![]()
CHAPTER 73. CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND HEALTH INSURANCE Sec.
73.173.5 [Reserved].
73.1173.13 [Reserved].
73.2173.29 [Reserved].
73.3173.43 [Reserved].
73.51. [Reserved].
73.101. Purpose.
73.102. Applicability.
73.103. Definitions.
73.104. Life insurance and life insurance with TPD benefit.
73.105. Life insurance and life insurance with TPD benefit requirements.
73.106. Life insurance rate standards.
73.107. A and H insurance benefits.
73.108. A and H insurance requirements.
73.109. A and H insurance rate standards.
73.110. Involuntary unemployment insurance benefits.
73.111. Involuntary and voluntary unemployment insurance requirements.
73.112. Involuntary unemployment insurance rate standards.
73.113. Voluntary unemployment insurance rate standards.
73.114. Insurability requirements.
73.115. Benefit exclusions.
73.116. Age requirements
73.117. Employment eligibility requirements.
73.118. Initial eligibility requirements.
73.119. Combination coverage rate.
73.120. Composite term premium rate.
73.121. Maximum rates.
73.122. Deviated rates.
73.123. Loss ratio standards.
73.124. Duration of deviation.
73.125. Portability of rates.
73.126. Voluntary unemployment experience reports.
73.127. Refunds.
73.128. Terminations.
73.129. Dividends.
73.130. Election of coverage and disclosure requirements.
73.131. Choice of insurer.
73.132. Collection of premiums.
73.133. Claims and examination procedures
73.134. Compensation of producers and creditors.
73.135. Licensed producers.
73.136. Filing of forms and rates.
73.137. Compensating balances or special deposits.
73.138. Financial statement reserves.
73.139. Credit insurance on open end loans.
73.140. Credit insurance on closed end variable interest loans.
73.141. Credit insurance on lease transactions.
73.142. Credit insurance on fixed residual loans.
73.143. Credit insurance on balloon loans.Authority The provisions of these § § 73.10173.143 issued under sections 206, 506, 1501 and 1502 of The Administrative Code of 1929 (71 P. S. § § 66, 186, 411 and 412); section 12 of the Model Act for the Regulation of Credit Life Insurance and Credit Accident and Health Insurance (40 P. S. § 1007.12); and section 649 of The Insurance Department Act of 1921 (40 P. S. § 289), unless otherwise noted.
Source The provisions of these § § 73.10173.143 adopted March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401, unless otherwise noted.
Cross References This chapter cited at 31 Pa. Code § 84a.2 (relating to applicability and scope).
§ 73.1. [Reserved].
Source The provisions of this § 73.1 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended April 14, 1978, effective April 15, 1978, 8 Pa.B. 1104; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240436) to (240437).
Notes of Decisions Age
Carriers may impose age restrictions which may not be used to terminate coverage or deny claims, they may challenge age misstatements during the contestable period, and they must terminate coverage within 60 days from the date of the loan where an ineligible debtor correctly states his age. Security of America Life Insurance Company v Insurance Department, 372 A.2d 54 (Pa. Cmwlth. 1977).
Contestable Period
The provisions requiring that termination or denial may be made within the two-year contestable period and not thereafter is not contrary to the equitable adjustment requirement of the act of May 11, 1949 (P. L. 1210, No. 367) (40 P. S. § § 532.1532.9). Security of America Life Insurance Company v. Insurance Department, 372 A.2d 54 (Pa. Cmwlth. 1977).
The provision forbidding forms to refer to an aggregate maximum insurance is irreconcilable with the establishment of an aggregate maximum by the act of May 11, 1949 (P. L. 1210, No. 367) (40 P. S. § § 532.1532.9). Security of America Life Insurance Co. v. Insurance Department, 372 A.2d 54 (Pa. Cmwlth. 1977).
§ 73.2. [Reserved].
Source The provisions of this § 73.2 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240437) to (240438).
§ 73.3. [Reserved].
Source The provisions of this § 73.3 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through October 19, 1979, effective September 15, 1979, 9 Pa.B. 3516; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240438) to (240439).
§ 73.4. [Reserved].
Source The provisions of this § 73.4 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240439) to (240440).
§ 73.5. [Reserved].
Source The provisions of this § 73.5 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240440).
§ 73.11. [Reserved].
Source The provisions of this § 73.11 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through April 14, 1978, effective April 15, 1978, 8 Pa.B. 1104; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240440) to (240442).
§ 73.12. [Reserved].
Source The provisions of this § 73.12 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240442).
§ 73.13. [Reserved].
Source The provisions of this § 73.13 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240442) to (240444).
§ 73.21. [Reserved].
Source The provisions of this § 73.21 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240444) to (240447).
Notes of Decisions The Departments interpretation of the term experience period as the most recent year or years in which sufficient premium volume is produced was held to be neither plainly erroneous nor inconsistent with either the Model Act or the regulation. Consumers Life Insurance Co. v. Insurance Department, 483 A.2d 1055 (Pa. Cmwlth. 1984).
§ 73.22. [Reserved].
Source The provisions of this § 73.22 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240447).
Notes of Decisions The procedure for determining an insurers Basic Loss Ratio is set forth in this section. Consumers Life Insurance Co. v. Insurance Department, 483 A.2d 1055 (Pa. Cmwlth. 1984).
