C.R.S. Section 10-4-403
Standards for rates

  • competition
  • procedure
  • requirement for independent actuarial opinions regarding 1991 legislation

(1)

Rates shall not be excessive, inadequate, or unfairly discriminatory. The following rate standards shall apply:

(a)

Rates are excessive if they are likely to produce a long run profit that is unreasonably high for the insurance provided or if expenses are unreasonably high in relation to services rendered.

(b)

Concerning inadequacy, rates are not inadequate unless clearly insufficient to sustain projected losses and expenses, or the use of such rates, if continued, will tend to create a monopoly in the market.

(c)

Concerning unfair discrimination, unfair discrimination exists if, after allowing for practical limitations, price differentials fail to reflect equitably the differences in expected losses and expenses. A rate is not unfairly discriminatory solely if different premiums result for policyholders with like loss exposures but different expenses, or like expenses but different loss exposures, so long as the rate reflects the differences with reasonable accuracy. Additionally, the provisions of section 10-3-1104 (1)(f) shall apply.

(2)

Intentionally left blank —Ed.

(a)

In determining whether rates comply with the excessiveness standard, the inadequacy standard, and the unfair discrimination standard, the following criteria shall apply:

(I)

Concerning basic factors in rates, due consideration shall be given to past and prospective loss and expense experience, to catastrophe hazards and contingencies, to events or trends, to loadings for leveling premium rates over time or for dividends or savings to be allowed or returned by insurers to their policyholders, members, or subscribers, and to all other relevant factors, including judgment;

(II)

Concerning expenses, the expense provisions included in the rates to be used by an insurer shall reflect the operating methods of the insurer and, so far as it is credible, its own actual and anticipated expenses experience;

(III)

Concerning profits, the rate shall contain provisions for contingencies and an allowance permitting a reasonable profit. In determining the reasonableness of profit, consideration should be given to all investment income attributable to premiums and the reserves associated with those premiums.

(b)

In setting rates, insurers shall consider past and prospective loss experience and catastrophic hazards, if any, solely within the state of Colorado. However, if there is insufficient experience within Colorado upon which a rate can be based, the insurer may consider experiences within any other state or states which have a similar cost of claim and frequency of claim experience as the state of Colorado; and, if insufficient experience is available, the insurer may use a countrywide experience. The insurer, in its rate filing or in its records, shall expressly state and describe what rate experience it is using, and for Colorado business other than workers’ compensation insurance, the insurer shall specify the state or states from which experiences were drawn and the considerations used in setting the rates. In considering experience outside the state of Colorado, as much weight as possible shall be given to the Colorado experience. The rates shall allow a reasonable margin for profit, as allowed in subparagraph (III) of paragraph (a) of this subsection (2), and contingencies.

(2.1)

Intentionally left blank —Ed.

(a)

In setting rates for medical malpractice insurance, rates shall not be excessive or inadequate, as defined in this section, nor shall they be unfairly discriminatory. No rate shall be held to be excessive unless such rate is unreasonably high for the insurance provided and a reasonable degree of competition does not exist in the area with respect to the classification to which such rate is applicable. No rate shall be held to be inadequate unless such rate is unreasonably low for the insurance provided and the continued use of such rate endangers the solvency of the insurer using the same, or unless such rate is unreasonably low for the insurance provided and the use of rate by the insurer using the same has, or if continued will have, the effect of destroying competition or creating a monopoly.

(b)

In setting rates, medical malpractice insurers shall consider past and prospective loss experience and catastrophic hazards, if any, solely within the state of Colorado. However, if there is insufficient experience within Colorado upon which a rate can be based, the insurer may consider experiences within any other state or states which have a similar cost of claim and frequency of claim experience as the state of Colorado; and, if insufficient experience is available, the insurer may use a nationwide experience. The insurer, in its rate filing or in its records, shall expressly state and describe what rate experience it is using, specifying the state or states from which experiences were drawn and the considerations used in setting the rates. In considering experience outside the state of Colorado, as much weight as possible shall be given to the Colorado experience. The rates shall allow a reasonable margin for profit and contingencies, including dividends, savings, or unearned premium deposits allowed or returned by insurers to their policyholders, members, or subscribers. In determining profits, the insurer shall consider investment income from unearned premium reserves and reserves for incurred losses and incurred but not reported losses.

