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Other Liability

LINE OF BUSINESS: Other Liability LINE(S) OF INSURANCE CODES LINE(S) OF INSURANCE CODES
  17.0000 Occurrence (Other Liability) 17.1000 Liquor Liability 17.0014
  Product Liability Claims Made (Other Liability) 17.2000 Municipal Liability 17.0016
  18.0000 Commercial General liability 17.0001 Nuclear Energy Liability 17.0016
    Completed Operations 17.0002 Personal Injury Liability 17.0017
    Comprehensive Personal Liability 17.0003 Premises and Operations 17.0018
    Contractual Liability 17.0004 Professional Errors and Omissions 17.0019
    Day Care Centers 17.0005 Umbrella & Excess (Commercial) 17.0020
    Directors & Officers Liability 17.0006 Umbrella & Excess (Personal) 17.0021
    Elevators and Escalators Liability 17.0007 Other 17.0022
    Employee Benefit Liability 17.0008 Veterinarian 17.0023
    Employers Liability 17.0009 Internet Liability 17.0024
    Employment Practices Liability 17.0010 Occurrence (Products Liability) 18.0001
    Environmental Pollution Liability 17.0011 Claims Made (Products Liability) 18.0002
    Fire Legal Liability 17.0012    
    Kidnap & Ransom Liability 17.0013    
IF CHECKLIST IS NOT APPLICABLE, PLEASE EXPLAIN:  
  _________________________________________________________
   

REVIEW REQUIREMENTS

REFERENCE

DESCRIPTION OF REVIEW

STANDARDS REQUIREMENTS

LOCATION OF STANDARD IN FILING

GENERAL REQUIREMENTS FOR ALL FILINGS

 

 

 

ELECTRONIC FILINGS

Insurance Bulletin 360

Title 24-A § 2304-A Rate filings

Title 24-A § 2412 Filings, approval of forms

Maine requires that all rate and form filings be filed electronically through the NAIC’s System for Electronic Rate and Form Filings (SERFF).  See also Bureau of Insurance Bulletin 360 Electronic Submissions of Rate and Form Filings.

 

COVER LETTER

 

Cover letters may be attached to the Supporting Documentation Tab or the text entered under the Filing Description located under the General Information tab in SERFF.

 

FILING SUBMISSION

Title 24-A § 2412 Filings, approval of forms

Title 24-A § 2304-A Rate filings

Form filing requirements.

 

Rate filing requirements.

 

EFFECTIVE DATE WORDING

 

Include proposed effective date on SERFF General Information.  Policies effective at 12:01 AM Standard Time.

 

LIMITATIONS/RESTRICTIONS ON TRANSACTING BUSINESS

Title 24-A - §404. Certificate of authority required; enforcement; penalty

Must have certificate of authority to transact business.

 

LINE OF AUTHORITY

Other Liability

Products Liability

Must have certificate of authority to transact business before submitting rate/rule/form filings.

 

NO FILE OR FILING EXEMPTIONS

Title 24-A - §2412-A. Large commercial contracts

Policy forms and rates/rules pertaining to large commercial risks exempt from filing — see statute for criteria and definition of large commercial risk.

 

SIDE BY SIDE COMPARISON

 

Please provide a marked-up copy of the existing rate/rule page(s) or forms being revised highlighting all changes by underlining additions and striking through deletions.

 

THIRD PARTY FILERS AUTHORITY

Title 24-A § 2412 Filings, approval of forms

Title 24-A § 2304-A Rate filings

Must include authorization to communicate directly with third party filers.

 

FORMS--POLICY
PROVISIONS

 

 

 

ACCESS TO COURTS

Title 24-A § 2433.  Jurisdiction of courts, limitation of actions

Maine courts must have jurisdiction.

 

ACTION AGAINST COMPANY

Title 24-A § 2433.  Jurisdiction of courts, limitation of actions

Insured must be given 2 years from date of loss to bring suit against insurer.  

 

AMBIGUOUS & MISLEADING

Title 24-A § 2413.  Grounds for disapproval

Forms shall be disapproved by the superintendent if they contain or incorporate by reference any inconsistent, ambiguous or misleading clauses

 

APPLICATIONS

Title 24-A §2411
Representations in applications

Title 24-A § 2412 Filings, approval of forms

Must file applications only if to be made part of the policy
All statements are considered representations not warranties.  The Maine Fraud Warning must appear permanently affixed on all application (i.e. new business, renewal, supplemental, etc…). 

