2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 519A - MEDICAL MALPRACTICE INSURANCE
519A.5 - POLICY FORMS AND RATES.

        519A.5  POLICY FORMS AND RATES.
         1.  The rates, rating plans, rating classifications, and policy
      forms and endorsements applicable to insurance written by the
      association and the statistical and experience data relating thereto
      shall be subject to sections 519A.2 to 519A.13 and to the provisions
      of the general insurance code which are not inconsistent with the
      purposes and provisions of this chapter.
         2.  All policies issued by the association shall provide for a
      continuous period of coverage beginning with their respective
      effective dates.  All policies shall terminate at 12:01 a.m. two
      years from the date of finding of an emergency by the commissioner,
      or earlier in accordance with sections 519A.2 through 519A.13; or
      because of failure of the policyholder to pay any premium or
      stabilization reserve fund charge or portion of either when due.  All
      policies shall be issued subject to the group retrospective rating
      plan and the stabilization reserve fund authorized by this chapter.
      No policy form shall be used by the association unless it has been
      filed with and approved by the commissioner.
         3.  The commissioner shall specify whether policy forms and the
      rate structure shall be on a "claims-made" or "occurrence" basis and
      coverage shall be provided by the association only on the basis
      specified by the commissioner.  The commissioner shall specify the
      "claims-made" basis only if the contract makes provision for residual
      "occurrence" coverage upon the retirement, death, disability or
      removal from this state of the insured. Provision may be made for a
      premium charge allocable to any such residual "occurrence" coverage
      and such premium charges for such residual coverage shall be
      segregated and separately maintained for such purpose which may
      include the reinsurance of all or a part of that portion of the risk.

         4.  The rates, rating plans, rating rules, and rating
      classifications applicable to the insurance written by the
      association shall be on an actuarially sound basis, giving due
      consideration to the group retrospective rating plan and the
      stabilization reserve fund, and shall be calculated to be
      self-supporting.
         5.  All policies issued by the association shall be subject to a
      nonprofit group retrospective rating plan to be approved by the
      commissioner under which the final premium for all policyholders of
      the association, as a group, will be equal to the administrative
      expenses, loss and loss adjustment expenses and taxes, plus a
      reasonable allowance for contingencies and servicing.  Policyholders
      shall be given full credit for all investment income, net of expenses
      and a reasonable management fee, on policyholder supplied funds.  The
      standard premium, before retrospective adjustment, for each policy
      issued by the association shall be established for portions of the
      policy period coinciding with the association's fiscal year on the
      basis of the association's rates, rating plans, rating rules, and
      rating classifications then in effect.  The maximum final premium for
      all policyholders of the association, as a group, shall be limited as
      provided in section 519A.6, subsection 5. Since the business of the
      association is subject to the nonprofit group retrospective rating
      plan required by this subsection, there shall be a presumption that
      the rates filed and premiums imposed by the association are not
      unreasonable or excessive.
         6.  The association shall certify to the commissioner the
      estimated amount of any deficit remaining after the stabilization
      reserve fund has been exhausted in payment of the maximum final
      premium for all policyholders of the association.  Within sixty days
      after that certification the commissioner shall authorize the members
      of the association to commence recoupment of their respective shares
      of the deficit by deducting their share of the deficit from past or
      future premium taxes due the state of Iowa. The association shall
      amend the amount of its certification of deficit to the commissioner
      as the values of its incurred losses become finalized and the members
      of the association shall amend their recoupment procedure
      accordingly.
         7.  In the event that sufficient funds are not available for the
      sound financial operation of the association, all members shall
      contribute to the financial requirements of the association in the
      manner provided for in section 519A.8. Any contribution shall be
      reimbursed to the members by recoupment as provided in subsection 6.
      

         Section History: Early Form

         [C77, 79, 81, § 519A.5] 

         Section History: Recent Form

         2002 Acts, ch 1111, §33
         Referred to in § 519A.1, 519A.2, 519A.3, 519A.4, 519A.10, 519A.13