PURPOSE: This rule provides requirements for use and recordkeeping for insurance companies or reciprocal interinsurance exchanges using rate variations (consent to rate). This rule was adoptedpursuant to the provisions of section 374.045, RSMo and implements sections 375.031, 375.136, 379.318.2., 379.321.3. and 379.470.6., RSMo.

1. (1) Standards for the Use of Consent to Rate.

   1. (A) No insurance company or reciprocal interinsurance exchange using rates subject to section 379.313 or 379.470, RSMo shall effect a policy of insurance or a renewal at a rate varying from the rate properly filed for its use on that specific risk unless the form contained as Exhibit A or one (1) substantially similar is completed by the insured.

   2. (B) Reasons for any individual modifications in rate for private passenger automobile or homeowners or occupied residential dwelling fire policies must be entered in Exhibit A and must-

      1. 1. Be highly unusual and have a documen-

tably probable effect upon losses, stating specifically why the proposed insured is not within a reasonable class or classification system;

1. 2. Be clearly and specifically stated as to each specific risk factor (such general statements as “Risk does not meet normal rates” are not acceptable);
2. 3. Not be based solely upon the actions of another insurer toward that insured or that person’s age, residence, race, sex, color, creed, national origin, ancestry or lawful occupation; and
3. 4. The following statement must be a part

of each form 20 CSR 500-4.300 Exhibit A and signed by the insured: “I, ,declare that I have been unable to obtain this insurance from other companies and hereby consent to pay the higher rates which I am being charged for this insurance. I understand that any deductible amount statedin my policy will be deducted from each claim I may make under the policy issued me.”

1. (C) Schedule experience rated policies, or both, approved and filed by the Missouri Department of Insurance (MDI) are exempt from this rule.
2. (D) Policies rated on any substandard dwelling schedule or rating plan filed with the MD1 are considered special rating policies for the purposes of the record requirements of section (2) of this rule.

1. (2) Recordkeeping Requirements.

   1. (A) All insurance companies subject to this rule shall-

      1. 1. Complete and execute monthly, with

the signature of a person authorized by the company to do so, Exhibit B;

1. 2. File and preserve the original com-

pleted Exhibits A and B in the company’s policy file and a duplicate copy of each in the company’s Missouri records file; and

1. 3. Transmit to the Department of In-

surance a completed signed copy of Exhibit B before the end of the next monthly period.

1. (B) Exhibits A and B or forms substantially similar may be prepared by each company concerned. Auth: sections 374.045,375.031,375.136, 379.318(Z), 379.321(3) and 379.470(6), RSMo (1986).* This rule was previously filed as 4 CSR 190-16.080. Original rule filed Dec. 20. 1974. effective Dec. 30. i974. ’ ” *origina1 authority: 374.045, RSMo (1967); 375.031, RSMo (19791, amended 1985, 1986; 375.136, RSMo (19671, amended 1977; 379.318 and 379.321, RSMo (1972); and 379.470, RSMo (1947).

   Judith K. Moriarty

   CODE OFSTATE REGULATIONS (g/20/91) 20CSR 500-4

Chapter4-Rating Laws

EXHIBIT A

State of Missouri Department of Insurance (Complete in duplicate)

NAME OF COMPANY

For Audit & Examination Use Only

INDICATE LINE OF BUSlNESS Automobile (ud.lnmrminnri Fire

Liability

1. 1. Name of Insured Mailing Address
2. 2. Property or other risk insured
3. 3. Coverage involved and Code or Classification

4. 4. Specific Reasons for Special Rating (Use reverse, if necessary)

   Proposed New Rates

5. 5. Standard Filed Rates (or filed if substandard)

   I

6. 6. Policy Effective Date

   Policy Expiration Date

7. 7. Policy Number

8. 8. (I understand that rates charged are not standard and accept this cost).

   Insured’s Signature

9. 9. Agent’s Signature

   Date

10. 10. Company Officer’s Signature

    Date

(Company officer certifies that company and agent are licensed for business written)

(8/20/91)* 9

Secretary or state

m 20 CSR 500-4--INSURANCE

EXHIBIT B

State of Missouri Department of Insurance (Complete in duplicate)

NAME OF COMPANY

Total Special Rating Policies 19 Month Total Total Special Rating Policies (By line of business) in ,19 Month Automobile Fire Liability

Individual Listing of Policy Number by Line of Business: (Attach extra page if necessary)

Judith K. Moriarty

20 CSR 500-4

Chapter$-Rating Laws