 

ARBITRATION

Title 24-A § 2433.  Jurisdiction of courts, limitation of actions

Arbitration must take place in the Maine County in which the policy was issued for delivery.

 

BLANK ENDORSEMENTS

Title 24-A § 2412 Filings, approval of forms

Title 24-A §2308 Excess rates

Blank endorsements are considered manuscript forms and generally not acceptable.  Each manuscripted change is subject to review and can be filed as a consent to form filing pursuant to 24-A § 2308(2).

 

CANCELLATION & NON-RENEWAL

Title 24-A - §2908. Cancellation and nonrenewal

Maine amendatory endorsement must include statutory grounds for mid-term cancellation — refer to subsection 2 of statute; a post-office certificate of mailing to the named insured at his last known address is conclusive proof of receipt of notice on the 3rd calendar day after mailing.

 

CONTENT OF POLICIES

Title 24-A - §2901. Contracts subject to general provisions

Title 24-A - Chapter 27, THE INSURANCE CONTRACT

Title 24-A – Chapter 39, CASUALTY INSURANCE CONTRACTS

Title 24-A - MAINE INSURANCE CODE

Casualty contracts are subject to provisions of Chapters 27 and 39 and to other applicable general provisions of Title 24-A (The Maine Insurance Code).

 

CREDIT SCORING NOTICE

Title 24-A - §2169-B. Use of consumer reports in insurance underwriting

Insurance - Bulletin 329

 

 

DISCRIMINATION

Title 24-A §2162. Unfair discrimination, rebates prohibited -- property, casualty, surety insurance

Restrictions on policy provisions relating to benefits not associated with loss and reductions in premium associated with savings and expenses.

 

FICTITIOUS GROUPS

Title 24-A § 2172.  Fictitious groups prohibited

Prohibited

 

FRAUD WARNING

Title 24-A §2186
Insurance fraud prevention

Statutory (or substantially similar) wording must be included on all applications (i.e. new business, renewal, supplemental, etc…) and claim forms.

 

GROUP POLICIES

Title 24-A §2951. Group property and casualty insurance

Group policies for liability ONLY permitted for risk purchasing groups in compliance with chapter 72-A.

 

LEAD

Title 24-A §2413
Grounds for disapproval

Title 22 - Chapter 252, LEAD POISONING CONTROL ACT

Maine permits the exclusion of lead except in the case of any dwelling unit or child-occupied facility (as defined in (22 M.R.S.A. § 1315(1-C)).  In these cases Maine will permit a lead exclusion which begins ≥ 31 days after State of Maine Department of Health and Human Services or a DHHS licensed lead inspector has given insured notice of environmental lead hazard & insured failed to remove the lead hazard. 

 

MEDICAL PAYMENTS SUBROGATION

Title 24-A § 2910-A Subrogation;  medical payments coverage

Policy may not provide for subrogation or priority over the insured of payment for any hospital, nursing, medical or surgical services or of any expenses paid or reimbursed under the medical payments coverage in the policy in the event the insured is entitled to receive payment or reimbursement from any other person as a result of legal action or claim, except as provided in this section.

The coverage may contain a provision that allows the payments if :
A. The provision requires the written approval of the insured;

B. The provision provides that the insurer’s subrogation right is subject to subtraction to account for the pro rata share of the insured's attorney's fees incurred in obtaining the recovery from another source; and

C. The provision is approved by the superintendent.

 

NOTICE OF CANCELLATION

Title 24-A § 2908.  Cancellation and nonrenewal  

Insurance - Bulletin 201

Minimum 10 days advance notice required for cancellation & must allow for 3 days mail time, i.e., proof of mailing is not proof of receipt until the third calendar day after mailing.  Also, notice must inform insured of right to request a hearing within 45 days of receipt of notice.

 

NOTICE OF NON-RENEWAL

Title 24-A § 2908.  Cancellation and nonrenewal  

Insurance - Bulletin 201

Minimum 30 days advance notice required for nonrenewal & must allow for 3 days mail time, i.e., proof of mailing is not proof of receipt until the third calendar day after mailing.