§ 73.23. [Reserved].
Source The provisions of this § 73.23 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through October 26, 1979, effective September 15, 1979, 9 Pa.B. 3980; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240447) to (240449).
Notes of Decisions Experience Period
In upholding the disapproval of a proposed schedule of premium rates for having been calculated contrary to this section, the court held the Departments interpretation of the term experience period as the most recent year or years in which sufficient premium volume is produced to be neither plainly erroneous nor inconsistent with either the Model Act or the regulation at 31 Pa. Code § 73.21. Consumers Life Insurance Co. v. Insurance Department, 483 A.2d 1055 (Pa. Cmwlth. 1984).
§ 73.24. [Reserved].
Source The provisions of this § 73.24 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240449).
§ 73.25. [Reserved].
Source The provisions of this § 73.25 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended December 23, 1976, effective December 24, 1976, 6 Pa.B. 3149; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240449) to (240450).
Notes of Decisions For purposes of determining the actual case ratio, the Departments interpretation of the term experience period as the most recent year or years in which sufficient premium volume is produced was held to be neither plainly erroneous nor inconsistent with either the Model Act or the regulation at 31 Pa. Code § 73.21. Consumers Life Insurance Co. v. Insurance Department, 483 A.2d 1055 (Pa. Cmwlth. 1984).
§ 73.26. [Reserved].
Source The provisions of this § 73.26 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended April 14, 1978, effective April 15, 1978, 8 Pa.B. 1104; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240450).
§ 73.27. [Reserved].
Source The provisions of this § 73.27 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through August 31, 1979, effective April 15, 1978, 8 Pa.B. 2934; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240451).
§ 73.28. [Reserved].
Source The provisions of this § 73.28 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240451) to (240453).
§ 73.29. [Reserved].
Source The provisions of this § 73.29 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through August 4, 1978, effective August 5, 1978, 8 Pa.B. 2166; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240453) to (240462).
§ 73.31. [Reserved].
Source The provisions of this § 73.31 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended December 23, 1976, effective December 24, 1976, 6 Pa.B. 3149; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240462) to (240463).
§ 73.32. [Reserved].
Source The provisions of this § 73.32 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended through November 3, 1978, effective November 4, 1978, 8 Pa.B. 3202; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240463) to (240464).
§ § 73.33 and 73.34. [Reserved].
Source The provisions of these § § 73.33 and 73.34 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240464) to (240465).
§ 73.35. [Reserved].
Source The provisions of this § 73.35 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended December 23, 1976, effective December 24, 1976, 6 Pa.B. 3149; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240465).
§ § 73.36 and 73.37. [Reserved].
Source The provisions of these § § 73.36 and 73.37 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240465) to (240467).
§ 73.38. [Reserved].
Source The provisions of this § 73.38 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended December 23, 1976, effective December 24, 1976, 6 Pa.B. 3149; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240467) to (240468).
§ § 73.3973.41. [Reserved].
Source The provisions of these § § 73.3973.41 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240468) to (240469).
§ 73.42. [Reserved].
Source The provisions of this § 73.42 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; amended December 23, 1976, effective December 24, 1976, 6 Pa.B. 3149; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240469) to (240470).
§ 73.43. [Reserved].
Source The provisions of this § 73.43 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240470).
§ 73.51. [Reserved].
Source The provisions of this § 73.51 adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240470) to (240471).
§ 73.101. Purpose.
The purpose of this chapter is to interpret and implement the act and section 641 of The Insurance Department Act of 1921 (40 P. S. § 281). This chapter is intended to protect the interests of debtors and the public in this Commonwealth by providing a system of rate, contract form and operating standards for the transaction of credit life, credit accident and health and credit unemployment insurance. This chapter is not intended to prohibit or discourage reasonable competition.
§ 73.102. Applicability.
This chapter applies to the following:
(1) An individual or group credit insurance policy.
(2) Certificates issued under a group credit insurance policy and applications or other forms used in connection with the policy or certificate.
(3) A premium rate charged for credit insurance.
The provisions of this § 73.103 amended July 14, 2006, effective January 1, 2007, 36 Pa.B. 3665. Immediately preceding text appears at serial pages (242923) to (242927).
Cross References This section cited in 31 Pa. Code § 73.103 (relating to definitions); 31 Pa. Code § 73.110 (relating to involuntary unemployment insurance benefits); 31 Pa. Code § 73.134 (relating to compensation of producers and creditors); and 31 Pa. Code § 73.136 (relating to filing of forms and rates).
§ 73.113. Voluntary unemployment insurance rate standards.
(a) Debtor insurance charge. The amount charged a debtor by a creditor for credit voluntary unemployment insurance may not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined.
(b) Premium rates based on loss ratio. The premium rates shall be based on a loss ratio not less than the loss ratio standard in § 73.123 (relating to loss ratio standards).
(c) Actuarial memorandum filing. The insurer shall include, with the rate filing made under § 73.136(a) (relating to filing of forms and rates), an actuarial memorandum which contains the basis of the claim costs used in computing the premium rates.
(d) Joint rates.
(1) When each debtor is insured for 100% of the monthly unemployment benefit, the premium rates for joint credit voluntary unemployment insurance shall equal 180% of the premium rates for single voluntary unemployment coverage.
