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| Home > Statutes > Usa-Missouri |
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USA Statutes : missouri
Title : BUSINESS AND FINANCIAL INSTITUTIONS
Chapter : Chapter 379 Insurance Other Than Life
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1. Any number of persons, not less than thirteen in number, a majority of whom shall be citizens of this state, may associate and form a corporation, association or company for the purpose of making insurance regarding the following classes:
(1) Property, which shall consist of insurance on the following subclasses:
(a) Marine, inland marine, and transportation;
(b) Animals;
(c) All other real and personal property, intangible or tangible;
(2) Liability, which shall consist of insurance for the following subclasses:
(a) Workers' compensation and employers' liability;
(b) Professional malpractice;
(c) Contractual liability;
(d) All other legal liability of the insured to another;
(3) Fidelity and surety;
(4) Accident and health, including death by accident;
(5) Miscellaneous, consisting of all other legitimate forms of insurance not described above but excluding life and annuities.
2. No company shall commence business or make insurance on one of the classes of insurance named in subsection 1 of this section unless, if it is a stock company, it has and maintains a paid in capital of at least eight hundred thousand dollars and a surplus of at least eight hundred thousand dollars or, if it is a mutual company, it has and maintains a policyholders' surplus of at least one million six hundred thousand dollars. No company shall commence business or make insurance on more than one of the classes of insurance enumerated in subsection 1 of this section unless, if it is a stock company, it has and maintains a paid in capital of at least one million two hundred thousand dollars and a surplus of not less than one million two hundred thousand dollars or, if it is a mutual company, it has and maintains a policyholders' surplus of not less than two million four hundred thousand dollars.
3. Violation of any of the provisions of this section by an insurer is grounds for the revocation of its certificate of authority by the director.
4. Notwithstanding any provision of this section, a mutual company licensed to do:
(1) More than one class of business in this state under this section on July 1, 1987, which did not maintain an aggregate amount of at least two million four hundred thousand dollars as policyholders' surplus on December 31, 1986, may renew its license for business specified therein by maintaining an aggregate amount of at least one million six hundred thousand dollars as policyholders' surplus, if all other conditions have been met, until December 31, 1989, at which time the following provisions relating to minimum policyholders' surplus shall be met:
(a) On and after December 31, 1989, one million eight hundred thousand dollars;
(b) On and after December 31, 1990, two million dollars;
(c) On and after December 31, 1991, two million two hundred thousand dollars;
(d) On and after December 31, 1992, two million four hundred thousand dollars;
(2) One class of business in this state under this section on July 1, 1987, which did not maintain an aggregate amount of at least one million six hundred thousand dollars as a policyholders' surplus on December 31, 1986, may renew its license for business specified therein by maintaining an aggregate amount of at least eight hundred thousand dollars as a policyholders' surplus, if all other conditions have been met, until December 31, 1989, at which time the following provisions relating to policyholders' surplus shall be met:
(a) On and after December 31, 1989, one million dollars;
(b) On and after December 31, 1990, one million two hundred thousand dollars;
(c) On and after December 31, 1991, one million four hundred thousand dollars;
(d) On and after December 31, 1992, one million six hundred thousand dollars.
5. Notwithstanding any provision of this section, a stock company licensed to do:
(1) More than one class of business in this state under this section on August 28, 1989, which did not have a fully paid capital of at least one million two hundred thousand dollars and a surplus of at least one million two hundred thousand dollars on December 31, 1986, may renew its license for business specified therein by maintaining a fully paid capital of at least eight hundred thousand dollars and a surplus of at least eight hundred thousand dollars, if all other conditions have been met, until December 31, 1989, at which time the following provisions relating to minimum capital and surplus shall be met:
(a) On and after December 31, 1989, nine hundred thousand dollars capital, nine hundred thousand dollars surplus;
(b) On and after December 31, 1990, one million dollars capital, one million dollars surplus;
(c) On and after December 31, 1991, one million one hundred thousand dollars capital, one million one hundred thousand dollars surplus;
(d) On and after December 31, 1992, one million two hundred thousand dollars capital, one million two hundred thousand dollars surplus.
(2) One class of business in this state under this section on July 1, 1987, which did not have a fully paid capital of at least eight hundred thousand dollars and a surplus of at least eight hundred thousand dollars on December 31, 1986, may renew its license for business specified therein by maintaining a fully paid capital of not less than four hundred thousand dollars and a surplus of at least four hundred thousand dollars, if all other conditions have been met, until December 31, 1989, at which time the following provisions relating to minimum capital and surplus shall be met:
(a) On and after December 31, 1989, five hundred thousand dollars capital, five hundred thousand dollars surplus;
(b) On and after December 31, 1990, six hundred thousand dollars capital, six hundred thousand dollars surplus;
(c) On and after December 31, 1991, seven hundred thousand dollars capital, seven hundred thousand dollars surplus;
(d) On and after December 31, 1992, eight hundred thousand dollars capital, eight hundred thousand dollars surplus. (RSMo 1939 § 5904, A.L. 1945 p. 1014, A.L. 1963 p. 485, A.L. 1967 p. 516, A.L. 1977 S.B. 368, A.L. 1987 H.B. 700, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5793; 1919 § 6203; 1909 § 6995
Every insurance company licensed to do business in this state and authorized to make insurance on classes of insurance enumerated in subdivisions (1), (2) and (3) of subsection 1 of section 379.010 shall have authority to combine in single policies of insurance the perils of fire and allied lines with any one or more perils of casualty, fidelity, surety and inland marine insurance, which such company is authorized to make, and may charge therefor one indivisible premium or rate which may differ from the aggregate premium or rate applicable to separate policies covering the same property and risk or risks, and the difference in rates or premiums shall not be deemed to be unfairly discriminatory under the provisions of chapter 375, RSMo, and this chapter. (L. 1959 H.B. 249 §§ 1, 2, A.L. 1965 p. 586, A.L. 1967 p. 516, A.L. 1972 S.B. 547, A.L. 1989 S.B. 250)
Corporations may be formed for the purpose of doing business mentioned in section 379.010, either on the stock or mutual plan; and every corporation so formed on the mutual plan shall have the word "mutual" affixed to the name which it assumes; and it shall not be lawful for any corporation so formed to do business on any other plan than that upon which it is organized, or for a corporation formed upon the mutual plan in any manner to use its name or to make publication thereof, unless the word "mutual" be affixed thereto in plain letters of the size of the letters in which the balance of the name is printed; and no such corporation shall adopt the name of any existing company or corporation transacting the same kind of business, or a name so similar as to be calculated to mislead the public; and the mutual companies shall not issue policies known as stock policies, or do business as joint stock companies, or upon the joint stock plan; but any mutual company upon a majority vote of its members present at an annual meeting, or at any special meeting called for that purpose after one week's notice by advertisement in one or more newspapers printed and published in the city or county where the chief office of said company is located, may charge and receive for the mutual benefit of all its policyholders cash in payment of premiums on such of its policies as shall be, by a majority vote of such meeting, determined upon. (RSMo 1939 § 5907, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5796; 1919 § 6206; 1909 § 6998
The persons mentioned in section 379.010 shall be designated as "incorporators", and any such incorporators desiring to form a company for the purpose of transacting the business mentioned in said section, upon either of the plans named in section 379.025, shall file in the office of the director of the insurance department a declaration, signed by each of such incorporators, setting forth their intention to form a corporation for the purpose of transacting the business aforesaid, which declaration shall comprise a copy of the articles of incorporation or association proposed to be adopted by them; and they shall publish a notice of such intention once in each week, or oftener, for at least four weeks, in a newspaper of general circulation, published in the county where such corporation is proposed to be located. (RSMo 1939 § 5908, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5797; 1919 § 6207; 1909 § 6999
When such incorporators propose to form a corporation for the purposes designated in section 379.010, on the joint stock plan, the articles of incorporation or association comprised in the declaration in section 379.030 shall set forth:
(1) The name assumed by such corporation, and by which it shall be known;
(2) The place where the principal office for the transaction of its business shall be located;
(3) The specific kind or kinds of business which it proposes to transact;
(4) The amount of its capital stock, and the number of shares into which it shall be divided, and the manner in which it shall be paid up or secured;
(5) The manner in which the corporate powers granted by this chapter shall be exercised, showing the number of directors, which shall not be less than nine nor more than twenty-five; and such other particulars as may be necessary to make manifest the objects and purposes of the corporation, and the manner in which it is to be conducted. (RSMo 1939 § 5909, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5798; 1919 § 6208; 1909 § 7000
Whenever the incorporators shall have filed the declaration required by section 379.030, and also proof of the publication therein required, by the affidavit of the publisher of the newspaper in which the publication was made, his foreman or clerk, with the director, it shall be the duty of the director to submit such declaration to the attorney general of this state for examination, and if it shall be found by him to be in accordance with the provisions of sections 379.010 to 379.160, and not inconsistent with the constitution and laws of this state and the United States, he shall so certify, and deliver it back to the director, who shall record the declaration, affidavit, and the certificate of the attorney general, in a book kept for that purpose, and shall furnish a certified copy of the same to the incorporators, and shall also file a certified copy of the same with the secretary of state, who, upon payment to the state director of revenue of the tax required by section 351.065, RSMo, shall issue a certificate of incorporation, upon the receipt of which they may proceed to organize in the manner set forth in their charter, and to open books for subscription to the capital stock of the company, and keep the same open until the whole amount specified in the charter is subscribed; but it shall not be lawful for such companies to issue policies or transact any business of any kind or nature whatever, except as aforesaid, until they have fully complied with the requirements of sections 379.050 and 379.055. (RSMo 1939 § 5910, A.L. 1947 V. I p. 329, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5799; 1919 § 6209; 1909 § 7001
Upon notification that the capital stock named in the charter has been subscribed, and the amounts required by section 379.010 to be paid in have been paid in as therein required, the director shall make an examination, or cause one to be made by some disinterested person, especially appointed by him for that purpose; and if it shall be found by himself, or if the person so appointed shall certify, under oath, that such capital and surplus stock, to the amount therein named as commencing capital and surplus, has been paid in and is possessed by the company in investments permitted by section 379.080, then he shall so certify, and the incorporators or officers of such company shall be required to certify under oath that the investments exhibited to the person making the examination, are the bona fide property of such company. (RSMo 1939 § 5912, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5801; 1919 § 6211; 1909 § 7002
When the corporators have fully complied with the requirements of section 379.050, and have transferred to and deposited with the director of the insurance department the securities as required by sections 379.080 and 379.098, the director shall furnish them a certificate of deposit and his certificate of authority for them to commence the business proposed in the charter, and a certified copy of the aforesaid declaration and certificates, which, on being filed and recorded in the office of the recorder of the county in which the company is located, shall be its authority to commence business and issue policies; and the certified copy of the declaration and certificates may be used in evidence for or against the company with the same effect as the originals. (RSMo 1939 § 5913, A.L. 1961 p. 463, A.L. 1967 p. 516)
Prior revisions: 1929 § 5802; 1919 § 6212; 1909 § 7003
When such incorporators propose to form a corporation for the purpose of doing business on the mutual plan, the charter comprised in the declaration mentioned in section 379.030 shall set forth:
(1) The name assumed by such corporation, and by which it shall be known;
(2) The place where the principal office for the transaction of its business shall be located;
(3) The specific kind or kinds of business which it proposes to transact;
(4) The number of persons from whom proposals for insurance shall be received, the amount of premiums to be received on deposit, and the amount of cash to be paid on the same, before the company shall begin to do business and issue policies;
(5) The manner in which the corporate powers granted by sections 379.010 to 379.160 are to be exercised, showing the number of directors and trustees, which shall not be more than thirteen nor less than nine, and their respective powers and duties, and such other particulars as may be necessary to make manifest the object and purposes of the association, and the manner in which it is to be conducted. (RSMo 1939 § 5914, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5803; 1919 § 6213; 1909 § 7004
Whenever the incorporators shall have filed the declaration required by section 379.030 and also proof of the publication therein required, by the affidavit of the publisher of the newspaper in which the publication was made, his foreman or clerk, with the director, it shall be the duty of said director to submit such declaration to the attorney general of this state for examination; and if it shall be found by him to be in accordance with the provisions of sections 379.010 to 379.160, and not inconsistent with the constitution and laws of this state and of the United States, he shall so certify and deliver it back to the director, who shall cause the said declaration and affidavit, with the certificate of the attorney general, to be recorded in a book to be kept for that purpose, and shall furnish a certified copy of the same to the corporators, and shall also file a certified copy of the same with the secretary of state, who, upon payment to the state director of revenue of the sum of seventy-five dollars, shall issue a certificate of incorporation, upon the receipt of which they may proceed to organize in the manner set forth in their articles of incorporation or association, to open books and receive subscriptions to the policyholders' surplus mentioned in section 379.010 and issue receipts therefor, and to keep such books open until the whole amount specified in its articles of incorporation or association is received; but it shall not be lawful for such company to issue policies or transact any business of any kind, except as aforesaid, until it has fully complied with the requirements of sections 379.070 and 379.075. (RSMo 1939 § 5915, A.L. 1947 V. I p. 329, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5804; 1919 § 6214; 1909 § 7005
Upon notification that subscriptions to the policyholders' surplus mentioned in section 379.065 have been made, and that the subscriptions therein mentioned have been received, the director shall make an examination, or cause one to be made by some disinterested person specially appointed by him for that purpose; and if it shall be found by himself, or if the person so appointed shall certify, under oath, that the policyholders' surplus has been received, in the manner and to the amount required by section 379.010, and that the amount is held by it in investments permitted by section 379.080, then he shall so certify, and the incorporators or officers of such company shall be required to certify, under oath, that the investments exhibited to the person making the examination, have been received on deposit for subscriptions to such policyholders' surplus. (RSMo 1939 § 5916, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5805; 1919 § 6215; 1909 § 7006
When the incorporators have fully complied with the requirements of sections 379.010 to 379.070 and the laws of this state governing the organization of private corporations, and such corporation has transferred to and deposited with the director of the insurance department of this state the amount required by section 379.098 it shall be the duty of the director to furnish the association a certified copy of the certificate of such deposit and his certificate of authority for them to commence the business proposed in the charter, and a certified copy of the aforesaid declaration and certificates, which, on being filed and recorded in the office of the recorder of the county in which the association is to be located, shall be its authority to commence business and issue policies; and such certified copies of the declaration, certificate of authority and certificate of deposit may be used in evidence for or against such company, with the same effect as the originals. (RSMo 1939 § 5917, A.L. 1967 p. 516, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5806; 1919 § 6216; 1909 § 7007
1. (1) The amount of the minimum capital required of a stock company to write the lines of business it proposes to transact or is transacting, or if the company is a mutual company an amount equal to the minimum capital required of a stock company transacting the same classes of business, shall be held in cash or invested in:
(a) Treasury notes or bonds of the United States;
(b) Bonds of the state of Missouri;
(c) Bonds issued by any school district of the state of Missouri;
(d) Bonds of any political subdivision of this state;
(2) The remainder of the capital, surplus or policyholders' surplus of these companies and their other assets may be invested, to the extent allowed by this or any other provision of law, in:
(a) The investments authorized by subdivision (1) of subsection 1 of this section;
(b) Loans safely secured by personal property collateral worth, at its cash market value, not less than twenty percent in excess of the amount loaned thereon;
(c) Stocks, bonds or evidences of indebtedness issued by corporations organized under the laws of this state, or of the United States or of any other state;
(d) Bonds or other obligations issued by multinational development banks in which the United States is a member nation, including the African Development Bank;
(e) Bonds of any other state, or of any political subdivision of any other state;
(f) Mortgages or deeds of trust on unencumbered real estate in this or any other state worth not less than twenty percent in excess of the amount loaned thereon;
(g) If a company is authorized to do business in a foreign country or a possession of the United States or has outstanding insurance or reinsurance contracts on risks located in a foreign country or United States' possession, the company may invest the remainder of its capital and other assets in securities, cash or other investments payable in the currency of the foreign country or possession that are of substantially the same kinds and classes as those eligible for investments under this subsection, provided that such investments are made with the approval of the director. The aggregate amount of the foreign investments and cash shall not exceed the greater of one and one-half times the amount of the company's reserves and other obligations under the contracts or the amount that the company is required by law to invest in the foreign country or possession, and the aggregate amount of foreign investments and cash shall not exceed five percent of the company's admitted assets. All foreign investments shall be reported to the director from time to time as he directs;
(h) Loans evidenced by bonds, notes or other evidences of indebtedness guaranteed or insured, but only to the extent guaranteed or insured by the United States, any state, territory or possession of the United States, the District of Columbia, or by any agency, administration, authority or instrumentality of any of the political units enumerated;
(i) Shares of insured state-chartered building and loan associations and federal savings and loan associations, if such shares are insured by the Federal Deposit Insurance Corporation;
(j) Investments permitted by section 99.550, RSMo;
(k) Data processing equipment, automobiles, real estate and put or call options and financial futures contracts to the extent allowed by this section and any other provision of law;
(l) Investments in subsidiaries to the extent allowed by section 382.020, RSMo;
(m) Any other investments not described herein provided the aggregate amount of such investments shall not exceed eight percent of the admitted assets of the company;
(n) Any investments in an investment pool meeting the requirements of section 379.083 and any other provision of law relating to investments made by individual property and casualty companies;
(o) Any other investments expressly authorized in writing by the director of the department of insurance; and
(p) Any investment in a Missouri tax credit certificate or partnership interest which entitles the company to receive Missouri tax credits that may be used as a credit against the gross premium tax.
2. Violation of any of the provisions of this section by an insurer is grounds for the suspension or revocation of its certificate of authority by the director. (RSMo 1939 § 5918, A.L. 1943 p. 610, A.L. 1947 V. II p. 269, A.L. 1963 p. 485, A.L. 1977 S.B. 368, A.L. 1981 S.B. 11, A.L. 1982 S.B. 729, A.L. 1985 H.B. 589, A.L. 1987 H.B. 700, A.L. 1989 S.B. 250, A.L. 1992 H.B. 1574, A.L. 1993 H.B. 709, A.L. 1997 H.B. 793, A.L. 2002 H.B. 1568 merged with S.B. 1009)
CROSS REFERENCES:
Bi-state development agency, bonds of, investment in authorized, RSMo 70.377
Savings accounts in insured savings and loan associations, investment in authorized, RSMo 369.194
1. Property or liability domestic insurers shall maintain assets which meet both the following requirements:
(1) The assets shall be diversified both as to type and issue; and
(2) The assets shall be reasonably liquid.
2. As used in this section, the following terms mean:
(1) "Insurer", a property or liability domestic insurer;
(2) "Policyholder obligations", those liabilities of the insurer to, or for, its policyholders arising out of its policies and to its creditors and includes the liabilities required to be included in the insurer's annual statement, including, but not limited to:
(a) The unearned premium reserve;
(b) Claim or loss reserves, including incurred but not reported claims and including loss adjustment expense reserves;
(c) Minimum capital and minimum surplus or minimum policyholders surplus; and
(d) Ceded reinsurance balances payable. "Policyholder obligations" do not include that portion of the insurer's capital and surplus, or policyholders surplus if a mutual, in excess of the minimum capital and surplus or minimum policyholders surplus required by law for such insurer.
3. An insurer's assets covering policyholder obligations shall meet all of the following standards in order to be deemed diversified under subdivision (1) of subsection 1 of this section:
(1) An insurer may have assets consisting of * investments in, without limitation and notwithstanding the provisions of subdivision (2) of this subsection:
(a) Assets described in paragraphs (a), (b), (c) and (d) of subdivision (1) of subsection 1 of section 379.080;
(b) Bonds and other evidences of indebtedness issued by corporations organized under the laws of this state or of the United States or of any other state, if rated 1 or 2 by the Securities Valuation Office of the National Association of Insurance Commissioners; and
(c) Assets described in paragraphs (e) and (h) of subdivision (2) of subsection 1 of section 379.080, where such bonds, notes or evidences of indebtedness are:
a. Issued, guaranteed or insured by the United States or any agency, administration, authority or instrumentality of the United States; or
b. Rated 1 or 2 by the Securities Valuation Office of the National Association of Insurance Commissioners;
(2) No insurer may have assets to cover policyholder obligations or investments to cover policyholder obligations in:
(a) Subsidiaries in excess of the amount allowed by paragraph (o) of subdivision (2) of subsection 1 of section 379.080;
(b) The securities, including for this purpose partnership and other equity interests, in one institution in excess of five percent of policyholder obligations. For purposes of this paragraph, one institution includes all entities under common ownership or control as defined in subdivision (2) of section 382.010, RSMo. This paragraph is an additional standard applicable to bonds and short term investments under paragraph (c) of this subdivision, common stocks under paragraph (d) of this subdivision, preferred stocks under paragraph (e) of this subdivision, and other invested assets and aggregate write-ins for invested assets under paragraph (f) of this subdivision;
(c) Investments in bonds and short term investments which violate the standards mandated by sections 375.1070 to 375.1075, RSMo. No insurer shall be forced to liquidate or nonadmit bonds purchased before August 28, 1991;
(d) Common stocks in excess of ten percent of policyholder obligations;
(e) Preferred stocks in excess of ten percent of policyholder obligations;
(f) Other invested assets and aggregate write-ins for invested assets, and aggregate write-ins for other than invested assets, as described in the insurer's filed annual statement, in excess of five percent of policyholder obligations;
(g) Mortgage loans on real estate, in excess of:
a. Ten percent of policyholder obligations, regarding the aggregate of such loans; and
b. One percent of policyholder obligations, regarding the amount loaned upon any one particular piece of real estate;
(h) Real estate occupied by the company and for other purposes, in excess of the standards set forth in section 375.330, RSMo;
(i) Collateral loans on personal property in excess of:
a. Five percent of policyholder obligations, regarding the aggregate of such loans; and
b. One percent of policyholder obligations, regarding the amount loaned upon any one particular personal property;
(j) Receivables from parents, subsidiaries or affiliates, as described in the insurer's filed annual statement, in excess of five percent of policyholder obligations;
(k) Assets other than cash and the assets described in paragraphs (c) to (j) of this subdivision, in excess of twenty-five percent of policyholder obligations.
(3) Assets may be invested or held in amounts in excess of the limitations provided by subdivision (2) of this subsection to the extent of that portion of the insurer's capital and surplus, or policyholders surplus if a mutual, in excess of the minimum capital and surplus or minimum policyholders surplus required by law for such insurer.
4. Assets shall be deemed reasonably liquid under subdivision (2) of subsection 1 of this section, if the assets are convertible to cash within a reasonable period of time to discharge timely the insurer's claims and other liabilities. (L. 1992 H.B. 1574 § 13)
*Word "an" appears here in original rolls.
1. As used in this section, the following terms mean:
(1) "Affiliate", as defined in section 382.010, RSMo;
(2) "Business entity", a corporation, limited liability company, association, partnership, joint stock company, joint venture, mutual fund trust, or other similar form of business organization, including such an entity when organized as a not-for-profit entity;
(3) "Qualified bank", a national bank, state bank or trust company that at all times is no less than adequately capitalized as determined by the standards adopted by the United States banking regulators and that is either regulated by state banking laws or is a member of the Federal Reserve System.
2. An insurer may acquire investments in investment pools that invest only in investments which an insurer may acquire pursuant to sections 379.080, 379.082 and other provisions of law. The insurer's proportionate interest in the amount invested in these investments shall not exceed the applicable limits of sections 379.080, 379.082 and other provisions of law. An insurer and its affiliated insurers may invest in a maximum of three investment pools.
3. An investment pool qualified pursuant to this section shall not:
(1) Acquire securities issued, assumed, guaranteed or insured by the insurer or an affiliate of the insurer;
(2) Borrow or incur an indebtedness for borrowed money, except for transactions that meet the requirements of sections 379.080, 379.082 and other provisions of law;
(3) Permit the aggregate value of securities then loaned or sold to, purchased from or invested in any one business entity, which in no event will be an affiliated entity of the participant, to exceed ten percent of the total assets of the investment pool; or
(4) Lend money or other assets to participants in the pool.
4. An insurer shall not acquire an investment in an investment pool pursuant to this section if, as a result of such investment, the aggregate amount of investments then held by the insurer pursuant to this section:
(1) In any one investment pool would exceed ten percent of its admitted assets; or
(2) In all investment pools would exceed thirty percent of its admitted assets.
5. For an investment in an investment pool to be qualified pursuant to this section, the manager of the investment pool shall:
(1) Be organized under the laws of the United States or an individual state and be designated as the pool manager in a pooling agreement;
(2) Be the insurer, an affiliated insurer, a qualified bank, a business entity registered under the federal Investment Advisors Act of 1940 (15 U.S.C. section 80A-1 et seq.) as amended or, in the case of a reciprocal insurer or interinsurance exchange, its attorney-in-fact;
(3) Compile and maintain detailed accounting records setting forth:
(a) The cash receipts and disbursements reflecting each participant's proportionate investment in the investment pool;
(b) A complete description of all underlying assets of the investment pool, including amount, interest rate, maturity date, if any, and other appropriate designations; and
(c) Other records which, on a daily basis, allow third parties to verify each participant's investment in the investment pool; and
(4) Maintain the assets of the investment pool in one custody account, in the name of or on behalf of the investment pool, under a custody agreement with a qualified bank. All custodial agreements shall be filed with the department of insurance for prior approval. The custody agreement shall:
(a) State and recognize the claims and rights of each participant;
(b) Acknowledge that the underlying assets of the investment pool are held solely for the benefit of each participant in proportion to the aggregate amount of its investments in the investment pool; and
(c) Contain an agreement that the underlying assets of the investment pool shall not be commingled with the general assets of the custodian qualified bank or any other person.
6. The pooling agreement for each investment pool shall be in writing and shall provide that:
(1) An insurer and its affiliated insurers shall, at all times, hold one hundred percent of the interests in the investment pool;
(2) The underlying assets of the investment pool shall not be commingled with the general assets of the pool manager or any other person;
(3) In proportion to the aggregate amount of each pool participant's interest in the investment pool:
(a) Each participant owns an undivided interest in the underlying assets of the investment pool; and
(b) The underlying assets of the investment pool are held solely for the benefit of each participant;
(4) A participant or, in the event of the participant's insolvency, bankruptcy or receivership, its trustee, receiver or other successor-in- interest, may withdraw all or any portion of its investment from the pool under the terms of the pooling agreement;
(5) Withdrawals may be made upon demand without penalty or other assessment on any business day, but settlement of funds shall occur within a reasonable and customary period thereafter not to exceed five business days. Distributions pursuant to this subdivision shall be calculated in each case net of all then applicable fees and expenses of the pool. The pooling agreement shall provide that the pool manager shall distribute to a participant, at the discretion of the pool manager:
(a) In cash, the then fair market value of the participant's pro rata share of each underlying asset of the investment pool;
(b) In kind, a pro rata share of each underlying asset; or
(c) In a combination of cash and in-kind distributions, a pro rata share in each underlying asset; and
(6) The pool manager shall make the records of the investment pool available for inspection by the director of the department of insurance.
7. The investment pool authorized pursuant to this section shall be a business entity.
8. The pooling agreement and any other arrangements or agreements relating to an investment pool, and any amendments thereto, shall be submitted to the department of insurance for prior approval pursuant to section 382.195, RSMo. Individual financial transactions between the pool and its participants in the ordinary course of the investment pool's operations shall not be subject to the provisions of section 382.195, RSMo. Investment activities of pools and transactions between pools and participants shall be reported annually in the registration statement required by section 382.100, RSMo. (L. 1997 H.B. 793)
1. No company formed upon the mutual plan for the purpose of doing the fire and marine business designated in the first of the three classes of insurance named in section 379.010 shall commence or continue to do business until it has a surplus or guaranty fund of one million six hundred thousand dollars and agreements have been entered into for insurance with at least two hundred applicants, the premiums on which shall amount to not less than one hundred thousand dollars which shall have been paid in cash. Annual cash premiums shall not exceed five hundred dollars each, and no policy shall be issued for a longer term than five years.
2. Except that any mutual company formed upon the mutual plan for the purpose of doing the fire and marine business designated in the first of the three classes of insurance named in section 379.010 and licensed to do business in this state on July 1, 1987, which did not maintain an aggregate amount of at least one million six hundred thousand dollars as a guaranty fund or policyholders' surplus on December 31, 1986, may renew its license for business specified therein if it annually maintains agreements with two hundred applicants, the premiums from which amount to not less than one hundred thousand dollars, and if it maintains an aggregate amount of not less than eight hundred thousand dollars as a guaranty fund or policyholders' surplus, if all other conditions have been met, until December 31, 1989, at which time the provisions of subsection 1 of this section shall be met.
