State of Illinois
91st General Assembly
Legislation

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91_HB2980

 
                                               LRB9107003WHdv

 1        AN  ACT  to amend the Illinois Insurance Code by changing
 2    Section 456.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.   The  Illinois  Insurance Code is amended by
 6    changing Section 456 as follows:

 7        (215 ILCS 5/456) (from Ch. 73, par. 1065.3)
 8        Sec. 456.  Making of rates. (1) All rates shall  be  made
 9    in accordance with the following provisions:
10        (a)  Due   consideration  shall  be  given  to  past  and
11    prospective loss experience within and outside this state, to
12    catastrophe hazards, if  any,  to  a  reasonable  margin  for
13    profit and contingencies, to dividends, savings or unabsorbed
14    premium  deposits  allowed  or returned by companies to their
15    policyholders,  members   or   subscribers,   to   past   and
16    prospective  expenses  both  countrywide  and those specially
17    applicable  to  this  state,  to  underwriting  practice  and
18    judgment and to all other relevant factors within and outside
19    this state;
20        (b)  The systems of expense provisions  included  in  the
21    rates for use by any company or group of companies may differ
22    from  those  of  other  companies  or  groups of companies to
23    reflect the requirements of the operating methods of any such
24    company or group with respect to any kind  of  insurance,  or
25    with  respect  to  any subdivision or combination thereof for
26    which subdivision or combination separate expense  provisions
27    are applicable;
28        (c)  Risks  may  be  grouped  by  classifications for the
29    establishment of rates and minimum  premiums.  Classification
30    rates  may  be modified to produce rates for individual risks
31    in accordance with rating plans which  measure  variation  in
 
                            -2-                LRB9107003WHdv
 1    hazards or expense provisions, or both. Such rating plans may
 2    measure  any  differences  among  risks  that have a probable
 3    effect upon losses or expenses;
 4        (d)  Rates shall not be excessive, inadequate or unfairly
 5    discriminatory.
 6        A rate in a competitive market is not excessive.  A  rate
 7    in  a  noncompetitive  market is excessive if it is likely to
 8    produce a long run profit that is unreasonably high  for  the
 9    insurance  provided  or  if expenses are unreasonably high in
10    relation to the services rendered.
11        A rate is not inadequate  unless  such  rate  is  clearly
12    insufficient  to sustain projected losses and expenses in the
13    class of business to which it applies and  the  use  of  such
14    rate   has   or,  if  continued,  will  have  the  effect  of
15    substantially lessening competition or the tendency to create
16    monopoly in any market.
17        Unfair  discrimination  exists  if,  after  allowing  for
18    practical limitations, price differentials  fail  to  reflect
19    equitably the differences in expected losses and expenses.  A
20    rate   is   not  unfairly  discriminatory  because  different
21    premiums result for policyholders  with  like  exposures  but
22    different  expenses,  or  like  expenses  but  different loss
23    exposures, so long as the rate reflects the differences  with
24    reasonable accuracy.
25        (e)  The rating plan shall contain a mandatory offer of a
26    deductible  applicable  only to the medical benefit under the
27    Workers' Compensation Act.  Such deductible offer shall be in
28    a minimum amount of at least $1,000 per accident.
29        (f)  Any rating plan or  program  shall  include  a  rule
30    permitting   2   or   more   employers   with   similar  risk
31    characteristics, who participate in a loss prevention program
32    or safety group, to pool their premium and loss experience in
33    determining their rate or premium for such  participation  in
34    the program.
 
                            -3-                LRB9107003WHdv
 1        (g)  Following  a  conviction  of  a person of an offense
 2    involving a fraudulent workers' compensation insurance  claim
 3    and    a    finding   by   the   Industrial   Commission   of
 4    noncompensability, the insurer  shall  file  the  appropriate
 5    documents  to  remove the fraudulent and noncompensable claim
 6    from the employer's experience modification factor.
 7        (2)  Except  to  the  extent  necessary   to   meet   the
 8    provisions  of  subdivision  (d)  of  subsection  (1) of this
 9    Section, uniformity among companies in any matters within the
10    scope of this Section is neither required nor prohibited.
11    (Source: P.A. 82-939.)

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