(2) When each debtor is insured for a specific portion of the monthly unemployment benefit, the premium rates for joint credit voluntary unemployment insurance shall equal 100% of the premium rates for single voluntary unemployment coverage.
(e) Adoption of prima facie rates. If, in the opinion of the Commissioner, there is sufficient credit voluntary unemployment insurance experience data in this Commonwealth, the Commissioner may establish and adopt prima facie premium rates for voluntary unemployment and procedures for adjusting the prima facie premium rates.
(f) Review of nonclaim elements. By June 19, 1997, and at least every 9 years thereafter, the Department will review the changes in the average term and amount of coverage, changes in fixed and variable expenses, and the reasonable profit margin for insurers writing credit voluntary unemployment insurance in this Commonwealth. If this review indicates that a change in the loss ratio standard is necessary, the Department will propose an appropriate regulatory amendment to § 73.123 to reflect the change.
Cross References This section cited in 31 Pa. Code § 73.136 (relating to filing of forms and rates).
§ 73.114. Insurability requirements.
Plans of credit insurance as provided in § § 73.104(a), 73.107(a) and 73.110(a) (relating to life insurance and life insurance with TPD benefit; accident and health insurance benefits; and involuntary unemployment insurance benefits) may provide for either:
(1) An evidence of insurability requirement.
(2) No evidence of insurability requirement.
§ 73.115. Benefit exclusions.
Exclusions may be contained in a credit insurance plan as provided in § § 73.104(a), 73.107(a) and 73.110(a) (relating to life insurance and life insurance with TPD benefit; accident and health insurance benefits; and involuntary unemployment insurance benefits).
(1) The following exclusions may also be contained in a life insurance plan or a life insurance with TPD benefit plan:
(i) Death due to suicide within 1 year of the effective date of coverage.
(ii) TPD due to intentionally self-inflicted injury.
(iii) A preexisting conditions exclusion due to a condition for which the insured debtor received medical advice, consultation, diagnosis or treatment from a physician or podiatrist within 6 months before the effective date of coverage and due to which death occurs or TPD commences within 6 months after the effective date of coverage. This exclusion applies only if and to the extent that the total amount of all insurance that would otherwise be subject to the preexisting conditions exclusion exceeds $1,000.
(iv) For the application of the exclusions contained in subparagraphs (i)(iii), the effective date of coverage for each portion of the insurance attributable to a different advance under an open end loan, is the date on which the advance or charge occurs, or if later, the date on which coverage is elected.
(2) The following exclusions may also be contained in an A and H insurance plan:
(i) Normal pregnancy.
(ii) Intentionally self-inflicted injury.
(iii) Nonscheduled aircraft flight.
(3) The following exclusions may also be contained in an involuntary unemployment insurance plan:
(i) Voluntary resignation of employment.
(ii) Voluntary leave of absence.
(iii) Voluntary forfeiture of salary, wages or income.
(iv) Retirement.
(v) Injury or disease.
(vi) Disability.
(vii) Strike or unionized labor dispute.
(viii) Discharge by employer for cause.
(ix) Involuntary unemployment for which severance pay is received by the debtor.
§ 73.116. Age requirements.
(a) Debtor age provisions. Plans of credit insurance as provided in § § 73.104(a), 73.107(a) and 73.110(a) (relating to life insurance and life insurance with TPD benefit; A and H insurance benefits; involuntary unemployment insurance benefits) may provide for debtor age provisions not less favorable than any of the following:
(1) An age restriction making the debtor ineligible for coverage when one of the following applies:
(i) The debtor will have attained 65 years of age at the time the indebtedness is incurred.
(ii) The debtor will have attained 66 years of age on the scheduled maturity date of the indebtedness.
(2) A provision for coverage to terminate when the debtor attains a specified age not less than 66 years. If coverage is written on a single premium basis, the term of the insurance coverage on which the premium is based may not extend beyond the termination age.
(i) A debtor electing coverage that terminates when a specified age is attained shall be provided, at the time of election of insurance coverage, with a written disclosure specifying the age of the debtor at which the insurance will terminate.
(ii) A group certificate or individual policy providing coverage that terminates when a specified age is attained shall disclose the age of the debtor at which the insurance will terminate. The termination disclosure shall appear in prominent print on the first page of the group certificate or individual policy.
(b) Eligibility determination using age. An age restriction shall be used only to determine initial eligibility for coverage and may not be used as a basis for denying claims or terminating existing coverage, except as provided in subsection (a)(2) and in § 73.105 (3) and (4), § 73.108 (5) and (6) or § 73.111 (5) and (6).
§ 73.117. Employment eligibility requirements.
Plans of credit accident and health insurance as provided in § 73.107(a) (relating to accident and health insurance benefits) may provide for either:
(1) Any evidence of gainful employment requirement.
(2) No evidence of gainful employment requirement.
§ 73.118. Initial eligibility requirements.
Plans of credit involuntary unemployment insurance as provided in § 73.110 (a) (relating involuntary unemployment insurance benefits) may provide for initial eligibility requirements, whereby an insurer may choose to exclude from credit involuntary unemployment coverage, one or more of the following:
(1) Unemployed individuals.
(2) Self-employed individuals.
(3) Military personnel.