 

NOTICE REQUIREMENTS

Title 24-A § 2908.  Cancellation and nonrenewal

 

 

PeriodPAYMENT OF LOSS TIME

Title 24-A §2436. Interest on overdue payments

Payment within thirty days and interest on overdue payments of 1.5% per month.

 

PERMISSIBLE REASONS FOR CANCELLATION

Title 24-A § 2908.  Cancellation and nonrenewal

See statute for permissible grounds.

 

PERMISSIBLE REASONS FOR NON-RENEWAL

Title 24-A § 2908.  Cancellation and nonrenewal

 

 

POLLUTION EXCLUSION

 

Maine permits the use of pollution exclusions. 

 

POST-JUDGMENT INTERES

Title14 §1602-C. Interest after judgment

Insurance – Bulletin 353

Maine statutory law provides for the payment of post-judgment interest and case law has held that an insurer must pay post-judgment interest as a supplemental payment without regard to the policy terms (i.e. policy limit, sub-limits, exclusions, deductibles, retentions, etc…). 

 

PRIOR APPROVAL

Title 24-A § 2304-A Rate filings

Title 24-A § 2412 Filings, approval of forms

Filings are to be made no less than 30 days in advance of their stated effective/delivery date.  Filings made electronically shall be acted upon within 30 days unless the filer requests an extension.  Filings not acted upon pursuant to these statutes may be deemed after 30 days.

 

PRIVACY NOTICE

Title 24-A - §2206. Notice of insurance information practices

See Title 24-A, Ch. 24 generally for insurance information and privacy protection.

 

REBATES

Title 24-A - §2162. Unfair discrimination, rebates prohibited -- property, casualty, surety insurance

Title 24-A §2163. Receipt of rebate, illegal inducement prohibited

Insurance Bulletin 233

Sales inducements rebates prohibited unless contained in policy.

 

SERVICE CONTRACTS--VEHICLE & OTHER THAN VEHICLE

 

Maine is a dealer obligor state. 

 

SUIT

Title 24-A - §2433. Jurisdiction of courts, limitation of actions

Maine courts must have jurisdiction.

Insured must be given two years to bring suit against insurer.

 

VICARIOUS LIABILITY

Title 14 - §304. Liability of parents or legal guardians for damage by children

Parent or legal guardian liable for action of minor children up to $800.

 

VOIDANCE

Title 24-A §2411 Representations in applications

Insurers may not void coverage for concealment, misrepresentation or fraud except in compliance with Maine case law.  See American Home Assurance Co. v. Ingeneri, 479 A.2d 897 (Me. 1984).

 

WARRANTIES

Title 24-A §2411 Representations in applications

Statements in applications must be considered representations not warranties.

 

RATE, RULE, RATING PLAN, CLASSIFICATION, AND TERRITORY FILING REQUIREMENTS

 

 

 

"A" RATED RISKS

Title 24-A - §2304-A. Rate filings

“a” rates and ranges must be filed along with any rates designated as “refer to company” or similar phrasing.

 

ADOPTIONS OF RATE SERVICE ORGANIZATIONS (RSO) FILINGS

Title 24-A §2304-B Reference filings

Insurance - Bulletin 176

Insurer may satisfy rate filing requirements by adopting advisory organization filings and filing loss cost multiplier.

 

CALCULATIONOF UNEARNED/RETURN PREMIUM

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

CATASTROPHE HAZARDS

Title 24-A - §2303. Making of rates

Title 24-A - §2304-A. Rate filings

Rate provisions must be supported by experience or relevant catastrophe models.

 

CONSENT-TO-RATE

Title 24-A §2308 Excess rates

Permitted if rating manual filing previously filed does not contemplate the specific risk being assumed.

 

CREDIBILITY AND FACTORS TRENDING

Title 24-A - §2303. Making of rates

Rate or loss cost multiplier calculation should reflect credibility and trend factors of insurer.

 

CREDIT SCORING AND REPORTS

Title 24-A - §2169-B. Use of consumer reports in insurance underwriting

Insurance - Bulletin 329

 

 

DISCOUNTS

Title 24-A - §2303. Making of rates

Title 24-A - §2304-A. Rate filings

Surcharges and credits must be filed and supported.

