385.045. Filings required to be made with director--disapproval by director, effect of--rules, procedure. - Missouri Statutes

Filings required to be made with director--disapproval by director,effect of--rules, procedure.

385.045. 1. All policies, certificates of insurance, notices ofproposed insurance, applications for insurance, endorsements, and ridersdelivered or issued for delivery in this state, and the schedules ofpremium rates pertaining thereto, shall be filed with the director prior touse.

2. The director shall within sixty days after the filing of theschedule of premium rates, policies, certificates of insurance, notices ofproposed insurance, applications for insurance, endorsements, and riders,disapprove any form if the benefits provided therein are not reasonable inrelation to the premium charge in accordance with the provisions of section385.070, or if it contains provisions which are unjust, unfair,inequitable, misleading, deceptive, or encourage misrepresentation of thecoverage, or are contrary to any provision of the insurance code or of anyrule or regulation promulgated thereunder. No rule or portion of a rulepromulgated under the authority of sections 385.010 to 385.080 shall becomeeffective unless it has been promulgated pursuant to the provisions ofsection 536.024, RSMo. A premium rate or schedule of premium rates shallbe deemed reasonable for all purposes under sections 385.010 to 385.080 ifthe rate or schedule produces or reasonably may be expected to result inclaims incurred of not less than fifty percent of earned premium. Toassist his decision, the director may extend the stipulated time up to anadditional sixty days.

3. If the director notifies the insurer that the form is disapproved,it is unlawful for the insurer to issue or use the form. In the notice,the director shall specify the reason for his disapproval and state that ahearing will be granted within twenty days after receipt of request inwriting by the insurer. No such policy, certificate of insurance, noticeof proposed insurance, nor any application, endorsement, or rider, shall beissued or used until the expiration of sixty days after it has been sofiled, unless the director shall give his prior written approval thereto.The director may, at any time after a hearing held not less than twentydays after written notice to the insurer, withdraw his approval of any suchform on any ground set forth in subsection 2 of this section. The writtennotice of the hearing shall state the reason for the proposed withdrawal.It is unlawful for the insurer to issue such forms or use them after theeffective date of the withdrawal.

4. If a group policy of credit life insurance or credit accident andsickness insurance has been delivered in this state before September 28,1977, the insurer shall be required to file only the group certificate andnotice of proposed insurance delivered or issued for delivery in this stateas specified in subsections 2 and 4 of section 385.040. Such forms shallbe approved by the director if they conform with the requirements specifiedin said subsections and if the schedules of premium rates applicable to theinsurance evidenced by the certificate or notice are not in excess of theinsurer's schedules of premium rates filed with the director; provided,however, the premium rate in effect on existing group policies may becontinued until the first policy anniversary date following September 28,1977. If a group policy has been or is delivered in another state insuringcitizens of this state, the forms to be filed by the insurer with thedirector are the group certificates and notice of proposed insurance. Heshall approve them only if:

(1) They provide the information that would be required if the grouppolicy were delivered in this state;

(2) The applicable premium rates or charges do not exceed thoseapproved by the director.

5. Any order or final determination of the director under theprovisions of this section shall be subject to judicial review.

(L. 1977 H.B. 610 § 8, A.L. 1981 S.B. 200, A.L. 1995 S.B. 3)