFTER rates become effective

What this means:

Insurers can change their rates immediately. They just have to file the new rates with the Commissioner within 30 days after the rates are already in use.

Example: ABC Insurance raises commercial property rates on March 1st. They must file this change with the state by March 31st.

30

Days BEFORE for Forms

File BEFORE forms become effective

What this means:

New policy forms (the actual contract language) must be filed with the Commissioner at least 30 days BEFORE they can be used.

Example: ABC Insurance wants to use a new policy form starting April 1st. They must file it by March 1st (30 days before).

Memory Trick: Think of the Alphabet!

F comes before R

Forms = Before | Rates = afteR

FORMS = BEFORE

File 30 days BEFORE using them

(F comes first in alphabet = file first)

RATES = AFTER

File 30 days AFTER they're effective

(R comes later in alphabet = file later)

Rate Standards - The Three No's

Rates Cannot Be:

Even though insurers have more freedom, rates must still meet these three standards:

EXCESSIVE

Too high for the risk

What this looks like:

Charging $50,000/year to insure a low-risk office building worth $100,000 would be excessive - the rate is unreasonably high for the actual risk.

INADEQUATE

Too low to pay claims

What this looks like:

Charging $100/year to insure a $500,000 restaurant would be inadequate - not enough premium to pay expected claims.

Why would an insurer do this?

Predatory pricing: A large insurer might charge super-low rates to drive smaller competitors out of business, then raise rates later. This hurts competition AND eventually hurts consumers. That's why it's prohibited!

UNFAIRLY DISCRIMINATORY

Treats similar risks differently

What this looks like:

Charging Business A twice as much as Business B when both have identical risks, just because the owner is different.

What CAN Insurers Consider When Setting Rates?

  • 1. Past loss experience - How many claims has this type of risk had?
  • 2. Potential future losses - What might happen in the future?
  • 3. Catastrophe risk - Including risks from other states!
  • 4. All relevant factors for that type of insurance
  • 5. Reasonable profit - Insurers need to stay in business!
  • 6. Policyholder dividends (for participating policies)

Special Risks - The Exemption

What Are Special Risks?

Some commercial risks are so unusual or large that the normal rate filing rules don't apply. These are called "Special Risks."

$10,000

Minimum Premium for Special Risk

Key exam number!

Commercial risks with annual premiums over $10,000 (except medical malpractice) qualify as special risks and are exempt from the normal filing requirements.

Types of Special Risks

By Premium Size:

  • - Commercial risks with premium over $10,000
  • - Single policy OR multiple policies by same insurer
  • - Can combine premiums to reach threshold

By Nature of Risk:

  • - Unusual in nature
  • - High loss hazard
  • - Difficult to place or rate
  • - Excess or umbrella coverage
  • - Eligible for export (surplus lines)

These Are ALWAYS Special Risks (Regardless of Premium)

Inland Marine Insurance

What is it? Despite the name, this has nothing to do with boats! "Inland Marine" covers property that MOVES or is used for transportation/communication.

Examples: Contractor's tools in a truck, a jeweler's samples being transported, construction equipment moved between job sites, cell phone towers, bridges

Fidelity, Surety, and Forgery Bonds

Fidelity: Protects employers from employee theft
Surety: Guarantees a contractor will finish a job
Forgery: Protects against forged checks/documents

The Commissioner's Powers

When Things Go Wrong

Even with deregulation, the Commissioner still has power to step in when needed:

Can Order Rate Review

The Commissioner can order that rates for a particular line of business be submitted for review and approval before they take effect.

Example: If medical malpractice rates are skyrocketing, the Commissioner can require insurers to get approval before raising rates further.

Can Require Form Approval

The Commissioner can order that policy forms for a particular line of business be approved before they can become effective.

Example: If insurers are using confusing policy language that's causing claim disputes, the Commissioner can require pre-approval of all new forms.

Penalties for Violations

If the Commissioner suspects a violation:

Step 1: Must provide notice of hearing to the suspected violator
Step 2: Hold a hearing to gather evidence
Step 3: If violation is found, may suspend or revoke license
Step 4: May impose penalty: $25 to $500 per willful violation

Medical Malpractice - Special Rules

Why Special Rules for Medical Malpractice?

Medical malpractice insurance is so important to the healthcare system that the Commissioner has extra controls to prevent extreme rate changes.

The Designated Range

5% - 15%

Annual rate change range

The Commissioner sets a designated range for medical malpractice rate changes. It must be between a minimum of 5% and a maximum of 15%.

The One-Change Rule

1 Change

Per 12-month period

Insurers can only file one rate change (within the designated range) every 12 months without getting Commissioner approval.

What If Insurers Want a Bigger Change?

Rate changes that exceed the designated range must be approved by the Commissioner before they can take effect. This prevents dramatic premium spikes that could drive doctors out of practice.

Public Information

All Filings Are Public!

Here's something important: ALL rate filings and their supporting information become public information as soon as they're filed.

Anyone Can:

  • - Inspect filings at the Department
  • - Request copies of filings
  • - Review supporting documentation

What You Need:

  • - Pay a reasonable fee for copies
  • - No special permission needed
  • - Available "at any time"

Deregulation Cheat Sheet

Print for quick reference

1982

Act enacted

30 Days

AFTER for rates

30 Days

BEFORE for forms

$10,000

Special risk threshold

$25-$500

Penalty per violation

5%-15%

Med mal rate range

1 Change

Per 12 months (med mal)

Public

All filings available

Exam Trap Alerts

!

Rates = 30 Days AFTER, Forms = 30 Days BEFORE

This is the #1 trap! Don't confuse these. Rates file after they're effective. Forms file before they're effective.

!

$10,000 is for Special Risks, NOT Regular Filing

The $10,000 threshold is when risks are EXEMPT from filing rules, not a minimum for filing.

!

Medical Malpractice is NOT a Special Risk

Even though med mal has special rules, it's specifically EXCLUDED from the $10,000 special risk exemption.

!

The Three Rate Standards

Rates cannot be excessive (too high), inadequate (too low), OR unfairly discriminatory. Know all three!

!

Inland Marine and Bonds Are ALWAYS Special Risks

These don't need to meet the $10,000 threshold - they're automatically considered special risks.

Quick Reference Summary

Act Purpose

Encourage competition, prevent monopolies

Rate Filing

30 days AFTER effective

Form Filing

30 days BEFORE effective

Rate Standards

Not excessive, inadequate, or discriminatory

Special Risks

$10,000+ premium OR inland marine/bonds

Violations

$25-$500 penalty, license suspension/revocation