(4) Workers in seasonal or temporary jobs which are designed to last 6 consecutive months or less.
(5) Debtors who have been notified of a layoff or of employment termination occurring within 60 days of the termination notification.
§ 73.119. Combination coverage rate.
If an insurer combines two or more credit life, Credit A and H or credit unemployment insurance coverages which are provided under separate and distinct policy forms, and if the debtor may purchase only a package of these insurance coverages, the premium rate for the package shall be the sum of the separate approved premium rates for the applicable insurance coverages less a discount of 5% of the sum of the separate approved premium rates.
Cross References This section cited in 31 Pa. Code § 73.130 (relating to election of coverage and disclosure requirements).
§ 73.120. Composite term premium rate.
Composite term premium rates may be used under the following conditions:
(1) The insurer shall include in the filing of the composite term premium rates a demonstration that the expected total premium to be collected by the insurer will not exceed the total premium that would be collected if term specific rates were charged.
(2) The composite term premium rates may not exceed by more than 10% any term specific rates within the composite term period.
Cross References This section cited in 31 Pa. Code § 73.103 (relating to definitions).
§ 73.121. Maximum rates.
An insurer may use a rate for an account that is lower than the filed rate applicable to that account without notice to the Department.
§ 73.122. Deviated rates
An insurer may file for approval of and upon approval may use rates that are higher than the prima facie premium rates if the use of the higher rates will result in a loss ratio which is not less than the loss ratio standard in § 73.123 (relating to loss ratio standards). If rates higher than the prima facie rates are filed, the filing shall specify the account to which the rates apply. These rates may be:
(1) Applied uniformly to all accounts of the insurer.
(2) Applied on an equitable basis to only one or more accounts of the insurer for which the actual prima facie loss ratio was higher than the applicable loss ratio standard.
(3) Applied on an equitable basis in accordance with an account rating procedure. The account rating procedure shall be filed with and approved by the Department prior to use.
Cross References This section cited in 31 Pa. Code § 73.106 (relating to life insurance rate standards); 31 Pa. Code § 73.109 (relating to A and H insurance rate standards); and 31 Pa. Code § 73.112 (relating to involuntary unemployment insurance rate standards).
§ 73.123. Loss ratio standards.
Unless revised loss ratio standards are adopted, the loss ratio standards for the coverages specified shall be as follows:
Loss Ratio Standard Credit Life 55% Credit Life with TPD 55% Credit Accident and Health 14-Day Retroactive 65% 14-Day Nonretroactive 65% 30-Day Retroactive 60% 30-Day Nonretroactive 60% Credit Involuntary Unemployment 30-Day Retroactive 60% 30-Day Nonretroactive 60% Credit Voluntary Unemployment 60%
Cross References This section cited in 31 Pa. Code § 73.106 (relating to life insurance rate standards); 31 Pa. Code § 73.109 (relating to A & H insurance rate standards); 31 Pa. Code § 73.112 (relating to involuntary unemployment insurance rate standards); 31 Pa. Code § 73.113 (relating to voluntary unemployment insurance rate standards); and 31 Pa. Code § 73.122 (relating to deviated rates).
§ 73.124. Duration of deviation.
Deviated rates may not be in effect for a period longer than 3 years. An insurer may file for a new rate before the end of the 3 years, but not more often than once during any 12 month period.
§ 73.125. Portability of rates.
If an account for which a higher (deviated) rate is approved changes insurers, the rate approved for use for that account by the prior insurer shall be the maximum rate that may be used by any succeeding insurer for the remainder of the applicable rate period, applicable to the prior insurer, or until a new rate is filed for use in connection with the account, if sooner.
§ 73.126. Voluntary unemployment experience reports.
The Commissioner may require, with a minimum of 6 months advance notice, that each insurer doing credit voluntary unemployment insurance business in this Commonwealth file a report of credit voluntary unemployment insurance written on a calendar year basis. The report shall follow the format specified for credit unemployment insurance of the Credit Insurance Experience Exhibit as required by the annual statement instructions and shall contain separate specific data for this Commonwealth, rather than an allocation of the companys countrywide experience.
§ 73.127. Refunds.
(a) Refund provision. If insurance terminates prior to the scheduled maturity date of the indebtedness, a refund of any unearned premium shall be made as follows:
(1) If the indebtedness is discharged due to prepayment, renewal or refinancing prior to the scheduled maturity date, credit insurance shall be terminated and a refund of the unearned premium shall be made.
(2) A refund of any unearned credit A and H insurance premium, credit involuntary unemployment insurance premium or credit voluntary unemployment insurance premium shall be made if the indebtedness is prepaid by the proceeds of credit life insurance or credit life insurance with TPD benefit. The refund of the unearned credit insurance premium shall be in addition to any credit life insurance or TPD benefit proceeds.
(3) A refund of the total premium charged for credit insurance coverage shall be made if coverage is voided ab initio for any reason other than termination of the indebtedness.
(4) If joint coverage on one of the debtors is voided ab initio, a refund of the difference between the premium actually charged for the joint coverage, and the premium that would have been charged if only single coverage had been provided shall be made.
(b) Refund time frame. Refunds of premiums paid by or charged to the debtor shall be remitted to the debtor or credited to the debtors outstanding indebtedness within 10 working days after the agent or group policyholder receives the refund from the insurer.