3. Violation of any of the provisions of this section by an insurer is grounds for the revocation of its certificate of authority by the director. (RSMo 1939 § 5919, A.L. 1963 p. 485, A.L. 1977 S.B. 368, A.L. 1987 H.B. 700)
Prior revisions: 1929 § 5808; 1919 § 6218; 1909 § 7009
Effective 7-1-87
CROSS REFERENCE: Substitution of securities, collection of income therefrom, RSMo 375.460
1. Every person who shall insure in such mutual company, whose premium is payable by note, shall, before he receives his policy, deposit with the company a note for such sum or sums of money as may be agreed upon for the premium, a part, not less than ten percent of which, shall be immediately paid in cash before the company shall be liable for any loss; and the remainder of said note shall be made payable at any time, and in part or the whole as the directors of said company may demand, upon an assessment to be made by them whenever they shall deem the same necessary, for the payment of losses, expenses and other liabilities of said company; said note, or such part thereof as shall remain unpaid at the expiration or termination of the policy, shall be given up to the maker of the same, provided all assessments upon such note and all liabilities of said maker to the company shall have been paid.
2. All buildings and other property, real and personal, insured by and with such company, together with all right, title and interest of the insured to the lands on which such buildings are situated, shall be pledged to such company, and the company shall have a lien thereon until the aforesaid note is fully paid; provided, that the maker of said note shall assent to such lien in writing upon the face of the same. (RSMo 1939 § 5920)
Prior revisions: 1929 § 5809; 1919 § 6219; 1909 § 7010
1. The board of directors of every mutual insurance company organized under the provisions of sections 379.010 to 379.160 shall have the power, as often as they shall deem it necessary in order to settle the losses insured against, and the expenses and other liabilities of the company, to make an assessment upon the premium notes given by persons effecting insurance of the company.
2. Such assessment shall be made upon each and every note held by the company at the time of the assessment, and which has been in existence for one year prior to the date of the assessment, and shall be for a sum upon each note which bears the same ratio to the whole amount to be raised by the assessment that the full sum for which such note was given bears to the full amount for which all the notes assessed were given.
3. The amount so assessed upon each note shall be due and payable within thirty days after the publication of a notice of such assessment, and after written notice of the same to the maker of such note has been deposited in the post office, postage prepaid, or delivered to him in person; and the amount of said assessment, when paid, shall in every case be endorsed upon said note at the time of the payment.
4. The publication of the above notice shall be made in some newspaper of general circulation, published in the county or city where said company shall have its principal office, and shall set forth the full aggregate amount for which all the premium notes held by the company were given, upon which the assessment is made, the amount of losses adjusted and unpaid, the amount of losses claimed but unadjusted, giving the names of claimants, the amount of expenses accrued and unpaid, and the amount of cash on hand.
5. If any person shall neglect or refuse to pay the sum so assessed upon him, for thirty days after the publication and mailing or delivery of said notices, the directors of said company may sue for and recover the whole amount of his premium note held by the company, with costs of suit.
6. No person shall, in any case, be liable upon any premium note on account of any and all claims and assessments upon the same for an amount greater than the face of such note. (RSMo 1939 § 5921)
Prior revisions: 1929 § 5810; 1919 § 6220; 1909 § 7011
No existing insurance company organized under any general or special law of this state, and transacting business of the character designated in this chapter, or any company organized under this chapter, shall commence, continue, or carry on business until the company has transferred to and deposited with the director of the insurance department, for the security of its policyholders and creditors, bonds or treasury notes issued or guaranteed by the United States, or bonds of the state of Missouri, or in bonds issued by any school district of the state of Missouri, or bonds of any political subdivision of this state, and in all cases not to be received at a rate above their par value, nor above their current market value, in the following amounts:
(1) If a stock company, the amount of the minimum capital required of a company to write the lines of business it proposes to or is transacting;
(2) If a mutual company or reciprocal or interinsurance exchange, an amount equal to the amount required to be deposited by a stock company transacting the same kinds of business; provided, however, the deposit required for a mutual company shall not exceed the amount of its policyholders' surplus as required by law. (L. 1967 p. 516, A.L. 1989 S.B. 250)
The director of the insurance department of the state shall receive the deposits and securities required by the provisions of sections 379.010 to 379.160 to be deposited with him, and shall furnish a certificate of such deposits to the company making the same. (RSMo 1939 § 5922)
Prior revisions: 1929 § 5811; 1919 § 6221; 1909 § 7012
CROSS REFERENCE: Deposit of securities, how, where, collection of income therefrom, RSMo 375.460
Each company shall maintain as liabilities unearned premium and loss reserves. (L. 1989 S.B. 250)
1. It shall be the duty of the president or vice president and secretary or a majority of the directors of every insurance company organized pursuant to sections 379.010 to 379.160, or the laws of this state, or of the United States or any other state of the United States, doing the business mentioned in section 379.010 annually, on the first day of January, or within sixty days thereafter, to prepare under oath and deposit in the office of the director of the insurance department a statement made up for the year ending the thirty-first day of December next preceding, showing:
(1) The amount of capital stock of the company, if it be a joint stock company, or if it be a mutual company, the amount of the face of the premium notes held by it, and the amount thereof remaining unpaid, specifying the amount constituting liens on property, and the amount of guarantee fund, if the company has such fund;
(2) The property or assets held by the company, specifying:
(a) The value of the real estate held by such company;
(b) The amount of cash on hand or deposited in banks to the credit of the company, specifying in what banks the same is deposited;
(c) The amount of cash in the hands of agents, and in the course of transmission;
(d) The amount of loans secured by bonds and mortgages or by deeds of trust;
(e) The amount of notes and bills receivable, matured and remaining unpaid;
(f) The amount of notes and bills receivable maturing;
(g) The amount of other securities held by the company specifying what they are and their cash value;
(h) The amount of debts considered bad or doubtful;
(3) The liabilities of the company, as follows:
(a) The amount due or to become due to banks or other creditors;
(b) Losses adjusted and due;
(c) Losses adjusted and not due;
(d) Losses unadjusted and in suspense and awaiting further proofs;
(e) Premium reserved or amount required to safely reinsure all outstanding risks, to be estimated by taking fifty percent of the gross premiums on all unexpired fire risks that have less than one year to run, and a pro rata of all gross premiums on risks that have more than one year to run, with fifty percent of the gross premiums on all unexpired inland navigation risks, and the whole amount of the gross premiums on all unexpired marine risks, and a pro rata of all gross premiums on all other risks;
(f) All other claims against the company;
(4) Greatest amount insured in any one risk;
(5) The number of agents employed in this state or other states;
(6) The amount of outstanding risks and gross premiums received and receivable thereon at the date of each statement;
(7) The amount of receipts from all sources, and amount of expenditures for all purposes, including dividends for the last fiscal year preceding the date of the statement; and
(8) A statement of any other facts or information concerning the affairs of said company which may be required by the director.
2. Notwithstanding any other provision of law to the contrary, information regarding compensation of any employee or officer contained within a statement required to be filed pursuant to this section shall not be subject to disclosure to any person other than employees of the department. (RSMo 1939 § 5923, A.L. 1967 p. 516, A.L. 2000 S.B. 896)
Prior revisions: 1929 § 5812; 1919 § 6222; 1909 § 7013
As used in sections 379.110 to 379.120 the following words and terms mean:
(1) "Insurer", any insurance company, association or exchange authorized to issue policies of automobile insurance in the state of Missouri;
(2) "Nonpayment of premium", failure of the named insured to discharge when due any of his or her obligations in connection with the payment of premiums on a policy, or any installment of such premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit;
(3) "Policy", an automobile policy providing automobile liability coverage, uninsured motorists coverage, automobile medical payments coverage, or automobile physical damage coverage insuring a private passenger automobile owned by an individual or partnership which has been in effect for more than sixty days or has been renewed. "Policy" does not mean:
(a) Any policy issued under an automobile assigned risk plan or automobile insurance plan;
(b) Any policy insuring more than four motor vehicles;
(c) Any policy covering the operation of a garage, automobile sales agency, repair shop, service station or public parking place;
(d) Any policy providing insurance only on an excess basis, or to any contract principally providing insurance to such named insured with respect to other than automobile hazards or losses even though such contract may incidentally provide insurance with respect to such motor vehicles;
(4) "Renewal" or "to renew", the issuance and delivery by an insurer of a policy superseding at the end of the policy period a policy previously issued and delivered by the same insurer, such renewal policy to provide types and limits of coverage at least equal to those contained in the policy being superseded, or the issuance and delivery of a certificate or notice extending the term of a policy beyond its policy period or term with types and limits of coverage at least equal to those contained in the policy being extended; provided, however, that any policy with a policy period or term of less than six months or any period with no fixed expiration date shall for the purpose of this section be considered as if written for successive policy periods or terms of six months. Nothing in this subdivision shall be construed as superseding the provisions of subsection 9 of section 375.918, RSMo, and the term "third anniversary date of the initial contract" as used in subsection 9 of section 375.918, RSMo, means three years after the date of the initial contract. (L. 1973 H.B. 354 § 1, A.L. 1974 S.B. 572, A.L. 2004 S.B. 1299)
The provisions of sections 379.110 to 379.120 shall apply to that portion of policies of automobile insurance providing bodily injury and property damage liability, comprehensive, and collision coverages and to the provisions therein, if any, relating to medical payments and uninsured motorists coverage, which takes effect subsequent to September 28, 1973. (L. 1973 H.B. 354 § 2, A.L. 1974 S.B. 572)
1. Except as provided in sections 379.110 to 379.120, no insurer shall exercise its right to cancel a policy except for the following reasons:
(1) Nonpayment of premium; or
(2) The driver's license of the named insured has been under suspension or revocation at any time during the policy period. Provided, however, in the event more than one person is named as insured and only one of the persons named has his driver's license suspended or revoked then such policy may not be canceled, but the insurer may issue an exclusion providing, by name, that coverage will not be provided under the terms of the policy while such person is operating the insured vehicle during any period of suspension or revocation.
2. Renewal of a policy shall not constitute a waiver or estoppel with respect to grounds for cancellation which existed before the effective date of such renewal and which were unknown to the insurer at the time of such renewal.
3. No insurer shall cancel or refuse to write or refuse to renew a policy of automobile insurance on any person with at least two years' driving experience solely because of the age, residence, race, sex, color, creed, national origin, ancestry or lawful occupation, including the military service, of anyone who is or seeks to become insured or solely because another insurer has refused to write a policy, or has canceled or has refused to renew an existing policy in which that person was the named insured, nor shall any insurance company or its agent or representative require any applicant, policyholder or operator to divulge in a written application or otherwise whether any insurer has canceled or refused to renew or issue to the applicant, policyholder or operator a policy of automobile insurance; provided, however, nothing herein contained shall be construed so as to require any insurer which under its plan of operation insures a particular class of persons or customarily operates in a specific geographical territory to insure any person outside of the class or operate outside the geographical territory. (L. 1973 H.B. 354 § 3, A.L. 1974 S.B. 572)
(1977) This section does not prohibit a cancellation whose effective date would occur more than sixty-one days past the issuance of the policy so long as the cancellation was initiated during the initial sixty-day period. Hudson v. State Security Insurance Co. (A.), 555 S.W.2d 859.
Any insurer may at any time refuse to write a policy of automobile insurance or may cancel or refuse to renew such a policy if the operator's or chauffeur's license of the applicant or named insured has been suspended or revoked. If the operator's or chauffeur's license of any member of a policyholder's household has been suspended or revoked, an insurer may issue an exclusion providing, by name, that coverage will not be provided under the terms of the policy while such person is operating the insured vehicle during any period of suspension or revocation. (L. 1973 H.B. 354 § 4, A.L. 1974 S.B. 572)
1. If any insurer proposes to cancel or to refuse to renew a policy of automobile insurance delivered or issued for delivery in this state except at the request of the named insured or for nonpayment of premium, it shall, on or before thirty days prior to the proposed effective date of the action, send written notice by certificate of mailing of its intended action to the named insured at his last known address. The notice shall state:
(1) The proposed action to be taken;
(2) The proposed effective date of the action;
(3) The insurer's actual reason for proposing to take such action, the statement of reason to be sufficiently clear and specific so that a person of average intelligence can identify the basis for the insurer's decision without further inquiry. Generalized terms such as "personal habits", "living conditions", "poor morals", or "violation or accident record" shall not suffice to meet the requirements of this subdivision;
(4) That the insured may be eligible for insurance through the assigned risk plan if his insurance is to be canceled.
2. An insurer shall send an insured written notice of an automobile policy renewal at least fifteen days prior to the effective date of the new policy. The notice shall be sent by first class mail and shall contain the insured's name, the vehicle covered, the total premium amount, and the effective date of the new policy. (L. 1973 H.B. 354 § 5, A.L. 1974 S.B. 572, A.L. 1989 S.B. 250, A.L. 1990 H.B. 1739)
CROSS REFERENCE: Notice may be given by higher class U.S. mail, RSMo 375.011
If any insurer refuses to write a policy of automobile insurance, it shall, within thirty days after such refusal, send a written explanation of such refusal to the applicant at his last known address by certified mail or certificate of mailing. The explanation shall state:
(1) The insurer's actual reason for refusing to write the policy, the statement of reason to be sufficiently clear and specific so that a person of average intelligence can identify the basis for the insurer's decision without further inquiry. Generalized terms such as "personal habits", "living conditions", "poor morals", or "violation or accident record" shall not suffice to meet the requirements of this subdivision;
(2) That the applicant may be eligible for insurance through the assigned risk plan if other insurance is not available. (L. 1973 H.B. 354 § 6, A.L. 1974 S.B. 572, A.L. 1992 S.B. 831)
Effective 1-1-93
As used in sections 379.121 to 379.125, the following words and terms shall mean:
(1) "Adverse underwriting decision", placement by an insurer or agent of a risk with a residual market mechanism, an unauthorized insurer or an insurer which specializes in substandard risks;
(2) "Insurer", any insurance company, association or exchange authorized to issue policies of automobile insurance in the state of Missouri;
(3) "Policy", an automobile policy providing automobile liability coverage, uninsured motorists coverage, automobile medical payments coverage or automobile physical damage coverage insuring a private passenger automobile owned by an individual or partnership. (L. 2001 S.B. 151)
*Transferred 2004; formerly 379.124
1. No insurer shall refuse to write a policy for an applicant or base an adverse underwriting decision solely on the fact that the applicant has never purchased such a policy of motor vehicle insurance where the lack of motor vehicle insurance coverage is due to the applicant serving in the armed services and the applicant has not operated a motor vehicle in violation of any financial responsibility or compulsory insurance requirement within the past twelve months.
2. No insurer shall refuse to write a policy for an applicant or base an adverse underwriting decision solely on the fact that the applicant has not owned or been covered by such a policy of motor vehicle insurance during any specified period immediately preceding the date of application where the lack of motor vehicle insurance coverage is due to the applicant serving in the armed services and the applicant has not operated a motor vehicle in violation of any financial responsibility or compulsory insurance requirement within the past twelve months. Nothing in this subsection shall prohibit an insurer from giving a discount for such an applicant that has been covered by a policy of insurance during such a specified period.
3. Nothing in this section shall prohibit an insurer from basing an adverse underwriting decision on an applicant's previous driving record where such record indicates that the applicant is a substandard risk.
4. In order to establish compliance with this section, an insurer may require any applicant claiming to meet the criteria of subsection 1 or 2 of this section to provide proof of eligibility in a manner as the insurer may prescribe. (L. 2001 S.B. 151)
*Transferred 2004; formerly 379.126
Violation of section 379.122** shall be unfair trade practice as defined by sections 375.930 to 375.948, RSMo, and shall be subject to all of the provisions and penalties provided by such sections. (L. 2001 S.B. 151)
*Transferred 2004; formerly 379.127
**Original rolls contain "375.126", an apparent typographical error.
Any company or association, other than life, organized under the provisions of chapter 379 may cause itself to be wholly or partially reinsured against any loss arising from any risk which it may have undertaken, and in like manner may reinsure or guarantee any other corporation doing the same kind of business as itself, against loss arising from any risks that shall have been or may be undertaken by such corporation, or may join with any such corporation in any such risk, and may make and enter into all manner of contracts relating to such reinsurance and joint insurance, and the terms upon which the same shall be conducted; provided, however, any company reinsuring the whole of any single risk or risks the same being a substantial portion of all risks insured by the company shall be subject to the provisions of section 375.241, RSMo. (RSMo 1939 § 5927, A.L. 1967 p. 516)
Prior revisions: 1929 § 5816; 1919 § 6226; 1909 § 7017
(1958) Where each of two insurance policies covering the same loss contained provision that when insured had other insurance, the insurance provided by the policy was excess insurance over the other insurance, such provisions are mutually repugnant and are to be disregarded. Arditi v. Mass. Bonding & Ins. Co. (Mo.), 315 S.W.2d 736.
(1962) In garnishment proceeding by judgment creditor of insured against reinsurer of automobile liability policy, where superintendent of insurance as receiver of insolvent original insurer was a party and claimed money payable under reinsurance contract, held that under reinsurance contract indemnity against liability was provided and judgment creditor could recover from reinsurer as third party beneficiary. First National Bank of Kansas City v. Higgins (Mo.), 357 S.W.2d 139.
In all suits brought upon policies of insurance against loss or damage by fire hereafter issued or renewed, the defendant shall not be permitted to deny that the property insured thereby was worth at the time of the issuing of the policy the full amount insured therein on said property; and in case of total loss of the property insured, the measure of damage shall be the amount for which the same was insured, less whatever depreciation in value, below the amount for which the property is insured, the property may have sustained between the time of issuing the policy and the time of the loss, and the burden of proving such depreciation shall be upon the defendant; and in case of partial loss, the measure of damage shall be that portion of the value of the whole property insured, ascertained in the manner prescribed in this chapter, which the part injured or destroyed bears to the whole property insured. (RSMo 1939 § 5930)
Prior revisions: 1929 § 5819; 1919 § 6229; 1909 § 7020
(1964) Measure of damages in suit on fire insurance policy in absence of fraud is arbitrarily fixed at the amount for which property was insured, less depreciation, and court is foreclosed from considering whether insured, if it recovers on more than one policy, will have received more insurance than property was worth. MFA Mutual Ins. Co. v. Southwest Baptist Col., Inc. (Mo.), 381 S.W.2d 797.
(1964) Where fire loss exceeded aggregate of two fire policies, one insurer could not limit recovery to value of insurer's interest as vendor under sale contract. Miller v. National Fire Insurance Company (A.), 386 S.W.2d 668.
(1969) This section does not preclude insurer from questioning whether original insurable interest has been terminated. Lumbermen's Mutual Insurance Co. v. Edmister (A.), 412 F.2d 351.
(1970) The valued policy laws of Missouri are not limited in their application to insurance against loss by fire of improvements on real property but apply as well to policies of fire insurance on personal property. Prior cases to the contrary were overruled. Duckworth v. United States Fidelity and Guaranty Co. (A.), 452 S.W.2d 280.
1. When fire insurance policies shall be hereafter issued or renewed by more than one company upon the same property, and suit shall be brought upon any of said policies, the defendant shall not be permitted to deny that the property insured was worth the aggregate of the several amounts for which it was insured at the time the policy was issued or renewed thereon, unless willful fraud or misrepresentation is shown on part of the insured in obtaining such additional insurance; and in such suit the measure of damage shall be as provided in section 379.140; provided, that whatever depreciation in value below the amount for which the property is insured may be shown, as provided in section 379.140, shall be deducted from the amount insured in each policy, in the proportion which the amount in each such policy bears to the aggregate of all the amounts so insured on such property.
2. This and section 379.140 shall apply only to real property insured.
3. Any condition in any policy of insurance contrary to the provisions of this chapter shall be illegal and void. (RSMo 1939 § 5931)
Prior revisions: 1929 § 5820; 1919 § 6230; 1909 § 7021
(1964) Measure of damages in suit on fire insurance policy in absence of fraud is arbitrarily fixed at the amount for which property was insured, less depreciation, and court is foreclosed from considering whether insured, if it recovers on more than one policy, will have received more insurance than property was worth. MFA Mutual Ins. Co. v. Southwest Baptist Col., Inc. (Mo.), 381 S.W.2d 797.
(1970) The valued policy laws of Missouri are not limited in their application to insurance against loss by fire of improvements on real property but apply as well to policies of fire insurance on personal property. Prior cases to the contrary were overruled. Duckworth v. United States Fidelity and Guaranty Co. (A.), 452 S.W.2d 280.
Whenever there is a partial destruction or damage to property covered by insurance, it shall be the duty of the party writing the policies to pay the assured a sum of money equal to the damage done to the property, or repair the same to the extent of such damage, not exceeding the amount written in the policy, so that said property shall be in as good condition as before the fire, at the option of the insured. (RSMo 1939 § 5932)
Prior revisions: 1929 § 5821; 1919 § 6231; 1909 § 7022
(1957) Mutual automobile insurance company organized under §§ 379.205 to 379.310 is not subject to § 379.150 which gives insured option to require repair of damaged property or payment of money. Williams v. Farm Bur. Mut. Ins. Co. of Mo. (A.), 299 S.W.2d 587.
(1962) Where plaintiffs who suffered the loss of a house by fire elected to have insurer repair the place which could have been done at that time for less than the policy amount and the insurer upon such election undertook the repairs but abandoned the same and let the property stand whereby it was damaged, the insurer was liable for the amount of repairing the property notwithstanding the cost thereof exceeded the policy amount. Samuels v. Illinois Fire Insurance Co. (A.), 354 S.W.2d 352.
(1963) This statute giving insured, in case of partial destruction of a vehicle, the option of repairing it or claiming an amount equal to the damages done prevails over provisions in policy requiring insured to accept the value of the loss or cost of repair, whichever is the lesser. Boren v. Fidelity & Casualty Co. of New York (A.), 370 S.W.2d 706.
(2002) Section does not prohibit insurer from withholding depreciation from valid replacement cost claim. Dollard v. Depositors Insurance Company, 96 S.W.3d 885 (Mo.App. W.D.).
No fire insurance policy which may be issued after this section takes effect shall contain any clause or provision requiring the assured to take out or maintain a larger amount of insurance than that covered by such policy, nor in any way providing that the assured shall be liable as coinsurer with the company issuing the policy for any part of the loss or damage which may be occasioned by fire or lightning to the property covered by such policy, nor making provisions for a reduction of such loss or damage, or any part thereof, by reason of the failure of the assured to take out and maintain other insurance upon said property. And all clauses and provisions in fire policies, issued after the taking effect of this section, in contravention of the prohibitions in this section contained, shall be ab initio void and of no effect; provided, that the provisions of this section shall not apply to policies issued upon personal property in cities which now contain or which may hereafter contain one hundred thousand inhabitants or more whenever the insured sign an agreement endorsed across the face of said policy to be exempt from the provisions thereof. (RSMo 1939 § 5933)
Prior revisions: 1929 § 5822; 1919 § 6232; 1909 § 7023
1. Each fire insurance company doing business in the state of Missouri is hereby required to file the form of policy for use by it in the state of Missouri, covering the responsibilities of the companies as well as the duties of the assured, to be classed and known as the standard fire insurance policy. Said policy form may be approved by the director of insurance of the state, and no policy shall be issued in this state carrying risks by fire or lightning by any company which does not embrace the form filed and approved of, as herein provided. There may be printed upon such policy the words "Standard Fire Insurance Policy for Missouri" and there may be inserted before and after the word "Missouri" a designation of any state or states or territory in which such form is standard.
2. All such policies shall have an address of the company in the United States fully printed thereon, to which, in case of loss, the assured may send notice of such loss, and to which notice shall be given within sixty days after the loss.
3. The appearance of an adjuster of any company at the place of fire and loss in which said company is interested by reason of an insurance on such property, shall be considered evidence of notice and to be held as a waiver of the same on the part of the company; provided, that on any policies issued upon property, real or personal, or real and personal, there may be attached a coinsurance clause; and provided further, that when a coinsurance clause is attached to any policy a reduction in rate shall be given therefor, in accordance with coinsurance credits that are now or may hereafter be filed as a part of the public rating record in the office of the director of insurance in this state, by fire insurance companies, that have been or shall hereafter be approved by the director of insurance; provided further, that in all suits brought upon policies of insurance against loss or damage by fire hereafter issued or renewed, the defendant shall not be permitted to deny that the property insured thereby was worth at the time of the issuing of the policy the full amount insured therein on said property covering both real and personal property; and provided further, that nothing in this section shall be construed to repeal or change the provisions of section 379.140. (RSMo 1939 § 5940, A.L. 1957 p. 214, A.L. 1963 p. 498)
Prior revisions: 1929 § 5829; 1919 § 6239; 1909 § 7030
(1960) Insurer would not be heard to deny that the actual value of a house trailer at the time policy issued was the full amount for which it was insured. Gould v. M.F.A. Mut. Ins. Co. (A.), 331 S.W.2d 663.
(1964) Measure of damages in suit on fire insurance policy in absence of fraud is arbitrarily fixed at the amount for which property was insured, less depreciation, and court is foreclosed from considering whether insured, if it recovers on more than one policy, will have received more insurance than property was worth. MFA Mutual Ins. Co. v. Southwest Baptist Col., Inc. (Mo), 381 S.W.2d 797.
(1970) The valued policy laws of Missouri are not limited in their application to insurance against loss by fire of improvements on real property but apply as well to policies of fire insurance on personal property. Prior cases to the contrary were overruled. Duckworth v. United States Fidelity and Guaranty Co. (A.), 452 S.W.2d 280.
(1973) Insuror held liable for value in policy less depreciation from that value, not replacement costs. Citizens Discount and Investment Corp. v. Dixon (A.), 499 S.W.2d 231.
(1985) Where truck mounted drilling rig was destroyed by fire, the insured was entitled under this section to recover the face value of the policy less depreciation since the date of the policy. Snow v. Admiral Insurance Co., 612 F.Supp. 206 (D.C. Ark.).
The warranty of any fact or condition hereafter made by any person in his or her application for insurance against loss by fire, tornado or cyclone, which application, or any part thereof, shall thereafter be made a part of a policy of insurance, by being attached thereto, or by being referred to therein, or by being incorporated in such policy, shall, if not material to the risk insured against, be deemed, held and construed as representations only, in any suit brought at law or in equity in any of the courts of this state, upon such policy to enforce payment thereof, on account of loss of or damage to any property insured by such policy. (RSMo 1939 § 5934)
Prior revisions: 1929 § 5823; 1919 § 6233; 1909 § 7024
The warranty of any fact or condition hereafter incorporated in or made a part of any fire, tornado or cyclone policy of insurance, purporting to be made or assented to by the assured which shall not materially affect the risk insured against, shall be deemed, taken and construed as representations only in all suits at law or in equity brought upon such policy in any of the courts of this state. (RSMo 1939 § 5935)
Prior revisions: 1929 § 5824; 1919 § 6234; 1909 § 7025
No insurance company, corporation or association of persons doing a fire, cyclone or tornado insurance business in this state, shall have the right, power or authority, by contract or otherwise, to contract against or in any manner whatever evade the provisions of sections 379.165 and 379.170. (RSMo 1939 § 5936)
Prior revisions: 1929 § 5825; 1919 § 6235; 1909 § 7026
All adjustments, arbitrations, settlements and examinations of books, invoices and accounts shall be had at the town, city or neighborhood where the fire occurs, unless some other place be agreed upon between the insurer and the assured after the loss shall have occurred without regard to any provision in the policy to the contrary. (RSMo 1939 § 5937)
Prior revisions: 1929 § 5826; 1919 § 6236; 1909 § 7027
(1960) The conviction of insured of arson in connection with the burning of the insured property held admissible in action to recover the amount of the policy instituted by the insured. Connecticut Fire Insurance Co. v. Ferrara, 277 F.2d 388; Cert. den., 364 U.S. 903, 81 S.Ct. 231.
Whenever any loss or damage shall be suffered in this state from fire, by any person, persons or corporation, upon property insured under a policy of insurance of any fire insurance company doing business in this state, and notice of the fact that such loss or damage has occurred shall be given by the person, persons or corporation incurring the same, or the agent thereof, to the insurance company issuing such policy, or to the agent thereof nearest the place of loss, within a reasonable time after the date of such loss or damage, the limit to which reasonable time shall be mentioned in said policy and made a part thereof at the time of issuing the same, but the time fixed in the policy shall not be taken or construed to be a condition precedent to the right of recovery, then it shall thereupon become the duty of such insurance company to furnish to the person, persons or corporation incurring such loss or damage, such blank forms of statements and proofs of loss as such insurance company may desire to be filled out, in regard to the time, origin and circumstances of the fire causing such loss or damage, and the knowledge and belief of the insured touching the same, the lists and description and quantity of property destroyed or damaged, and of property saved and the original cost of such property, and the cash value thereof at the time of the fire, the details as to possession, ownership, title and encumbrances, and changes of title, use, occupation, possession, ownership, location and exposures since the time of issuing such policy, if any, and other insurance, if any, and description and schedules in such policy. (RSMo 1939 § 5938)
Prior revisions: 1929 § 5827; 1919 § 6237; 1909 § 7028
If any such fire insurance company shall fail, neglect or refuse to furnish blank forms of statements and proofs of loss to the insured, in case of loss or damage by fire, as provided in section 379.185, then such company shall be deemed to have waived the requiring of any such statements or proofs of loss at the hands of such insured person, persons or corporation, and upon suit brought upon such policy, such insurance company shall not be heard to complain of the failure of the insured to furnish any such statements or proofs of loss, any provision in any such policy of insurance to the contrary notwithstanding. (RSMo 1939 § 5939)
Prior revisions: 1929 § 5828; 1919 § 6238; 1909 § 7029
1. In respect to every contract of insurance made between an insurance company, person, firm or association, whether a stock, a mutual, a reciprocal or other company, association or organization, and any person, firm or corporation, by which such person, firm or corporation is insured against loss or damage on account of the bodily injury or death or damage to property by accident of any person, for which loss or damage such person, firm or corporation is responsible, whenever a loss occurs on account of a casualty covered by such contract of insurance, the liability of the insurance company, if liability there be, shall become absolute, and the payment of said loss shall not depend upon the satisfaction by the assured of a final judgment against him for loss, or damage, or death, or if the insured becomes insolvent or discharged in bankruptcy during the period that the policy is in operation or any part is due or unpaid, occasioned by said casualty.