 

EXPENSE MODIFICATION PLAN

Insurance Bulletin-233

Must be filed as part of rating plan.  Rate credits resulting from a negotiated/reduced commission are limited to no greater than 10% (see Bulletin 233).

 

EXPENSES

Title 24-A - §2303. Making of rates

Rate or loss cost multiplier calculation should reflect expenses of insurer

 

EXPERIENCE

Title 24-A - §2303. Making of rates

Rate or loss cost multiplier calculation should reflect experience of insurer.

 

EXPERIENCE RATING

Title 24-A - §2304-A. Rate filings

Considered part of rating plan.

 

GROUP POLICIES

Title 24-A - §2951. Group property and casualty insurance

Group policies for liability ONLY permitted for risk purchasing groups in compliance with chapter 72-A.

 

JUDGMENT

Title 24-A - §2303. Making of rates

Rate or loss cost multiplier calculation should reflect judgment of insurer.

 

LARGE DEDUCTIBLE

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

LOSS COST MULTIPLIERS

Title 24-A §2304-B Reference filings

Insurance Bulletin 176

Insurer may satisfy rate filing requirements by adopting advisory organization filings and filing loss cost multiplier.

 

LOSS COSTS

Title 24-A §2304-B Reference filings

Insurance Bulletin 176

Insurer may satisfy rate filing requirements by adopting advisory organization filings and filing loss costs multiplier.

 

MINIMUM PREMIUM RULES

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

MULTI-TIER

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

OTHER FEES ASSOCIATED WITH THE ISSUANCE OF A POLICY, DELIVERY OF A POLICY OR COLLECTION OF PREMIUM

Title 24-A - §2304-A. Rate filings

Title 24-A, §2403: "Premium" defined

Must be filed as part of rating plan

 

PAYMENT PLANS

Title 24-A - §2304-A. Rate filings

Title 24-A, §2403: "Premium" defined

Must be filed as part of rating plan

 

PRICING

Title 24-A - §2302-A Definitions

Title 24-A - §2303. Making of rates

Title 24-A - §2304-A. Rate filings

Title 24-A §2304-B Reference filings

Insurance Bulletin 176

All aspects of pricing must be filed and supported and/or may adopt advisory organization reference filing and file loss costs multiplier.

 

PROFIT LOADING

Title 24-A - §2303. Making of rates

Rate or loss cost multiplier calculation may reflect profit loading and must include consideration for investment income.

 

RATE RANGES

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

RATE/LOSS COST SUPPORTING INFORMATION

Title 24-A - §2302-A Definitions

Title 24-A - §2303. Making of rates

Title 24-A - §2304-A. Rate filings

Title 24-A §2304-B Reference filings

Insurance Bulletin 176

All aspects of pricing must be filed and supported and/or may adopt advisory organization reference filing and file loss costs multiplier.

 

RATING PLAN REQUIREMENTS

Title 24-A - §2304-A. Rate filings

All aspects of pricing must be filed and supported and/or may adopt advisory organization reference filing and file loss costs multiplier.

 

RETROSPECTIVE RATING

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

RETURN ON EQUITY DOCUMENT--INVESTMENT INCOME

Title 24-A - §2303. Making of rates

Title 24-A - §2304-A. Rate filings

Profit must give consideration to investment income.

Manual rates, minimum premium, class rate, rating schedule or rating plan, every other rating rule, and every modification to the foregoing should be filed and supported.

 

RISK CLASSIFICATION

Title 24-A - §2303. Making of rates

Risks may be grouped by classifications for the establishment of rates and minimum premiums.

 

SCHEDULE RATING (aka underwriting judgment)

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan and a maximum aggregate credit/debit permitted is 40%

 

SERVICE CHARGES (COLLECTION EXPENSE SUCH AS, BUT NOT LIMITED TO,  INSTALLMENT, NSF, REINSTATEMENT, LATE & CONVENIENCE FEES)

Title 24-A - §2304-A. Rate filings

Title 24-A, §2403: "Premium" defined

Must be filed as part of rating plan

 

SMALL DEDUCTIBLE

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

SURCHARGES

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

WRAP-UP RATING

Title 24-A - §2304-A. Rate filings

Must be filed as part of rating plan

 

 

 

Last Updated: April 30, 2013