(c) Refund notice. A refund payment shall be accompanied by an explanation that the payment is a refund of premium. If the refund amount has been deducted from the debtors outstanding indebtedness, the debtor shall be notified in writing that the refund was applied toward the outstanding indebtedness.
(d) Refund formulas. Insurers shall file for approval all refund formulas intended for use. A reference to the Rule of 78 shall be acceptable, in lieu of filing the actual formula.
(1) The refund of premiums on a single premium basis shall be calculated by multiplying the original single premium charged, by the appropriate refund factor.
(i) In determining the refund, if fewer than 15 days of insurance coverage has been provided during the loan month, no charge shall be made for that month. If 15 or more days of coverage have been provided during the loan month, a full month may be charged.
(ii) For gross decreasing credit life insurance with or without TPD benefits, the refund shall be computed based on the Rule of 78.
(iii) For level term credit life insurance with or without TPD benefits, the refund shall be computed based on a pro rata basis.
(iv) For full benefit period credit A and H insurance and full benefit period credit involuntary unemployment insurance, the refund shall be computed based on the Rule of 78.
(v) For any coverage not listed in subparagraphs (ii)(iv), the refund factor shall equal the sum of remaining insured balances divided by the sum of the original insured balances.
(2) Except as provided in § 73.139 (j) (relating to credit insurance on open end loans), the refund of any unearned premiums calculated and remitted to the insured on a monthly outstanding balance basis shall be equal to the monthly premium charged if fewer than 15 days of insurance coverage has been provided during that loan month. If coverage has been provided for 15 or more days of the loan month, no refund of premium is required.
(e) Minimum refund. Insurers need not issue refunds for less than $10.
(f) Termination and refund disclosures. The group policy and group certificate or individual policy issued to provide insurance coverage shall disclose the conditions under which the coverage will terminate and under which a premium refund is required. This refund disclosure shall also describe the method used to calculate the premium refund.
Cross References This section cited in 31 Pa. Code § 73.139 (relating to credit insurance on open end loans); and 31 Pa. Code § 73.140 (relating to credit insurance on closed end variable interest loans).
§ 73.128. Terminations.
(a) Individual policy termination. An individual policy of credit insurance may not be terminated by an insurer, except for nonpayment of premium, prior to the scheduled expiration date of the policy, unless the indebtedness is sooner discharged due to renewal, refinancing or prepayment.
(b) Continuation of coverage. If a debtor is insured under a single premium group credit insurance policy, the insurer shall provide that in the event of termination of the policy, insurance coverage with respect to the debtor shall continue with either the original insurer or a new insurer for the entire period for which the single premium has been paid.
(c) Notice of termination. If a debtor is insured under a group credit insurance policy providing for the payment of premiums to the insurer on a monthly premium basis, the insurer shall, in the event of termination of the policy, cause a notice of termination to be provided to the insured debtor at least 30 days prior to the effective date of termination. A termination notice is not required if replacement coverage, of at least equal value, takes effect on the effective date of termination. The terminating insurer shall be responsible for assuring that any required termination notice is provided.
(d) Assumption of coverage. If an existing group policy is assumed by another insurer, the assuming insurer shall issue to the group policyholder a certificate of assumption for attachment to the group policy. If the entity to which the insured debtor is indebted is other than the group policyholder, the assuming insurer shall make reasonable efforts to notify the entity of the assumption.
§ 73.129. Dividends.
(a) Dividend payment. Dividends on participating individual policies of credit insurance may be payable to the owners of the individual policies. Payment of dividends may be deferred until the policy is terminated.
(b) Nonparticipating policies. Experience refunds or retrospective premium rate adjustments may not be applied to nonparticipating individual credit insurance policies.
(c) Dividends or retrospective rate credits as compensation. Dividends or retrospective rate credits on group policies may be paid or credited to the group policyholder. Dividends or retrospective rate credits, less the policyholders own contributions, if any, and less any amounts of the dividends or retrospective rate credits paid or credited to the benefit of debtors insured under the group policy, shall be considered compensation for the purpose of § 73.134 (relating to compensation of producers or creditors).
Cross References This section cited in 31 Pa. Code § 73.134 (relating to compensation of producers and creditors).
§ 73.130. Election of coverage and disclosure requirements.
(a) Separate purchase of coverages. If more than one type of credit insurance coverage is offered for purchase in connection with an indebtedness and each coverage is provided under separate and distinct policy forms, the debtor shall be allowed to separately purchase each credit insurance coverage, unless the premium rate for a package policy is provided under § 73.119 (relating to combination coverage rate).
(b) Election of coverage. If an identifiable charge is made to the debtor for credit insurance coverage, no coverage may be provided unless the debtor is liable under the credit agreement and the coverage is elected and authorized by the proposed insured debtor in the insurance application. If joint life, joint life with TPD benefit, joint A and H, joint involuntary unemployment or joint voluntary unemployment coverage is offered, and an identifiable charge is made for the joint coverage, each proposed insured debtor shall be liable under the credit agreement, and shall elect the coverage by authorizing the insurance application. An insurer may require that only one of the joint debtors elect the credit insurance coverage if the following exist:
(1) The insurance application is mailed or electronically transmitted to the debtor and returned to the insurer or creditor by mail or electronically.