2. No such contract of insurance shall be canceled or annulled by any agreement between the insurance company and the assured after the said assured has become responsible for such loss or damage, and any such cancellation or annulment shall be void. (RSMo 1939 § 6009)
Prior revision: 1929 § 5898
CROSS REFERENCE: Claimant and tort-feasor may contract to limit recovery to amount covered by specific insurer, RSMo 537.065
(1957) Oral agreement to provide insurance from March 31, 1955, held not merged in policy issued to cover period beginning April 19, 1955, where such policy was not accepted and such oral contract could not be modified after a loss. Am. Surety Co. of N.Y. v. Williford, 243 F.2d 494.
(1964) In action by injured party against the insurer, after judgment has been obtained by the injured party against insured, the injured party stands in shoes of insured and his rights are no greater and no less than insured's would have been in action against insurer had insured paid the judgment to injured party. Meyers v. Smith (Mo.), 375 S.W.2d 9.
Upon the recovery of a final judgment against any person, firm or corporation by any person, including administrators or executors, for loss or damage on account of bodily injury or death, or damage to property if the defendant in such action was insured against said loss or damage at the time when the right of action arose, the judgment creditor shall be entitled to have the insurance money, provided for in the contract of insurance between the insurance company, person, firm or association as described in section 379.195, and the defendant, applied to the satisfaction of the judgment, and if the judgment is not satisfied within thirty days after the date when it is rendered, the judgment creditor may proceed in equity against the defendant and the insurance company to reach and apply the insurance money to the satisfaction of the judgment. This section shall not apply to any insurance company in liquidation. (RSMo 1939 § 6010, A.L. 1991 H.B. 385, et al.)
Prior revision: 1929 § 5899
CROSS REFERENCE:
Tax lien to follow and attach to fire or tornado insurance proceeds, RSMo 139.110
(1955) Plaintiff having judgment against insured in action arising out of automobile collision held entitled to assert that rider, excluding liability coverage when car was being operated by certain person, was void for lack of consideration. Wackerle v. Pacific Employers Ins. Co., 219 F.2d 1.
(1961) Equity action based on joint judgment was filed against defendants and their respective insurers. One of the judgment debtors and his insurer were nonresidents. After suit was filed, resident insurer paid half of judgment, nonresident insurer paid two-sevenths of judgment and a judgment for the remainder was rendered against the resident insurer who then filed a cross-claim against the nonresident insurer for contribution. The court ruled that this section applied and that it authorized a direct action on the foreign policy by the judgment debtor and his subrogee. State ex rel. McCubbin v. McMillan (A.), 349 S.W.2d 453.
(1963) Where purchaser of automobile did not receive certificate of title until after he was involved in accident, purchaser was not owner of automobile at time of accident and purchaser was an insured under garage liability of policy covering seller and insurer was liable in equitable garnishment suit for satisfaction of judgment obtained against purchaser. Sabella v. American Indemnity Co. (Mo.), 372 S.W.2d 36.
(1971) In action by insured's judgment creditors against insured and insurer, court held that where automobile policy provided coverage for a six month period of February 27 to August 27, was countersigned by insurer's agent and mailed to insured who received it and "put it in the car", neither insured nor plaintiffs were in position to invoke reformation of contract to provide coverage at time of accident, September 1. Galemore v. Haley (A.), 471 S.W.2d 518.
(2001) Section is not judgment creditor's exclusive remedy for obtaining insurance proceeds from judgment debtor's insurer; ordinary postjudgment garnishment process may be used to reach insurance proceeds. Lancaster v. American and Foreign Insurance Co., 272 F.3d 1059 (8th Cir.).
Every motor vehicle liability insurance policy insuring a motor vehicle licensed in this state must extend its liability coverage to include any other motor vehicle operated by the insured individual if the other motor vehicle is loaned, with or without consideration, to the insured individual for demonstration purposes or as a replacement vehicle while the insured's vehicle is out of use because of breakdown, repair, or servicing and if the other motor vehicle is loaned by a person, firm, or corporation engaged in the business of selling, repairing, or servicing motor vehicles. Such extension of liability coverage must include coverage for damage to the loaned vehicle. (L. 1985 H.B. 388 § 1)
1. No automobile liability insurance covering liability arising out of the ownership, maintenance, or use of any motor vehicle shall be delivered or issued for delivery in this state with respect to any motor vehicle registered or principally garaged in this state unless coverage is provided therein or supplemental thereto, or in the case of any commercial motor vehicle, as defined in section 301.010, RSMo, any employer having a fleet of five or more passenger vehicles, such coverage is offered therein or supplemental thereto, in not less than the limits for bodily injury or death set forth in section 303.030, RSMo, for the protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of uninsured motor vehicles because of bodily injury, sickness or disease, including death, resulting therefrom. Such legal entitlement exists although the identity of the owner or operator of the motor vehicle cannot be established because such owner or operator and the motor vehicle departed the scene of the occurrence occasioning such bodily injury, sickness or disease, including death, before identification. It also exists whether or not physical contact was made between the uninsured motor vehicle and the insured or the insured's motor vehicle. Provisions affording such insurance protection against uninsured motorists issued in this state prior to October 13, 1967, shall, when afforded by any authorized insurer, be deemed, subject to the limits prescribed in this section, to satisfy the requirements of this section.
2. For the purpose of this coverage, the term "uninsured motor vehicle" shall, subject to the terms and conditions of such coverage, be deemed to include an insured motor vehicle where the liability insurer thereof is unable to make payment with respect to the legal liability of its insured within the limits specified herein because of insolvency.
3. An insurer's insolvency protection shall be applicable only to accidents occurring during a policy period in which its insured's uninsured motorist coverage is in effect where the liability insurer of the tort-feasor becomes insolvent within two years after such an accident. Nothing herein contained shall be construed to prevent any insurer from affording insolvency protection under terms and conditions more favorable to its insureds than is provided hereunder.
4. In the event of payment to any person under the coverage required by this section, and subject to the terms and conditions of such coverage, the insurer making such payment shall, to the extent thereof, be entitled to the proceeds of any settlement or judgment resulting from the exercise of any rights of recovery of such person against any person or organization legally responsible for the bodily injury for which such payment is made, including the proceeds recoverable from the assets of the insolvent insurer; provided, however, with respect to payments made by reason of the coverage described in subsections 2 and 3 above, the insurer making such payment shall not be entitled to any right of recovery against such tort-feasor in excess of the proceeds recovered from the assets of the insolvent insurer of said tort-feasor.
5. In any action on a policy of automobile liability insurance coverage providing for the protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of uninsured motor vehicles, the fact that the owner or operator of such uninsured motor vehicle whether known or unknown failed to file the report required by section 303.040, RSMo, shall be prima facie evidence of uninsured status, and such failure to file may be established by a statement of the absence of such a report on file with the office of the director of revenue, certified by the director, which statement shall be received in evidence in any of the courts of this state. In any such action, the report required by section 303.040, RSMo, when filed by the owner or operator of an uninsured motor vehicle, shall be prima facie evidence of lack of insurance coverage and the report, or a copy thereof, certified by the director of revenue, may be introduced into evidence in accordance with section 303.310, RSMo. (L. 1967 p. 516, A.L. 1971 H.B. 85, A.L. 1972 S.B. 458, A.L. 1982 S.B. 480, A.L. 1991 H.B. 385, et al.)
(1974) Held that where vehicle was run off road without actual contact uninsured motorist coverage would apply if vehicle which ran plaintiff off the road could be positively identified and was in fact an uninsured motorist. Ward v. Allstate Insurance Co. (Mo.), 514 S.W.2d 576.
(1975) Where insured was passenger in his car and car was being driven by insured's brother who carried no insurance, insured was denied recovery under the uninsured motorist provisions of his policy after single automobile accident. Term "uninsured motor vehicle" requires insurers to protect their insureds only from collisions with other vehicles lacking liability coverage. Miles v. State Farm Mutual Automobile Insurance Co. (A.), 519 S.W.2d 378.
(1975) Insuror is entitled to reimbursement, up to the amount it has paid under uninsured motorist coverage, from recovery had against uninsured motorist. State Farm ex. rel. Manchester Insurance and Indemnity Co. v. Moss (Mo.), 522 S.W.2d 772.
(1975) Holder of two policies on two different vehicles is entitled to "stack" uninsured motorist coverage of both policies if necessary to satisfy judgment. Galloway v. Farmers Insurance Company, In. (A.), 523 S.W.2d 339.
(1975) "Uninsured motor vehicle" does not mean underinsured vehicle. Mere fact that multiple claims greatly reduced coverage available to claimant does not allow him to come under uninsured motorist provision of his own policy. Brake v. MFA Mutual Insurance Company (A.), 525 S.W.2d 109.
(1975) Passenger in automobile is not a user within the policy provisions covering person "using" the insured automobile and is not covered under uninsured motorist coverage. Waltz v. Cameron Mutual Insurance Co. (A.), 526 S.W.2d 340.
(1976) Public policy expressed in this section prohibited insurer from limiting recovery by insured to only one of two separate uninsured motorist coverages, included in one policy and for which separate premiums were charged, one for each of two cars of which only one car was involved in the accident. Cameron Mutual Insurance Co. v. Madden (Mo.), 533 S.W.2d 538.
(1980) Employee eligible for payment under employer's uninsured motorist coverage was not entitled to "stacking" of the uninsured motorist coverage provided by the fleet policy for each vehicle insured by it. Linderer v. Royal Globe Insurance Co. (A.), 597 S.W.2d 656.
(1980) Person injured in accident involving his employer's vehicle and an uninsured motorist not entitled to a "stacking" of the uninsured motorist coverage provided for each of employer's 1,420 vehicles, but was entitled to a "stacking" of such coverage on his own vehicles. Linderer v. Royal Globe Insurance Co. (A.), 597 S.W.2d 656.
(1980) The term "uninsured motor vehicle" must be construed as referring to a vehicle being operated by a person whose legal responsibility for damages is not caused by any liability insurance provision. Dairyland Ins. Co. v. Hogan (Mo.), 605 S.W.2d 798.
(1980) Use of term "uninsured motorist" in statute requiring inclusion of uninsured motorist insurance within automobile liability policies, is shorthand expression for "owners and operators of uninsured motor vehicles"; therefore, focus of statute is on uninsured vehicle and not whether owner or operator is "uninsured motorist" under circumstances of accident. Harrison v. MFA Mutual Insurance Co. (Mo.), 607 S.W.2d 137.
(1980) Term "uninsured motor vehicle" as used in statutes providing that uninsured motorist insurance shall be included within automobile liability policy for protection of persons insured thereunder refers to vehicle whose operator or owner did not have in effect at time of accident an automobile liability policy with respect to motor vehicle involved in accident. Harrison v. MFA Mutual Insurance Co. (Mo.), 607 S.W.2d 137.
(1980) Uninsured motorist statute has no application in cases where tort-feasor did have automobile liability policy which complied with requirements of Motor Vehicle Safety Responsibility Law. Harrison v. MFA Mutual Insurance Co. (Mo.), 607 S.W.2d 137.
(1980) Provision of uninsured motorist statute which states that "uninsured motor vehicle" includes an insured motor vehicle where liability insurer thereof is unable to make payment with respect to legal liability of its insured because of insolvency applies only where automobile insured under policy is hit by another vehicle and insurer of record vehicle becomes insolvent. Harrison v. MFA Mutual Insurance Co. (Mo.), 607 S.W.2d 137.
(1980) Provision in statute requiring that uninsured motorist insurance be included within automobile liability policies allowing recovery under uninsured motorist provision when insurer of other vehicle involved is insolvent, by use of language "subject to the terms and conditions of such coverage," recognizes insurer's right to define uninsured automobile. Harrison v. MFA Mutual Insurance Co. (Mo.), 607 S.W.2d 137.
(1985) The public policy as declared in this section mandates that when an insured has two separate policies containing uninsured motorist clauses, effect shall be given to both coverages without reduction or limitation by policy provisions, and that both coverages are available to those insured thereby. Bergtholdt v. Farmers Ins. Co., Inc., (A.), 691 S.W.2d 357.
(1986) The term "uninsured motorist" as used in section 379.203, RSMo, includes a motorist who is underinsured by the standards of section 303.030, RSMo. Cook v. Pedigo, 714 S.W.2d 949 (Mo. App. 1986).
(1989) Insurer's prohibition of stacking by the policyholder's minor children is contrary to statute and invalid. Where plaintiff was a pedestrian and was injured by a hit and run driver, he was entitled to stack the uninsured motorist coverage on each of his father's autos. (Mo.App. E.D.) Husch by Husch v. Nationwide Mutual Fire Insurance Co., 772 S.W.2d 692.
(1993) Insurance company's limit of uninsured motorist coverage to injuries which were result of an accident is against public policy and is void because it attempts to narrow mandated uninsured motorist coverage required by section for every automobile liability policy. Thornburg v. Farmers Insurance Co., 859 S.W.2d 847 (Mo. App. W.D.).
(1995) Where plaintiff was otherwise qualified as an insured for liability purposes, insurance policy exclusions limiting uninsured motorist protection in insurance policy limiting coverage to owned vehicles was void as against Missouri law and public policy. Bernardo v. Northland Insurance Co., 45 F.3d 272 (8th Cir.).
(1996) Uninsured motorist coverage is not based on the vehicle in which the insured is operating or riding, but is personal coverage which follows the insured. Schmidt v. City of Gladstone, 913 S.W.2d 937 (Mo.App. W.D.).
Any underinsured motor vehicle coverage with limits of liability less than two times the limits for bodily injury or death pursuant to section 303.020, RSMo, shall be construed to provide coverage in excess of the liability coverage of any underinsured motor vehicle involved in the accident. (L. 1999 S.B. 19)
(2002) Requirement for insurers to provide excess underinsured motorist coverage under certain circumstances, effective August 28, 1999, does not apply retroactively. Melton v. Country Mutual Insurance Company, 75 S.W.3d 321 (Mo.App. E.D.).
A number of persons, not less than twenty-five, a majority of whom shall be bona fide residents of this state, by complying with the provisions of sections 379.205 to 379.310, may become together with others who may hereafter be associated with them or their successors, a body corporate for the purpose of carrying on the business of mutual insurance as herein provided. (RSMo 1939 § 5950)
Prior revisions: 1929 § 5839; 1919 § 6249
Any persons proposing to form any such company shall subscribe and acknowledge articles of incorporation specifying:
(1) The name, the purpose for which formed, and the location of its principal or home office, which shall be within this state;
(2) The names and addresses of those composing the board of directors in which the management shall be vested until the first meeting of the members;
(3) The names and places of residence of the incorporators. (RSMo 1939 § 5951)
Prior revisions: 1929 § 5840; 1919 § 6250
No name shall be adopted by such company which does not contain the word "mutual" or which is so similar to any name already in use by any such existing corporation, company or association, organized or doing business in the United States, as to be confusing or misleading. (RSMo 1939 § 5952)
Prior revisions: 1929 § 5841; 1919 § 6251
1. Such articles shall be submitted to the director of the insurance department, herein called "director".
2. Such publication shall be made as required by section 379.030, and upon proof of publication being made and approval of said articles by the attorney general as required by section 379.040, such articles shall be recorded by the director, who shall furnish a certified copy thereof to the incorporators and shall file a certified copy thereof with the secretary of state.
3. The secretary of state shall thereupon issue to the company a certificate of incorporation, which shall be its authority to begin business.
4. Such articles may be amended in the manner provided for other corporations or as may be provided in such articles. (RSMo 1939 § 5953)
Prior revisions: 1929 § 5842; 1919 § 6252
1. The company shall have legal existence from and after date of such certificate.
2. The board of directors named in such articles may thereupon adopt bylaws, accept applications for insurance, and proceed to transact the business of such company; provided, that no insurance shall be put into force until the company has been licensed to transact insurance as provided by sections 379.205 to 379.310.
3. Such bylaws and any amendments thereto shall within thirty days after adoption be filed with said director. (RSMo 1939 § 5954)
Prior revisions: 1929 § 5843; 1919 § 6253
Any company organized under the provisions of sections 379.205 to 379.310 is empowered and authorized to make contracts of insurance or to reinsure or accept reinsurance on any portion thereof, to the extent specified in its articles for the kinds of insurance following:
(1) Liability insurance. Against loss, expense or liability by reason of bodily injury or death by accident, disability, sickness or disease suffered by others for which the insured may be liable or have assumed liability, including workers' compensation.
(2) Disability insurance. Against bodily injury or death by accident and disability by sickness.
(3) Automobile insurance. Against any or all loss, expense and liability resulting from the ownership, maintenance or use of any automobile or other vehicle; provided, no policies shall be issued under this subsection against the hazard of fire alone.
(4) Steam boiler insurance. Against loss or liability to persons or property resulting from explosions or accidents to boilers, containers, pipes, engines, flywheels, elevators and machinery in connection therewith and against loss of use and occupancy caused thereby and to make inspection and issue certificates of inspection thereon.
(5) Use and occupancy insurance. Against loss from interruption of trade or business or loss of rents which may be the result of any accident or casualty.
(6) Miscellaneous insurance. Against loss or damage by any hazard upon any risk not provided for in this section, which is not prohibited by statute or at common law from being the subject of insurance, excepting life insurance and fire insurance. (RSMo 1939 § 5955)
Prior revisions: 1929 § 5844; 1919 § 6254
1. No such company shall issue policies or transact any business of insurance unless it holds a license from the director authorizing the transaction of such business. A license shall not be issued unless the company complies with the following conditions:
(1) It shall hold bona fide applications for insurance upon which it shall issue simultaneously, or it shall have in force, at least twenty policies to at least twenty members for the same kind of insurance upon not less than two hundred separate risks, each within the maximum single risk described herein.
(2) The maximum single risk shall not exceed five percent of the admitted assets or three times the average risk or one percent of the insurance in force, whichever is the greater, any reinsurance taking effect simultaneously with the policy being deducted in determining such maximum single risk.
(3) It has collected an annual premium upon each application, which premium shall be equal to not less than five times the maximum single risk assumed nor less than one hundred thousand dollars; provided, however, that the total assets of the company shall not be less than one hundred thousand dollars of paid-in premiums and a guaranty fund or contributed surplus of not less than six hundred thousand dollars which shall be held in cash or securities in which these insurance companies are authorized to invest; and provided further, that any mutual company other than life and fire licensed to do business on September 28, 1977, which confines its writings to burglary and theft, and liability, property damage and collision other than automobile and workers' compensation, shall maintain a guaranty fund or contributed surplus of not less than three hundred thousand dollars.
(4) For the purpose of transacting employer's liability and workers' compensation insurance the applications shall cover not less than one thousand five hundred employees, each employee being considered a separate risk for determining the maximum single risk.
2. Any other provision of law notwithstanding any mutual company other than life and fire licensed to do business in this state on September 28, 1977, may renew its license for business specified therein until December 31, 1979, if it maintains assets of not less than three hundred thousand dollars consisting of paid-in premiums and a guaranty fund or contributed surplus which shall be held in cash or securities in which these insurance companies are authorized to invest.
3. Violation of any of the provisions of this section by an insurer is grounds for the revocation of its certificate of authority by the director. (RSMo 1939 § 5956, A.L. 1953 p. 245, A.L. 1963 p. 485, A.L. 1977 S.B. 368)
Prior revisions: 1929 § 5845; 1919 § 6255
(1968) The certificate of authority issued to an insurance company is a license and not a contract with the state. Under its police power, the legislature may amend, repeal or reenact the statutes prescribing the conditions for such a license whenever it deems it necessary and the insurance company has no vested property right in its license. Public Mutual Casualty Co. v. Scharz (Mo.), 422 S.W.2d 301.
1. Any public or private corporation, board or association in this state or elsewhere may make applications, enter into agreements for and hold policies in any such mutual insurance company.
2. Any officer, stockholder, trustee or legal representative of any such corporation, board, association or estate may be recognized as acting for or on its behalf for the purpose of such membership, but shall not be personally liable upon such contract of insurance by reason of acting in such representative capacity.
3. The right of any corporation organized under the laws of this state to participate as a member of any such mutual insurance company is hereby declared to be incidental to the purpose for which such corporation is organized and as much granted as the rights and powers expressly conferred. (RSMo 1939 § 5957)
Prior revisions: 1929 § 5846; 1919 § 6256
Every member of the company shall be entitled to one vote, or to a number of votes based upon the insurance in force, the number of policies held, or the amount of premiums paid, as may be provided in the bylaws. (RSMo 1939 § 5958)
Prior revisions: 1929 § 5847; 1919 § 6257
1. The maximum premium payable by any member shall be expressed in the policy or in the application for the insurance.
2. Such maximum premium may be a cash premium and an additional contingent premium not less than the cash premium, or may be solely a cash premium.
3. No policy shall be issued for a cash premium without an additional contingent premium unless the company has a surplus of at least one hundred thousand dollars or a surplus which is not less in amount than the capital stock required of domestic stock insurance companies transacting the same kinds of insurance. (RSMo 1939 § 5959)
Prior revisions: 1929 § 5848; 1919 § 6258
No such company shall invest any of its assets except in accordance with the laws of this state relating to the investment of the assets of domestic stock companies transacting the same kinds of insurance. (RSMo 1939 § 5960)
Prior revisions: 1929 § 5849; 1919 § 6259
Any company organized or doing business under sections 379.205 to 379.310 shall comply with the provisions of section 379.098. (L. 1967 p. 516)
Such company shall maintain unearned premium and other reserves separately for each kind of insurance, upon the same basis as that required of domestic stock insurance companies transacting the same kind of insurance; provided, that any reserve for losses or claims based upon the premium income shall be computed upon the net premium income after deducting any so-called dividend or premium returned or credited to the member. (RSMo 1939 § 5961)
Prior revisions: 1929 § 5850; 1919 § 6260
Any company organized under the provisions of sections 379.205 to 379.310 shall on the first day of January of each year or within sixty days thereafter, file with the director of the insurance department a statement of its affairs in the same manner and form as provided in section 379.105. (L. 1967 p. 516)
Such company not possessed of assets at least equal to the unearned premium reserve and other liabilities shall make an assessment upon its members liable to assessment to provide for such deficiency, such assessment to be against each such member in proportion to such liability as expressed in his policy; provided, the director may, by written order, relieve the company from an assessment or other proceedings to restore such assets during the time fixed in such order; and provided, that any domestic company which shall be deficient in providing the unearned premium reserve required hereby may, notwithstanding such deficiency, come under this law on the condition that it shall each year thereafter reduce such deficiency at least fifteen percent of the original amount thereof, and in such case it may increase its assessments accordingly. (RSMo 1939 § 5962)
Prior revisions: 1929 § 5851; 1919 § 6261
1. Any director, officer or member of any such company, or any other person, may advance to such company any sum or sums of money necessary for the purpose of its business or to enable it to comply with any of the requirements of the law, and such moneys and such interest thereon as may have been agreed upon, not exceeding ten percent per annum, shall be payable only out of the surplus remaining after providing for all reserves and other liabilities, and shall not otherwise be a liability or claim against the company or any of its assets.
2. No commission or promotion expenses shall be paid in connection with the advance of any such money to the company, and the amount of such advance shall be reported in each annual statement. (RSMo 1939 § 5963)
Prior revisions: 1929 § 5852; 1919 § 6262
1. Any law requiring that policies be countersigned and delivered through a resident agent shall not apply to any policy of such mutual company on which no commission shall be paid to any local agent.
2. Such mutual company may insert in any form of policy prescribed by the law of this state any provisions or conditions required by its plan of insurance which are not inconsistent or in conflict with any law of this state. (RSMo 1939 § 5964)
Prior revisions: 1929 § 5853; 1919 § 6263
Every mutual insurance company or association admitted to Missouri under the provisions of sections 379.205 to 379.310 shall annually pay to the director of revenue a tax upon the direct premiums received, whether in cash or in notes, in this state, for the insurance of property or risks in this state at the rate of two percent per annum; provided, that such companies or associations shall be credited with canceled or return premiums actually paid during the year in this state. (RSMo 1939 § 5968, A.L. 1941 p. 399, A.L. 1945 p. 1021)
Prior revisions: 1929 § 5857; 1919 § 6267
1. Every such company or association shall, on or before the first day of March in each year, make a return, verified by the affidavit of its president and secretary or other chief officers, to the director of the insurance department, in the form prescribed by him, stating the amount of all gross direct premiums received, whether in cash, notes, credits or any other substitute for money, on contracts covering property, or risks located or resident in this state, during the year ending on the thirty-first day of December next preceding, and all credits to which such company or association shall be entitled under the provisions of section 379.290.
2. Upon receipt of such returns, the director of the insurance department shall verify the same and assess the tax upon various companies on the basis and at the rate provided in section 379.290, and make a schedule thereof, duplicate copies of which, properly certified by said director, shall be filed in the office of the director of revenue on or before the first day of April in each year.
3. Immediately thereafter the director of revenue shall notify the companies of the amount of taxes respectively due from them, and such taxes shall be paid to the director of revenue on or before the first day of May next ensuing.
4. If not so paid, the director of revenue shall certify such fact to the director of the insurance department, who shall thereafter suspend such delinquent company or companies from the further transaction of business in this state until such taxes shall be paid.
5. Upon receiving said money, the director of revenue shall deposit it in the state treasury and the state treasurer shall receipt one-half thereof into the general revenue fund of the state, and he shall place the remainder of said tax to the credit of the county foreign insurance tax fund. (L. 1941 p. 399 § 5968a, A.L. 1945 p. 1021)
If any company or association shall fail or refuse to make the return required by sections 379.205 to 379.310, the said director shall assess the tax against said company or association at the rate herein provided for on such amount of premiums as he shall deem just and the proceedings thereon shall be the same as if the return had been made. (L. 1941 p. 399 § 5968b, A.L. 1945 p. 1021)
1. Section 379.017 and sections 379.316 to 379.361 apply to insurance companies incorporated pursuant to sections 379.035 to 379.355, section 379.080, sections 379.060 to 379.075, sections 379.085 to 379.095, sections 379.205 to 379.310, and to insurance companies of a similar type incorporated pursuant to the laws of any other state of the United States, and alien insurers licensed to do business in this state, which transact fire and allied lines, marine and inland marine insurance, to any and all combinations of the foregoing or parts thereof, and to the combination of fire insurance with other types of insurance within one policy form at a single premium, on risks or operations in this state, except:
(1) Reinsurance, other than joint reinsurance to the extent stated in section 379.331;
(2) Insurance of vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity, or other risks commonly insured pursuant to marine, as distinguished from inland marine, insurance policies;
(3) Insurance against loss or damage to aircraft;
(4) All forms of motor vehicle insurance; and
(5) All forms of life, accident and health, and workers' compensation insurance.
2. Inland marine insurance shall be deemed to include insurance now or hereafter defined by statute, or by interpretation thereof, or if not so defined or interpreted, by ruling of the director, or as established by general custom of the business, as inland marine insurance.
3. Commercial property and commercial casualty insurance policies are subject to rate and form filing requirements as provided in section 379.321. (L. 1972 S.B. 547 § 2, A.L. 1999 S.B. 386, A.L. 2001 S.B. 186)
Rates shall be made in accordance with the provisions of this section:
(1) Due consideration shall be given to past and prospective loss experience within and outside this state, to conflagration and catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, to dividends or savings allowed or returned by insurers to their policyholders or members, to past and prospective expenses both countrywide and those specially applicable to this state, to all other relevant factors, including trend factors, within and outside this state, and in the case of fire insurance rates, to the underwriting experience of the fire insurance business during a period of not less than the most recent five-year period for which such experience is available and relevant.
(2) Risks may be grouped by classifications, by rating schedules or by any other reasonable methods, for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans which establish standards for measuring variations in hazards or expense provisions, or both. Such standards may measure any differences among risks that can be demonstrated to have a probable effect upon losses or expenses.
(3) The systems of expense provisions included in the rates for use by any insurer or group of insurers may differ from those of other insurers or groups of insurers to reflect the requirements of the operating methods of any such insurer or group with respect to any kind of insurance, or with respect to any subdivision or combination thereof for which subdivision or combination separate expense provisions are applicable and shall accurately reflect the expenses of insurers or groups of insurers.
