CHAPTER 212
HB 1246 – FINAL VERSION
05Mar2008… 0447h
21May2008… 1931eba
2008 SESSION
01/04
HOUSE BILL 1246
AN ACT relative to insurance policy denial provisions.
SPONSORS: Rep. Reardon, Merr 11; Rep. Spratt, Hills 3; Rep. DeStefano, Merr 13; Rep. Marshall Quandt, Rock 13
This bill adds a definition of “insurance claims adjuster” and clarifies the exemptions from the law governing them.
This bill also clarifies when the insurance commissioner may disapprove of forms filed by insurers.
This bill is a request of the insurance department.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
05Mar2008… 0447h
21May2008… 1931eba
08-2396
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to insurance policy denial provisions.
Be it Enacted by the Senate and House of Representatives in General Court convened:
212:1 Insurance Claims Adjusters; Exemption. RSA 402-B:2 is repealed and reenacted to read as follows:
402-B:2 Definition; Exemption.
I. In this chapter, “insurance claims adjuster” means a person who investigates, negotiates, or settles property, casualty, or workers’ compensation claims whether employed by or contracted by or with an insurer, a claims adjusting company, or a third party administrator.
II. The provisions of this chapter shall not apply to the following:
(a) Attorneys duly admitted to practice in this state pursuant to the provisions of RSA 311 when acting in their professional capacity as an attorney.
(b) A person employed solely to obtain facts surrounding a claim or to furnish technical assistance to a licensed insurance claims adjuster.
(c) An individual who is employed to investigate suspected insurance fraud and who does not adjust losses or determine claims payments.
212:2 Foreign Insurance Companies; Licensure. The section heading and paragraph I of RSA 405:44-a are repealed and reenacted to read as follows:
405:44-a Consultants; Producer; License Required.
I. No person, corporation, partnership or association shall engage in any of the following acts without holding a valid producer license pursuant to RSA 402-J and complying with the provisions of RSA 405:44-a through RSA 405:44-g:
(a) Place on any advertisements, cards, signs, circulars or letterheads, or elsewhere, or in any other way or manner by which public announcements are made, use the title “insurance consultant,” “insurance adviser,” “insurance specialist,” “insurance counselor,” “insurance analyst,” “policyholders’ advisor,” “policyholders’ counselor,” or any other similar title, or any title, word or combination of words indicating that the person, corporation, partnership or association gives, or is engaged in the business of giving, advice, counsel, recommendation or information to holders of policies of insurance or annuity or pure endowment contracts; or
(b) For a fee received or to be received, offer to examine, or examine or aid in examining, any policy of insurance for any annuity or pure endowment contract for the purpose of giving, or give or offer to give, any advice, counsel, recommendation or information in respect to the terms, conditions, benefits, coverage or premium of any such policy or contract, or in respect to the expediency or advisability of altering, changing, exchanging, converting, replacing, surrendering, continuing, renewing or rejecting any such policy or contract, or of accepting or procuring any such policy or contract from any company.
212:3 Property and Casualty Insurance; Purpose. Amend RSA 412:1, IX to read as follows:
IX. To [provide] ensure that policy forms, endorsements, [riders] applications, or other contract language [complies] comply with provisions of the insurance laws and do not contain provisions which are inequitable, misleading, deceptive, or encourage misrepresentation.
X. To protect policyholders and the public against the adverse effects of any policy provision that is not in the public interest or is contrary to public policy.
212:4 Property and Casualty Insurance; Approval of Form. Amend RSA 412:5, I to read as follows:
I. Every insurer and advisory organization shall file policy forms, endorsements, and other contract language covered by this chapter and RSA 264, for a waiting period of 30 days before it becomes effective, which period may be extended by the commissioner for an additional period not to exceed 30 days if written notice or electronic notice is given within the initial 30-day waiting period to the insurer or advisory organization which made the filing that additional time is needed for the consideration of the filing. Upon written application by the insurer or advisory organization, the commissioner may authorize a filing which has been reviewed to become effective before the expiration of the waiting period or extension thereof. The commissioner may disapprove such form if it contains a provision that does not comply with the requirements of law, is not in the public interest, is contrary to public policy, is inequitable, misleading, deceptive, or encourages misrepresentation of such policy. A filing shall be deemed to meet the requirements of this chapter unless disapproved by the commissioner within the waiting period or extension thereof. Every policy issued by an insurer on an unapproved form shall constitute a separate violation under RSA 412:40.
212:5 Property and Casualty Insurance. Amend RSA 412:15, III to read as follows:
III.(a) The use of any information from credit reports, credit histories, and credit scoring models for underwriting and rating purposes for homeowners insurance and [personal] private passenger automobile insurance shall be based upon objective, documented, and measurable standards and shall be used in a manner which [affords] provides for appropriate consumer protections, including adequate and clear consumer notice [provisions], procedures to promptly correct and adjust underwriting or rating decisions based on incorrect credit information, and confidentiality protections.
(b) The insurance commissioner shall, pursuant to RSA 541-A, adopt such rules as may be necessary to regulate the obligations of insurers with respect to the use of such information in the underwriting and rating of homeowners insurance and [personal] private passenger automobile insurance. Information that explains and justifies underwriting rules, credit scoring models or rating plans that rely upon credit reports, credit histories, or credit scoring mechanisms shall be included in the rate filing required pursuant to RSA 412:16.
212:6 Property and Casualty Insurance. Amend RSA 412:16, II to read as follows:
II. Every insurer shall file with the commissioner, except as to inland marine risks which are not written according to manual rates or rating plans, every manual, minimum premium, class rate, rating schedule or rating plan and every other rating rule, and every modification of any of the foregoing which it proposes to use. Personal lines filings shall include underwriting rules used by insurers or a group of affiliated insurers to the extent necessary to determine the applicable rate and/or policy premium for an individual insured or applicant. 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 RSA 412:23. Every such filing shall state the effective date, and shall indicate the character and extent of the coverage contemplated. Information contained in the underwriting rules that does not pertain to the formulation of rates and/or premiums shall be identified by the filer as proprietary and shall be kept confidential by the department and shall not be subject to the provisions of RSA 91-A.
212:7 Accident and Health Insurance; Disapproval of Forms. Amend RSA 415:2 to read as follows:
415:2 Disapproval of Forms.
I. The commissioner may, within 30 days after the filing of any such form, disapprove such form [(1)] if:
(a) The benefits provided therein are unreasonable in relation to the premium charged[, or];
[(2) if] (b) It contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive or encourage misrepresentation of such policy[,] ; or
[(3) if] (c) It does not comply with the requirements of law.
II. The 30-day period under paragraph I may be extended by the commissioner if the insurer has not provided all necessary information required to make a determination under paragraph I.
III. If the commissioner shall notify the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for such insurer to issue such form or use it in connection with any policy. In such notice the commissioner shall specify the reasons for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer.
212:8 Nullification. 2008, 18:14 (section 14 of HB 385), which amends RSA 405:44-a relative to consultants; producer license required, is hereby nullified.
212:9 Effective Date. This act shall take effect upon its passage.
Approved: June 16, 2008
Effective Date: June 16, 2008