(2) The credit insurance application is completed after the application for the indebtedness is completed.
(c) Single life designation. In situations where two debtors are each liable for repayment of an indebtedness and insurance coverage on only one life is offered, both debtors shall be provided with the option to elect the coverage, if there is an identifiable charge to the debtor for the coverage. Only one of the debtors shall be provided with the opportunity to elect the single coverage if the following conditions are met:
(1) The insurance application is mailed or electronically transmitted to the debtor and returned to the insurer or creditor by mail or electronically.
(2) The credit insurance election is completed after the application for the indebtedness is completed.
(d) Notice of proposed insurance. With respect to section 6(4) of the act (40 P. S. § 1007.6(4)), the application and notice of proposed insurance shall be deemed to be prominently set forth in the financial instrument if set forth in a separate provision on the face or reverse side of the financial instrument in type at least equal in size and prominence to the type used for other provisions of the financial instrument.
§ 73.131. Choice of insurer.
If insurance is required as additional security for an indebtedness, the debtor shall be informed by the creditor prior to completion of an application for credit insurance of the right to provide alternative insurance coverage through existing policies or by procuring and purchasing insurance coverage through an authorized insurer.
§ 73.132. Collection of premiums.
(a) Collecting premiums as a representative. If the creditor or its representative collects premiums or an identifiable charge for credit insurance from a debtor, it does so as a representative of the insurer and the moneys so collected shall be deemed received by the insurer for purposes of this chapter.
(b) Remittance of premiums. Premiums collected by the creditor from the debtor shall be remitted by the creditor to the insurer on a timely basis. For premiums collected on a single premium basis, premiums shall be remitted not later than 60 days from the last day of the month in which the insurance coverage was purchased. For premiums collected on a monthly outstanding premium basis, premiums shall be remitted not later than 60 days after the last day of the month or billing cycle in which the premiums from the debtor were charged or collected.
Cross References This section cited in 31 Pa. Code § 73.137 (relating to compensating balances or special deposits).
§ 73.133. Claims and examination procedures.
(a) Claim procedures. Every insurer shall be responsible for the settlement, adjustment and payment of all claims and shall establish and maintain adequate claim files.
(b) Claim reporting.
(1) Claims shall be promptly reported by the group policyholder or its representatives to the insurer or its designated claim representative, and all claims shall be settled as soon as practical and in accordance with the terms of the insurance contract.
(2) In the case where both A and H insurance benefit and life insurance with TPD benefit coverages are provided in connection with the same indebtedness, the group policyholder shall report the claim to the insurer for the appropriate coverage prior to or at the end of any applicable elimination period, subject to the group policyholder having received appropriate claim information from the insured debtor.
(c) Payment of claims. In addition to the payment of a claim by a draft drawn upon the insurer or by a check of the insurer, claims may also be paid by electronic transfer drawn by the insurer to the order of the claimant to whom payment of the claim is due. If the amount of the insurance payable exceeds the balance which the debtor is obligated to pay to the creditor, the creditor shall pay the excess directly to the beneficiary designated by the debtor or the estate entitled to the excess.
(d) Settlement of claims. If a group policyholder has made arrangements with an insurer to draw drafts or checks or make electronic transfers for payment of claims due to the group policyholder, the parties making the draws or electronic transfers may not be directly involved in making loans for the policyholder.
(e) Creditor examination. An insurer shall be responsible for conducting a thorough examination of creditors with respect to its credit insurance business during the first policy year and at least annually thereafter to assure compliance with this chapter and other applicable insurance laws and regulations of the Commonwealth. The examination shall verify the accuracy of premiums or other identifiable insurance charges, premium refunds, claim payments which have been reported to the insurer and any other pertinent information necessary for the insurer to determine that debtors are being afforded proper coverage. Examinations performed by an insurer shall be subject to review by the Department. The group policy shall contain a provision explaining that the account will be examined annually.
(f) Inspection of examination procedures. Each insurer shall make available for Department inspection upon request its creditor examination procedures.
(g) Record of examination. The insurer shall establish and maintain a written record of each creditor examination. This record shall be maintained for at least 3 years from the date of examination or until the conclusion of the next succeeding regular examination by the Department of its domicile, whichever is later.
(h) Record of coverage. An insurer or, at the option of the insurer, the creditor shall establish and maintain adequate credit insurance records for at least 2 years after the termination of an individual debtors insurance coverage. The records shall identify each individual debtor, the amount insured, the term of the insurance, the charge for the insurance and any refunds of unearned premiums. The records shall be made available for Department review upon request.
§ 73.134. Compensation of producers and creditors.
(a) Compensation limits. Premium rates shall be presumed to be excessive if the compensation for writing and handling credit insurance paid to a creditor, producer or any affiliate, associate, subsidiary, director, officer, employe or other representative of the creditor or producer, exceeds:
(1) For credit life insurance and credit life insurance with TPD benefit, 27% of the prima facie premium rates referenced in § 73.106 (relating to life insurance rate standards) or 27% of the actuarially consistent premium rates for insurance for which prima facie rates are not published in the Pennsylvania Bulletin.
(2) For credit A&H insurance or involuntary unemployment insurance, 21% of the prima facie premium rates referenced in § § 73.109 and 73.112 (relating to A and H insurance rate standards; and involuntary unemployment insurance rates standards) or 21% of the actuarially consistent premium rates for insurance for which prima facie rates are not published in the Pennsylvania Bulletin.