(4) Rates shall not be excessive, inadequate or unfairly discriminatory. No rate shall be held to be excessive unless such rate is unreasonably high for the insurance coverage provided and a reasonable degree of competition does not exist in the area with respect to the classification to which such rate is applicable. No rate shall be held to be inadequate unless such rate is unreasonably low for the insurance coverage provided and is insufficient to sustain projected losses and expenses; or unless such rate is unreasonably low for the insurance coverage provided and the use of such rate has, or if continued, will have, the effect of destroying competition or creating a monopoly. Unfair discrimination shall be defined to include, but shall not be limited to, the use of rates which unfairly discriminate between risks in the application of like charges or credits or the use of rates which unfairly discriminate between risks having essentially the same hazard and having substantially the same degree of protection against fire and allied lines.
(5) Uniformity among insurers in any matters within the scope of this section is neither required nor prohibited. (L. 1972 S.B. 547 § 3)
1. Every insurer shall file with the director, except as to commercial property or commercial casualty insurance as provided in subsection 6 of this section, every manual of classifications, rules, underwriting rules and rates, every rating plan and every modification of the foregoing which it uses and the policies and forms to which such rates are applied. Any insurer may satisfy its obligation to make any such filings by becoming a member of, or a subscriber to, a licensed rating organization which makes such filings and by authorizing the director to accept such filings on its behalf, provided that nothing contained in section 379.017 and sections 379.316 to 379.361 shall be construed as requiring any insurer to become a member of or a subscriber to any rating organization or as requiring any member or subscriber to authorize the director to accept such filings on its behalf. Filing with the director by such insurer or licensed rating organization within ten days after such manuals, rating plans or modifications thereof or policies or forms are effective shall be sufficient compliance with this section.
2. Except as to commercial property or commercial casualty insurance as provided in subsection 6 of this section, no insurer shall make or issue a policy or contract except pursuant to filings which are in effect for that insurer or pursuant to section 379.017 and sections 379.316 to 379.361. Any rates, rating plans, rules, classifications or systems, in effect on August 13, 1972, shall be continued in effect until withdrawn by the insurer or rating organization which filed them.
3. Upon the written application of the insured, stating his or her reasons therefor, filed with the insurer, a rate in excess of that provided by a filing otherwise applicable may be used on any specific risk.
4. Every insurer which is a member of or a subscriber to a rating organization shall be deemed to have authorized the director to accept on its behalf all filings made by the rating organization which are within the scope of its membership or subscribership, provided:
(1) That any subscriber may withdraw or terminate such authorization, either generally or for individual filings, by written notice to the director and to the rating organization and may then make its own independent filings for any kinds of insurance, or subdivisions, or classes of risks, or parts or combinations of any of the foregoing, with respect to which it has withdrawn or terminated such authorization, or may request the rating organization, within its discretion, to make any such filing on an agency basis solely on behalf of the requesting subscriber; and
(2) That any member may proceed in the same manner as a subscriber unless the rating organization shall have adopted a rule, with the approval of the director:
(a) Requiring a member, before making an independent filing, first to request the rating organization to make such filing on its behalf and requiring the rating organization, within thirty days after receipt of such request, either:
a. To make such filing as a rating organization filing;
b. To make such filing on an agency basis solely on behalf of the requesting member; or
c. To decline the request of such member; and
(b) Excluding from membership any insurer which elects to make any filing wholly independently of the rating organization.
5. Any change in a filing made pursuant to this section during the first six months of the date such filing becomes effective shall be approved or disapproved by the director within ten days following the director's receipt of notice of such proposed change.
6. Commercial property and commercial casualty requirements differ as follows:
(1) All commercial property and commercial casualty insurance rates, rate plans, modifications, and manuals of classifications, where appropriate, shall be filed with the director for informational purposes only. Such rates are not to be reviewed or approved by the department of insurance as a condition of their use. Nothing in this subsection shall require the filing of individual rates where the original manuals, rates and rules for the insurance plan or program to which such individual policies conform have already been filed with the director;
(2) If an insurer will only renew a commercial casualty or commercial property insurance policy with an increase in premium of twenty-five percent or more, a "premium alteration requiring notification" notice must be mailed or delivered by the insurer at least sixty days prior to the expiration date of the policy, except in the case of an umbrella or excess policy the coverage of which is contingent on the coverage of an underlying policy of commercial property or casualty insurance, in which case notice of an increase in premium of twenty-five percent or more shall be mailed or delivered at least thirty days prior to the expiration date of the policy. Such notice shall be mailed or delivered to the agent of record and to the named insured at the address shown in the policy. If the insurer fails to meet this notice requirement, the insured shall have the option of continuing the policy for the remainder of the notice period plus an additional thirty days at the premium rate of the existing policy or contract. This provision does not apply if the insurer has offered to renew a policy without such an increase in premium or if the insured fails to pay a premium due or any advance premium required by the insurer for renewal. For purposes of this section, "premium alteration requiring notification" means an annual increase in premium of twenty-five percent or more, exclusive of premium increases due to a change in the operations of the insured which increases either the hazard insured against or the individual loss characteristics, or due to a change in the magnitude of the exposure basis, including, without limitation, increases in payroll or sales. For commercial multiperil policies, no "premium alteration requiring notification" shall be required unless the increase in premium for all of a policyholder's policies taken together amounts to a twenty-five percent or more annual increase in premium;
(3) Commercial property and commercial casualty policy forms shall be filed with the director as provided pursuant to subsection 1 of this section. However, if after review, it is determined that corrective action must be taken to modify the filed forms, the director shall impose such corrective action on a prospective basis for new policies. All policies previously issued which are of a type that is subject to such corrective action shall be deemed to have been modified to conform to such corrective action retroactive to their inception date;
(4) For purposes of this section, "commercial casualty" means "commercial casualty insurance" as defined in section 379.882. For purposes of this section, "commercial property" means property insurance, which is for business and professional interests, whether for profit, nonprofit or public in nature which is not for personal, family or household purposes, and shall include commercial inland marine insurance, but does not include title insurance;
(5) Nothing in this subsection shall limit the director's authority over excessive, inadequate or unfairly discriminatory rates. (L. 1972 S.B. 547 § 4, A.L. 1999 S.B. 386, A.L. 2001 S.B. 186, A.L. 2002 H.B. 1468)
1. A "rating organization" is an individual, partnership, corporation or unincorporated association other than an insurer located within or without this state, who or which has as its primary object and purpose the making and filing of rates, rating plans, rating systems or rules relating thereto, and who or which may also examine policies, daily reports, binders, renewal certificates, endorsements and other evidences of insurance or the cancellation thereof for any member or subscriber requesting such auditing service.
2. Such a rating organization shall make application to the director for license as a rating organization for such kinds of insurance, or subdivisions, or classes or risk, or parts or combinations of any of the foregoing as are specified in its application and shall file therewith:
(1) A copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its bylaws, rules and regulations governing the conduct of its business;
(2) A list of its members and subscribers;
(3) The name and address of a resident of this state upon whom notices or orders of the director or process affecting such rating organization may be served;
(4) A statement of its qualifications as a rating organization; and
(5) An agreement that the director may examine such rating organization in accordance with the provisions of section 379.343.
3. If the director finds that the applicant is competent, trustworthy, and otherwise qualified to act as a rating organization, and that its constitution, articles of agreement or association or certificate of incorporation, and its bylaws, rules and regulations governing the conduct of its business conform to the requirements of law, he shall issue a license specifying the kinds of insurance, or subdivisions, or classes or risk, or parts or combinations of any of the foregoing for which the applicant is authorized to act as a rating organization. Every such application shall be granted or denied in whole or in part by the director within sixty days of the date of its filing with him. Licenses issued pursuant to this section shall remain in effect for three years unless sooner suspended or revoked by the director. The fee for the license is twenty-five dollars. Licenses issued pursuant to this section may be suspended or revoked by the director, after hearing upon notice, in the event the rating organization ceases to meet the requirements of this subsection. Every rating organization shall notify the director promptly of every change in:
(1) Its constitution, its articles of agreement or association, or its certificate of incorporation, and its bylaws, rules and regulations governing the conduct of its business;
(2) Its list of members and subscribers; and,
(3) The name and address of the resident of this state designated by it upon whom notices or orders of the director or process affecting such rating organization may be served.
4. Subject to rules and regulations which have been approved by the director as reasonable, each rating organization shall permit any insurer, not a member, to be a subscriber to its services for any one or more of the kinds of insurance, subdivisions, or classes or risk or parts or combinations of any of the foregoing for which it is authorized to act as an organization. Notice of proposed changes in such rules and regulations shall be given to subscribers. Each rating organization shall furnish its services without discrimination to its members and subscribers. The reasonableness of any rule or regulation in its application to subscribers, or the refusal of any rating organization to admit an insurer as a subscriber, shall, at the request of any subscriber or any such insurer, be reviewed by the director at a hearing held upon at least ten days' written notice to such rating organization and to such subscriber or insurer. If the director finds that such rule or regulation is unreasonable in its application to subscribers, he shall order that such rule or regulation shall not be applicable to subscribers. If the rating organization fails to grant or reject an insurer's application for subscribership within thirty days after it was made, the insurer may request a review by the director as if the application had been rejected. If the director finds that the insurer has been refused admittance to the rating organization as a subscriber without justification, he shall order the rating organization to admit the insurer as a subscriber. If he finds that the action of the rating organization was justified, he shall make an order affirming its action.
5. No rating organization shall adopt any rule the effect of which would be to prohibit or regulate the payment of dividends or savings allowed or returned by insurers to their policyholders or members.
6. Cooperation among rating organizations or among rating organizations and insurers in ratemaking or in other matters within the scope of section 379.017 and sections 379.316 to 379.361 is hereby authorized, provided the filings resulting from such cooperation are subject to all the provisions of section 379.017 and sections 379.316 to 379.361 which are applicable to filings generally. The director may review such cooperative activities and practices and if, after a hearing, he finds that any such activity or practice is unfair or unreasonable, or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, he may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, and requiring the discontinuance of such activity or practice.
7. Any rating organization may subscribe for or purchase actuarial, technical or other services, and such services shall be available to all members and subscribers without discrimination.
8. A "member of a rating organization" means an insurer entitled to participate in its management and electing to exercise its right to so participate. (L. 1972 S.B. 547 § 5)
1. Any member or subscriber to a rating organization may file with the director a deviation from the rates, rating schedules, rating plans, rating systems or rules respecting any kind of insurance, division, subdivision, classification, or any part or combination of any of the foregoing. Such a filing shall specify the nature and extent of the deviation.
2. Such deviation shall become effective upon the date of filing by delivery or upon date of mailing by registered mail to the director. It shall be in effect until terminated by the filer giving notice to the director of the termination of the deviation. A change in the rates, rating schedules, rating plans, rating systems or rules to which the deviation applies shall not terminate the deviation without the consent of the insurer to which the deviation applies. Any such deviation may be terminated by the director after notice and hearings as provided in section 379.323.
3. A deviation filing shall be open to public inspection as soon as stamped "filed" within* a reasonable time after receipt by the director and copies may be had by any person on request and upon the payment of a reasonable charge therefor. (L. 1972 S.B. 547 § 6)
*Word "with" appears in original rolls.
1. Every group, association or other organization of insurers, whether located within or outside this state, which assists insurers which make their own filings or rating organizations in ratemaking, by the collection and furnishing of loss or expense statistics, or by the submission or recommendations, but which does not make filings under section 379.017 and sections 379.316 to 379.361, shall be known as an "advisory organization".
2. Every advisory organization shall file with the director
(1) A copy of its constitution, its articles of agreement or association or its certificate of incorporation and of its bylaws, rules and regulations governing its activities,
(2) A list of its members,
(3) The name and address of a resident of this state upon whom notices or orders of the director or process issued at his direction may be served, and
(4) An agreement that the director may examine such advisory organization in accordance with the provisions of section 379.343.
3. If, after a hearing, the director finds that the furnishing of such information or assistance involves any act or practice which is unfair or unreasonable or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, he may issue a written order specifying in what respect such act or practice is unfair or unreasonable or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, and requiring the discontinuance of such act or practice.
4. No insurer which makes its own filings nor any rating organization shall support its filings by statistics or adopt ratemaking recommendations furnished to it by an advisory organization which has not complied with this section or with an order of the director involving such statistics or recommendations issued under subsection 3. If the director finds such insurer or rating organization to be in violation of this subsection, he may issue an order requiring the discontinuance of the violation. (L. 1972 S.B. 547 § 7)
1. Every group, association or other organization of insurers which engages in joint underwriting or joint reinsurance shall be subject to regulation with respect thereto as herein provided, subject, however, with respect to joint underwriting, to all other provisions of section 379.017 and sections 379.316 to 379.361 and, with respect to joint reinsurance, to section 379.343.
2. If, after a hearing, the director finds that any activity or practice of any such group, association or other organization is unfair or unreasonable or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, he may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with the provisions of section 379.017 and sections 379.316 to 379.361, and requiring the discontinuance of such activity or practice. (L. 1972 S.B. 547 § 8)
Subject to and in compliance with the provisions of section 379.017 and sections 379.316 to 379.361 authorizing insurers to be members or subscribers of rating or advisory organizations or to engage in joint underwriting or joint reinsurance, two or more insurers may act in concert with each other and with others with respect to any matters pertaining to the making of rates or rating systems, the preparation or making of insurance policy forms, underwriting rules, surveys, inspections and investigations, the furnishing of loss or expense statistics or other information and data, or carrying on of research. (L. 1972 S.B. 547 § 9)
With respect to any matters pertaining to the making of rates or rating systems, the preparation or making of insurance policy forms, underwriting rules, surveys, inspections and investigation, the furnishing of loss or expense statistics or other information and data, or carrying on of research, two or more admitted insurers having a common ownership or operating in this state under common management or control, are hereby authorized to act in concert between or among themselves the same as if they constituted a single insurer. (L. 1972 S.B. 547 § 10)
Members and subscribers of rating or advisory organizations may use the rates, rating systems, underwriting rules or policy forms of such organizations, either consistently or intermittently, but, except as provided in sections 379.331 and 379.336, shall not agree with each other or rating organizations or others to adhere thereto. The fact that two or more admitted insurers, whether or not members or subscribers of a rating or advisory organization, use either consistently or intermittently, the rates or rating systems made or adopted by a rating organization, or the underwriting rules or policy forms prepared by a rating or advisory organization, shall not be sufficient in itself to support a finding that an agreement to so adhere exists, and may be used only for the purpose of supplementing or explaining direct evidence of the existence of any such agreement. (L. 1972 S.B. 547 § 11)
Licensed rating organizations and admitted insurers are authorized to exchange information and experience data with rating organizations and insurers in this and other states and may consult with them with respect to ratemaking and the application of rating systems. (L. 1972 S.B. 547 § 12)
1. The director of insurance may, at any time he may deem it advisable, examine any insurer writing any class of insurance which is subject to the provisions of section 379.017 and sections 379.316 to 379.361, any rating organization licensed under the provisions of section 379.323, any advisory organization referred to in section 379.326, and every group, association, or other organization referred to in section 379.328, and he shall at least once every four years make or cause to be made such examination.
2. The examination of an insurer may be made during the course of an examination pursuant to provisions of other laws of this state.
3. During the course of any examination provided for in this section the officers, managers, agents and employees of the insurer, rating organization, advisory organization, or group, association or other organization may be examined under oath and shall exhibit all books, records, accounts, documents, or agreements governing its method of operation as may be requested by the director.
4. The reasonable cost of any examination provided for in this section shall be paid by the insurer, rating organization, advisory organization or group, association, or other organization undergoing such examination.
5. No report of examination shall be made public until the organization examined has an opportunity to review the proposed report and to file its comments with reference thereto, after which the report and its comments shall be filed for public inspection and become admissible in evidence as a public record.
6. The director may accept the report of an examination made by the insurance supervisory official of another state in lieu of any examination provided for in this section. (L. 1972 S.B. 547 § 13)
1. The purpose of examination, as provided for in section 379.017 and sections 379.316 to 379.361, is to enable the director to ascertain whether there is compliance with the provisions of section 379.017 and sections 379.316 to 379.361.
2. If as a result of such examination the director finds that any rate, rating plan or rating system made or used by a rating organization or by an insurer does not meet the standards and provisions of section 379.017 and sections 379.316 to 379.361 applicable to it, or that a rating organization or an advisory organization or group, association or other organization referred to in section 379.017 and sections 379.316 to 379.361 is not in compliance with the provisions of section 379.017 and sections 379.316 to 379.361 applicable to it, the director shall hold a public hearing in connection therewith, provided, that within a reasonable period of time, which shall be not less than ten days before the date of such hearing, he shall mail written notice specifying the matters to be considered at such hearing to every person or organization believed by him not to be in compliance with the provisions of section 379.017 and sections 379.316 to 379.361.
3. If the director, after such hearing, for good cause finds that such rate, rating plan or rating system does not meet the provisions of section 379.017 and sections 379.316 to 379.361, he shall issue an order specifying in what respects any such rate, rating plan or rating system fails to meet the provisions of section 379.017 and sections 379.316 to 379.361 and stating when, within a reasonable period of time thereafter, the further use of such rate, rating plan or rating system by the rating organization or insurer which is the subject of the examination shall be prohibited and a copy of such order shall be sent to such rating organization or insurer; that a rating organization, an advisory organization, or any group, association or other organization mentioned in section 379.328, is not in compliance with the provisions of section 379.017 and sections 379.316 to 379.361, he shall issue a written order to such rating organization, specifying in what respect it is not complying with the provisions of section 379.017 and sections 379.316 to 379.361 and requiring compliance. (L. 1972 S.B. 547 § 14)
Any individual, corporation, firm, partnership, association, or any similar entity or combination of the foregoing, aggrieved by any rate charged, rating plan, rating system, or underwriting rule followed or adopted by an insurer or rating organization may request the insurer or rating organization to review the manner in which the rate, plan, system, or rule has been applied with respect to insurance afforded him. Such request may be made by the authorized representative of such individual, corporation, firm, partnership, association, or any similar entity or combination of the foregoing, and shall be written. If the request is not granted within thirty days after it is made, the requestor may treat it as rejected. Any individual, corporation, firm, partnership, association, or any similar entity or combination of the foregoing, aggrieved by the action of an insurer or rating organization in refusing the review requested, or in failing or refusing to grant all or part of the relief requested, may file a written complaint and request for hearing with the director, specifying the grounds relied upon. If the director has information concerning a similar complaint he may deny the hearing. If he believes that probable cause for the complaint does not exist or that the complaint is not made in good faith he shall deny the hearing. Otherwise, and if he finds that the complaint charges a violation of section 379.017 and sections 379.316 to 379.361 and that the complainant would be aggrieved if the violation is proven, he shall proceed as provided in section 379.346. (L. 1972 S.B. 547 § 15)
1. The director shall approve reasonable rules and statistical plans, reasonably adapted to each of the rating systems on file with him, which may be modified from time to time and which shall be used thereafter by each insurer in the recording and reporting of its loss and countrywide expense experience, in order that the experience of all insurers may be made available at least annually. Such rules and plans may also provide for the recording and reporting of expense experience items which are specially applicable to this state and are not susceptible of determination by a prorating of countrywide expense experience. In approving such rules and plans, the director shall give due consideration to the rating systems on file with him and, in order that such rules and plans may be as uniform as is practicable among the several states, to the rules and to the form of the plans used for such rating systems in other states. No insurer shall be required to record or report its loss experience on a classification basis that is inconsistent with the rating system filed by it. The director may designate rating organizations or other agencies, or both, to assist him in gathering such experience and making compilations thereof, and such compilations shall be made available, subject to reasonable rules approved by the director, to insurers and advisory and rating organizations.
2. In order to further uniform administration of rate regulatory laws, the director and every insurer, rating organization, advisory organization or statistical agency may exchange information and experience data with insurance supervisory officials, insurers, rating organizations, advisory organizations or statistical agencies in this and other states, and may consult with them with respect to ratemaking and the application of rating systems.
3. The director may make reasonable rules and regulations necessary to effect the purposes of this section. (L. 1972 S.B. 547 § 16)
No person or organization shall willfully withhold information from, or knowingly give false or misleading information to, the director or any statistical agency designated by the director. No person or organization shall knowingly give false or misleading information to any rating organization of which it is a member or subscriber or to any insurer with which it is engaged in joint underwriting activities which will affect the rates or premiums chargeable under section 379.017 and sections 379.316 to 379.361. A violation of this section shall subject the one guilty of such violation to the penalties provided in section 379.361. (L. 1972 S.B. 547 § 17)
1. No insurer or insurance producer shall knowingly charge, demand or receive a premium for any policy of insurance except in accordance with the provisions of section 379.017 and sections 379.316 to 379.361. No insurer or employee thereof, and no insurance producer shall pay, allow, or give, directly or indirectly, as an inducement to insurance, or after insurance has been effected, any rebate, discount, abatement, credit or reduction of the premium named in a policy of insurance, or any special favor or advantage in the dividends or other benefits to accrue thereon, or any valuable consideration or inducement whatever, not specified in the policy of insurance, except to the extent provided for in applicable filings. No insured named in any policy of insurance shall knowingly receive or accept, directly or indirectly, any rebate, discount, abatement, credit or reduction of premium, or any special favor or advantage or valuable consideration or inducement. Nothing in this section shall be construed as prohibiting the payment of, nor permitting the regulation of the payment of, commissions or other compensation to duly licensed insurance producers; nor as prohibiting, or permitting the regulation of, any insurer from allowing or returning to its participating policyholders or members, dividends or savings.
2. An insurer or insurance producer, agent or broker may charge additional incidental fees for premium installments, late payments, policy reinstatements, or other similar services specifically provided for by law or regulation. Such fees shall be disclosed to the applicant or insured in writing. (L. 1972 S.B. 547 § 18, A.L. 2001 S.B. 186 merged with S.B. 193)
Effective 1-1-03
CROSS REFERENCE: Incidental fees, additional, may be charged, when, disclosure to insured, RSMo 375.052
Nothing in section 379.017 and sections 379.316 to 379.361 abridges or restricts the freedom of contract of insurers, agents or brokers with reference to the amount of commission to be paid to agents or brokers by insurers, and such payments are expressly authorized. (L. 1972 S.B. 547 § 19)
1. The director may, if he finds that any insurer or filing organization has violated any provision of section 379.017 and sections 379.316 to 379.361, impose a penalty of not more than five hundred dollars for each violation, but if he finds the violation to be willful, he may impose a penalty of not more than five thousand dollars for each violation. These penalties may be in addition to any other penalty provided by law.
2. The director may suspend the license of any rating organization or insurer which fails to comply with an order of the director within the time limited by such order, or any extension thereof which the director may grant. The director shall not suspend the license of any rating organization or insurer for failure to comply with an order until the time prescribed for an appeal therefrom has expired or if an appeal has been taken, until the order has been affirmed. The director may determine when a suspension of license shall become effective and it shall remain in effect for the period fixed by him, unless he modifies or rescinds such suspension or until the order upon which such suspension is based is modified, rescinded or reversed.
3. No penalty shall be imposed or no license shall be suspended or revoked except upon a written order of the director, stating his findings, made after a hearing held upon not less than ten days' written notice to such person or organization specifying the alleged violation. (L. 1972 S.B. 547 § 20)
Sections 379.420 to 379.510 may be referred to as "The Casualty and Surety Rate Regulatory Law". (L. 1947 V. II p. 254 § 12)
1. Sections 379.420 to 379.510 apply to casualty insurance, including fidelity, surety and guaranty bonds, and to all forms of motor vehicle insurance, on risks or operations in this state, except:
(1) Reinsurance, other than joint reinsurance to the extent stated in section 379.460 and subsection 2 of section 379.430;
(2) Insurance against workers' compensation liability;
(3) Accident and health insurance;
(4) Insurance against loss of or damage to aircraft, or against liability, other than employers' liability, arising out of the ownership, maintenance or use of aircraft.
2. Commercial casualty insurance policies shall be exempt from the provisions of sections 379.420 to 379.510 to the extent permitted pursuant to subsection 6 of section 379.321. (L. 1947 V. II p. 254 § 1, A.L. 1999 S.B. 386, A.L. 2001 S.B. 186)
1. Subject to the provisions of sections 379.420 to 379.510, two or more licensed insurers may act in concert with each other and with others with respect to any or all matters pertaining to the making of rates, rating plans or rating systems or the preparation or making of insurance policy or bond forms, underwriting rules, surveys, inspections and investigations or the furnishing of loss or expense statistics or other information and data, or carrying on of research.
2. Two or more insurers may act in concert in the making or use of rates when executing fidelity or surety bonds through cosurety or reinsurance, or when affiliated through common ownership, management or control. (L. 1947 V. II p. 254 § 3)
Any corporation, unincorporated association, partnership, or individual, other than a licensed insurer, which has as its or his object or purpose the making of rates, rating plans, or rating systems shall be known as a "rating organization" and may, subject to the provisions of sections 379.420 to 379.510, conduct such operations in the state of Missouri. No insurer shall be deemed to be a rating organization. (L. 1947 V. II p. 254 § 3)
1. No corporation, unincorporated association, partnership, or individual shall act as a rating organization in this state without first filing with the director of insurance a written application for, and securing a license as, a rating organization for such kinds of insurance or subdivisions thereof as are specified in its application.
2. Any corporation, unincorporated association, partnership, or individual, whether located within or outside this state may make application for and obtain a license as a rating organization for such kinds of insurance or subdivision or class of risk or a part or combination thereof as are specified in its application, provided it shall meet the requirements for license set forth in sections 379.420 to 379.510.
3. To obtain a license as a rating organization, every such corporation, unincorporated association, partnership or individual shall file therewith
(1) A copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its bylaws, rules and regulations governing the conduct of its business;
(2) A list of its members and subscribers;
(3) The name and address of a resident of this state upon whom notices or orders of the director of insurance or process affecting such rating organization may be served; and
(4) A statement of its qualifications as a rating organization. (L. 1947 V. II p. 254 § 3)
To obtain and retain a license, a rating organization shall provide satisfactory evidence to the director of insurance that it will
(1) Permit any licensed insurer to become a subscriber to such rating organization or withdraw therefrom without obligation to adhere to its manual of classifications, rules and rates or rating plans or systems;
(2) Neither adopt any rule nor exact any agreement the effect of which would be to prohibit or regulate the payment of dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers. A plan for the payment of dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers shall not be deemed to be a rating plan or system;
(3) Neither practice nor sanction any plan or act of boycott, coercion or intimidation;
(4) Neither enter into nor sanction any contract or act by which any person is restrained from lawfully engaging in the insurance business;
(5) Submit to examination as prescribed by section 379.475;
(6) Notify the director of insurance promptly of every change in its constitution, its articles of agreement or association, or its articles of incorporation and of its bylaws, rules and regulations governing the conduct of its business; its list of members and subscribers; and the name and address of the resident of this state designated by it upon whom notices or orders of the director or process affecting such organization may be served. (L. 1947 V. II p. 254 § 3)
1. If the director of insurance finds that the applicant meets the licensing requirements of sections 379.420 to 379.510 applicable to it and is trustworthy and competent to act as a rating organization and that its constitution, articles of agreement or association or certificate of incorporation, and its bylaws, rules and regulations governing the conduct of its business conform to the requirements of sections 379.420 to 379.510, he shall issue a license specifying the kinds of insurance or subdivisions thereof for which the applicant is authorized to act as a rating organization.
2. Every such application shall be granted or denied in whole or in part by the director within sixty days of the date of its filing with him.
3. Licenses issued pursuant to this section shall remain in effect until revoked as provided in sections 379.420 to 379.510. (L. 1947 V. II p. 254 § 3)
1. Any corporation, unincorporated association, partnership or individual, other than a licensed insurer, whether located within or outside this state, which prepares policy forms, makes underwriting rules, surveys or inspections incident to but not including the making of rates, rating plans or rating systems, or which collects and furnishes to licensed insurers or rating organizations loss or expense statistics or other statistical information and data and acts in an advisory as distinguished from a ratemaking capacity shall be known as an advisory organization and shall file with the director
(1) A copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its bylaws, rules and regulations governing its activities;
(2) A list of its members;
(3) The name and address of a resident of this state upon whom notices or orders of the director or process issued at his direction may be served; and
(4) An agreement that the director may examine such advisory organization in accordance with the provisions of section 379.475.
2. Every such advisory organization shall notify the director promptly of every change in its constitution, its articles of agreement or association, or its articles of incorporation and of its bylaws, rules and regulations governing the conduct of its business, its list of members and subscribers, and the name and address of the resident of this state designated by it upon whom notices or orders of the director or process affecting such organization may be served.
3. No such group, association or organization shall engage in any unfair or unreasonable practice with respect to its activities. (L. 1947 V. II p. 254 § 3)
1. Every group, association or other organization of insurers which engages in joint underwriting through joint reinsurance shall file with the director
(1) A copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its bylaws, rules and regulations governing its activities;
(2) A list of its members;
(3) The name and address of a resident of this state upon whom notices or orders of the director or process issued at his direction may be served; and
(4) An agreement that the director may examine such organization in accordance with the provisions of section 379.475.