(c)

Medical malpractice insurers shall specify in their rate filings and shall consider and support the evaluation with an analysis and opinion of a qualified property and casualty actuary, and the commissioner as a result of such filing or upon his own motion may also consider, the impact of the following on medical malpractice rates:

(I)

Tort reform legislation;

(II)

Risk management activities;

(III)

Underwriting standards and practices;

(IV)

Any other activity designed to reduce rates or rate increases or the cost of administration and determination of claims.

(d)

and (e) Repealed.

(2.5)

Notwithstanding any provision of law to the contrary, any insurer licensed to sell motor vehicle insurance within the state of Colorado may offer a reduction in premiums if the claims experience subsequent to the enactment of section 42-4-237, C.R.S., so warrants.

(3)

The systems of expense provisions included in the rates for use by any insurer or group of insurers may differ from those of other insurers or groups of insurers to reflect the requirements of the operating methods of any such insurer or group with respect to any subdivision or combination thereof for which subdivision or combination separate expense provisions are applicable.

(4)

Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans which establish standards for measuring variations in hazards or expense provisions or both. Such standards may measure any difference among risks that can be demonstrated to have a probable effect upon losses or expenses.

(4.6)

Repealed.

(5)

Under the commissioner’s power to review rates of all companies, if he determines, after a hearing and on the basis of findings of fact and conclusions, that, with respect to any territory or to any kind, subdivision, or class of insurance, competition is either insufficient to assure that rates will not be excessive, or so conducted as to be destructive of competition or detrimental to the solvency of insurers, he shall order that the rates for such insurance or territory shall be regulated as type I kinds of insurance as defined in section 10-4-401 (3)(a). Such order shall have a specified duration of not more than one year but may be renewed by the commissioner upon appropriate findings of fact, conclusions, and order.

(6)

The commissioner shall require an independent actuarial opinion that the best estimate of the impact of the reforms to the workers’ compensation system enacted in Senate Bill 91-218 during the first regular session of the fifty-eighth general assembly have been incorporated in any workers’ compensation rate change filed with the commissioner until July 1, 1994.

(7)

This section shall not apply to insurers providing coverage to exempt commercial policyholders, as defined pursuant to section 10-4-1402 and rules adopted by the commissioner pursuant to that section.

Source: Section 10-4-403 — Standards for rates - competition - procedure - requirement for independent actuarial opinions regarding 1991 legislation, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-10.­pdf (accessed Oct. 20, 2023).

