CHAPTER 701
PERSONAL AND COMMERCIAL RISK INSURANCE
RATING PRACTICES

Table of Contents

Sec. 38a-676. (Formerly Sec. 38-201n). Review of classifications, rules, rates and form of commercial risk insurance contracts. Waiting period for workers' compensation and employers' liability insurance. Prior rate approval and hearing re medical malpractice insurance.
Sec. 38a-676a. Review of professional liability rates for physicians and surgeons, hospitals, advanced practice registered nurses and physicians assistants. Working group. Recommendations.

      Sec. 38a-676. (Formerly Sec. 38-201n). Review of classifications, rules, rates and form of commercial risk insurance contracts. Waiting period for workers' compensation and employers' liability insurance. Prior rate approval and hearing re medical malpractice insurance. (a) With respect to rates pertaining to commercial risk insurance, and subject to the provisions of subsection (b) of this section with respect to workers' compensation and employers' liability insurance and professional liability insurance for physicians and surgeons, hospitals, advance practice registered nurses and physician assistants, on or before the effective date of such rates, each admitted insurer shall submit to the Insurance Commissioner for the commissioner's information, except as to inland marine risks which by general custom of the business are not written according to manual rates or rating plans, each manual of classifications, rules and rates, and each minimum, class rate, rating plan, rating schedule and rating system and any modification of the foregoing which it uses. Such submission by a licensed rating organization of which an insurer is a member or subscriber shall be sufficient compliance with this section for any insurer maintaining membership or subscribership in such organization, to the extent that the insurer uses the manuals, minimums, class rates, rating plans, rating schedules, rating systems, policy or bond forms of such organization. The information shall be open to public inspection after its submission.

      (b) (1) Each filing described in subsection (a) of this section for workers' compensation or employers' liability insurance shall be on file with the Insurance Commissioner for a waiting period of thirty days before it becomes effective, which period may be extended by the commissioner for an additional period not to exceed thirty days if the commissioner gives written notice within such waiting period to the insurer or rating organization which made the filing that the commissioner needs such additional time for the consideration of such filing. Upon written application by such insurer or rating organization, the commissioner may authorize a filing which the commissioner has reviewed to become effective before the expiration of the waiting period or any extension thereof. A filing shall be deemed to meet the requirements of sections 38a-663 to 38a-696, inclusive, unless disapproved by the commissioner within the waiting period or any extension thereof. If, within the waiting period or any extension thereof, the commissioner finds that a filing does not meet the requirements of said sections, the commissioner shall send to the insurer or rating organization which made such filing written notice of disapproval of such filing, specifying therein in what respects the commissioner finds such filing fails to meet the requirements of said sections and stating that such filing shall not become effective. Such finding of the commissioner shall be subject to review as provided in section 38a-19.

      (2) (A) Each filing described in subsection (a) of this section for professional liability insurance for physicians and surgeons, hospitals, advanced practice registered nurses or physician assistants shall be subject to prior rate approval in accordance with this section. On and after July 13, 2005, each insurer or rating organization seeking to increase its rates over the rates in the insurer's previous filing for such insurance by seven and one-half per cent or more shall (i) file a request for such change with the Insurance Commissioner, and (ii) send written notice of any request for an increase in rates to insureds who would be subject to the increase on such form as the commissioner prescribes by certified mail, return receipt requested. Such request shall be filed and such notice shall be sent at least sixty days prior to the proposed effective date of the increase. The notice to insureds of a request for an increase in rates shall indicate that the insured may request a public hearing by submitting a written request to the Insurance Commissioner not later than fifteen days after the date notice was sent. Any request for an increase in rates under this subdivision shall be filed after notice is sent to insureds and shall indicate the date such notice was sent. Not later than fifteen days after such notice is sent, the insurer shall submit a list to the commissioner indicating the name of each insured to whom notice was sent and whether a return receipt was received for the notice sent to the insured.

      (B) The Insurance Commissioner shall review each filing under subparagraph (A) of this subdivision and shall (i) not approve, modify or deny the request until the expiration of the period for insureds to request a hearing pursuant to subparagraph (A) of this subdivision, and (ii) hold a public hearing, if requested by insureds, on such increase prior to approving, modifying or denying the request. The Insurance Commissioner shall approve, modify or deny the filing not later than forty-five days after its receipt. Such finding of the commissioner shall be subject to review as provided in section 38a-19.

      (c) The form of any insurance policy or contract the rates for which are subject to the provisions of sections 38a-663 to 38a-696, inclusive, other than fidelity, surety or guaranty bonds, and the form of any endorsement modifying such insurance policy or contract, shall be filed with the Insurance Commissioner prior to its issuance. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, establishing a procedure for review of such policy or contract. If at any time the commissioner finds that any such policy, contract or endorsement is not in accordance with such provisions or any other provision of law, the commissioner shall issue an order disapproving the issuance of such form and stating the reasons for disapproval. The provisions of section 38a-19 shall apply to any such order issued by the commissioner.