2. Every such group, association or other organization shall notify the director promptly of every change in its constitution, its articles of agreement or association, or its articles of incorporation and of its bylaws, rules and regulations governing the conduct of its business, its list of members and subscribers, and the name and address of the resident of this state designated by it upon whom notices or orders of the director or process affecting such organization may be served.
3. No such group, association or organization shall engage in any unfair or unreasonable practice with respect to its activities. (L. 1947 V. II p. 254 § 3)
1. Every rating organization and insurer may exchange information and experience data with insurers and rating organizations in this and other states and may consult with them with respect to ratemaking and the application of rating systems.
2. With the approval of the director, agreements may be made between two or more insurers to adhere to rates, rating plans, rating systems or underwriting practices or uniform modifications thereof for any of the classes of insurance included in sections 379.420 to 379.510.
3. With the approval of the director, agreements may also be made among insurers with respect to the equitable apportionment among them of insurance which may be afforded applicants who are in good faith entitled to but who are unable to procure such insurance through ordinary methods, and with respect to the use of reasonable rate modifications for such insurance.
4. Such agreements shall be submitted in written form to the director for his consideration together with such information as he may require to determine whether they are consistent with the provisions of sections 379.420 to 379.510 and otherwise in the public interest. (L. 1947 V. II p. 254 § 3)
The rates made by each insurer or rating organization shall be subject to the following provisions:
(1) Rates shall not be excessive or inadequate, as herein defined, nor shall they be unfairly discriminatory.
(2) No rate shall be held to be excessive unless such rate is unreasonably high for the insurance provided and a reasonable degree of competition does not exist in the area with respect to the classification to which such rate is applicable.
(3) No rate shall be held to be inadequate unless such rate is unreasonably low for the insurance provided and the continued use of such rate endangers the solvency of the insurer using the same, or unless such rate is unreasonably low for the insurance provided and the use of such rate by the insurer using same has, or if continued will have, the effect of destroying competition or creating a monopoly.
(4) Due consideration shall be given to past and prospective loss experience within this state and consideration may also be given to past and prospective loss experience outside this state to the extent appropriate. Each insurer and rating organization may also give consideration to physical hazards, to catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, to dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers, to past and prospective expenses both countrywide and those especially applicable to this state, and to any other factors within or outside this state which the insurer or rating organization deems relevant to the making of rates.
(5) The systems of expense provisions included in the rates for use by any insurer or group of insurers may differ from those of other insurers or groups of insurers to reflect the requirements of the operating methods of any such insurer or group with respect to any kind of insurance, or with respect to any subdivision or combination thereof for which subdivision or combination separate expense provisions are applicable.
(6) Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with standards for measuring variations in hazards or expense provisions, or both. Such standards may measure any differences among risks that can be demonstrated to have a probable effect upon losses or expenses. Classifications or modifications of classification or any portion or any division thereof, of risks may be predicated upon size, expense, management, individual experience, purpose of insurance, location or dispersion of hazard, or any other reasonable considerations, provided such classifications and modifications shall be applicable to the fullest practicable extent to all risks under the same or substantially the same circumstances or conditions. Classification rates may also be modified to produce rates for individual or special risks which are not susceptible to measurement by any established standards.
(7) Except to the extent necessary to meet the provisions of subdivision (1) of this section, uniformity among insurers in any matters within the scope of this section is not required. (L. 1947 V. II p. 254 § 2)
1. The director of insurance shall have the power, at any time he may deem it advisable, to examine any insurer writing any class of insurance which is subject to the provisions of sections 379.420 to 379.510, any rating organization licensed under said sections, any advisory organization referred to in section 379.455, and every group, association, or other organization referred to in section 379.460.
2. The examination of an insurer may be made during the course of an examination pursuant to provisions of other laws of this state.
3. It shall be the duty of the director at least once every three years to make or cause to be made an examination of every rating organization licensed under sections 379.420 to 379.510.
4. During the course of any examination provided for in this section the officers, managers, agents and employees of the insurer, rating organization, advisory organization, or group, association or other organization may be examined under oath and shall exhibit all books, records, accounts, documents, or agreements governing its method of operation as may be requested by the director.
5. The reasonable cost of any examination provided for in this section shall be paid by the insurer, rating organization, advisory organization or group, association, or other organization undergoing such examination.
6. The director may accept the report of an examination made by the insurance supervisory official of another state in lieu of any examination provided for in this section. (L. 1947 V. II p. 254 § 4)
1. The purpose of examination, as herein provided for, is to enable the director to ascertain whether there is compliance with the provisions of sections 379.420 to 379.510.
2. If as a result of such examination the director has reason to believe that any rate, rating plan or rating system made or used by a rating organization or by an insurer does not meet the standards and provisions of sections 379.420 to 379.510 applicable to it, or that a rating organization or an advisory organization or group, association or other organization referred to in section 379.460 is not in compliance with the provisions of sections 379.420 to 379.510 applicable to it, the director may hold a public hearing in connection therewith, providing that within a reasonable period of time, which shall be not less than ten days before the date of such hearing, he shall mail written notice specifying the matters to be considered at such hearing to every person or organization believed by him not to be in compliance with the provisions of sections 379.420 to 379.510.
3. If the director, after such hearing, for good cause finds that such rate, rating plan or rating system does not meet the provisions of sections 379.420 to 379.510, he shall issue an order specifying in what respects any such rate, rating plan or rating system fails to meet the provisions of sections 379.420 to 379.510 and stating when, within a reasonable period of time thereafter, the further use of such rate, rating plan or rating system by the rating organization or insurer which is the subject of the examination shall be prohibited and a copy of such order shall be sent to such rating organization or insurer; that a rating organization, an advisory organization, or any group, association or other organization mentioned in section 379.460, is not in compliance with the provisions of sections 379.420 to 379.510, he shall issue a written order to such rating organization, advisory organization or other group, association or organization, specifying in what respect it is not complying with the provisions of sections 379.420 to 379.510 and requiring compliance. (L. 1947 V. II p. 254 § 4)
1. If any rating organization or insurer shall fail to comply with an order of the director lawfully made by him under section 379.480, the director may, in addition to other penalties provided in sections 379.420 to 379.510 or any other law, suspend or revoke the license of such rating organization or insurer with respect to the class or classes of insurance as to which there is such failure to comply.
2. No penalty provided in sections 379.420 to 379.510 or any suspension or revocation of license as herein provided shall be imposed except upon a written order of the director stating his findings.
3. The director's power to suspend or revoke shall include the power to modify, rescind, or reverse such suspension or revocation. (L. 1947 V. II p. 254 § 4)
Any rate, rating plan or rating system made or adopted by an insurer or by a rating organization licensed hereunder and any modifications and amendments thereto may be used subject to the provisions of sections 379.420 to 379.510. (L. 1947 V. II p. 254 § 5)
1. Nothing in sections 379.420 to 379.510 shall be construed to prohibit or regulate the payment of dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers.
2. No plan for the payment of dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers shall be deemed to be a rating plan or system. (L. 1947 V. II p. 254 § 6)
Nothing in sections 379.420 to 379.510 shall abridge or restrict the freedom of contract of insurers, agents, or brokers with reference to the amount of commissions or fees to be paid to such agents or brokers by insurers, and such payments are expressly authorized. (L. 1947 V. II p. 254 § 7)
1. Any insurer or rating organization aggrieved by any order or decision of the director made without a hearing, may, within thirty days after notice of the order to the insurer or organization, make written request to the director for a hearing thereon.
2. The director shall hear such party or parties within twenty days after receipt of such request and shall give not less than ten days' written notice of the time and place of the hearing.
3. Within fifteen days after such hearing the director shall affirm, reverse or modify his previous action, specifying his reasons therefor. Pending such hearing and decision thereon the director shall suspend the effective date of his previous action.
4. Nothing contained in sections 379.420 to 379.510 shall require the observance at any hearing of formal rules of pleading or evidence.
5. Any order, rule or decision of the director under sections 379.420 to 379.510 shall be subject to review by the courts of this state as provided in chapter 536, RSMo.
6. No order, rule or decision of the director which is submitted for judicial review may become effective until after final action or decision by the court, but if approved or affirmed by the court, such order, rule or decision shall relate back to the date of its making by the director. (L. 1947 V. II p. 254 § 8)
Any person or organization who willfully violates a final order of the director under sections 379.420 to 379.510 shall be deemed guilty of a misdemeanor and shall upon conviction thereof be punished by a fine not to exceed five hundred dollars for such violation. (L. 1947 V. II p. 254 § 9)
Any corporation now or hereafter organized and incorporated or existing under any general or special law of this state to do any insurance business other than that of life insurance the period of whose corporate existence is about to terminate may reorganize and extend and continue its corporate existence under the general laws of this state in the manner herein provided. (RSMo 1939 § 5990)
Prior revisions: 1929 § 5879; 1919 § 6289
Whenever any such corporation desires to avail itself of the provisions of sections 379.515 to 379.580 and to reorganize and extend and continue its corporate existence under the general laws of this state after the time limited by law or its charter for the termination of its corporate existence, the directors thereof shall within one year prior to such time draw up and submit to its stockholders, if it be a stock company, or to its policyholders if it be a mutual company, or to its stockholders and its policyholders in its mutual department if it be a stock and mutual company, articles of association, which shall set forth
(1) The name of the company;
(2) The place where the principal office for the transaction of business shall be located;
(3) The specific kinds of business it proposes to transact;
(4) The period of time for which its corporate existence shall be extended and continued;
(5) The manner in which the corporate powers granted under the general insurance statutes shall be exercised, showing the number of directors, which shall not be more than twenty-five nor less than nine, and such other particulars as may be necessary to make manifest the objects and purposes of the corporation; provided, however, that the name of the corporation shall not be changed, nor shall the objects or plan of business embrace any other or more than under the general insurance statutes of this state can be carried on by any one corporation. (RSMo 1939 § 5991)
Prior revisions: 1929 § 5880; 1919 § 6290
1. If such company be a stock company, then the articles of association shall set forth, in addition to the requirements of section 379.520, the amount of the capital stock, the number of shares into which it shall have been divided, and the amount which has been paid upon each share, and if the capital stock is less than that required by the general statutes it shall be increased to at least that amount.
2. If such company be a mutual company, its articles of association shall set forth, in addition to what is required by section 379.520, the number of policyholders, the amount of premium notes, their face value, the amount of assessments paid thereon, and in all cases the amount of cash and other assets, itemized, held and owned by such company; provided, that the aggregate amount of assets shall not be of less value than required by new companies organizing under the insurance statutes of this state concerning mutual companies. (RSMo 1939 § 5992)
Prior revisions: 1929 § 5881; 1919 § 6291
After drafting the proposed articles of association, it shall be the duty of the directors of said company to call a special meeting, if a stock company, of its stockholders; if a mutual company, of its policyholders; or if a stock and mutual company, of its stockholders and its policyholders in the mutual department, by a notice, which shall be published at least once a week in some newspaper of general circulation in the city, county or town in which said company is located, the first insertion to be not less than sixty days, the last to be not less than one nor more than six days, previous to the day on which such meeting shall be held, but if there be no newspaper published therein, then in some newspaper published in the next nearest county, and by posting up a handbill in the office of said company; said notice shall state the time and place of the meeting and the objects thereof, and shall further state where a draft of the proposed articles of association can be seen and examined. (RSMo 1939 § 5993)
Prior revisions: 1929 § 5882; 1919 § 6292
1. At the time and place designated, the proposition as to the reorganization and extension and continuance of the corporate existence of such company under the general laws of the state, increase of capital stock if necessary, and adoption of the proposed articles of association, as submitted or amended, shall be voted upon.
2. If a stock company, the assent of the person holding a majority in amount of the capital stock issued by the company and then outstanding, or if it be a mutual company, the assent of a majority in number of the policyholders thereof, or if it be a stock and mutual company, the assent of the persons holding a majority in amount of the capital stock issued by the company and then outstanding and a majority in number of the policyholders in the mutual department of the company, shall be requisite for the adoption of the propositions submitted; and in addition, any company doing a stock and mutual business may submit and determine in the same manner, and decide upon continuing either of the two plans of insurance and discontinuing the other; provided, that the right of any stockholder or policyholder not assenting to such proposition to have paid or distributed to him his equitable interest or proportion, if any, in the net assets which such company might have at the time limited by law or its charter for the termination of its corporate existence shall not be prejudiced by such reorganization and extension and continuance of the corporate existence of such company, but the value of such equitable interest or proportion in such net assets shall be secured and paid to him as herein provided. (RSMo 1939 § 5994)
Prior revisions: 1929 § 5883; 1919 § 6293
1. If the assent is obtained as provided in section 379.535, the directors of the company, or a majority of them, or any five stockholders, may sign and acknowledge the articles of association adopted in the same manner provided for the acknowledgment of deeds, and the president and secretary of the meeting shall draw up a declaration in the form of an affidavit verified by them, which shall set forth the proceedings of the meeting, the propositions acted upon, the number of votes cast upon each proposition submitted, the number of votes cast in favor of and the number of votes cast against the same, and, if it be a stock company, the amount of stock held respectively by those voting in favor of and against the same, and if the company be a stock company the amount of stock held by persons not voting, or if a mutual company the number of policyholders not voting, or if a stock and mutual company the amount of stock held by persons not voting and the number of policyholders in the mutual department not voting upon such propositions; to which declaration shall be attached the articles of association as adopted by the meeting and acknowledged as aforesaid.
2. Said declaration and articles of association shall thereupon be delivered to the board of directors and shall be by them submitted to and filed with the director of the insurance department of this state. (RSMo 1939 § 5995)
Prior revisions: 1929 § 5884; 1919 § 6294
Said director, if satisfied that the said propositions for reorganization and extension and continuance of the corporate existence of the company under the general laws and articles of association have been duly adopted, and that the said articles of association are in conformity with the general insurance statutes of this state, and that said articles of association have been submitted to the attorney general in accordance with the requirements of section 379.040, if a stock company, or of section 379.065, if a mutual company, and have been found by him to be in accordance with the provisions of this chapter and not inconsistent with the constitution of this state, or that of the United States, and have been delivered back to him so certified, shall comply with all the requirements of said sections 379.040 and 379.065 and shall so certify upon said declaration and shall deliver to said company a certified copy of said articles and his certificate, together with authority to reorganize thereunder. (RSMo 1939 § 5996)
Prior revisions: 1929 § 5885; 1919 § 6295
1. Upon receiving the certificate and authority aforesaid, the board of directors shall by resolution accept the same, and shall file with the secretary of state a copy of said articles of association and of the certificate and authorization of said director, and the corporate existence of said company shall thereupon be deemed and held extended and continued for the period mentioned in said articles of association, and a certificate by the secretary of state, under the seal of the state, that said corporation has been duly organized and its corporate existence extended and continued for such period shall be taken by all courts as evidence of the continued corporate existence of such company.
2. They shall also, at the time of filing said articles, pay to the state director of revenue the fee required of new companies on filing articles of corporation.
3. If a new board of directors is designated in the articles of association, they shall at the time originally limited by law or the charter of the company for the termination of its corporate existence enter upon the performance of their duties.
4. After such time the board of directors of the company shall make the necessary changes, if any, in the stock and business of the company to conform to the articles of association and the general insurance statutes of this state, and shall thereupon notify the director of the fact that the company is prepared to continue operations under the general insurance statutes and articles of association aforesaid. (RSMo 1939 § 5997, A.L. 1947 V. I p. 331)
Prior revisions: 1929 § 5886; 1919 § 6296
1. If, upon examination made by him, the said director shall find that the company has been duly reorganized as provided by this chapter and that its capital is such as set forth in the articles of association, and that its assets, capital, premium notes and investments are of not less amount or value than required of new companies organized under the insurance statutes of this state, and that such company is in sound and solvent condition, according to the insurance statutes of this state, he shall deliver to the officers a certificate to that effect, and an authorization to do business under the general insurance statutes of this state.
2. Any and all special privileges, if any, contained in the original charter of the company or contrary to or not conferred by said articles of association and the general insurance statutes of this state shall cease and determine at the time originally limited by law or its charter for the termination of its corporate existence, and thereafter, unless sooner determined by proceedings under the general insurance statutes, said company shall continue as a corporation and possess all the powers and franchises conferred by and be subject to all the provisions of the general insurance statutes of this state, and for the term specified in the articles of association; provided, however, that said company as reorganized shall not be deemed a new corporation, nor shall such reorganization and extension and continuance of the corporate existence of said company under the general insurance statutes change or affect the title of said company to its assets, nor change or affect its members nor its policies of insurance or other obligations and contracts then existing; but all such shall remain, belong to and be obligatory upon said company as reorganized, in the same manner and with the same effect as under its charter and before such reorganization they pertained to and were held by and were obligatory upon said company, subject to the general insurance and corporation laws of this state. (RSMo 1939 § 5998)
Prior revisions: 1929 § 5887; 1919 § 6297
If the assent be obtained as provided in section 379.535, but there be any stockholders or policyholders who have not at such meeting given their assent to such propositions to reorganize and extend and continue the corporate existence of the company under the general insurance statutes of the state, and such stockholders or policyholders shall not thereafter and prior to the expiration of the time herein provided for the filing of the petition of said company in the circuit court have delivered to such company their written assent or ratification of such propositions, then such equitable interests or proportions, if any, as such stockholders or policyholders not so assenting or ratifying such propositions have in the net assets which such company had at the time originally limited by law or its charter for the termination of its corporate existence shall be ascertained and paid and distributed to them as herein provided. (RSMo 1939 § 5999)
Prior revisions: 1929 § 5888; 1919 § 6298
In such event, said company shall within six months after the time originally limited by law or its charter for the termination of its corporate existence file a petition in equity in the circuit court of the county where its principal office or place of business shall be located setting forth in its petition the facts regarding the proceedings taken by it toward such reorganization and extension and continuance of the corporate existence of such company, the condition of the company and a description of its assets at the time so as aforesaid limited for the termination of its corporate existence, and if a stock company the amount of its capital stock and the number of stockholders and the amount of the stock held by them, respectively, assenting to or ratifying and not assenting to or ratifying such reorganization and extension and continuance of the corporate existence of such company, or if a mutual company the number of policyholders respectively assenting to or ratifying and not assenting to or ratifying the same, or if a stock and mutual company the number of stockholders respectively assenting to or ratifying and not assenting to or ratifying the same and the amount of stock held by them respectively and the number of policyholders in the mutual department respectively assenting to or ratifying and not assenting to or ratifying the same, and praying the court to ascertain and by its judgment and decree to determine the persons who were such stockholders or policyholders of said company at the time originally limited by law or its charter for the termination of its corporate existence who have not assented to or ratified such reorganization and extension and continuance of the corporate existence of such company and the value of their respective equitable interests or proportions, if any, in the net assets which such company had at the time originally limited by law or its charter for the termination of its corporate existence, and authorizing and directing it to pay to such persons the value of their respective equitable interests or proportions in such net assets in full satisfaction of their respective claims and interests in such assets. (RSMo 1939 § 5999)
Prior revisions: 1929 § 5888; 1919 § 6298
1. On the filing of said petition with the clerk of said court, it shall be the duty of said clerk to cause a notice to be published in some newspaper published in the county where the cause is pending, and if there is no newspaper published in said county, then in some newspaper published in the next nearest county, addressed to all whom it may concern, and setting forth the filing of said petition and stating briefly the object and general nature of the petition and that a judgment and decree will be entered in said cause at the next term of the said court after due publication of said notice, as prayed in said petition.
2. And at the next term of said court after due publication of said notice, as herein provided, the court shall hear the said petition and the evidence which may be produced by the petitioner and by any person interested in such company as a stockholder, if it be a stock company, or as a policyholder if it be a mutual company, or as a stockholder or a policyholder in its mutual department if it be a stock and mutual company, at the time originally limited by law or its charter for the termination of the corporate existence of such company who has not assented to or ratified such reorganization and extension and continuance of the corporate existence of such company, and shall make and enter its judgment and decree ascertaining and determining the number and names of the persons who were stockholders if it be a stock company, or who were policyholders if it be a mutual company, or who were stockholders or policyholders in its mutual department if it be a stock and mutual company, of said company at the time originally limited by law or its charter for the termination of its corporate existence who have not assented to or ratified such reorganization and extension and continuance of the corporate existence of such company and the value of their respective equitable interests or proportions in its net assets at that time, and authorizing and directing such company to pay to them respectively the value of their equitable interests or proportions in such net assets as thus ascertained and determined in full satisfaction of their respective claims and interests in such net assets; and thereupon payment by said company to such stockholders or policyholders of the value of their respective equitable interests or proportions in such net assets as thus ascertained and determined such stockholders or policyholders shall have no further claims or interests in such assets of said company; provided, that the court may, if it deem it advisable, refer the matter to some suitable person as referee to hear said matter and ascertain and report to the court his findings concerning the same, as in other cases. (RSMo 1939 § 6000)
Prior revisions: 1929 § 5889; 1919 § 6299
1. Any person interested in such company as a stockholder, if it be a stock company, or as a policyholder if it be a mutual company, or as a stockholder or a policyholder in its mutual department, at the time originally limited by law or its charter for the termination of its corporate existence who has not assented to or ratified such reorganization and extension and continuance of the corporate existence of such company shall be entitled to appear as a defendant and be heard in said cause.
2. The proceedings in such cause shall, as near as may be, conform to and be governed by the laws regulating practice in civil cases. (RSMo 1939 § 6001)
Prior revisions: 1929 § 5890; 1919 § 6300
All costs of such proceeding prior to and including the judgment and decree of the court, or, if the matter be referred, prior to and including the filing and approval of the referee's report, shall be paid by the petitioner, and the court, as to all costs made subsequent thereto, shall make such order as in its discretion may be deemed just. (RSMo 1939 § 6002)
Prior revisions: 1929 § 5891; 1919 § 6301
Any insurance company, other than life, incorporated and organized under the laws of this state, and now doing business in this state, may surrender its charter, and accept in lieu of said charter the provisions of the general insurance statutes, and reorganize thereunder in the manner herein set forth. (RSMo 1939 § 5941)
Prior revisions: 1929 § 5830; 1919 § 6240; 1909 § 7031
When any such company desires to avail itself of the provisions of sections 379.585 to 379.625, the directors thereof shall draw up articles of association which shall set forth
(1) The name of the company;
(2) The place where the principal office for the transaction of business shall be located;
(3) The specific kind of business it proposes to transact;
(4) The manner in which the corporate powers granted under the general insurance statutes shall be exercised, showing the number of directors, which shall not be more than thirteen nor less than nine, and such other particulars as may be necessary to make manifest the objects and purposes of the corporation; provided, however, that the name of the corporation shall not be changed, nor shall the object or plan of business embrace any others than those designated in the existing charter, nor embrace more than under the general insurance statutes of this state can be carried on by any one corporation. (RSMo 1939 § 5942)
Prior revisions: 1929 § 5831; 1919 § 6241; 1909 § 7032
1. If such company be a stock company, then the articles of association shall set forth, in addition to the requirements of section 379.590, the amount of capital stock, the number of shares in which it shall have been divided, and the amount which has been paid upon each share, and if the capital stock is less than that required by general statutes, it shall be increased to at least that amount.
2. If such company be a mutual company, its articles of association shall set forth, in addition to what is required by section 379.590, the number of policyholders, the amount of premium notes, their face value, the amount of assessments paid thereon, and in all cases the amount of cash and other assets, itemized, held and owned by such company; provided, that the aggregate amount of the assets shall not be of less value than required by new companies organizing under the insurance statutes of this state concerning mutual companies. (RSMo 1939 § 5943)
Prior revisions: 1929 § 5832; 1919 § 6242; 1909 § 7033
After drafting the proposed articles of association, it shall be the duty of the directors of said company to call a special meeting, if a stock company, of its stockholders, if a mutual company, of its policyholders, or if a stock and mutual company, of its stockholders and its policyholders in the mutual department, by a notice, which shall be published at least once a week in some newspaper of general circulation in the city, county or town in which said company is located, the first insertion to be not less than sixty days, the last to be not less than one or more than six days previous to the day on which such meeting shall be held, but if there be no newspaper published therein, then in some newspaper published in the next nearest county, and by posting up a handbill in the office of said company; said notice shall state the time and place of the meeting and the objects thereof, and shall further state where a draft of the proposed articles of association can be seen and examined. (RSMo 1939 § 5944)
Prior revisions: 1929 § 5833; 1919 § 6243; 1909 § 70334
1. At the time and place designated, the proposition as to the surrender of the charter, adoption of the general insurance statutes in lieu thereof, reorganization thereunder, increase of stock, if necessary, and adoption of the proposed articles of association, as submitted or amended, shall be voted upon.
2. If a stock company, the assent of the persons holding all of the stock issued by the company, and then outstanding, or if it be a mutual company, the assent of all the policyholders, and if the company be a stock and mutual company, the assent of all the stockholders and of the policyholders in the mutual department, shall be requisite for the adoption of the propositions submitted; and, in addition, any company doing a stock and mutual business may submit and determine in the same manner and decide upon continuing either of the two plans of insurance and discontinuing the other. (RSMo 1939 § 5945)
Prior revisions: 1929 § 5834; 1919 § 6244; 1909 § 7035
1. If the assent is obtained as provided in section 379.605, the directors of the company, or a majority of them, or any five stockholders, or if a mutual company, any five policyholders, may sign and acknowledge the articles of association adopted, in the same manner provided for acknowledgment of deeds, and the president and secretary of the meeting shall draw up a declaration in the form of an affidavit, verified by them, which shall set forth the proceedings of the meeting, the propositions acted upon, the number of votes cast upon each proposition submitted to which declaration shall be attached the articles of association as adopted by the meeting and acknowledged as aforesaid.
2. Said declaration and articles of association shall thereupon be delivered to the board of directors, and shall be by them submitted to and filed with the director of the insurance department of this state. (RSMo 1939 § 5946)
Prior revisions: 1929 § 5835; 1919 § 6245; 1909 § 7036
Said director, if satisfied that the proposed surrender of the existing charter and substitution therefor of the articles of association have been duly adopted, and that the said articles of association are in conformity with the general insurance statutes of this state, and that said articles of association have been submitted to the attorney general in accordance with the requirements of section 379.040, and have been found by him to be in accordance with the provisions of this chapter, and not inconsistent with the constitution of this state, or that of the United States, and have been delivered back to him so certified, shall comply with all the requirements of said section 379.040, and shall so certify upon said declaration, and shall deliver to said company a certified copy of said articles and his certificate, together with authority to the company to reorganize thereunder. (RSMo 1939 § 5947)
Prior revisions: 1929 § 5836; 1919 § 6246; 1909 § 7037
Upon receiving the certificate and authorization aforesaid, the board of directors shall, by resolution, accept the same, and shall file with the secretary of state a copy of said articles of association and of the certificate and authorization of said director, and the corporate existence shall date from the time of filing said copies of such articles and a certificate by the secretary of state, under the seal of the state, that said corporation has been duly organized, shall be taken by all courts of this state as evidence of the corporate existence of such corporation. They shall also, at the time of filing said articles, pay into the state treasury the fee required of new companies on filing articles of corporation. If a new board of directors is designated in the articles of association, they shall at once enter upon the performance of their duties. The board of directors designated in the articles of association shall thereupon make the necessary changes in the stock and business of the company to conform to the articles of association and the general insurance statutes of this state, and shall thereupon notify the director of the insurance department of the fact that the company is prepared to continue operations under the general insurance statutes and articles of association aforesaid. (RSMo 1939 § 5948)
Prior revisions: 1929 § 5837; 1919 § 6247; 1909 § 7038
1. If, upon examination made by him, the said insurance director shall find that the company has been duly reorganized as provided by this chapter, and that its assets, capital, premium notes and investments are such as set forth in the articles of association required in sections 379.585 to 379.625, and that such company is in sound and solvent condition, according to the insurance statutes of this state, he shall deliver to the officers thereof a certificate to that effect, and an authorization to do business under the general insurance statutes of this state.
2. Thereupon the charter of said company shall be held and shall be considered as surrendered, and the articles of association and the general insurance statutes of this state substituted in lieu thereof.
3. Any and all special privileges contained in said charter contrary to or not conferred by said articles of association and general insurance statutes shall cease and determine, and thereafter, unless sooner determined by proceedings under the general statutes, said company shall continue as a corporation, and possess all the powers and franchises conferred by and be subject to all the provisions of the general insurance statutes of this state, and for the term specified in the articles of association; provided, however, that said company as reorganized shall not be deemed a new corporation, nor shall such reorganization, under and by the acceptance of the provisions of the general insurance statutes, change or affect the title of said company to its assets, nor change or affect its membership nor its policies of insurance or other obligations and contracts then existing; but all such shall remain, belong to and be obligatory upon said company as reorganized, in the same manner and with the same effect as under its charter and before such reorganization they pertained to and were held by and were obligatory upon said company, subject to the general insurance and corporation laws of this state. (RSMo 1939 § 5949)
Prior revisions: 1929 § 5838; 1919 § 6248; 1909 § 7039
1. Individuals, partnerships and corporations of this state, hereby designated subscribers, are hereby authorized to exchange either assessable or nonassessable reciprocal or interinsurance contracts with each other, or with individuals, partnerships and corporations of other states and countries, providing indemnity among themselves, for the purpose of making insurance regarding the following classes:
(1) Property which shall consist of insurance on the following subclasses:
(a) Marine, inland marine, and transportation;
(b) Animals;
(c) All other real and personal property, intangible or tangible;
(2) Liability, which shall consist of insurance for the following subclasses:
(a) Workers' compensation and employers' liability;
(b) Professional malpractice;
(c) Contractual liability;
(d) All other legal liability of the insured to another;
(3) Fidelity and surety;
(4) Accident and health, including death by accident;
(5) Miscellaneous, consisting of all other legitimate forms of insurance not described above but excluding life and annuities.
