1. a. A contractual obligation for legal insurance shall be evidenced by a policy or master policy. Legal insurance may be written on an individual, group, blanket, or franchise basis. Each person insured under a group policy must be issued a certificate of coverage. A legal insurance policy or certificate of any kind shall not be issued or delivered in this state unless and until a copy of the policy or master policy and certificate of coverage has been filed with and approved by the commissioner.
b. The policy or master policy and certificate of coverage must meet all of the following requirements:
(1) A policy or master policy must contain a detailed list and description of the legal services promised or the legal matters for which expenses are to be reimbursed and the amount of reimbursement.
(2) A policy or certificate under a master policy must indicate prominently the name of the insurer and the full address of its principal place of business.
(3) A certificate issued under a group policy may summarize the terms of the master contract but must contain a full and clear statement of the benefits provided.
c. The commissioner may disapprove the form of a policy, master policy, or certificate of coverage if the commissioner finds that it fails any of the following:
(1) Does not meet the requirements of subsection "b".
(2) Is unfair, unfairly discriminatory, misleading, obscure, or encourages misrepresentation or misunderstanding of the contract, including cases where the form does any of the following:
(a) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed.
(b) Fails to attain a reasonable degree of readability, simplicity, and conciseness.
(c) Is misleading, deceptive, or obscure because of its physical aspects such as format, typography, style, color, or organization.
(3) Provides coverage or benefits or contains other provisions that would endanger the solvency of the insurer.
(4) Is contrary to law.
2. a. Rate filing and rate review procedures applicable to this chapter shall be those set out in chapter 515A and supporting rules.
b. The rates of a legal expense insurer must meet all of the following requirements:
(1) The rates must be established and justified in accordance with generally accepted insurance principles, including but not limited to the experience or judgment of the insurer making the rate filing or actuarial computations.
(2) The rates shall not be excessive, inadequate, or unfairly discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among persons insured under group, franchise, or blanket policies.
c. The commissioner may by written order, suspend, or modify the requirements of filing for any risk, group, or class of risk, the rates for which cannot practically be filed before they are used.
3. If the commissioner determines that a form reviewed under subsection 1 or a schedule of rates reviewed under subsection 2 complies with the requirements of this section, the commissioner shall approve the form or schedule within thirty days, which may be extended for an additional thirty days, by notice in writing to the person making the filing prior to the expiration of the first thirty days. If the commissioner disapproves a filing the commissioner shall notify the person making the filing in writing specifying the reasons for disapproval. A hearing shall be granted within thirty days after a request in writing by any person aggrieved by the decision of the commissioner. The commissioner may, after notice and hearing, disapprove any rate that has been previously approved.
4. The commissioner may require the submission of any information deemed by the commissioner to be relevant and reasonably necessary to determine whether to approve or disapprove a filing made pursuant to subsection 1, 2, or 4.
90 Acts, ch 1150, §5
Referred to in § 523F.22
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