Current through Pa Acts 2024-53, 2024-56 through 2024-111
Section 814 - Classification of risks; underwriting rules; premium rates; schedule and merit rating plans; appeals(a) The classification of risks, underwriting rules, premium rates, and schedule or merit rating plans for insurance of employers and employes under "The Workmen's Compensation Act of nineteen hundred and fifteen," and acts amendatory thereof or supplementary thereto, and for insurance under "The Pennsylvania Occupational Disease Act of nineteen hundred and thirty-nine," and acts amendatory thereof or supplementary thereto, and for insurance with respect to the Commonwealth of Pennsylvania as to liability under "The United States Longshoremen's and Harbor Workers' Compensation Act" of one thousand nine hundred twenty-seven, and acts amendatory thereof or supplementary thereto, written as a part of a workmen's compensation and employers' liability policy, shall be proposed annually by one or more rating bureaus, said rating bureau or bureaus to be situate within the Commonwealth of Pennsylvania, subject to supervision and to examination by the Insurance Commissioner and approved by the Insurance Commissioner as adequately equipped to compile rates on an equitable and impartial basis. Such schedule or merit rating plans shall be applied only by the approved rating bureau or bureaus, and, in the preparation of schedules, no employer shall be discriminated against or penalized because of physical impairment of any employe or because of the number of dependents of any employe.(b) The system of classification of risks, underwriting rules, premium rates and schedule or merit rating plans for insurance of employers and employes under such acts, shall be filed with, and shall be subject to review by the Insurance Commissioner, and the Insurance Commissioner shall by order modify, amend or approve the same. Any person, corporate or otherwise, aggrieved by such order, classification, rule, rate or schedule issued by the Insurance Commissioner may obtain a review thereof before the Insurance Commissioner.(c) The assignment by an approved rating bureau of any individual risk to a particular classification in accordance with the system of classification of risks and underwriting rules approved by the Insurance Commissioner may be appealed by any person, corporate or otherwise, aggrieved by such assignment before the assigning bureau in accordance with procedures of the bureau approved by the Insurance Commissioner and, if still aggrieved by such reviewed assignment, such person may obtain a further review thereof by filing an appeal with the Insurance Commissioner within thirty days of the mailing date of the final decision of the bureau. The Insurance Commissioner shall hold a hearing upon not less than ten days written notice to the applicant and to the rating bureau which made such classification, and shall issue an order modifying, amending or approving the placement of the individual risk within the particular classification as the result of that hearing. Any order made by the Insurance Commissioner in accordance with this paragraph shall be appealable to the Commonwealth Court in accordance with Title 42 of the Pennsylvania Consolidated Statutes (relating to judiciary and judicial procedure).(d) No risk classification system, underwriting rule, premium rate, or schedule or merit rating plan shall take effect without the consent of the Insurance Commissioner, and he may withdraw his approval whenever, in his judgment, the same is inadequate or discriminates unfairly between risks of essentially the same hazard.(e) Neither the State Workmen's Insurance Fund, nor any insurance corporation, mutual association, or company, shall issue, renew, or carry any policy or contract of insurance against such liability under such acts, except in accordance with the classifications, underwriting rules, premium rates, and schedule or merit rating plans, proposed by the rating bureau or bureaus aforesaid for the risk insured and as modified, amended or approved by the Insurance Commissioner for such insurer.(f) Notwithstanding any other provisions of this section, upon the written consent of the insured stating his reasons therefor, filed with and approved by the Insurance Commissioner, a rate in excess of that determined in accordance with the other provisions of this section may be used on any specific risk.(g) A complete copy of every policy or a true copy of the substantive provisions of any policy or contract of insurance against such liability under such acts, and a true copy of every endorsement upon any such policy and of every agreement pertaining thereto, shall be filed with the rating bureau or bureaus aforesaid within a reasonable time after the effective date of any such policy, endorsement, contract, or agreement.1921, May 17, P.L. 682, art. VI, § 654. Amended 1941, July 31, P.L. 607, § 1; 1953, July 2, P.L. 342, § 4. Affected 1971, June 3, P.L. 130, No. 6 §1 ( § 509(a)(77)); 1978, April 28, P.L. 202, No. 53, § 2(a) [1048], effective 6/27/1978. Amended 1980 , July 1, P.L. 336, No. 84, § 3, effective 7/1/1981.