      (1969, P.A. 665, S. 14; 1971, P.A. 498; P.A. 75-8; P.A. 77-614, S. 163, 610; P.A. 79-376, S. 61; P.A. 80-482, S. 312, 348; P.A. 81-94; P.A. 82-353, S. 10, 26; P.A. 88-326, S. 6; P.A. 01-174, S. 14; P.A. 05-275, S. 11.)

      History: 1971 act inserted new Subsec. (b) re filing for workmen's compensation or employer's liability insurance, relettering former Subsec. (b) accordingly and adding reference to Subsec. (b) in Subsec. (a); P.A. 75-8 required submission of forms and contracts thirty days before their effective date rather than "within a reasonable time after" their effective date; P.A. 77-614 placed insurance commissioner within the department of business regulation and made insurance department a division within that department, effective January 1, 1979; P.A. 79-376 replaced "workmen's compensation" with "workers' compensation"; P.A. 80-482 restored insurance commissioner and division to prior independent status and abolished the department of business regulation; P.A. 81-94 deleted word "printed" modifying "endorsement" in Subsec. (c); P.A. 82-353 limited the application of the section to commercial risk insurance and eliminated the hearing requirement before the issuance of an order disapproving the policy or contract form, effective July 1, 1983; P.A. 88-326 required the commissioner to adopt regulations establishing a procedure for policy and contract review; Sec. 38-201n transferred to Sec. 38a-676 in 1991; P.A. 01-174 substituted references to Sec. 38a-696 for Sec. 38a-697 in Subsecs. (b) and (c) and made technical changes, including changes for the purpose of gender neutrality, throughout; P.A. 05-275 amended Subsec. (a) to make professional liability insurance for physicians and surgeons, hospitals, advance practice registered nurses and physician assistants subject to Subsec. (b) and make technical changes, amended Subsec. (b) to designate existing provisions as Subdiv. (1), delete "as" therein and add Subdiv. (2) re prior rate approval, hearing and review for such professional liability insurance, and make technical changes in Subsec. (c), effective July 13, 2005.

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)

      Sec. 38a-676a. Review of professional liability rates for physicians and surgeons, hospitals, advanced practice registered nurses and physicians assistants. Working group. Recommendations. (a) Not earlier than October 1, 2008, the Insurance Commissioner shall review professional liability insurance rates in this state for physicians and surgeons, hospitals, advanced practice registered nurses and physicians assistants to determine whether (1) the amount or frequency of insured awards and settlements against physicians and surgeons, hospitals, advanced practice registered nurses and physicians assistance have decreased since October 1, 2005, (2) such rates reflect any such decrease, and (3) such rates bear a reasonable relationship to the costs of writing such insurance in this state. In conducting the review, the commissioner shall examine the rates for such insurance under policies issued by (A) captive insurers and risk retention groups, to the extent such information is available to the commissioner, and (B) insurers licensed in this state.

      (b) If after such review the commissioner determines that such insurance rates have not decreased, and such insurance rates are not reasonably related to the costs of writing such insurance in this state, the commissioner shall convene a working group in accordance with subsection (c) of this section. The working group shall consider, among other things, the amounts of awards and settlements during the prior ten years and shall recommend appropriate revisions, if any, to the general statutes in order to decrease rates or establish reasonable rates. Such revisions may include, but need not be limited to, reasonable limitations on noneconomic damages awards, revisions to procedures used by insurers to establish rates, and regulation of reimbursement rates paid by health insurers and health care centers to health care providers in this state. The working group shall submit its recommendations to the General Assembly and the Governor in accordance with section 11-4a.

      (c) Any working group convened pursuant to subsection (b) of this section shall consist of:

      (1) The chairpersons and ranking members, or their designees, of (A) the joint standing committees of the General Assembly having cognizance of matters relating to the judiciary, public health and insurance, and (B) the Legislative Program Review and Investigations Committee;

      (2) One member appointed by the Connecticut Medical Society;

      (3) One member appointed by the Connecticut Hospital Association;

      (4) One member appointed by the Connecticut Trial Lawyers Association;

      (5) One representative of a patient advocacy group appointed by the speaker of the House of Representatives;

      (6) One representative of a medical malpractice insurer licensed and actively doing business in this state appointed by the president pro tempore of the Senate;

      (7) The Commissioner of the Office of Health Care Access, or a designee; and

      (8) The Insurance Commissioner.

      (P.A. 05-275, S. 12.)

(Return to
Chapter Table of Contents)
(Return to
List of Chapters)
(Return to
List of Titles)