DEPARTMENT OF CONSUMER AND INDUSTRY SERVICES
INSURANCE BUREAU
WORKERS' COMPENSATION INSURANCE
(By authority conferred on the commissioner of insurance by sections 210, 2407, and 2419
of Act No. 218 of the Public Acts of 1956, as amended, being SS500.210, 500.2407, and
500.2419 of the Michigan Compiled Laws)
R 500.1351 Premium dispute; insurer's responsibility to provide information upon
conclusion of the personal meeting.
Rule 1. (1) An insured who has reason to believe that the insured's premium charges for
workers' compensation insurance are excessive as a result of unreasonable reserves or the
unreasonable redemption of a claim or claims is entitled to a personal meeting with a
management representative of the insurer. Upon conclusion of the personal meeting, the
insurer shall provide the following information to the insured:
(a) The action taken by the insurer.
(b) The facts, with supporting documentation, upon which the action is based.
(c) A statement explaining the insured's right to appeal the matter to the commissioner
within 30 days after receipt of the information provided pursuant to this rule.
(2) The insurer shall offer to provide the information in writing. If the insured accepts
the offer, the insurer shall mail the written statement, with supporting documentation if
any, by first-class mail, within 3 business days after acceptance.
History: 1983 AACS.
R 500.1352 Premium dispute; appeal to commissioner.
Rule 2. (1) If the personal meeting involving the insured and the insurer fails to
resolve the dispute, the insured is entitled to bring the matter before the commissioner for
resolution. The commissioner shall rule on the reasonableness of reserves or redemptions only
with respect to their application in an insurer's rating system. In making a ruling on the
reasonableness of a reserve calculation used in applying an insurer's rating system, the
commissioner shall take into account the following factors:
(a) Whether or not the initial reserve amount is consistent with the information about
the claim available to the insurer at the time the initial case reserve was created.
(b) The presence or absence of reasonable adjustments to the reserve as additional
information becomes available.
(2) The insured shall appeal the matter to the commissioner within 30 days of the date
the insured receives the information provided pursuant to R 500.1351.
(3) The insured is entitled to a review of the matter by the commissioner either by
a review of written materials or through a meeting with the parties involved in the dispute.
History: 1983 AACS.
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