You Now Have the Right to Know How Your Insurer Determines Your Eligibility for Insurance Coverage

The public has a right to know how insurers choose who is eligible for coverage.
Earlier this month, on August 10, 2018, the general counsel for the California Department of Insurance issued a legal opinion that under insurance reform law Proposition 103, insurers’ underwriting rules submitted with a rate application must be made available for public inspection.
Underwriting rules are used by insurance companies to determine whom to insure, what they will insure, and whether to renew an existing policy.
Transparency of underwriting rules lets consumers know if they’re being treated fairly by their insurers

“Consumers and insurers alike benefit from transparency,” said Insurance Commissioner Dave Jones. “Consumers are able to better understand how insurance companies decide who to insure and who to renew.”
In the past, certain insurers have contended their underwriting rules are confidential or proprietary information and not subject to public disclosure.
In response to a request by a member of the public, the general counsel analyzed the issue and determined Proposition 103 does not allow this practice.
So in accordance with the opinion, future rate-approval applications should not designate underwriting rules as confidential. Insurers submit their rate-approval applications to the Department through an NAIC database (SERFF). The Department uses a platform (WARFF) on its website to access the SERFF database so that the public can access and view filings. When such rate-approval applications are now submitted, the underwriting rules should be uploaded to the database as a public document along with the rest of the insurer’s rate-approval application.

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