10‑4‑101
Legislative declaration 10‑4‑102
Federal “voluntary fair access to insurance required, property insurance program” - state qualification 10‑4‑103
Voluntary partial payment of liability claims without admission of liability 10‑4‑104
Competency of minor to contract for insurance - nonavoidance 10‑4‑105
Valuation of bonds and policies other than life 10‑4‑106
Assigned risks 10‑4‑106.5
Medical malpractice insurers - requirement to provide information to the department of public health and environment 10‑4‑107
Cancellation of medical malpractice policies 10‑4‑108
Notice 10‑4‑109
Nonrenewal of medical malpractice policies 10‑4‑109.5
Notice of intent prior to unilateral increase in premium or decrease in coverage previously provided in medical malpractice policies 10‑4‑109.6
Medical malpractice insurers - protections relating to reproductive health care - definition 10‑4‑109.7
Notice of intent prior to cancellation of certain policies of insurance 10‑4‑110
Notice of intent prior to nonrenewal of certain policies of insurance 10‑4‑110.3
Exclusions where claim involves sexual misconduct - void 10‑4‑110.4
Exclusion - claims involving loss in progress not known to insured 10‑4‑110.5
Notice of intent prior to unilateral increase in premium or decrease in coverage previously provided in certain policies of insurance 10‑4‑110.6
Homeowner’s insurance - definition 10‑4‑110.7
Cancellation or nonrenewal - homeowner’s insurance policies 10‑4‑110.8
Homeowner’s insurance - prohibited and required practices - estimates of replacement value - additional living expense coverage - copies of policies - personal property contents coverage - inventory of personal property - requirements concerning total loss scenarios resulting from wildlife disasters - definitions - rules 10‑4‑110.9
Fire insurance - issuance and renewal of policies within federally designated disaster areas 10‑4‑111
Summary disclosure forms required 10‑4‑112
Property damage - time of payment 10‑4‑113
Exemptions 10‑4‑114
Requirements on hazard insurance coverage for loans secured by real property 10‑4‑115
Private utilization review 10‑4‑116
Use of credit information 10‑4‑117
Loss history information report - notice to insured - definition 10‑4‑118
Severability 10‑4‑119
Monthly and electronic payment of premiums 10‑4‑120
Unfair or discriminatory trade practices - legislative declaration 10‑4‑121
Authority of insurer to protect policyholders’ property - emergency 10‑4‑301
Bond executed by surety company 10‑4‑302
Release of surety - other security 10‑4‑303
Application for release of surety - refund 10‑4‑304
Place of deposit 10‑4‑305
Bond part of expense 10‑4‑401
Purpose - applicability 10‑4‑402
Definitions 10‑4‑403
Standards for rates - competition - procedure - requirement for independent actuarial opinions regarding 1991 legislation 10‑4‑404
Rate administration 10‑4‑404.5
Rating plans - property and casualty type II insurers - rules 10‑4‑405
Filing of rating information - certain coverages 10‑4‑406
Review of filings - certain coverages 10‑4‑407
Hearings 10‑4‑408
Rating organization - study of workers’ compensation rates - premium reductions - adoption of rules 10‑4‑409
Rates furnished - cooperation among organizations 10‑4‑410
Advisory organizations 10‑4‑411
Joint underwriting 10‑4‑412
Assigned risk motor vehicle insurance 10‑4‑413
Records required to be maintained 10‑4‑414
Examinations 10‑4‑415
Prohibition against anticompetitive behavior 10‑4‑416
Prohibiting changes in rates or coverages 10‑4‑417
False or misleading information 10‑4‑418
Enforcement procedures - penalties 10‑4‑419
Claims-made policy forms 10‑4‑419.5
Workers’ compensation form certification 10‑4‑420
Risk management procedures 10‑4‑421
Notice of rate increases and decreases 10‑4‑501
Short title 10‑4‑502
Legislative declaration 10‑4‑503
Definitions 10‑4‑504
Scope 10‑4‑505
Construction 10‑4‑506
Colorado insurance guaranty association 10‑4‑507
Board of directors 10‑4‑508
Powers and duties of association 10‑4‑508.5
Aggregate liability of association 10‑4‑509
Plan of operation 10‑4‑510
Duties and powers of commissioner 10‑4‑511
Effect of paid claims 10‑4‑512
Nonduplication of recovery 10‑4‑513
Prevention of insolvencies 10‑4‑514
Examination of association 10‑4‑515
Tax exemption 10‑4‑516
Recognition of assessments in rates 10‑4‑517
Immunity 10‑4‑518
Stay of proceedings 10‑4‑519
Termination - distribution of funds 10‑4‑520
Advertising 10‑4‑601
Definitions 10‑4‑601.5
Administrative authority 10‑4‑602
Basis for cancellation 10‑4‑603
Notice 10‑4‑604
Nonrenewal 10‑4‑604.5
Issuance or renewal of insurance policies - proof of insurance provided by certificate, card, or other media 10‑4‑605
Proof of notice 10‑4‑606
Further notice 10‑4‑607
Immunity 10‑4‑608
Exemptions 10‑4‑609
Insurance protection against uninsured motorists - applicability 10‑4‑610
