W. Va. Code R. § 85-3-9

Current through Register Vol. XLI, No. 40, October 4, 2024
Section 85-3-9 - Transition
9.1. The commission will continue to operate under these rules until the termination of the commission.
9.2. Upon novation of the employers' excess liability fund to the successor to the commission:
a. The successor to the commission shall continue to offer employers' excess liability coverage until at least June 30. 2008. Nothing in these rules shall prevent the successor to the commission from offering employers' excess liability coverage beyond June 30. 2008.
b. The application for coverage process and application for coverage information required by the successor to the commission or other private carrier shall be governed by the business practices of the successor to the commission or other private carrier.
c. Policy terms, including, but not limited to. payment, exclusions, and conditions of an employers' excess liability contract of insurance coverage between the successor to the commission and an employer are not governed by the provisions of this rule, except an insofar as the coverage terms include the elements of "deliberate intention" as contained within the provisions of W. Va. Code § 23-4-2(d)(2)(ii).
d. Nothing in these provisions will require the successor to the commission or other private carrier to provide employers' excess liability coverage to an employer. The issuance of a employers' excess liability policy is entirely within the discretion of the successor to the commission or other private carrier.
e. The successor to the commission or other private carrier may decline coverage, or cancel or refuse to renew with sixty (60) days notice: in addition, the successor to the commission or other private carrier may cancel a policy for failure to pay with (fifteen) 15 days notice.
f. Within thirty (30) days prior to the novation of the employers' excess liability fund to the successor to the commission, the successor to the commission and all private carriers of employers' excess liability insurance shall submit to the insurance commissioner their proposed rates, which may be higher than the base rates established by the board of managers or. upon termination of the commission, the industrial council. The insurance commissioner retains authority to disapprove rates in effect if it is determined that the rates are not in compliance with the following:
1. Rates must not be excessive, inadequate or unfairly discriminatory, nor may an insurer charge any rate which if continued will have or tend to have the effect of destroying competition or creating a monopoly.
2. The insurance commissioner may disapprove rates if there is not a reasonable degree of price competition at the consumer level with respect to the class of business to which they apply. In determining whether a reasonable degree of price competition exists, the insurance commissioner shall consider all relevant tests, including:
A. The number of insurers actively engaged in the class of business and their shares of the market:
B. The existence of differentials in rates in that class of business:
C. Whether long-run profitability for private carriers generally of the class of business is unreasonably high in relation to its risk:
D. Consumers' knowledge in regard to the market in question: and
E. Whether price competition is a result of the market or is artificial. If competition does not exist, rates are excessive if they are likely to produce a long-run profit that is unreasonably high in relation to the risk of the class of business, or if expenses are unreasonably high in relation to the services rendered.
3. Rates are inadequate if they are clearly insufficient, together with the income from investments attributable to them, to sustain projected losses and expenses in the class of business to which they apply.
4. One rate is unfairly discriminatory in relation to another in the same class if it clearly fails to reflect equitably the differences in expected losses and expenses. Rates are not unfairly discriminatory because different premiums result for policyholders with similar exposure to loss but different expense factors, or similar expense factors but different exposure to loss, so long as the rates reflect the differences with reasonable accuracy. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, franchise or blanket policy.

5. The successor to the commission and all private carriers shall thereafter file their rates on an annual basis subject to the approval of the insurance commissioner.

W. Va. Code R. § 85-3-9