North Dakota Administrative Code

For the three-year period immediately preceding the cancellation or nonrenewal of policyholder coverage, the following loss and claim information must be retained: 1. Date of loss or claim; 2. General nature of loss or claim; and 3. Amount paid. This information must be retained …

As used in this chapter: 1. "Authorized to transact insurance in this state" and "admitted" means an insurer authorized by a subsisting certificate of authority issued by the commissioner to transact insurance in this state. 2. "Commissioner" means the insurance commissioner of N…

Any risk retention group doing business in this state shall submit to the commissioner all of the following: 1. By March first of each year, a copy of the group's financial statement submitted to its state of domicile, which must be certified by an independent public accountant a…

1. Any risk retention group chartered in a state other than North Dakota and not holding a subsisting certificate of authority issued by the commissioner of the state of North Dakota, before offering liability insurance as a risk retention group on any risk located, resident or t…

1. Any purchasing group which intends to do business in this state, before soliciting any member to insure through the group any liability risk located, resident or to be performed in this state, shall furnish notice of its intent to do business to the commissioner, in the form a…

1. Any risk retention group or purchasing group authorized to do business in the state of North Dakota shall notify the commissioner in writing within thirty days of any changes in its operations, which result in the registration or notice then on file containing false, inaccurat…

1. License requirement. No person, resident or nonresident in this state, may act as or hold out in this state to be a risk retention group representative for a risk retention group, or a purchasing group representative for a purchasing group which solicits members for the purpos…

For the purposes of this chapter, a purchasing group must be deemed located in this state if any member of said group is located or resident in this state. History: Effective October 1, 1989. General Authority: NDCC 26.1-46-13, 28-32-02 Law Implemented: NDCC 26.1-46 4…

Any purchasing group duly authorized to do business in the state of North Dakota may purchase insurance only from the following sources: 1. A risk retention group authorized to do business in this state. 2. An admitted insurance carrier. 3. An authorized surplus lines carrier lis…

memorandum. Any risk retention group representative or purchasing group representative effecting insurance on any risk located, resident or to be performed within or properly allocated to this state with an unauthorized risk retention group or unauthorized insurer, pursuant to th…

1. Any risk retention group required to register in this state pursuant to section 3(d) of the Federal Liability Risk Retention Act of 1986 or section 45-05-05-02 which utilizes risk retention representatives in soliciting, negotiating, procuring, or providing liability insurance…

Repealed effective January 1, 2008.

If any section of this chapter or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of this chapter and the application of such section to other persons and circumstances shall not be affected thereby. History: Effective Oct…

This chapter applies to all commercial lines of insurance (including farmowners) except those excepted risks described in North Dakota Century Code section 26.1-30.1-01 and for plans such as Automobile Insurance Plan Services Office (AIPSO), Market Assistance Plan (MAP), Joint Un…

1. "Experience rating plan" means any rating plan or system whereby a manual rate for insurance is adjusted or modified based on the past loss experience of the insured. 2. "Manual rate" means a rate, designed to apply on a generic basis to similar risks within the same class, fi…

Rate modification plans, justified according to the standards herein, are allowed by the insurance code. However, the commissioner has determined that the use of unjustified rate modification plans is not reasonable, is not objective, and is unfairly discriminatory. Therefore, th…

Exposure, premium, and loss figures used in the calculation of experience rating plans must be verifiable and justifiable. History: Effective October 1, 1989. General Authority: NDCC 28-32-02 Law Implemented: NDCC 26.1-25, 26.1-30-19

Upon the request of the commissioner, an insurer authorized to write any insurance in this state to which this chapter applies shall submit to the commissioner the number of policies by line issued with rate modification as defined in subsection 3 of section 45-05-07-02 and the p…

To determine compliance with this chapter the commissioner may order a rate compliance examination be made of any insurer to which this chapter applies. Any examination must be conducted pursuant to North Dakota Century Code chapter 26.1-03. History: Effective October 1, 1989. Ge…