2. Subscribers exchanging assessable contracts shall not at the same time exchange nonassessable contracts; and provided, further, that if an assessable contract is exchanged the subscriber's agreement shall provide that a subscriber shall be subject to a contingent liability of at least one premium deposit. (RSMo 1939 § 6078, A.L. 1957 p. 216, A.L. 1967 p. 516, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5966; 1919 § 6374
The contracts may be executed by an attorney in fact, herein designated attorney, duly authorized and acting for the subscribers, and the attorney may be a corporation. The office or offices of the attorney, herein defined as an exchange, may be maintained at such places as may be designated by the subscribers in the power of attorney. (RSMo 1939 § 6079, A.L. 1967 p. 516)
Prior revisions: 1929 § 5967; 1919 § 6375
The subscribers so contracting among themselves shall, through their attorney, file with the director of insurance of this state a declaration verified by the oath of the attorney setting forth:
(1) The name or title of the office at which the subscribers propose to exchange indemnity contracts. The name or title shall not be so similar to any other name or title previously adopted by a similar organization or by any insurance corporation or association as in the opinion of the director of insurance is calculated to result in confusion or deception;
(2) The kind or kinds of insurance to be effected or exchanged;
(3) A copy of the form of policy contract or agreement under or by which the insurance is to be effected or exchanged;
(4) A copy of the form of power of attorney or other authority of the attorney under which the insurance is to be effected or exchanged;
(5) The location of the offices from which the contracts or agreements are to be issued;
(6) That, except as to the kinds of insurance herein specifically mentioned in this subdivision, applications have been made for indemnity upon at least one hundred separate risks aggregating not less than one and one-half million dollars represented by executed contracts or bona fide applications to become concurrently effective. In the case of employer's liability or workers' compensation insurance, applications shall have been made for indemnity upon at least one hundred separate risks covering a total payroll of not less than two and one-half million dollars as represented by executed contracts or bona fide applications to become concurrently effective. In the case of automobile insurance, applications shall have been made for indemnity upon at least one thousand motor vehicles or for insurance aggregating not less than one and one-half million dollars represented by executed contracts or bona fide applications to become concurrently effective on any or all classes of automobile insurance effected by the subscribers through the attorney;
(7) That there is in the possession of the attorney and available for the payment of losses, assets conforming to the requirements of sections 379.700 and 379.710. (RSMo 1939 § 6080, A.L. 1967 p. 516)
Prior revisions: 1929 § 5968; 1919 § 6376
1. Concurrently with the filing of the declaration provided for by the terms of section 379.670, the attorney shall file with the director of insurance an instrument in writing, executed by him for the subscribers, conditioned that, upon the issuance of certificate of authority provided for in section 379.750, service of process may be had upon the director of insurance in all suits in this state arising out of the policies, contracts or agreements, which service shall be valid and binding upon all subscribers exchanging at any time reciprocal or interinsurance contracts through the attorney.
2. Three copies of the process shall be served, and the director of insurance shall file one copy, forward one copy to the attorney, and return one copy with his admission of service. (RSMo 1939 § 6081, A.L. 1967 p. 516)
Prior revisions: 1929 § 5969; 1919 § 6377
CROSS REFERENCE: For service outside of state see sections 506.500 to 506.520
(1958) Action by assignee of right to return of unearned premiums due policy holders against interinsurance exchange, held within this section so as to authorize service thereunder. State ex rel. Subscribers at Eagle Reciprocal Exchange v. Brady (Mo.), 308 S.W.2d 652.
There shall be filed with the director of insurance of this state, by the attorney, a statement under the oath of the attorney, showing in the case of fire insurance, the maximum amount of indemnity upon any single risk, and the attorney shall, whenever and as often as the same shall be required, file with the director of insurance a statement verified by his oath to the effect that he has examined the commercial rating of the subscribers as shown by the reference book of a commercial agency having at least one hundred thousand subscribers, and that from the examination or from* other information in his possession, it appears that no subscriber has assumed on any single fire insurance risk an amount greater than ten percent of the net worth of the subscriber. (RSMo 1939 § 6082, A.L. 1967 p. 516)
Prior revisions: 1929 § 5970; 1919 § 6378
*Word "for" in original rolls.
There shall be maintained at all times assets in cash or securities authorized by the laws of the state in which the principal office of the attorney is located for the investment of similar funds of insurance companies doing the same kind of business in* an amount equal to fifty percent of the net annual advance premiums or deposits collected and credited to the accounts of subscribers on policies having one year or less to run and pro rata on those for longer periods; or, in lieu thereof, one hundred percent of the net unearned premiums or deposits collected and credited to the accounts of subscribers, which assets shall not be charged as a liability. (RSMo 1939 § 6083, A. 1949 H.B. 2092, A.L. 1967 p. 516)
Prior revisions: 1929 § 5971; 1919 § 6379
*Word "in" not in original rolls.
1. In order to commence writing the business enumerated in only one subdivision of subsection 1 of section 379.650, a reciprocal or interinsurance exchange shall have as a surplus, in addition to other reserves required, a sum in cash or securities amounting to at least one million six hundred thousand dollars.
2. In order to commence writing the business enumerated in more than one of the subdivisions of subsection 1 of section 379.650, a reciprocal or interinsurance exchange shall have as a surplus, in addition to other reserves required, a sum in cash or securities amounting to at least two million four hundred thousand dollars.
3. In order to continue writing new business, any reciprocal or interinsurance exchange shall maintain a surplus in the amount required to commence business.
4. In addition to the foregoing requirements, in the case of employer's liability, public liability, workers' compensation and automobile insurance, there shall be maintained as a claim or loss reserve in cash or securities, assets sufficient to discharge all liabilities on all outstanding losses arising under policies issued, the same to be calculated in accordance with the laws of the state relating to similar reserves for companies insuring similar risks.
5. Violation of any of the provisions of this section by a reciprocal or interinsurance exchange is grounds for the suspension or revocation of its certificate of authority by the director.
6. Notwithstanding any other provision of this section, any reciprocal or interinsurance exchange licensed in this state to write the business specified in one subdivision of subsection 1 of section 379.650 on July 1, 1987, which did not have a surplus of at least one million six hundred thousand dollars on December 31, 1986, may renew its license for business specified therein until December 31, 1989, if it maintains as a surplus, in addition to other sums required, a sum, in cash or securities, if all other conditions are met, amounting to not less than:
(1) On and after December 31, 1989, one million dollars;
(2) On and after December 31, 1990, one million two hundred thousand dollars;
(3) On and after December 31, 1991, one million four hundred thousand dollars;
(4) On and after December 31, 1992, one million six hundred thousand dollars.
7. Notwithstanding any other provision of this section, any reciprocal or interinsurance exchange licensed to do business in this state and to write the business specified in more than one of the subdivisions of subsection 1 of section 379.650 on July 1, 1987, which did not have a surplus of at least two million four hundred thousand dollars on December 31, 1986, may renew its license for business specified therein until December 31, 1989, if it maintains as a surplus, in addition to other sums required, a sum, in cash or securities, if all other conditions are met, amounting to not less than:
(1) On and after December 31, 1989, one million eight hundred thousand dollars;
(2) On and after December 31, 1990, two million dollars;
(3) On and after December 31, 1991, two million two hundred thousand dollars;
(4) On and after December 31, 1992, two million four hundred thousand dollars.
8. Notwithstanding any other provision of this section, any reciprocal or interinsurance exchange, which before August 28, 1989, was lawfully transacting business in this state under the surplus requirements for a reciprocal or interinsurance exchange transacting only one class of insurance but which after August 28, 1989, will be subject to the surplus requirements for a reciprocal or interinsurance exchange transacting more than one class of insurance, shall be allowed to continue to transact the same business under the surplus requirements for a reciprocal or interinsurance exchange transacting only one class of insurance until December 31, 1990, at which time the surplus requirements for a reciprocal or interinsurance exchange transacting more than one class of insurance shall be met. (RSMo 1939 § 6083, A. 1949 H.B. 2092, A.L. 1957 p. 216, A.L. 1963 p. 485, A.L. 1967 p. 516, A.L. 1977 S.B. 368, A.L. 1989 S.B. 250)
Prior revisions: 1929 § 5971; 1919 § 6379
1. If at any time the amounts on hand are less than the requirements of sections 379.700 and 379.710, the subscribers or their attorney for them shall make up the deficiency.
2. Where funds other than those which have accrued from premiums or deposits of subscribers are supplied to make up a deficiency as herein provided for they shall be deposited and held for the benefit of subscribers under such terms and conditions as the director of insurance may require so long as the deficiency exists, thereafter to be returned to the depositors.
3. "Net premiums" or "deposits" as used in this law shall be construed to mean the advance premiums or deposits made by subscribers after deducting therefrom the amount for expenses specifically provided in the subscriber's agreement. (RSMo 1939 § 6083, A. 1949 H.B. 2092, A.L. 1967 p. 516)
Prior revisions: 1929 § 5971; 1919 § 6379
1. The attorney shall make an annual report to the director of insurance for the calendar year, showing that the financial condition of affairs at the office where the contracts are issued is in accordance with the standard of solvency provided for herein and shall furnish such additional information and reports as may be required to show the total premiums or deposits collected, the total losses paid, the total amounts returned to subscribers, and the amounts retained for expenses; provided, however, that the attorney shall not be required to furnish the names and addresses of any subscribers.
2. The business affairs and assets of the reciprocal or interinsurance exchanges, as shown at the office of the attorney thereof, shall be subject to examination by the director of insurance as often as he sees fit, and the cost thereof shall be paid by the exchange examined. (RSMo 1939 § 6084, A.L. 1967 p. 516)
Prior revisions: 1929 § 5972; 1919 § 6380
Any corporation now or hereafter organized under the laws of this state shall, in addition to the rights, powers and franchises specified in its articles of incorporation, have full power and authority to exchange insurance contracts of the kind and character herein mentioned. The right to exchange the contracts is hereby declared to be incidental to the purposes for which the corporations are organized and as much granted as the rights and powers expressly conferred. (RSMo 1939 § 6085, A.L. 1967 p. 516)
Prior revisions: 1929 § 5973; 1919 § 6381
1. Each attorney by whom or through whom are issued any policies of or contracts for indemnity of the character referred to in sections 379.650 to 379.790 shall procure from the director of insurance annually a certificate of authority, stating that all of the requirements of the sections have been complied with, and upon compliance and the payment of the fees required by those sections the director of insurance shall issue the certificate of authority.
2. The director of insurance may revoke or suspend any certificate of authority issued hereunder in case of breach of any of the conditions imposed by sections 379.650 to 379.790 after reasonable notice has been given the attorney, in writing, so that he may appear and show cause why action should not be taken.
3. Any attorney who may have procured a certificate of authority hereunder shall renew same annually as of July first thereafter; provided, however, that any certificate of authority shall continue in full force and effect until the new certificate of authority be issued or specifically refused. (RSMo 1939 § 6087, A.L. 1967 p. 516, A.L. 1969 3d Ex. Sess. H.B. 21)
Prior revisions: 1929 § 5975; 1919 § 6383
Effective 1-1-71
Two or more domestic reciprocal exchanges or interinsurers may merge or consolidate on affirmative vote of not less than two-thirds of the subscribers of each exchange or interinsurer who vote on the merger or consolidation, pursuant to due notice and prior approval of the director of the department of insurance of this state of the terms and manner of the notice and of the manner and form of the voting and of the proposed merger or consolidation. (L. 1959 S.B. 31 § 375.895, A.L. 1967 p. 516, A.L. 2001 H.B. 212)
1. Except as provided in this section, no law of this state relating to insurance shall apply to the exchange of indemnity contracts. When any other law is applicable, it shall be construed in accordance with the fundamental nature of a reciprocal or interinsurance exchange. In the event of any conflict between such law and the provisions of this section or the provisions of sections 379.650 to 379.770, the latter shall prevail. The other law may, however, supplement or explain the provisions of this section and sections 379.650 to 379.770, and the laws herein made applicable to reciprocal or interinsurance exchanges.
2. The following laws shall be applicable to reciprocal or interinsurance exchanges:
(1) Chapter 148, RSMo, wherein applicable to the taxation of insurance companies and associations;
(2) Chapter 374, RSMo, wherein applicable to insurers or insurance companies except wherein the provisions thereof are specifically or clearly applicable only to a stock or mutual insurer;
(3) Chapter 375, RSMo, wherein applicable to insurers or insurance companies except wherein the provisions thereof are specifically or clearly applicable only to a stock or mutual insurer;
(4) Sections 379.098, 379.100, 379.125, 379.140, 379.203, 379.420 to 379.510, inclusive, and sections 379.650 to 379.790, inclusive. (RSMo 1939 § 6089, A.L. 1967 p. 516, A.L. 1969 3d Ex. Sess. H.B. 21, A.L. 1975 H.B. 945)
Prior revisions: 1929 § 5977; 1919 § 6385
Any attorney who shall exchange any contracts of indemnity of the kind and character specified in sections 379.650 to 379.790, or directly or indirectly solicit or negotiate any applications for same without first complying with the foregoing provisions, shall be deemed guilty of a misdemeanor, and upon conviction thereof shall be subject to a fine of not less than one hundred dollars nor more than one thousand dollars; provided however, that the director of insurance may, in his discretion and on such terms as he may prescribe, issue a permit for organization purposes, the permit to continue in force or be canceled at the pleasure of the director of insurance. (RSMo 1939 § 6086, A.L. 1967 p. 516)
Prior revisions: 1929 § 5974; 1919 § 6382
All of the provisions of the law relating to insurance agents, agencies, brokers and companies, and to the administration and enforcement of the laws of the state relating to insurance by the department of insurance, which are repealed by sections 374.030 to 379.790 and reenacted hereby in part or in whole under new section numbers in the same or a different chapter, so far as they are the same as those of the prior law, shall be construed as a continuation of such law and not as a new enactment. (L. 1967 p. 516 § B)
In addition to any other coverage provided under an insurance policy on real property transferred by a deed described in section 461.025, RSMo, the designated grantee beneficiary shall be deemed to be an insured party under the policy for the period from the date of the owner's death until the first to occur of:
(1) The date that is thirty days after the owner's death;
(2) The end of the policy period, determined as if the owner was still living; or
(3) The date the designated grantee beneficiary obtains alternative coverage.
Nothing in this section shall affect any coverage provided under the policy to household members or others who are deemed to be insureds upon the death of the owner. (L. 2004 H.B. 1090)
There is hereby established the "Missouri Basic Property Insurance Inspection and Placement Program" (hereinafter referred to as "program") to make available basic property insurance to persons having property interests in this state who are in good faith entitled to but who are unable to procure such coverage through ordinary methods. Such program shall provide for the equitable distribution and placement of risks among all insurers in the manner and subject to the conditions hereinafter stated. (L. 1969 H.B. 772 § 379.131)
As used in this section, the following terms mean:
(1) "All-industry placement facility" (hereinafter referred to as "the facility"), the organization formed by insurers to assist applicants in securing basic property insurance, to issue policies and to administer the program and the joint reinsurance association;
(2) "Basic property insurance", the coverage against direct loss to real and tangible personal property at a fixed location that is provided in the standard fire policy and extended coverage endorsement, including builders' risk, and such vandalism and malicious mischief endorsements, and such other classes of insurance as may be added to the program with respect to the property by amendment as hereinafter provided. Basic property insurance does not include automobile risks or such types of manufacturing risks as the governing committee may exclude with the approval of the director. Any contract, as defined in section 375.918, RSMo, of the facility shall be subject to the provisions of section 375.918, RSMo;
(3) "Commercial", basic property insurance not included under the personal lines statistical plan;
(4) "Director", the director of the department of insurance of the state of Missouri;
(5) "Habitational", basic property insurance included under the personal lines statistical plan;
(6) "Inspection bureau", the rating bureau or other organization designated by the facility with the approval of the director to make inspections as required under the program and to perform such other duties as may be authorized by the facility;
(7) "Insurer", any insurance company, reciprocal or interinsurance exchange or other organization licensed and authorized by the director to write property insurance, including the property insurance components of multiperil policies, on a direct basis, in this state;
(8) "Person" includes any individual or group of individuals, corporation, partnership, or association, or any other organized group of persons;
(9) "Premiums written", gross direct premiums (excluding that portion of premium on risks ceded to the joint reinsurance association) charged during the second preceding calendar year with respect to property in this state on all policies of basic property insurance and the basic property insurance premium components of all multiperil policies, as computed by the facility, less return premiums, dividends paid or credited to policyholders, or the unused or unabsorbed portions of premium deposits;
(10) "Property owner", with respect to any real, personal, or mixed real and personal property, means any person having an insurable interest in such property;
(11) "Secretary", the Secretary of the United States Department of Housing and Urban Development. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701, A.L. 2004 S.B. 1299)
1. Any property owner or his representative, the insurer, or the insurance agent or other producer may request an inspection by the inspection bureau. Such requests need not be in writing. The absence of a building owner or his representative during an inspection shall not preclude a tenant seeking insurance from obtaining an inspection under the program.
2. The manner and scope of the inspections of program business shall be prescribed by the facility with the approval of the director.
3. An inspection report shall be made for each property inspected. The report shall cover pertinent structural and occupancy features as well as the general condition of the building and surrounding structures. A representative photograph of the property may be taken during the inspection.
4. During the inspection, the inspector shall point out features of structure and occupancy to the applicant or his representative and shall indicate those features which may result in condition charges if the risk is accepted. The inspector shall have no authority to advise whether the facility will provide the coverage.
5. Within five business days after the inspection, a copy of the completed inspection report, and any photograph indicating the pertinent features of the building, construction, maintenance, occupancy and surrounding property shall be sent promptly to the facility. Included with the report shall be a rate makeup statement, including any condition charges or surcharges proposed as a result of the inspection and permitted by filings approved by the director. A copy of the inspection report shall be made available to the applicant upon request. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
1. The facility, upon receipt of an application for coverage and the corresponding inspection report from the inspection bureau, shall, after it finds that the property is eligible for insurance under this program, issue a policy.
2. The facility shall apportion the liability so assumed to the insurers in the manner hereinafter provided in section 379.835.
3. Assessments upon each insurer in the program for expenses in connection with program business shall be levied and assessed by the governing committee of the facility in the manner hereinafter provided in section 379.835, subject to such minimum assessment as shall be established by the governing committee.
4. Subject to the insurable value thereof, the maximum limits of liability which may be placed through this program are: on any habitational property at one location, two hundred thousand dollars; and on any commercial property at one location, one million dollars. The facility will endeavor to assist in placement when the requested amount of insurance exceeds the maximum limit of liability available under this program. The word "location" as used herein means real and personal property consisting of and contained in a single building or consisting of and contained in contiguous buildings under one ownership. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701, A.L. 2004 H.B. 1253 merged with S.B. 1299)
1. The facility shall, within five business days after receipt of the inspection report and application, complete an action report advising that:
(1) The risk is acceptable; or
(2) The risk is acceptable at a surcharged rate and the improvements necessary before coverage will be provided at an unsurcharged premium rate; or
(3) The risk will be acceptable if the improvements noted in the action report are made by the applicant and confirmed by reinspection; or
(4) The risk is not acceptable for the reasons stated in the action report.
2. In the event a risk is declined because it fails to meet reasonable underwriting standards, the facility will so notify the applicant.
(1) Reasonable underwriting standards shall include, but not be limited to, the following:
(a) Physical condition of the property, such as its construction, heating, wiring, evidence of previous fires or general deterioration;
(b) Its present use or housekeeping, such as vacancy, overcrowding, storage of rubbish or flammable materials.
(2) Neighborhood or area location or any environmental hazard beyond the control of the property owner shall not be deemed to be acceptable criteria for declining a risk.
3. If the risk is acceptable to the facility, the facility shall notify the applicant, and the licensed producer designated by the applicant, of the acceptability of the risk and the premium to be charged. The facility, upon receipt of the premium, shall within three business days issue the policy to be effective at 12:00 noon of the date of the receipt of the premium, unless a later effective date is specified. The policy shall be forwarded to the applicant with a copy to the licensed producer. The facility shall pay the commission to the licensed producer designated by the applicant.
4. In the event the risk is conditionally declined because the property does not meet reasonable underwriting standards but can be improved to meet such standards, the facility shall promptly advise the applicant what improvements noted in the action report should be made to the property. Upon completion of the improvements by the applicant or property owner, the facility, when so notified, will have the property promptly reinspected and thereupon shall process the application in the manner described in subsection 3 of this section.
5. If the inspection of the property reveals that there are one or more substandard conditions, surcharges may be imposed in conformity with the filings approved by the director.
6. If the facility declines the risk, or agrees to write the coverage sought on condition that the property will be improved, it shall promptly send a copy of both the inspection and action reports to the property owner and the director. At the time the facility sends such reports to the property owner, it shall also explain his right to appeal the decision of the facility to the director pursuant to section 379.850 of the program and shall in writing set forth the procedures to be followed for such appeal. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
1. A "Joint Reinsurance Association" (hereinafter referred to as "the association") shall be created consisting of all insurers. The association shall assume from the facility one hundred percent reinsurance on behalf of insurers and shall distribute the liability in accordance with section 379.825.
2. Each insurer shall participate in the writings, expenses, profits and losses of the association in the following manner:
(1) For habitational risks, the same proportion as its habitational premiums written bear to the aggregate habitational premiums written by all insurers in the program;
(2) For commercial risks, the same proportion as its commercial premiums written bear to the aggregate commercial premiums written by all insurers in the program.
3. Such association shall adopt a plan of operation and rules of procedure which, prior to being placed in effect, shall be filed with and approved by the director. Any amendments to the plan of operation or rules of procedure so adopted shall also be filed with and approved by the director prior to being placed into effect. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
All policies issued shall be for basic property insurance on the forms and in accordance with the rate or rating procedures approved by the director for use with the program. Such policies shall be issued for a term of one year. (L. 1969 H.B. 772 § 379.131)
1. The facility shall not cancel a policy or binder issued under the program without approval of the governing committee except in case of:
(1) Evidence of incendiarism (meaning arson by or at the direction of the insured); or
(2) For nonpayment of premium; or
(3) Fraud or material misrepresentation; or
(4) A finding by the facility on the basis of satisfactory evidence that changes in the physical condition of the property or other changed conditions make the risk uninsurable.
2. Any notice of cancellation or notice of nonrenewal of a policy or binder issued under the program, together with a statement of the reason therefor, shall be sent to the insured and a copy retained by the facility. Any such notice shall be sent not less than thirty days prior to the cancellation or nonrenewal of any risk under the program to allow ample time for an application for new coverage to be made and a new policy to be written under the program.
3. Any cancellation or nonrenewal notice to the insured relating to a policy or binder issued under the program shall contain the procedures for obtaining an inspection under the program and shall be accompanied by a statement that the insured has a right of appeal as hereinafter provided. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
1. Any applicant may appeal a decision of the facility relating to the conditions for acceptance of coverage to the director, in writing, within thirty days from the decision of the facility.
2. Other than as provided in subsection 1 of this section, any applicant or insurer shall have the right of appeal to the governing committee. A decision of the committee may be appealed to the director, in writing, within thirty days from the action or decision of the committee. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
1. Commission under the program shall be twelve percent on new business and ten percent on renewal business on the policy premium and shall be paid to the licensed producer designated by the applicant.
2. If a licensed producer is not designated, the commission shall be deposited by the facility in a fund to be held by the director to be applied to the state of Missouri contribution as provided in Section 1223, Para (1), of U.S. Public Law 90-448. One year after termination of the program, any funds so held by the director and not applied as above set out shall be paid over to the treasurer of the state of Missouri as general revenue. (L. 1969 H.B. 772 § 379.131)
1. This program shall be administered by a governing committee (hereinafter referred to as "the committee") of the facility, subject to the supervision of the director, and operated by a manager appointed by the committee.
2. The committee shall consist of thirteen members:
(1) Ten members shall be elected from the following:
American Insurance Association, two
Alliance of American Insurers, two
National Association of Independent Insurers, two
All other stock insurers, two
All other nonstock insurers, two
(2) Three members shall be appointed by the director from each of the following:
Missouri insurer, one
Licensed agent of an insurer, two
Not more than one insurer in a group under the same management or ownership shall serve on the committee at the same time.
3. In case of a vacancy on the governing committee the director shall appoint a representative to such vacancy pending the designation or election as provided in the program.
4. A temporary governing committee shall be appointed by the director to serve until an official committee is duly elected and appointed. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
1. There shall be an annual meeting of the insurers and members of the governing committee on a date fixed by the committee.
2. A special meeting may be called at such time and place designated by the committee or upon the written request to the committee of any ten insurers, not more than one of which may be in a group under the same management or ownership.
3. Twenty days' notice of such annual or special meeting shall be given in writing by the committee to insurers. A majority of the insurers shall constitute a quorum. Voting by proxy shall be permitted. Notice of any meeting shall be accompanied by an agenda for such meeting.
4. Any matter may be proposed and voted upon by mail, provided such procedure is unanimously authorized by the members of the committee present and voting at any meeting of the committee. If so approved by the committee, notice of any proposal shall be mailed to the insurers not less than twenty days prior to the final date fixed by the committee for voting thereon.
5. At any regular or special meeting at which the vote of the insurers is or may be required on any proposal or any vote of the insurers which may be taken by mail on any proposal, such votes shall be cast and counted on a weighted basis in accordance with each insurer's premiums written. On any proposal, deemed by the committee to relate exclusively to habitational or exclusively to commercial business, the votes shall be cast and counted on a weighted basis in accordance with each insurer's respective habitational or commercial premiums written, as the case may be. A proposal shall become effective when approved by at least two-thirds of the votes cast on such weighted basis. (L. 1969 H.B. 772 § 379.131)
1. The committee shall meet as often as may be required to perform the general duties of administration of the program or on the call of the director.
2. The committee shall be empowered to appoint a manager, who shall serve at the pleasure of the committee, to budget expenses, levy assessments, disburse funds, and perform all other duties provided herein or necessary or incidental to the proper administration of the program. The adoption of or substantive changes in pension plans or employee benefit programs shall be subject to approval of insurers. Assessments upon each insurer shall be levied on the basis of its premiums written.
3. Annually the manager shall prepare an operating budget which shall be subject to approval of the committee. Such budget shall be furnished to the insurers after approval. Any contemplated expenditure in excess of or not included in the annual budget shall require prior approval by the committee.
4. The committee shall furnish to all insurers and to the director a written report of operations annually in such form and detail as the committee may determine.
5. The presence of seven members of the committee, at least five of whom shall be insurers, shall constitute a quorum.
6. The committee shall appoint an underwriting committee to review with the manager of the program risks which have been submitted for insurance and may appoint such other committees as it may deem advisable. (L. 1969 H.B. 772 § 379.131)
1. The facility shall separately code and maintain separate statistics on business written in accordance with the foregoing program and shall make reports thereon as may be required by the committee and director.
2. The manager shall submit annually or at such other periods as may be designated by the director to the committee, the director and the Secretary of Housing and Urban Development, a report setting forth the number of requests for inspections, the number of risks inspected, the number of policies written, the number of risks conditionally accepted and reinspections made, the number of risks declined, and such other information as the director may request. (L. 1969 H.B. 772 § 379.131, A.L. 1986 S.B. 701)
All insurers agree to undertake a continuing public education program, in cooperation with producers and others, to assure that the basic property insurance inspection and placement program receives adequate public attention. (L. 1969 H.B. 772 § 379.131)
As used in sections 379.882 to 379.886:
(1) "Commercial casualty insurance" means casualty insurance for business or nonprofit interests which is not for personal, family or household purposes, and which is provided by issuance of a policy of insurance and not merely a binder for such insurance coverage;
(2) "Director" means the director of the department of insurance;
(3) "Insurer" means all insurance companies, reciprocals or interinsurance exchanges transacting the business of commercial casualty insurance in this state;
(4) "Nonpayment of premium" means failure of the named insured to discharge when due any of his obligations in connection with payment of premiums on the policies or any installment of the premium whether the premium is payable directly to the insurer or its agents or indirectly under any premium finance plan or extension of credit;
(5) "Nonrenewal" means the determination of an insurer not to issue or deliver a policy replacing at the end of the policy period a policy previously issued and delivered by the same insurer or a certificate of notice extending the term of a policy beyond its policy period or term;
(6) "Renewal" or "to renew" means a policy previously issued and delivered by the same insurer or the issuance and delivery of a certificate or notice extending the term of the policy beyond its policy period or term, and any policy written for a term longer than one year or any policy with no fixed expiration date shall be considered as if written for successive policy periods or terms of one year. (L. 1987 H.B. 700 § 22)
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1. No notice of cancellation of a commercial casualty insurance policy shall be effective unless prior written notice of the cancellation is mailed or delivered by the insurer to the named insured at least sixty days prior to the effective date of the cancellation, except where the cancellation is based on one or more of the following reasons:
(1) Nonpayment of premium;
(2) Fraud or material misrepresentation affecting the policy or in the presentation of a claim thereunder or a violation of any of the terms or conditions of a policy;
(3) Changes in conditions after the effective date of the policy which have materially increased the hazards originally insured;
(4) Insolvency of the insurer; or
(5) The insurer involuntarily loses reinsurance for the policy.