(b) Additional compensation. When a licensed producer, general producer, general agency or home office producer, having no direct or indirect affiliation or connection with the creditor, is involved in the solicitation of a credit insurance policy, the compensation of 27% as provided in subsection (a) shall be increased to 30% and the compensation of 21% as provided by subsection (b) shall be increased to 25% provided that the entire amount or any part of additional compensation shall be used solely as commission for the licensed producer, general producer, general agency or home office producer involved in the solicitation. The creditor is prohibited from receiving indirectly or directly all or any portion of the additional 3% or 4% commission.
(c) Compensation defined. For purposes of this chapter, compensation means money or anything else of value paid or credited to or on behalf of any group policyholder, producer, or general producer or withheld by any group policyholder producer, broker or general producer within or outside this Commonwealth in relation to business produced or to be produced or written or to be written in this Commonwealth and paid or credited by or on behalf of the insurer or by any affiliate of the insurer or by another person. Compensation includes the following:
(1) Commissions.
(2) Fees, including administrative fees, service fees, consulting fees and expense fees.
(3) Electronic data processing equipment used for purposes other than electronic rate books.
(4) Electronic data processing services other than the programming of existing electronic data processing equipment used in lieu of rate books or charts.
(5) Supplies, other than forms approved by the Commissioner and usual and customary claims and reporting forms and envelopes.
(6) Rental equipment of any type provided by an insurer, its agent or any related person without charge of actual cost or at a charge less than the usual cost.
(7) Advertising provided by an insurer, its agent or a related person without charge of actual cost or at a charge less than the usual cost.
(8) Communication devices provided by an insurer, its agent or a related person without charge of actual cost or at a charge less than the usual cost.
(9) Profit sharing plans.
(10) Experience rating refunds and credits.
(11) Dividends as provided in § 73.129 (relating to dividends).
(12) Dividends received by a producer of credit insurance business who owns in part or whole a reinsurance company which assumes the credit insurance business from the direct insurer, if any of the following criteria are met:
(i) The dividend payment on each share of stock represents more than a reasonable return on the producers capital investment.
(ii) The direct insurer has contractually guaranteed to reassume any losses sustained by the reinsurer on the ceded business.
(13) Expense allowances or reimbursement.
(14) Stock plans and bonuses.
(15) Extension of credit.
(16) Reimbursement for expenditures.
Cross References This section cited in 31 Pa. Code § 73.129 (relating to dividends); 31 Pa. Code § 73.135 (relating to licensed producers).
§ 73.135. Licensed producers.
(a) Individual policy. All individual policies of credit life insurance, credit A and H insurance or credit involuntary or voluntary unemployment insurance shall be issued only through a producer licensed in this Commonwealth. A person performing in connection with an individual policy a conduct which would fall within the definition of a producer shall be licensed as a producer.
(b) Employes of creditor or insurer. If a group policy is issued to a creditor, bona fide employes of the creditor or insurer may issue certificates and perform functions related to the issuance of certificates and administration of the group policy without being licensed as producers.
(c) Receipt of compensation without licensing. If a group policy is issued to a creditor, the creditor may, without being licensed as a producer, receive compensation for the issuance of certificates and performance of functions related to the issuance of certificates, subject to the limitation on compensation as provided in § 73.134 (relating to compensation of producers or creditors).
This section cited in 31 Pa. Code § 73.113 (relating to voluntary unemployment insurance rate standards); 31 Pa. Code § 73.139 (relating to credit insurance on open end loans); 31 Pa. Code § 73.140 (relating to credit insurance on closed end variable interest loans); 31 Pa. Code § 73.141 (relating to credit insurance on lease transactions); 31 Pa. Code § 73.142 (relating to credit insurance on fixed residential loans); and 31 Pa. Code § 73.143 (relating to credit insurance on balloon loans).
§ 73.137. Compensating balances or special deposits.
(a) Definition. Compensating balances or special deposit accounts shall include the following:
(1) The deposit of premiums or money to the account of the insurer or an affiliate of the insurer when the account is either noninterest bearing or bearing interest at a rate less than the current market rate. The rate of interest will be considered less than usual if a higher rate of interest could be earned by combining the account with one or more other accounts, unless there is a business reason unrelated to the credit insurance program for maintaining separate accounts.
(2) The remittance of premiums to the insurer after the expiration of the grace period, except as provided in § 73.132(b) (relating to collection of premiums), on a regular basis thereby resulting in an arrearage period which is constant.
(3) The retention of premiums by a producer to whom the financial institution remits premiums beyond a reasonable period of time needed for the producer to remit premiums to an insurer, if the delay is a continuing practice in the premium paying process.
(4) Any other practice which unduly delays receipt of premiums by the insurer on a regular basis, or which involves the use of the financial resources of an insurer for the benefit of a financial institution.
(b) Illegal inducement. The use of compensating balances or special deposit accounts in connection with a credit insurance program constitutes a violation of section 635 of The Insurance Department Act of 1921 (40 P. S. § 271), section 346 of The Insurance Company Law of 1921 (40 P. S. § 471) and section 5(a)(4) of the Unfair Insurance Practices Act (40 P. S. § 1171.5(a)(4)).
