§ 2339 — Charging or receiving of rates; deviations

New York § 2339

• Jurisdiction: New York
• Law ISC: Insurance
• Art. 23: Property/casualty Insurance Rates

Text

§ 2339. Charging or receiving of rates; deviations. (a) This section\nshall apply only to kinds of insurance the rates for which are subject\nto prior approval pursuant to subsection (b) of section two thousand\nthree hundred five of this article.\n (b) No member of or subscriber to a rate service organization, and no\ninsurer which makes and files its own rates, shall charge or receive any\nrate which deviates from the rates, rating plans, classifications,\nschedules, rules and standards made and filed by such rate service\norganization, or by such insurer, as the case may be, which are\napplicable to any kind or type of business done by such member or\nsubscriber, or by such insurer, except as provided in this article.\n (c) Any insurer which is a member of or subscriber to a rate service\norganization may make written application to the superintendent for\npermission to deviate from the rates, schedules, rating plans or rules\nfiled on its behalf by the rate service organization. The application\nshall specify the basis for the modification and a copy shall also be\nsent simultaneously to such rate service organization. In considering\nthe application to deviate the superintendent shall give consideration\nto the available statistics and the principles for rate making as\nprovided in section two thousand three hundred four of this article. If\nthe superintendent finds the deviation to be justified, he shall approve\nit to be effective for a period to be fixed by him, but in no event for\na period of less than one year, unless sooner terminated by the\napplicant with the permission of the superintendent or unless sooner\nwithdrawn or appropriately adjusted by an order of the superintendent\nmade in accordance with the provisions of this article generally\napplicable to rate filings. If the superintendent finds that the\ndeviation applied for does not meet the requirements of this article, he\nshall send to the applicant written notice of his disapproval,\nspecifying in what respects he finds it fails to meet the requirements\nof this article. The superintendent shall inform the rate service\norganization of his action upon the deviation application.\n (d) (1) Notwithstanding any other provision of law, except as provided\nin paragraph three of this subsection, the state insurance fund shall\nnot charge an insured any rate, or receive from an insured any rate in\nexcess of the total of (i) the applicable loss cost approved by the\nsuperintendent, (ii) the applicable expense component of the state\ninsurance fund and (iii) a fair and reasonable differential charge which\ntakes into consideration the nature and hazards of the insured's\nbusiness or operations, the insured's prior loss experience, the\ninsured's prior and presently existing safety practices, the insured's\nprior premium payment history, the number of persons the insured employs\nin such business or operations and the specific type of work they\nperform, the insured's prior and current compliance with obligations\nimposed upon the insured by the workers' compensation law and other laws\nwhich require premium or other payments by the insured on the basis of\nearnings and other remuneration earned by persons engaged in the\nfurtherance of the insured's enterprise or enterprises, the promptness\nand completeness of such reports as the insured has filed on accidents\nand claims, and such other factors as may be relevant to the appraisal\nof the insured or proposed insured as a risk in whole.\n (2) A differential charge applied by the state insurance fund to a\nworkers' compensation and employer's liability insurance policy may be\nchallenged by the insured by an appeal to the superintendent after an\nexhaustion by the insured of all internal review procedures of the state\ninsurance fund as established by rules adopted by the commissioners of\nthe state insurance fund and filed with the secretary of state; provided\nthat a writing setting forth the grounds upon which such appeal is based\nis served and filed with the superintendent and with the secretary to\nthe board of commissioners of the state insurance fund within thirty\ndays after a final determination by the state insurance fund. Appeals to\nthe superintendent shall be determined upon papers and documents that\nwere before the state insurance fund in connection with the internal\nreview procedures, the writing setting forth the grounds of the\ninsured's appeal and any answer to such appeal served by the state\ninsurance fund upon the insured and filed with the superintendent within\nthirty days after the service of the insured's notice.\n (3) The provisions of this section shall not apply to a policy sold by\nthe state insurance fund under article six-G of the executive law. The\nrate which the state insurance fund may charge under such article shall\nbe governed only by such regulations or guidelines as the superintendent\nmay issue.\n