2. No notice of nonrenewal of a commercial casualty insurance policy shall be effective unless mailed or delivered by the insurer to the named insured at least sixty days prior to the effective date of the nonrenewal.
3. Notice of cancellation or nonrenewal of a commercial casualty insurance policy shall state the insurer's actual reason for proposing the action, the statement of reason to be sufficiently clear and specific so that the recipient can identify the basis of the insurer's decision without further inquiry. An assignment or transfer of a commercial casualty insurance policy among affiliated insurers within an insurance holding company system is not a cancellation or nonrenewal for purposes of sections 379.882 to 379.895. (L. 1987 H.B. 700 §§ 23, 24, A.L. 1998 H.B. 1080)
In the case of a cancellation or nonrenewal, the policyholder shall have the right to receive within thirty days of his written request, a statement of his claims history for that policy for the three years prior to the date of the cancellation or nonrenewal, or total experience if the policy has been in effect less than three years prior to cancellation or nonrenewal. (L. 1987 H.B. 700 § 25)
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Proof of mailing of notice of cancellation or of intention not to renew or reasons for cancellation to the named insured at the address shown in the policy shall be sufficient proof of notice. (L. 1987 H.B. 700 § 26)
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No insurance company shall cancel or nonrenew an entire line or class of commercial casualty insurance without giving ninety days' prior written notice to the director prior to the mailing of notices of cancellation or nonrenewal to the insured. (L. 1987 H.B. 700 § 27)
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1. As used in sections 379.888 to 379.893, the following terms mean:
(1) "'A' rated risk", any insurance coverage for which rates are individually determined based upon judgment because neither a rate service organization nor the insurer has yet established a manual rate based upon experience, except that if a rate service organization or the insurer acquires sufficient experience to establish, or if the insurer itself has, a manual rate for such coverage, then such coverage shall no longer be considered an "A" rated risk for each insurer;
(2) "Base rate", the rate designed to reflect the average aggregate experience of a particular market, prior to adjustment for individual risk characteristics resulting from application of any rating plan;
(3) "Classification", a grouping of insurance risks according to a classification system used by an insurer;
(4) "Classification system", a schedule of classifications and a rule or set of rules used by an insurer for determining the classification applicable to an insured;
(5) "Commercial casualty insurance", casualty insurance for business or nonprofit interests which is not for personal, family, or household purposes;
(6) "Director", the director of the department of insurance;
(7) "Rate", a monetary amount applied to the units of exposure basis assigned to a classification and used by an insurer to determine the premium for an insured;
(8) "Rating plan", a rule or set of rules used by an insurer to calculate premium for an insured, and the parameter values used in such calculation, after application of classification premium rates to units of exposure; and
(9) "Rating system", a collection of rating plans to be used by an insurer, rules for determining which rating plans are applicable to an insured, a classification system, and other rules used by an insurer for determining contractual consideration for insured.
2. Nothing in this section applies to premium increases or decreases from:
(1) Change in hazard of the insured's operation;
(2) Change in magnitude of the exposure basis for the insured, including, without limitation, changes in payroll or sales;
(3) "A" rated risks.
3. Any renewal notice of a commercial casualty insurance policy as defined in section 379.882 for any Missouri risk or portion thereof which would have the effect of increasing the premium charged to the insured due to a change in any scheduled rating factor applied to the policy during the previous policy period shall contain or be accompanied by a notice to the insured informing the insured that any inquiry by the insured concerning the change may be directed to the agent of record or directly to the insurer. When any insured makes a request for information pursuant to this subsection, the insurer, directly or through the insurer's agent, shall inform the insured in writing in terms sufficiently clear and specific of the basis for any reduction in a scheduled rating credit or increase in a scheduled rating debit which is applied to the policy. Evidence supporting the basis for any scheduled rating credit or debit shall be retained by the insurer for the policy term plus two calendar years pursuant to section 374.205, RSMo. The department of insurance shall notify commercial casualty insurers of the requirements of this section by bulletin.
4. Any renewal involving a "premium alteration requiring notification" as defined in subsection 6 of section 379.321, shall be handled pursuant to the requirements of that subsection. (L. 1987 H.B. 700 § 28, A.L. 1998 H.B. 1080, A.L. 1999 S.B. 386, A.L. 2001 S.B. 186)
Commercial casualty insurance rates shall not be excessive, inadequate or unfairly discriminatory. No rate shall be held to be excessive unless such rate is unreasonably high for the insurance coverage provided. No rate shall be held to be inadequate unless such rate is unreasonably low for the insurance coverage provided and is insufficient to sustain projected losses and expenses or unless such rate is unreasonably low for the insurance coverage provided and the use of such rate has, or if continued will have, the effect of destroying competition or creating a monopoly. Unfair discrimination shall be defined to include, but shall not be limited to, the use of rates which unfairly discriminate between risks in the application of like charges or credits or the use of rates which unfairly discriminate between risks having essentially the same hazard. (L. 1987 H.B. 700 § 29, A.L. 2002 H.B. 1468)
Supporting actuarial data shall be filed in support of a commercial casualty insurance rate, rating plan, or rating system filing, whenever requested by the director to determine whether rates are excessive, inadequate or unfairly discriminatory. The data shall be in sufficient detail to:
(1) Justify any rate level changes; and
(2) Demonstrate the statistical significance of differences or correlations relevant to rating plan definitions and rate differentials. (L. 1987 H.B. 700 § 30, A.L. 2002 H.B. 1468)
The director shall have authority to promulgate reasonable rules and regulations limiting or modifying any aspect of any commercial casualty insurance rating plan or rating system which involves a possible modification of the base rate. No rule or portion of a rule promulgated under the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo. (L. 1987 H.B. 700 § 31, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)
1. Every insurance company doing commercial casualty business in this state shall annually on or before March first report its closed claims experience for the previous calendar year to the director on a form prescribed by the director. The form shall include data as required by the director for profitability by line and such other data as the director may prescribe. The information to be included on such report shall also include the following:
(1) Number and dollar amount of claims closed with payment by year incurred for each commercial liability class or line, and the dollar amount reserved for such claims:
(a) In the event a claim is paid pursuant to a verdict being rendered by a court, the insurer shall report the number of claims in which the insurer paid:
a. More than three hundred thousand dollars in noneconomic damages to one person or entity; and
b. More than five hundred thousand dollars in noneconomic damages to a person or entity;
(b) In the event a claim is being paid pursuant to a verdict being rendered by a court assessing punitive damages the insurer shall report the number of claims in which the insured paid:
a. More than three hundred thousand dollars; and
b. More than five hundred thousand dollars;
(2) Number and dollar amount of claims closed without payment by year incurred for each commercial liability class or line, and the dollar amount reserved for such claims.
2. The annual report required by this section shall not include information which is reported to the director pursuant to section 374.415, RSMo, or pursuant to a report required by any provision of chapter 383, RSMo. (L. 1987 H.B. 700 § 32)
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1. As used in this section the term "prepaid legal service plan", means any person, company, corporation, partnership or other legal entity who collects periodic fees on a prepaid basis from residents of this state in connection with legal coverage other than:
(a) Retainer contracts made by attorneys-at-law with an individual client with fees based on estimates of the nature and amount of legal services to be provided to that specific client and similar contracts made with a group of clients involved in the same or closely related legal matters;
(b) Any lawyer aid or other legal services program for the indigent;
(c) Any employer-employee welfare benefit plans to the extent that state laws are superseded by the Employee Retirement Income Security Act of 1974, 29 U.S.C., s. 1144, or any amendments thereto, provided evidence of exemption from state law is shown to the department;
(d) The furnishing of legal assistance by labor unions and other employee organizations to their members in matters relating *to employment or occupations*;
(e) The furnishing of legal assistance to members or their dependents by churches, cooperatives, educational institutions, credit unions, labor unions or other organizations of employees, where such organizations contract with and pay directly a lawyer or law firm for the provision of legal services, where the assistance is provided as an incident to membership and not on the basis of an optional fee or charge and the administration of such program of legal assistance is wholly conducted by the organization;
(f) Legal services provided by an agency of the federal or state government or a subdivision thereof to its employees.
2. Any person who solicits memberships on behalf of a prepaid legal services plan shall be licensed as an insurance agent as provided by chapter 375, RSMo. (L. 1990 H.B. 1739 § 15)
*Words "to employment or occupations" were inadvertently omitted in original rolls.
1. Sections 379.930 to 379.952 shall be known and may be cited as the "Small Employer Health Insurance Availability Act".
2. For the purposes of sections 379.930 to 379.952:
(1) "Actuarial certification" means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the director that a small employer carrier is in compliance with the provisions of section 379.936, based upon the person's examination, including a review of the appropriate records and of the actuarial assumptions and methods used by the small employer carrier in establishing premium rates for applicable health benefit plans;
(2) "Affiliate" or "affiliated" means any entity or person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person;
(3) "Agent" means "insurance agent" as that term is defined in section 375.012, RSMo;
(4) "Base premium rate" means, for each class of business as to a rating period, the lowest premium rate charged or that could have been charged under the rating system for that class of business, by the small employer carrier to small employers with similar case characteristics for health benefit plans with the same or similar coverage;
(5) "Basic health benefit plan" means a lower cost health benefit plan developed pursuant to section 379.944;
(6) "Board" means the board of directors of the program established pursuant to sections 379.942 and 379.943;
(7) "Broker" means "broker" as that term is defined in section 375.012, RSMo;
(8) "Carrier" means any entity that provides health insurance or health benefits in this state. For the purposes of sections 379.930 to 379.952, carrier includes an insurance company, health services corporation, fraternal benefit society, health maintenance organization, multiple employer welfare arrangement specifically authorized to operate in the state of Missouri, or any other entity providing a plan of health insurance or health benefits subject to state insurance regulation;
(9) "Case characteristics" means demographic or other objective characteristics of a small employer that are considered by the small employer carrier in the determination of premium rates for the small employer, provided that claim experience, health status and duration of coverage since issue shall not be case characteristics for the purposes of sections 379.930 to 379.952;
(10) "Class of business" means all or a separate grouping of small employers established pursuant to section 379.934;
(11) "Committee" means the health benefit plan committee created pursuant to section 379.944;
(12) "Control" shall be defined in manner consistent with chapter 382, RSMo;
(13) "Dependent" means a spouse or an unmarried child under the age of nineteen years; an unmarried child who is a full-time student under the age of twenty-three years and who is financially dependent upon the parent; or an unmarried child of any age who is medically certified as disabled and dependent upon the parent;
(14) "Director" means the director of the department of insurance of this state;
(15) "Eligible employee" means an employee who works on a full-time basis and has a normal work week of thirty or more hours. The term includes a sole proprietor, a partner of a partnership, and an independent contractor, if the sole proprietor, partner or independent contractor is included as an employee under a health benefit plan of a small employer, but does not include an employee who works on a part-time, temporary or substitute basis. For purposes of sections 379.930 to 379.952, a person, his spouse and his minor children shall constitute only one eligible employee when they are employed by the same small employer;
(16) "Established geographic service area" means a geographical area, as approved by the director and based on the carrier's certificate of authority to transact insurance in this state, within which the carrier is authorized to provide coverage;
(17) "Health benefit plan" means any hospital or medical policy or certificate, health services corporation contract, or health maintenance organization subscriber contract. Health benefit plan does not include a policy of individual accident and sickness insurance or hospital supplemental policies having a fixed daily benefit, or accident-only, specified disease-only, credit, dental, vision, Medicare supplement, long-term care, or disability income insurance, or coverage issued as a supplement to liability insurance, worker's compensation or similar insurance, or automobile medical payment insurance;
(18) "Index rate" means, for each class of business as to a rating period for small employers with similar case characteristics, the arithmetic mean of the applicable base premium rate and the corresponding highest premium rate;
(19) "Late enrollee" means an eligible employee or dependent who requests enrollment in a health benefit plan of a small employer following the initial enrollment period for which such individual is entitled to enroll under the terms of the health benefit plan, provided that such initial enrollment period is a period of at least thirty days. However, an eligible employee or dependent shall not be considered a late enrollee if:
(a) The individual meets each of the following:
a. The individual was covered under qualifying previous coverage at the time of the initial enrollment;
b. The individual lost coverage under qualifying previous coverage as a result of termination of employment or eligibility, the involuntary termination of the qualifying previous coverage, death of a spouse or divorce;
c. The individual requests enrollment within thirty days after termination of the qualifying previous coverage;
(b) The individual is employed by an employer that offers multiple health benefit plans and the individual elects a different plan during an open enrollment period; or
(c) A court has ordered coverage be provided for a spouse or minor or dependent child under a covered employee's health benefit plan and request for enrollment is made within thirty days after issuance of the court order;
(20) "New business premium rate" means, for each class of business as to a rating period, the lowest premium rate charged or offered, or which could have been charged or offered, by the small employer carrier to small employers with similar case characteristics for newly issued health benefit plans with the same or similar coverage;
(21) "Plan of operation" means the plan of operation of the program established pursuant to sections 379.942 and 379.943;
(22) "Premium" means all moneys paid by a small employer and eligible employees as a condition of receiving coverage from a small employer carrier, including any fees or other contributions associated with the health benefit plan;
(23) "Producer" includes an insurance agent or broker;
(24) "Program" means the Missouri small employer health reinsurance program created pursuant to sections 379.942 and 379.943;
(25) "Qualifying previous coverage" and "qualifying existing coverage" mean benefits or coverage provided under:
(a) Medicare or Medicaid;
(b) An employer-based health insurance or health benefit arrangement that provides benefits similar to or exceeding benefits provided under the basic health benefit plan; or
(c) An individual health insurance policy (including coverage issued by a health maintenance organization, health services corporation or a fraternal benefit society) that provides benefits similar to or exceeding the benefits provided under the basic health benefit plan, provided that such policy has been in effect for a period of at least one year;
(26) "Rating period" means the calendar period for which premium rates established by a small employer carrier are assumed to be in effect;
(27) "Restricted network provision" means any provision of a health benefit plan that conditions the payment of benefits, in whole or in part, on the use of health care providers that have entered into a contractual arrangement with the carrier pursuant to section 354.400, RSMo, et seq. to provide health care services to covered individuals;
(28) "Small employer" means any person, firm, corporation, partnership or association that is actively engaged in business that, on at least fifty percent of its working days during the preceding calendar quarter, employed not less than three nor more than twenty-five eligible employees, the majority of whom were employed within this state. In determining the number of eligible employees, companies that are affiliated companies, or that are eligible to file a combined tax return for purposes of state taxation, shall be considered one employer;
(29) "Small employer carrier" means a carrier that offers health benefit plans covering eligible employees of one or more small employers in this state;
(30) "Standard health benefit plan" means a health benefit plan developed pursuant to section 379.944. (L. 1992 S.B. 796 § 1)
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1. Sections 379.930 to 379.952 shall apply to any health benefit plan that provides coverage to the employees of a small employer in this state if any of the following conditions are met:
(1) Any portion of the premium or benefits is paid by or on behalf of the small employer;
(2) An eligible employee or dependent is reimbursed, whether through wage adjustments or otherwise, by or on behalf of the small employer for any portion of the premium; or
(3) The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 162, section 125 or section 106 of the federal Internal Revenue Code.
2. (1) Except as provided in subdivision (2) of this subsection, for the purposes of sections 379.930 to 379.952, carriers that are affiliated companies or that are eligible to file a consolidated tax return shall be treated as one carrier and any restrictions or limitations imposed by this act* shall apply as if all health benefit plans delivered to small employers in this state by such affiliated carriers were issued by one carrier.
(2) An affiliated carrier that is a health maintenance organization having a certificate of authority under section 354.400, et seq., RSMo, may be considered to be a separate carrier for the purposes of sections 379.930 to 379.952.
(3) Unless otherwise authorized by the director, a small employer carrier shall not enter into one or more ceding arrangements with respect to health benefit plans delivered or issued for delivery to small employers in this state if such arrangements would result in less than fifty percent of the insurance obligation or risk for such health benefit plans being retained by the ceding carrier.
3. Sections 379.930 to 379.952 shall not apply to any plan or program when the employees pay the total cost of the health benefit plan. (L. 1992 S.B. 796 § 2)
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*"This act" (S.B. 796, 1992) contains numerous sections. Consult Disposition of Sections table for definitive listing.
1. A small employer carrier may establish a class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:
(1) The small employer carrier uses more than one type of system for the marketing and sale of health benefit plans to small employers;
(2) The small employer carrier has acquired a class of business from another small employer carrier; or
(3) The small employer carrier provides coverage to one or more association groups that meet the requirements of subdivision (5) of subsection 1 of section 376.421, RSMo.
2. A small employer carrier may establish up to nine separate classes of business under subsection 1 of this section. A small employer carrier which immediately prior to the effective date of sections 379.930 to 379.952* had established more than nine separate classes of business may, on the effective date of sections 379.930 to 379.952*, establish no more than twelve separate classes of business, and shall reduce the number of such classes to eleven within one year after the effective date of sections 379.930 to 379.952*; ten within two years after such date; and nine within three years after such date.
3. The director may promulgate rules to provide for a period of transition in order for a small employer carrier to come into compliance with subsection 2 of this section in the instance of acquisition of an additional class of business from another small employer carrier.
4. The director may approve the establishment of additional classes of business upon application to the director and a finding by the director that such action would enhance the efficiency and fairness of the small employer marketplace. (L. 1992 S.B. 796 § 3)
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*See § 379.940 subsec. 5 for effective dates.
1. Premium rates for health benefit plans subject to sections 379.930 to 379.952 shall be subject to the following provisions:
(1) The index rate for a rating period for any class of business shall not exceed the index rate for any other class of business by more than twenty percent;
(2) For a class of business, the premium rates charged during a rating period to small employers with similar case characteristics for the same or similar coverage, or the rates that could be charged to such employers under the rating system for that class of business shall not vary from the index rate by more than twenty-five percent of the index rate;
(3) The percentage increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of the following:
(a) The percentage change in the new business premium rate measured from the first day of the prior rating period to the first day of the new rating period. In the case of a health benefit plan into which the small employer carrier is no longer enrolling new small employers, the small employer carrier shall use the percentage change in the base premium rate, provided that such change does not exceed, on a percentage basis, the change in the new business premium rate for the most similar health benefit plan into which the small employer carrier is actively enrolling new small employers;
(b) Any adjustment, not to exceed fifteen percent annually and adjusted pro rata for rating periods of less than one year, due to the claim experience, health status or duration of coverage of the employees or dependents of the small employer as determined from the small employer carrier's rate manual for the class of business; and
(c) Any adjustment due to change in coverage or change in the case characteristics of the small employer, as determined from the small employer carrier's rate manual for the class of business;
(4) Adjustments in rates for claim experience, health status and duration of coverage shall not be charged to individual employees or dependents. Any such adjustment shall be applied uniformly to the rates charged for all employees and dependents of the small employer;
(5) Premium rates for health benefit plans shall comply with the requirements of this section notwithstanding any assessments paid or payable by small employer carriers pursuant to sections 379.942 and 379.943;
(6) A small employer carrier may utilize the employer's industry as a case characteristic in establishing premium rates, provided that the rate factor associated with any industry classification shall not vary by more than ten percent from the arithmetic mean of the highest and lowest rate factors associated with all industry classifications;
(7) In the case of health benefit plans issued prior to July 1, 1993, a premium rate for a rating period may exceed the ranges set forth in subdivisions (1) and (2) of this subsection for a period of three years following July 1, 1993. In such case, the percentage increase in the premium rate charged to a small employer for a new rating period shall not exceed the sum of the following:
(a) The percentage change in the new business premium rate measured from the first day of the prior rating period to the first day of the new rating period. In the case of a health benefit plan into which the small employer carrier is no longer enrolling new small employers, the small employer carrier shall use the percentage change in the base premium rate, provided that such change does not exceed, on a percentage basis, the change in the new business premium rate for the most similar health benefit plan into which the small employer carrier is actively enrolling new small employers;
(b) Any adjustment due to change in coverage or change in the case characteristics of the small employer, as determined from the carrier's rate manual for the class of business;
(8) (a) Small employer carriers shall apply rating factors, including case characteristics, consistently with respect to all small employers in a class of business. Rating factors shall produce premiums for identical groups which differ only by amounts attributable to plan design and do not reflect differences due to the nature of the groups assumed to select particular health benefit plans;
(b) A small employer carrier shall treat all health benefit plans issued or renewed in the same calendar month as having the same rating period;
(9) For the purposes of this subsection, a health benefit plan that utilizes a restricted provider network shall not be considered similar coverage to a health benefit plan that does not utilize such a network, provided that utilization of the restricted provider network results in substantial differences in claims costs;
(10) A small employer carrier shall not use case characteristics, other than age, sex, industry, geographic area, family composition, and group size without prior approval of the director;
(11) The director may promulgate rules to implement the provisions of this section and to assure that rating practices used by small employer carriers are consistent with the purposes of sections 379.930 to 379.952, including:
(a) Assuring that differences in rates charged for health benefit plans by small employer carriers are reasonable and reflect objective differences in plan design, not including differences due to the nature of the groups assumed to select particular health benefit plans; and
(b) Prescribing the manner in which case characteristics may be used by small employer carriers.
2. A small employer carrier shall not transfer a small employer involuntarily into or out of a class of business. A small employer carrier shall not offer to transfer a small employer into or out of a class of business unless such offer is made to transfer all small employers in the class of business without regard to case characteristics, claim experience, health status or duration of coverage.
3. The director may suspend for a specified period the application of subdivision (1) of subsection 1 of this section as to the premium rates applicable to one or more small employers included within a class of business of a small employer carrier for one or more rating periods upon a filing by the small employer carrier and a finding by the director either that the suspension is reasonable in light of the financial condition of the small employer carrier or that the suspension would enhance the efficiency and fairness of the marketplace for small employer health insurance.
4. In connection with the offering for sale of any health benefit plan to a small employer, a small employer carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of all of the following:
(1) The extent to which premium rates for a specified small employer are established or adjusted based upon the actual or expected variation in claims costs or actual or expected variation in health status of the employees of the small employer and their dependents;
(2) The provisions of the health benefit plan concerning the small employer carrier's right to change premium rates and factors, other than claim experience, that affect changes in premium rates;
(3) The provisions relating to renewability of policies and contracts; and
(4) The provisions relating to any preexisting condition provision.
5. (1) Each small employer carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation that demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.
(2) Each small employer carrier shall file with the director annually on or before March fifteenth an actuarial certification certifying that the carrier is in compliance with sections 379.930 to 379.952 and that the rating methods of the small employer carrier are actuarially sound. Such certification shall be in a form and manner, and shall contain such information, as specified by the director. A copy of the certification shall be retained by the small employer carrier at its principal place of business.
(3) A small employer carrier shall make the information and documentation described in subdivision (1) of this section available to the director upon request. (L. 1992 S.B. 796 § 4)
Effective 7-1-93
1. A health benefit plan subject to sections 379.930 to 379.952 shall be renewable with respect to all eligible employees and dependents, at the option of the small employer, except in any of the following cases:
(1) Nonpayment of the required premiums;
(2) Fraud or misrepresentation of the small employer or, with respect to coverage of individual insureds, the insureds or their representatives;
(3) Noncompliance with the carrier's minimum participation requirements;
(4) Noncompliance with the carrier's employer contribution requirements;
(5) Repeated misuse of a provider network provision; or
(6) The small employer carrier elects to nonrenew all of its health benefit plans delivered or issued for delivery to small employers in this state. In such a case the carrier shall:
(a) Provide advance notice of its decision under this subdivision to the insurance supervisory official in each state in which it is licensed; and
(b) Provide notice of the decision not to renew coverage to all affected small employers and to the insurance supervisory official in each state in which an affected covered individual is known to reside at least one hundred eighty days prior to the nonrenewal of any health benefit plan by the carrier. Notice to the insurance supervisory official under this paragraph shall be provided at least three working days prior to the notice to the affected small employers;
(7) The director finds that the continuation of the coverage would:
(a) Not be in the best interests of the policyholders or certificate holders; or
(b) Impair the carrier's ability to meet its contractual obligations.
In such instance the director shall assist affected small employers in finding replacement coverage.
2. A small employer carrier that elects not to renew a health benefit plan under subdivision (6) of subsection 1 of this section shall be prohibited from writing new business in the small employer market in this state for a period of five years from the date of notice to the director.
3. In the case of a small employer carrier doing business in one established geographic service area of the state, the provisions of this section shall apply only to the carrier's operations in such service area. (L. 1992 S.B. 796 § 5)
Effective 7-1-93
1. (1) Every small employer carrier shall, as a condition of transacting business in this state with small employers, actively offer to small employers at least two health benefit plans. One plan offered by each small employer carrier shall be a basic health benefit plan and one plan shall be a standard health benefit plan.
(2) (a) A small employer carrier shall issue a basic health benefit plan or a standard health benefit plan to any eligible small employer that applies for either such plan and agrees to make the required premium payments and to satisfy the other reasonable provisions of the health benefit plan not inconsistent with sections 379.930 to 379.952.
(b) In the case of a small employer carrier that establishes more than one class of business pursuant to section 379.934, the small employer carrier shall maintain and issue to eligible small employers at least one basic health benefit plan and at least one standard health benefit plan in each class of business so established. A small employer carrier may apply reasonable criteria in determining whether to accept a small employer into a class of business, provided that:
a. The criteria are not intended to discourage or prevent acceptance of small employers applying for a basic or standard health benefit plan;
b. The criteria are not related to the health status or claim experience of the small employer;
c. The criteria are applied consistently to all small employers applying for coverage in the class of business; and
d. The small employer carrier provides for the acceptance of all eligible small employers into one or more classes of business. The provisions of this paragraph shall not apply to a class of business into which the small employer carrier is no longer enrolling new small employers.
(3) A small employer is eligible under subdivision (2) of this subsection if it employed at least three or more eligible employees within this state on at least fifty percent of its working days during the preceding calendar quarter.
(4) The provisions of this subsection shall be effective one hundred eighty days after the director's approval of the basic health benefit plan and the standard health benefit plan developed pursuant to section 379.944, provided that if the small employer health reinsurance program created pursuant to sections 379.942 and 379.943 is not yet in operation on such date, the provisions of this subsection shall be effective on the date that such program begins operation.
2. Health benefit plans covering small employers shall comply with the following provisions:
(1) A health benefit plan shall not deny, exclude or limit benefits for a covered individual for losses incurred more than twelve months following the effective date of the individual's coverage due to a preexisting condition. A health benefit plan shall not define a preexisting condition more restrictively than:
(a) A condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care or treatment during the six months immediately preceding the effective date of coverage;
(b) A condition for which medical advice, diagnosis, care or treatment was recommended or received during the six months immediately preceding the effective date of coverage; or
(c) A pregnancy existing on the effective date of coverage.
(2) A health benefit plan shall waive any time period applicable to a preexisting condition exclusion or limitation period with respect to particular services for the period of time an individual was previously covered by qualifying previous coverage that provided benefits with respect to such services, provided that the qualifying previous coverage was continuous to a date not less than thirty days prior to the effective date of the new coverage. This subdivision does not preclude application of any waiting period applicable to all new enrollees under the health benefit plan.
(3) A health benefit plan may exclude coverage for late enrollees for the greater of eighteen months or provide for an eighteen-month preexisting condition exclusion, provided that if both a period of exclusion from coverage and a preexisting condition exclusion are applicable to a late enrollee, the combined period shall not exceed eighteen months from the date the individual enrolls for coverage under the health benefit plan.
(4) (a) Except as provided in paragraph (d) of this subdivision, requirements used by a small employer carrier in determining whether to provide coverage to a small employer, including requirements for minimum participation of eligible employees and minimum employer contributions, shall be applied uniformly among all small employers with the same number of eligible employees applying for coverage or receiving coverage from the small employer carrier.
(b) A small employer carrier may vary application of minimum participation requirements only by the size of the small employer group.
(c) a. Except as provided in paragraph (b) of this subdivision, in applying minimum participation requirements with respect to a small employer, a small employer carrier shall not consider employees or dependents who have qualifying existing coverage in determining whether the applicable percentage of participation is met.
b. With respect to a small employer with ten or fewer eligible employees, a small employer carrier may consider employees or dependents who have coverage under another health benefit plan sponsored by such small employer in applying minimum participation requirements.
(d) A small employer carrier shall not increase any requirement for minimum employee participation or any requirement for minimum employer contribution applicable to a small employer at any time after the small employer has been accepted for coverage.