(c) Premium basis. The prohibition on compensating balances and special deposits applies regardless of whether premiums are due the insurer on the single premium basis or on the monthly outstanding balance premium basis.
The provisions of this § 73.140 corrected April 24, 1998, effective June 19, 1998, 28 Pa.B. 1941.
Cross References This section cited in 31 Pa. Code § 73.107 (relating to accident and health insurance benefits); and 31 Pa. Code § 73.110 (relating to involuntary unemployment insurance benefits).
§ 73.142. Credit insurance on fixed residual loans.
(a) General requirements. Credit insurance may be provided in connection with motor vehicle fixed residual value financing. This section supersedes other provisions of this chapter to the extent that the provisions would otherwise relate to credit insurance on fixed residual loans.
(b) Identification. A credit insurance program designed for use with fixed residual value financing shall be identified as such when filed with the Department in accordance with § 73.136 (relating to filing of forms and rates).
(c) Filing requirement. Every insurer shall file a fixed residual value financing loan form and the formula demonstrating the manner in which the actual installment payment will be calculated for each installment payment calculation method.
(d) Level life coverage. If the fixed residual value amount is insured, life insurance coverage shall be provided on a level term basis.
(e) A and H and involuntary unemployment coverage. The monthly A and H insurance benefit and the involuntary unemployment insurance benefit may not exceed the amount of each monthly installment payment. No credit A and H or involuntary unemployment insurance may be provided on the residual amount.
(f) Single premium gross calculation. If premiums for credit life insurance or credit life insurance with TPD benefit are payable on a single premium basis, when the benefit is the gross unpaid indebtedness, the single premium shall equal the sum of the single premium for decreasing insurance with an amount of initial insured gross unpaid indebtedness equal to the sum of the schedule of installment payments and the single premium for level insurance with an amount of insurance equal to the fixed residual value.
(g) Single premium net calculation. If premiums for credit life insurance or credit life insurance with TPD benefit are payable on a single premium basis, when the benefit is the net unpaid indebtedness, the single premium shall equal the sum of the single premium for decreasing insurance based on an initial amount financed minus an amount equal to the fixed residual value, and the single premium for level insurance with an amount of insurance equal to the fixed residual value.
(h) Payment to beneficiary. If the insurance benefit is the gross unpaid indebtedness, and if the life insurance or TPD proceeds are applied to continue the installment, the group policy and group certificate or individual policy providing the coverage shall provide that the difference between the sum of the remaining payments plus the amount of level insurance, if applicable, and the sum of the present value of the remaining payments plus the present value of the fixed residual value payment, if applicable, shall be paid to the named beneficiary or the estate of the debtor, regardless of whether the benefit is paid to the creditor as a lump sum or in installments. The present value shall be calculated using an interest rate of at least 5%.
§ 73.143. Credit insurance on balloon loans.
(a) General requirements. Credit insurance may be provided in connection with balloon loans. This section supersedes other provisions of this chapter to the extent that the provisions would otherwise relate to credit insurance on balloon loans.
(b) Identification. Any credit insurance program designed for use with balloon loans shall be identified as such when filed with the Department in accordance with § 73.136 (relating to filing for forms and rates).
(c) Disclosure. Every individual policy or group certificate shall contain a disclosure that neither the A and H nor the involuntary unemployment insurance benefit is provided on the balloon amount of the loan. The disclosure shall appear in prominent type on the first page of the individual policy or group certificate.
(d) Benefit amount.
(1) For credit life insurance or credit life insurance with TPD benefit, the balloon amount shall be included in determining the amount of gross unpaid indebtedness or net unpaid indebtedness.
(2) For credit A and H, involuntary unemployment or voluntary unemployment insurance, no monthly benefit may be provided on the balloon amount.
(e) Life insurance single premium gross calculation. If premiums for credit life insurance or credit life insurance with TPD benefit are payable on a single premium basis when the benefit is the gross unpaid indebtedness, the single premium shall equal the sum of the single premium for the decreasing insurance with an amount of initial insured gross unpaid indebtedness equal to the actual amount of initial insured gross unpaid indebtedness minus the balloon amount and the single premium for level insurance with an amount of insurance equal to the balloon amount.
(f) Life insurance single premium net calculation. If premiums for credit life insurance or credit life insurance with TPD benefit are payable on a single premium basis when the benefit is the net unpaid indebtedness, the single premium shall equal the sum of the single premium for the decreasing insurance based on the initial amount financed minus the balloon amount and the single premium for level insurance with an amount of insurance equal to the balloon amount.
APPENDIX A [Reserved]
Source The provisions of this Appendix A adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240472) to (240474).
APPENDIX B [Reserved]
Source The provisions of this Appendix B adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial page (240475).
APPENDIX C [Reserved]
Source The provisions of this Appendix C adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240476) to (240479).
APPENDIX D [Reserved]
Source The provisions of this Appendix D adopted October 1, 1971; amended May 9, 1975, effective May 10, 1975, 5 Pa.B. 1211; reserved March 20, 1998, effective June 19, 1998, 28 Pa.B. 1401. Immediately preceding text appears at serial pages (240480) to (240486).
No part of the information on this site may be reproduced for profit or sold for profit.
This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.