1. (1) Purpose. This section interprets and implements ss. 601.42, 631.20, 631.22 and 631.61, Stats.
2. (2) Scope. The requirements of this section shall apply to forms subject to s. 631.01, Stats., for the lines of insurance listed in s. Ins 6.75, except s. Ins 6.75 (2) (b) and (k).

3. (3) Definitions.

   1. (a) “Affiliated insurer” means an insurer which is a member or subscriber to a rate service organization licensed under s. 625.32, Stats., and which has authorized the rate service organization to file forms on its behalf.
   2. (b) “Certificate of compliance and readability” means a document in substantially identical format to Appendix A which is signed by an officer of the insurer.
   3. (c) “Certificate of readability” means a written statement signed by an officer of the insurer stating that the form is subject to s. Ins 6.07 and that the form meets the minimum standards set forth in that section.
   4. (d) “OCI” means the office of the commissioner of insurance.
   5. (e) “Submission” means a filing under s. 631.20, Stats., or any request received by the office of the commissioner of insurance for approval of a single form or combination of forms.

   6. (f) “Transmittal document” means a document substantially identical in format to the form established by standards adopted by the National Association of Insurance Commissioners (NAIC), on which an insurer shall list information about each form submitted for approval.

      Note: A copy of the transmittal document may be obtained at no cost from the Office of the Commissioner of Insurance, P.O. Box 7873, Madison WI 53707-7873, or at the Office’s web address: oci.wi.gov.

4. (4) Filing procedure.

   1. (a) Each paper submission of forms shall include all of the following:

      1. 1. A properly completed insurance transmittal document in duplicate.
      2. 2. A properly completed certificate of compliance and readability in substantially identical format as in Appendix A.

      3. 3. A filing letter that contains the following information:

         1. a. In the case of a form that alters or replaces a previously approved form, a description of the change.
         2. b. One copy of each form in final format exactly as it will be offered for issuance or delivery in the state of Wisconsin, except for hypothetical data and other appropriate variable material.
      4. 5. If a form contains variable material or language, a written description identifying the range of the variable material or language.
      5. 6. A second copy of each form, if the insurer requires an OCI stamped copy for its records.
      6. 7. A copy of the previously approved form clearly marked “for reference only” if the current form is to supercede the previously approved form.
      7. 8. If the submission of forms is filed by a third-party on behalf of an insurer, a letter from the insurer, authorizing the third-party to file forms on its behalf.
      8. 9. A self-addressed return envelope of sufficient size to return one copy of the materials in subds. 1. and 6., to the insurer.

   2. (b) Each electronic submission of forms shall include all of the following:

      1. 1. All of the data elements on the transmittal document.
      2. 2. A properly completed certificate of compliance and readability in substantially identical format as in Appendix A.

      3. 3. A filing letter that contains all of the following information:

         1. a. In the case of a form that alters or replaces a previously filed form, a description of the changes.
         2. b. The form number and approval or filing date of any form superseded by the new form.
      4. 4. One copy of each form in final electronic format exactly as it will be offered for issuance or delivery in the state of Wisconsin, except for hypothetical data and other appropriate variable material.
      5. 5. If a form contains variable material or language, a written description identifying the range of the variable material or language.
      6. 6. A copy of the previously approved or filed form clearly marked “for reference only” if the current form is to supersede the previously approved or filed form.
      7. 7. If the submission of forms is filed by a third-party on behalf of an insurer, a letter from the insurer authorizing the third-party to file forms on its behalf.
   3. (c) A submission filed by a rate service organization will be considered as filed on behalf of all affiliated insurers.
5. (5) Insurer records. Each insurer shall maintain a file of all forms approved or filed under s. 631.20, Stats., for use in Wisconsin until all exposure on the risks insured against has terminated. The file is subject to examination and the commissioner may request that any portion of the file be available for review within ten days of a written request.
6. (6) Incomplete filing. The commissioner shall reject without further review any filing which does not include all of the items in sub. (4) (a) and (b).

7. (7) Penalty. Insurers violating the provision of this rule by using unapproved or unfiled forms shall be subject to the penalties in s. 601.64, Stats. Each form issued to an individual policyholder shall constitute a separate violation.

   Ins 6.05 Appendix A

   CERTIFICATE OF COMPLIANCE AND READABILITY

   I __________________________, (name), an officer of____________________(company name), hereby certify that I have authority to bind and obligate the company by filing this (these) form(s). I further certify that, to the best of my information, knowledge and belief:

   1. The accompanying form(s) as identified by the attached listing comply(ies) with all applicable provisions of the Wisconsin Statutes and with all applicable administrative rules of the Commissioner of Insurance;

   2. The form(s) does (do) not contain any inconsistent, ambiguous, or misleading clauses;

   3. The form(s) does (do) not contain specification or conditions that unreasonably or deceptively limit the risk purported to be assumed in the general coverage of the policy form(s);

   4. The only variations from a form currently on file with the commissioner of insurance and the only unconventional policy provisions are clearly marked or otherwise indicated pages __________________ of the attached form(s) or in an attachment; and

   5. The attached form(s) is (are) in final printed format or typed facsimile and is (are) as will be offered for issuance or delivery in Wisconsin after approval by the Commissioner of Insurance, except for hypothetical data and other appropriate variable material.

   6. If this form is a consumer insurance policy, the text of the form(s) meet(s) the minimum reading ease score or, if authorized by the commissioner, the score is lower than the minimum required by s. Ins 6.07 (4) (a) 1., Wis. Adm. Code. Product used to determine the Flesch score:____________________.

   I understand that the commissioner of insurance will rely on this certification regarding the forms filed, and should it be determined that the policy form(s) does(do) not comply with the applicable laws, regulations, filing requirements and product standards or that this certification is materially false or incorrect, appropriate corrective and disciplinary action, including retroactive disapproval, as authorized by law, may be taken by the commissioner against the company and the officer completing this certification.

   
   (signature)
   
   (title)
   
   (date)
   
   Individual responsible for this filing:
   
   Name:       Title:_________________________
   
   Address:     ________________
   
   Phone Number:_______________ Date:

History

History: Cr. Register, July, 1958, No. 31, eff. 8-1-58; am. (3), Register, May, 1975, No. 233, eff. 6-1-75; emerg. am. (1), eff. 6-22-76; am. (1), Register, September, 1976, No. 249, eff. 10-1-76; r. and recr. Register, November, 1977, No. 263, eff. 12-1-77; r. and recr. (4), Register, January, 1980, No. 289, eff. 2-1-80; am. (4) (a), (b) (intro.) and 7., Register, February, 1982, No. 314, eff. 3-1-82; cr. (4) (c) and (d), Register, July, 1982, No. 319, eff. 8-1-82; r. and recr. December, 1987, No. 384, eff. 1-1-88; r. (5), renum. (6) to (8) to be (5) to (7), Register, July, 1989, No. 403, eff. 8-1-89; CR 10-076: am. (3) (b), (4) (a) (intro.), 1. to 5., 8., 9., (5), (6), (7), renum. (3) (d), (e), (f) to be (3) (f), (d), (e) and am., renum. (4) (b) to be (4) (c), cr. (4) (b) Register January 2011 No. 661, eff. 2-1-11.