(5) (a) If a small employer carrier offers coverage to a small employer, the small employer carrier shall offer coverage to all of the eligible employees of a small employer and their dependents. A small employer carrier shall not offer coverage to only certain individuals in a small employer group or to only part of the group, except in the case of late enrollees as provided in subdivision (3) of this subsection.
(b) A small employer carrier shall not modify a basic or standard health benefit plan with respect to a small employer or any eligible employee or dependent through riders, endorsements or otherwise, to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the health benefit plan.
3. (1) A small employer carrier shall not be required to offer coverage or accept applications pursuant to subsection 1 of this section in the case of the following:
(a) To a small employer, where the small employer is not physically located in the carrier's established geographic service area;
(b) To an employee, when the employee does not work or reside within the carrier's established geographic service area; or
(c) Within an area where the small employer carrier reasonably anticipates, and demonstrates to the satisfaction of the director, that it will not have the capacity within its established geographic service area to deliver service adequately to the members of such groups because of its obligations to existing group policyholders and enrollees.
(2) A small employer carrier that cannot offer coverage pursuant to paragraph (c) of subdivision (1) of this subsection may not offer coverage in the applicable area to new cases of employer groups with more than twenty-five eligible employees or to any small employer groups until the later of one hundred eighty days following each such refusal or the date on which the carrier notifies the director that it has regained capacity to deliver services to small employer groups.
4. A small employer carrier shall not be required to provide coverage to small employers pursuant to subsection 1 of this section for any period of time for which the director determines that requiring the acceptance of small employers in accordance with the provisions of subsection 1 of this section would place the small employer carrier in a financially impaired condition.
5. Sections 379.930 to 379.938 and sections 379.942 to 379.950 shall become effective July 1, 1993, this section and section 379.952 shall become effective July 1, 1994. (L. 1992 S.B. 796 §§ 6, B)
Effective 7-1-94
1. There is hereby created a nonprofit entity to be known as the "Missouri Small Employer Health Reinsurance Program". All small employer carriers shall participate in the program as reinsuring carriers for a minimum of three years beginning July 1, 1993. After the expiration of such three years, a small employer carrier may apply to the director to opt out of the program. The director shall decide whether to grant such an application to opt out, and shall consider in making such determination only: the carrier's financial condition and the financial condition of its guaranteeing or reinsuring corporation, if any; its history of assuming and managing risk; its ability to assume and manage the risk of enrolling small employers without the protection of the program; and its commitment to market fairly to all small employers in its service area. If the director grants such application, the small employer carrier shall participate in the program neither as a ceding nor reinsuring carrier.
2. (1) The program shall operate subject to the supervision and control of the board. Subject to the provisions of subdivision (2) of this subsection, the board shall consist of nine members appointed by the director plus the director or his designated representative, who shall serve as an ex officio member of the board.
(2) (a) In selecting the members of the board, the director shall include representatives of small employers, small employer employees or their representatives and small employer carriers and such other individuals determined to be qualified by the director. At least five of the members of the board shall be representatives of reinsuring carriers and at least one of the members of the board shall be a representative of a health maintenance organization which is a small employer carrier. All members shall be selected from individuals nominated by small employer carriers in this state pursuant to procedures and guidelines developed by the director, except that the director shall select two small employers' employees, including at least one representative of a labor organization.
(b) In the event that the program becomes eligible for additional financing pursuant to subdivision (3) of subsection 8 of section 379.943, the board shall be expanded to include two additional members who shall be appointed by the director. In selecting the additional members of the board, the director shall choose individuals who represent reinsuring carriers. The expansion of the board under this paragraph shall continue for the period that the program continues to be eligible for additional financing under subdivision (3) of subsection 8 of section 379.943.
(3) The initial board members shall be appointed as follows: one-third of the members to serve a term of two years; one-third of the members to serve a term of four years; and one-third of the members to serve a term of six years. Subsequent board members shall serve for a term of three years. A board member's term shall continue until his successor is appointed.
(4) A vacancy in the board shall be filled by the director. A board member may be removed by the director for cause.
3. Within sixty days of July 1, 1993, each small employer carrier shall make a filing with the director containing the carrier's net health insurance premium derived from health benefit plans delivered or issued for delivery to small employers in this state in the previous calendar year. (L. 1992 S.B. 796 § 7 subsecs. 1, 2, 3)
Effective 7-1-93
1. Within one hundred eighty days after the appointment of the initial board, the board shall submit to the director a plan of operation and thereafter any amendments thereto necessary or suitable, to assure the fair, reasonable and equitable administration of the program. The director may, after notice and hearing, approve the plan of operation if the director determines it to be suitable to assure the fair, reasonable and equitable administration of the program, and provides for the sharing of program gains or losses on an equitable and proportionate basis in accordance with the provisions of section 379.942 and this section. The plan of operation shall become effective upon approval in writing by the director.
2. If the board fails to submit a suitable plan of operation within one hundred eighty days after its appointment, the director shall, after notice and hearing, promulgate and adopt a temporary plan of operation. The director shall amend or rescind any plan so adopted under this subsection at the time a plan of operation is submitted by the board and approved by the director.
3. The plan of operation shall:
(1) Establish procedures for handling and accounting of program assets and moneys and for an annual fiscal report to the director;
(2) Establish procedures for selecting an administering carrier and setting forth the powers and duties of the administering carrier;
(3) Establish procedures for reinsuring risks in accordance with the provisions of section 379.942 and this section;
(4) Establish procedures for collecting assessments from reinsuring carriers to fund claims and administrative expenses incurred or estimated to be incurred by the program; and
(5) Provide for any additional matters necessary for the implementation and administration of the program.
4. The program shall have the general powers and authority granted under the laws of this state to insurance companies and health maintenance organizations licensed to transact business, except the power to issue health benefit plans directly to either groups or individuals. In addition thereto, the program shall have the specific authority to:
(1) Enter into contracts as necessary or proper to carry out the provisions and purposes of sections 379.930 to 379.952, including the authority, with the approval of the director, to enter into contracts with similar programs in other states for the joint performance of common functions or with persons or other organizations for the performance of administrative functions;
(2) Sue or be sued, including taking any legal actions necessary or proper to recover any assessments and penalties for, on behalf of, or against the program or any reinsuring carriers;
(3) Take any legal action necessary to avoid the payment of improper claims against the program;
(4) Define the health benefit plans for which reinsurance will be provided, and to issue reinsurance policies, in accordance with the requirements of sections 379.930 to 379.952;
(5) Establish rules, conditions and procedures for reinsuring risks under the program;
(6) Establish actuarial functions as appropriate for the operation of the program;
(7) Assess carriers in accordance with the provisions of subsection 8 of this section, and to make advance interim assessments as may be reasonable and necessary for organizational and interim operating expenses. Any interim assessments shall be credited as offsets against any regular assessments due following the close of the calendar year;
(8) Appoint appropriate legal, actuarial and other committees as necessary to provide technical assistance in the operation of the program, policy and other contract design, and any other function within the authority of the program; and
(9) Borrow money to effect the purposes of the program. Any notes or other evidence of indebtedness of the program not in default shall be legal investments for carriers and may be carried as admitted assets.
5. A small employer carrier participating in the program may reinsure an entire small employer group with the program as provided for in this subsection:
(1) With respect to a basic health benefit plan or a standard health benefit plan, the program shall reinsure the level of coverage provided and, with respect to other plans, the program shall reinsure up to the level of coverage provided in a basic or standard health benefit plan.
(2) A small employer carrier may reinsure an entire small employer group within sixty days of the commencement of the group's coverage under a health benefit plan or within thirty days after an annual renewal of a small employer group.
(3) (a) The program shall not reimburse a small employer carrier with respect to the claims of an employee or dependent who is part of a reinsured small employer group until the carrier has incurred an initial level of claims for such employee or dependent of five thousand dollars in a calendar year for benefits covered by the program. In addition, the small employer carrier shall be responsible for ten percent of the remaining incurred claims during a calendar year and the program shall reinsure the remainder. A small employer carrier's liability under this paragraph shall not exceed a maximum limit of twenty-five thousand dollars in any one calendar year with respect to any individual who is part of a reinsured small employer group.
(b) The board annually shall adjust the initial level of claims and the maximum limit to be retained by the carrier to reflect increases in costs and utilization within the standard market for health benefit plans within the state. The adjustment shall not be less than the annual change in the medical component of the Consumer Price Index for All Urban Consumers of the federal Department of Labor, Bureau of Labor Statistics, unless the board proposes and the director approves a lower adjustment factor.
(4) A small employer carrier may terminate reinsurance for a small employer on any plan anniversary.
6. (1) The board, as part of the plan of operation, shall establish a methodology for determining premium rates to be charged by the program for reinsuring small employers and individuals pursuant to section 379.942 and this section. The methodology shall include a system for classification of small employers that reflects the types of case characteristics commonly used by small employer carriers in the state. The methodology shall also include a system for classification of small employer carriers that reflects the degree to which the small employer carrier uses the cost containment features adopted by the health benefit plan committee under section 379.944. The methodology shall provide for the development of base reinsurance premium rates, which shall be multiplied by the factors set forth in subdivision (2) of this act to determine the premium rates for the program. The base reinsurance premium rates shall be established by the board, subject to the approval of the director, and shall be set at levels which reasonably approximate gross premiums charged to small employers by small employer carriers for health benefit plans with benefits similar to the standard health benefit plan.
(2) Only an entire small employer group may be reinsured, and the rate for such reinsurance shall be one and one-half times the base reinsurance insurance premium rate for the group established pursuant to this subsection.
(3) The board periodically shall review the methodology established under subdivisions (1) and (2) of this section, including the system of classification and any rating factors, to assure that it reasonably reflects the claims experience of the program. The board may propose changes to the methodology which shall be subject to the approval of the director.
7. If a health benefit plan for a small employer is reinsured with the program, the premium charged to the small employer for any rating period for the coverage issued shall meet the requirements relating to premium rates set forth in section 379.936.
8. (1) Prior to March first of each year, the board shall determine and report to the director the program net loss for the previous calendar year, including administrative expenses and incurred losses for the year, taking into account investment income and other appropriate gains and losses.
(2) Any net loss for the year shall be recouped by assessments of reinsuring carriers.
(a) The board shall establish, as part of the plan of operation, a formula by which to make assessments against reinsuring carriers and small employer carriers. The assessment formula shall be based on:
a. The share of each reinsuring carrier which reinsures any small employer group with the program, of the program net loss described in this subsection shall be their proportionate share, determined by premiums earned in the preceding calendar year from health benefit plans which have been ceded to the program, times one-half of the total program net loss;
b. Each reinsuring carrier's share of the program net loss described in this subsection shall be its proportionate share, determined by premiums earned in the preceding calendar year from all health benefit plans delivered or issued for delivery to small employers in this state by all reinsuring carriers, times one-half of the total program net loss. An assessment levied or paid by a reinsuring carrier pursuant to subparagraph a of this paragraph shall not be credited or offset against any assessment levied pursuant to this subparagraph.
(b) The formula established pursuant to paragraph (a) of this subdivision shall not result in any reinsuring carrier having an assessment share that is less than fifty percent nor more than one hundred fifty percent of an amount which is based on the proportion of the small employer carrier's total premiums earned in the preceding calendar year from health benefit plans delivered or issued for delivery to small employers in this state by small employer carriers to total premiums earned in the preceding calendar year from health benefit plans delivered or issued for delivery to small employers in this state by all small employer carriers.
(c) The director by rule and after a hearing thereon may change the assessment formula established pursuant to paragraph (a) of this subdivision from time to time as appropriate. The director may provide for the shares of the assessment base attributable to premiums from all health benefit plans and to premiums from health benefit plans ceded to the program to vary during a transition period.
(d) Subject to the approval of the director, the board shall make an adjustment to the assessment formula for reinsuring carriers that are approved health maintenance organizations which are federally qualified under 42 U.S.C. Section 300, et seq., to the extent, if any, that restrictions are placed on them that are not imposed on other small employer carriers.
(e) Premiums and benefits payable by a reinsuring carrier that are less than an amount determined by the board to justify the cost of collection shall not be considered for purposes of determining assessments.
(3) (a) Prior to March first of each year, the board shall determine and file with the director an estimate of the assessments needed to fund the losses incurred by the program in the previous calendar year.
(b) If the board determines that the assessments needed to fund the losses incurred by the program in the previous calendar year will exceed the amount specified in paragraph (c) of this subdivision, the board shall evaluate the operation of the program and report its findings, including any recommendations for changes to the plan of operation, to the director within ninety days following the end of the calendar year in which the losses were incurred. The evaluation shall include: an estimate of future assessments, the administrative costs of the program, the appropriateness of the premiums charged and the level of insurer retention under the program and the costs of coverage for small employers. If the board fails to file a report with the director within ninety days following the end of the applicable calendar year, the director may evaluate the operations of the program and implement such amendments to the plan of operation the director deems necessary to reduce future losses and assessments.
(c) For any calendar year, the amount specified in this paragraph is five percent of total premiums earned in the previous year from health benefit plans delivered or issued for delivery to small employers in this state by reinsuring carriers.
(d) a. If assessments in each of two consecutive calendar years exceed the amount specified in paragraph (c) of this subdivision, the program shall be eligible to receive additional financing as provided in subparagraph b of this paragraph.
b. The additional financing provided for in subparagraph a of this paragraph shall be obtained from additional assessments apportioned among all carriers which are not small employer carriers; the amount of the assessment for each carrier determined by the carrier's proportionate share of premiums earned in the preceding calendar year from all health benefit plans delivered, issued for delivery or continued in this state to individuals and groups, other than small employer groups subject to sections 379.930 to 379.952, by all carriers, times the total amount of additional financing to be obtained.
c. The additional assessment provided by subparagraph b of this paragraph shall not exceed an amount equal to one percent of the gross premium derived by that carrier from all health benefit plans delivered, issued for delivery or continued in this state to individuals and groups, other than small employer groups subject to sections 379.930 to 379.952.
d. Any loss sustained by the program which is not reimbursed by additional financing obtained pursuant to this paragraph shall be carried forward to the calendar year succeeding the year in which the loss is sustained, and shall be recouped by an increase in premiums charged by the board for reinsurance of small employer groups with the program.
e. Additional financing received by the program pursuant to this paragraph shall be distributed to reinsuring carriers in proportion to the assessments paid by such carriers over the previous two calendar years.
(4) If assessments exceed net losses of the program, the excess shall be held at interest and used by the board to offset future losses or to reduce program premiums. As used in this paragraph, "future losses" includes reserves for incurred but not reported claims.
(5) Each carrier's proportion of the assessment shall be determined annually by the board based on annual statements and other reports deemed necessary by the board and filed by the carriers with the board.
(6) The plan of operation shall provide for the imposition of an interest penalty for late payment of assessments.
(7) A carrier may seek from the director a deferment from all or part of an assessment imposed by the board. The director may defer all or part of the assessment of a carrier if the director determines that the payment of the assessment would place the carrier in a financially impaired condition. If all or part of an assessment against a carrier is deferred, the amount deferred shall be assessed against the other participating carriers in a manner consistent with the basis for assessment set forth in this subsection. The carrier receiving such deferment shall remain liable to the program for the amount deferred and the interest penalty provided in subdivision (6) of this subsection and shall be prohibited from reinsuring any groups in the program until such time as it pays such assessments.
9. Neither the participation in the program as reinsuring carriers, the establishment of rates, forms or procedures, nor any other joint or collective action required by sections 379.930 to 379.952 shall be the basis of any legal action, criminal or civil liability, or penalty against the program or any of its reinsuring carriers either jointly or separately, other than any action by the director to enforce the provisions of sections 379.930 to 379.952.
10. The board, as part of the plan of operation, shall develop standards setting forth the manner and levels of compensation to be paid to producers for the sale of basic and standard health benefit plans. In establishing such standards, the board shall take into the consideration: the need to assure the broad availability of coverages; the objectives of the program; the time and effort expended in placing the coverage; the need to provide ongoing service to the small employer; the levels of compensation currently used in the industry; and the overall costs of coverage to small employers selecting these plans.
11. The program shall be exempt from any and all taxes.
12. The director shall make an initial assessment of one thousand dollars on each insurance company authorized to transact accident or health insurance, each health services corporation, and each health maintenance organization. Initial assessments shall be made during January, 1993, and shall be paid before April 1, 1993. Initial assessments shall be deposited into the department of insurance dedicated fund. Within ten days after the effective date of the program's plan of operation, the total amount of the initial assessments shall be transferred at the request of the director to the Missouri small employer health reinsurance program. The program may use such initial assessment in the same manner and for the same purposes as other assessments pursuant to section 379.942 and this section.
13. The program, as defined in section 379.930, shall not accept any new risks or renew any existing risk on or after October 1, 2005.
14. Any program assets or moneys that exceed six hundred thousand dollars on August 28, 2005, shall be delivered on October 1, 2005, to the Missouri health insurance pool as established in sections 376.960 to 376.989, RSMo, and shall be accepted by the Missouri health insurance pool and used for the administration and operation of the Missouri health insurance pool.
15. Any program assets or moneys that remain on October 1, 2006, shall be delivered on October 31, 2006, to the Missouri health insurance pool as established in sections 376.960 to 376.989, RSMo, and shall be accepted by the Missouri health insurance pool and used for the administration and operation of the Missouri health insurance pool.
16. The provisions of this section shall expire on December 31, 2006. (L. 1992 S.B. 796 § 7 subsecs. 4 to 15, A.L. 2005 S.B. 261)
Expires 12-31-06
1. The director shall appoint a seven-member "Health Benefit Plan Committee". The committee shall be composed of one representative from each of the following categories: an insurance company which is a small employer carrier, a health services corporation which is a small employer carrier, a health maintenance organization which is a small employer carrier, a health care provider, and a small employer. The director shall select two representatives of employees of small employers, including at least one representative of a labor organization.
2. The committee shall recommend the form and level of coverages to be made available by small employer carriers pursuant to sections 379.942 and 379.943.
3. The committee shall recommend benefit levels, cost sharing levels, exclusions and limitations for the basic health benefit plan and the standard health benefit plan. The committee shall also design a basic health benefit plan and a standard health benefit plan which contain benefit and cost sharing levels that are consistent with the basic method of operation and the benefit plans of health maintenance organizations, including any restrictions imposed by federal law.
(1) The plans recommended by the committee shall include cost containment features such as:
(a) Utilization review of health care services, including review of medical necessity of hospital and physician services;
(b) Case management;
(c) Selective contracting with hospitals, physicians and other health care providers;
(d) Reasonable benefit differentials applicable to providers that participate or do not participate in arrangements using restricted network provisions; and
(e) Other managed care provisions.
(2) The committee shall submit the health benefit plans described in this subsection to the director for approval within one hundred eighty days after the appointment of the committee. (L. 1992 S.B. 796 § 8)
Effective 7-1-93
The board shall study and report at least every three years to the director on the effectiveness of sections 379.930 to 379.952. The report shall analyze the effectiveness of sections 379.930 to 379.952 in promoting rate stability, product availability, and coverage affordability. The report may contain recommendations for actions to improve the overall effectiveness, efficiency and fairness of the small group health insurance marketplace. The report shall address whether carriers and producers are fairly and actively marketing or issuing health benefit plans to small employers in fulfillment of the purposes of sections 379.930 to 379.952. The report may contain recommendations for market conduct or other regulatory standards or action. (L. 1992 S.B. 796 § 9)
Effective 7-1-93
Except for the coverages specified in subsection 3 of section 376.995, RSMo, no law requiring the coverage of a particular health care service or benefit, or requiring the reimbursement, utilization or inclusion of a specific category of licensed health care practitioner shall apply to a basic health benefit plan issued pursuant to sections 379.930 to 379.952. (L. 1992 S.B. 796 § 10)
Effective 7-1-93
CROSS REFERENCE: Mammography and other services to be furnished, exceptions to exemptions, RSMo 376.995
The director may promulgate rules pursuant to chapter 536, RSMo, for the implementation and administration of sections 379.930 to 379.952 and section 374.184, RSMo. No rule or portion of a rule promulgated under the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo. (L. 1992 S.B. 796 § 11, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)
1. Each small employer carrier shall actively market health benefit plan coverage, including the basic and standard health benefit plans, to eligible small employers in the state. If a small employer carrier denies coverage to a small employer on the basis of the health status or claims experience of the small employer or its employees or dependents, the small employer carrier shall offer the small employer the opportunity to purchase a basic health benefit plan or a standard health benefit plan.
2. (1) Except as provided in subdivision (2) of this subsection, no small employer carrier or agent or broker shall, directly or indirectly, engage in the following activities:
(a) Encouraging or directing small employers to refrain from filing an application for coverage with the small employer carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer;
(b) Encouraging or directing small employers to seek coverage from another carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer.
(2) The provisions of subdivision (1) of this subsection shall not apply with respect to information provided by a small employer carrier or agent or broker to a small employer regarding the established geographic service area or a restricted network provision of a small employer carrier.
3. (1) Except as provided in subdivision (2) of this subsection, no small employer carrier shall, directly or indirectly, enter into any contract, agreement or arrangement with an agent or broker that provides for or results in the compensation paid to an agent or broker for the sale of a health benefit plan to be varied because of the health status, claims experience, industry, occupation or geographic location of the small employer.
(2) Subdivision (1) of this subsection shall not apply with respect to a compensation arrangement that provides compensation to an agent or broker on the basis of percentage of premium, provided that the percentage shall not vary because of the health status, claims experience, industry, occupation or geographic area of the small employer.
4. A small employer carrier shall provide reasonable compensation, as provided under the plan of operation of the program, to an agent or broker, if any, for the sale of a basic or standard health benefit plan.
5. No small employer carrier shall terminate, fail to renew or limit its contract or agreement of representation with an agent or broker for any reason related to the health status, claims experience, occupation, or geographic location of the small employers placed by the agent or broker with the small employer carrier.
6. No small employer carrier or producer shall induce or otherwise encourage a small employer to separate or otherwise exclude an employee from health coverage or benefits provided in connection with the employee's employment.
7. Denial by a small employer carrier of an application for coverage from a small employer shall be in writing and shall state the reason or reasons for the denial with specificity.
8. The director may promulgate rules setting forth additional standards to provide for the fair marketing and broad availability of health benefit plans to small employers in this state.
9. (1) A violation of this section by a small employer carrier or a producer shall be an unfair trade practice under sections 375.930 to 375.949, RSMo.
(2) If a small employer carrier enters into a contract, agreement or other arrangement with a third-party administrator to provide administrative marketing or other services related to the offering of health benefit plans to small employers in this state, the third-party administrator shall be subject to this section as if it were a small employer carrier. (L. 1992 S.B. 796 § 12)
Effective 7-1-94 (See § 379.940 subsec. 5)
Beginning January 1, 1993, in response to all original applications for a policy pursuant to subdivision (4) of section 375.001, RSMo, and any such policy renewed from January 1, 1993, to December 31, 1993, for coverage on property located in the New Madrid Seismic Zone, as defined by the United States Geological Survey in Missouri, susceptible to Modified Mercalli intensity VII or above from an earthquake occurring along the New Madrid Fault with a potential magnitude of 7.6 on the Richter scale, the insurer shall provide information to the applicant or policyholder regarding the availability of insurance for loss caused by earthquake. (L. 1992 H.B. 1574 § 15)
Every insurance company which insures property for loss caused by earthquake, whether by policy, endorsement, rider or otherwise, shall prepare and retain a written disaster plan covering earthquakes. This plan shall include specific provisions regarding procedures for handling claims under the insurance company's issued policies or endorsements covering loss or damage from the peril of earthquake. (L. 1992 H.B. 1574 § 16)
A domestic mutual insurance company organized and operating under this chapter may reorganize by forming a mutual insurance holding company as described in section 379.985, or by merging its policyholders' membership into such a mutual insurance holding company. The reorganized insurance company shall continue its corporate existence, either at the time of the reorganization or at some later time as a stock insurance company, or as a mutual insurance company. This authority is in addition to powers granted pursuant to chapter 382, RSMo. (L. 1996 S.B. 759)
1. A mutual insurance company proposing to reorganize pursuant to sections 379.980 to 379.988 shall form a mutual insurance holding company, hereafter referred to in sections 379.980 to 379.988 as a "mutual holding company", and shall file an application with the director which shall contain such insurer's plan of reorganization. The director shall review the application, and may retain such consultants as may be reasonably necessary, at the expense of the applicant; conduct an adequate review to assure that policyholders' interests are protected, and may conduct a public hearing. The director shall approve formation of the mutual holding company and the plan of reorganization if the director finds that the plan is fair and equitable to the policyholders. The director may condition such approval on the adoption of such modifications to the plan as the director finds necessary for the protection of the policyholders' interests.
2. No mutual insurance company may reorganize pursuant to sections 379.980 to 379.988 unless the reorganization plan is approved by a majority of the policyholders voting in person or by proxy at a special meeting called for that purpose. Any group of at least one hundred policyholders having a right to vote at such special meeting shall be entitled at their own expense to have the secretary of the company mail informational materials to all policyholders provided that such materials and the cost thereof are presented to the secretary at least forty-five days before the special meeting.
3. All of the shares of the capital stock of the reorganized insurance company, if any, shall be issued to the mutual holding company, which shall at all times own a majority of the voting shares of the capital stock of the reorganized insurance company, except that either at the time of the reorganization or, at some later time with the approval of the director, the mutual holding company may create a stock holding company pursuant to chapter 351, RSMo, for the purpose of owning all of the stock of the reorganized insurance company, so long as the mutual holding company shall at all times own a majority of the voting shares of the capital stock of the stock holding company. Any subsidiaries of the reorganized insurance company may remain as subsidiaries of such company or become subsidiaries of the mutual or stock holding company provided that, if such subsidiaries shall be subsidiaries of a stock holding company then the reorganized insurance company shall be reimbursed the fair market value of its holdings in such subsidiaries in the event shares of the stock holding company are or have been issued to other than the mutual holding company. (L. 1996 S.B. 759)
1. The membership interests of the policyholders of a reorganized insurance company shall become membership interests in the mutual holding company. Policyholders of the reorganized insurance company shall be members of the mutual holding company in accordance with the articles of incorporation and bylaws of the mutual holding company and the applicable provisions of this chapter relating to mutual insurance companies.
2. No member of a mutual holding company may transfer membership or any right arising therefrom.
3. A member of a mutual holding company is not, as such, personally liable for the acts, debts, liabilities or obligations of the company.
4. No assessments of any kind may be imposed upon the members of a mutual holding company by the directors, or members, or because of any liability of any company owned or controlled by the mutual holding company, or because of any act, debt or liability of the mutual holding company itself.
5. A membership interest in a domestic mutual holding company shall not constitute a security under the laws of this state. (L. 1996 S.B. 759)
1. Sections 382.040, 382.060 and 382.095, RSMo, are not applicable to a reorganization or merger pursuant to sections 379.980 to 379.988.
2. A mutual holding company organized pursuant to sections 379.980 to 379.988 shall be incorporated pursuant to this chapter. The articles of incorporation and any amendments to such articles of the mutual holding company shall be subject to approval of the director and the attorney general in the same manner as those of a mutual insurance company.
3. A mutual holding company shall have the same powers granted to domestic insurance companies pursuant to chapter 382, RSMo, relating to insurance holding company systems and shall be subject to its requirements and provisions and shall have all the powers granted to corporations organized pursuant to chapter 351, RSMo. Neither the mutual holding company or any stock holding company created pursuant to sections 379.980 to 379.988 shall be an insurer or may engage in the business of insurance. A mutual holding company may enter into an affiliation agreement or a merger agreement either at the time of the reorganization, or at some later time with the approval of the director, with any mutual insurance company authorized to do business in this state. Any such merger agreement may authorize participating policyholders of the mutual insurance company to become members of the mutual holding company. Any such affiliation agreement or merger agreement is subject to the insurance laws of this state relating to such transactions entered into by a domestic mutual insurance company. (L. 1996 S.B. 759)
1. A mutual holding company is subject to supervision of the director in the same manner as an insurer subject to the provisions of this chapter and shall automatically be a party to any proceeding pursuant to sections 375.1150 to 375.1246, RSMo, involving an insurance company which, as a result of a reorganization pursuant to sections 375.1150 to 375.1246, RSMo, is a subsidiary of the mutual holding company or a stock holding company created pursuant to section 379.982. In a proceeding pursuant to sections 375.1150 to 375.1246, RSMo, involving the reorganized insurance company, the assets of the mutual holding company are deemed to be assets of the estate of the reorganized insurance company for purposes of satisfying the claims of the reorganized company's policyholders. A mutual holding company shall not dissolve or liquidate without the approval of the director or as ordered by the court pursuant to sections 375.1150 to 375.1246, RSMo.
2. Sections 375.201, 375.206, 375.216, 375.221 and 375.226, RSMo, are applicable to a demutualization of a mutual holding company as if it were a mutual insurance company. This section does not apply to those companies organized under chapter 354, RSMo, or chapter 355, RSMo, and does apply only to for-profit mutual property and casualty insurance companies. (L. 1996 S.B. 759)
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