Property damage protection against uninsured motorists 10‑4‑611
Elimination of discounts - damage by uninsured motorist 10‑4‑613
Glass repair and replacement 10‑4‑614
Inflatable restraint systems - replacement - verification of claims - definition 10‑4‑615
Motorist insurance identification database program - reporting required - fine 10‑4‑616
Disclosure of credit reports 10‑4‑617
Insurers - biannual fee - auto theft prevention authority 10‑4‑619
Coverage compulsory 10‑4‑620
Required coverage 10‑4‑621
Required coverages are minimum 10‑4‑622
Required provision for intrastate and interstate operation 10‑4‑623
Conditions and exclusions 10‑4‑624
Self-insurers 10‑4‑625
Premium payments 10‑4‑626
Prohibited reasons for nonrenewal or refusal to write policy of automobile insurance applicable to this part 6 10‑4‑627
Discriminatory standards - premiums - surcharges - proof of financial responsibility requirements 10‑4‑628
Refusal to write - changes in - cancellation - nonrenewal of policies prohibited 10‑4‑629
Cancellation - renewal - reclassification 10‑4‑630
Exclusion of named driver 10‑4‑632
Reduction in rates for drivers aged fifty-five years or older who complete driver’s education course - legislative declaration 10‑4‑633
Certification of policy and notice forms 10‑4‑633.5
Automobile insurance policies - plain language required - rules 10‑4‑634
Assignment of payment for covered benefits 10‑4‑635
Medical payments coverage - exceptions - definitions 10‑4‑636
Disclosure requirements for automobile insurance products offered - rules 10‑4‑637
No discrimination by profession 10‑4‑638
Retroactive adjustment of health-care service claims 10‑4‑639
Claims practices for property damage 10‑4‑640
Operator’s policy of insurance 10‑4‑641
Rules - medical payments coverage 10‑4‑642
Prompt payment of direct benefits - legislative declaration - definitions 10‑4‑643
Electronic claim forms - rules 10‑4‑1001
Short title 10‑4‑1002
Definitions 10‑4‑1003
Disclosure of information 10‑4‑1004
Evidence - confidential 10‑4‑1005
Immunity 10‑4‑1006
Enforcement 10‑4‑1007
Penalty 10‑4‑1008
Municipal ordinances - concurrent jurisdiction - common law 10‑4‑1009
Continuing duties of insurers - unfair claim settlement practices 10‑4‑1201
Definitions 10‑4‑1202
Minimum standards 10‑4‑1203
Disclosure 10‑4‑1204
Penalties 10‑4‑1205
Applicability 10‑4‑1206
Effective date 10‑4‑1301
Legislative declaration 10‑4‑1302
Definitions 10‑4‑1303
Temporary joint underwriting association 10‑4‑1304
Board of directors - authority 10‑4‑1305
Plan of operation - annual certification 10‑4‑1306
Deficits - assessment - rebate of surplus 10‑4‑1307
Annual statements 10‑4‑1308
Examinations 10‑4‑1309
Legislative declaration - authority of commissioner - emergency rules - judicial review 10‑4‑1310
Privileged communications 10‑4‑1311
Tax exemption 10‑4‑1401
Legislative declaration 10‑4‑1402
Rules 10‑4‑1403
Exemption from rate filing, approval, and form certification requirements 10‑4‑1404
Multistate insurance risks - choice of law 10‑4‑1501
Definitions 10‑4‑1502
Licensure of vendors 10‑4‑1503
Requirements for sale of portable electronics insurance 10‑4‑1504
Authority of vendors of portable electronics 10‑4‑1505
Suspension or revocation of license 10‑4‑1506
Termination of portable electronics insurance 10‑4‑1507
Application for license - fees 10‑4‑1601
Definitions 10‑4‑1602
Exemptions 10‑4‑1603
Requirements for sale of consumer goods service contracts - definitions 10‑4‑1604
Obligations of reimbursement insurance companies 10‑4‑1605
Required disclosures - reimbursement insurance policy 10‑4‑1606
Required disclosures - service contracts 10‑4‑1607
Prohibited acts 10‑4‑1608
Required record keeping 10‑4‑1609
Enforcement provisions - rules 10‑4‑1701
Definitions 10‑4‑1702
Authority to issue license 10‑4‑1703
License - application - restrictions 10‑4‑1704
Disclosures to occupant 10‑4‑1705
Supervision of issuance - training 10‑4‑1706
Compensation 10‑4‑1707
Exemption from requirements 10‑4‑1708
Notification 10‑4‑1709
Enforcement 10‑4‑1801
Short title 10‑4‑1802
Legislative declaration 10‑4‑1803
Definitions 10‑4‑1804
Fair access to insurance requirements plan association - creation - participation required 10‑4‑1805
Fair access to insurance requirements plan association - board of directors - membership - duties 10‑4‑1806
FAIR plan - plan requirements - insurer requirements 10‑4‑1807
Plan of operation - mandatory components - amendments - revocation by commissioner - rules 10‑4‑1808
FAIR plans - requirements for licensed producers 10‑4‑1809
Assessment of fees 10‑4‑1810
Enforcement - suspension or revocation of certificate of authority - fines 10‑4‑1811
Appeals - judicial review 10‑4‑1812
Rules
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Current through Fall 2024

§ 10-4-403’s source at colorado​.gov