Within one hundred eighty days of October 1, 1989, each insurer to which this chapter applies shall refile its rate modification plans in accordance with the provisions of this chapter. At the end of the one hundred eighty-day period all prior rate modification plans filed with t…

If any provision of this chapter or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the chapter and the application of such provision shall not be affected thereby. History: Effective October 1, 1989. General Authority:…

Each insurer or rating organization is instructed to distribute a copy of this chapter to all personnel engaged in activities requiring knowledge of this chapter, and to instruct them as to its scope and operation. History: Effective October 1, 1989. General Authority: NDCC 28-32…

"Highly protected risk market" consists of commercial property coverage written specifically for large, complex, and multistate commercial and industrial properties. Further, the "highly protected risk market" is characterized by large size, high value, diversity and loss control…

The market commonly known as "highly protected risk market" is exempt from the filing restrictions limiting filings to prospective loss cost filings as found in North Dakota Century Code chapter 26.1-25 and an advisory organization may file fully developed rates on behalf of spec…

The North Dakota automobile insurance plan is an association of all insurance companies licensed to write automobile insurance in North Dakota and is the residual market mechanism for automobile liability insurance in North Dakota, through which applicants who are in good faith e…

The automobile insurance plan services office is exempt from the filing restrictions limiting filings to prospective loss cost filings as found in North Dakota Century Code chapter 26.1-25 and as an advisory organization may file fully developed rates on behalf of the North Dakot…

1. No admitted insurer shall issue or renew a policy of liability insurance in this state that includes defense expenses within the limit of liability unless the policy's minimum limit per occurrence or the aggregate liability limit for all liability risks and coverages under the…

Defense expenses within the limit of liability provisions are allowed only within the following types of policies or coverages within a policy with the limits of liability as required in section 45-05-09-01: 1. Cyber liability; 2. Fiduciary liability; 3. Directors and officers li…

The fact that defense expenses are within the limit of liability or defense costs are limited by an allowance must be disclosed on the declaration page in at least twelve-point bold print. History: Effective April 1, 2015; amended effective October 1, 2019. General Authority: NDC…

The applicant or insured must sign a disclosure form as part of the application or renewal process wherein the applicant or insured acknowledges that the subject policy has limits of liability which may be reduced or completely eliminated by payments for legal defense costs or cl…

Defense-only policies are excepted from the requirements of chapter 45-05-09. A defense-only policy is a policy which is purchased solely to provide a legal defense and is not meant to provide indemnification or to be a source of payment for damages to a third party. History: Eff…

1. Except as otherwise specifically provided in sections 45-06-01.1-05, 45-06-01.1-10, 45-06-01.1-11, 45-06-01.1-14, and 45-06-01.1-19, this chapter applies to: a. All Medicare supplement policies delivered or issued for delivery in this state on or after the effective date of th…

For purposes of this chapter: 1. "1990 standardized Medicare supplement benefit plan", "1990 standardized benefit plan", or "1990 plan" means a group or individual policy of Medicare supplement insurance issued on or after January 1, 1992, and with an effective date for coverage …

No policy or certificate may be advertised, solicited, or issued for delivery in this state as a Medicare supplement policy or certificate unless such policy or certificate contains definitions or terms which conform to the requirements of this section. 1. "Accident", "accidental…

1. Except for permitted preexisting condition clauses as described in subdivision a of subsection 1 of section 45-06-01.1-05, subdivision a of subsection 1 of section 45-06-01.1-06, and subdivision a of subsection 1 of section 45-06-01.1-06.1, no policy or certificate may be adve…

plan policies or certificates issued for delivery prior to January 1, 1992. No policy or certificate may be advertised, solicited, or issued for delivery in this state as a Medicare supplement policy or certificate unless it meets or exceeds the following minimum standards. These…

policies or certificates issued for delivery on or after January 1, 1992, and with an effective date for coverage prior to June 1, 2010. The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state on or…

policies or certificates issued for delivery with an effective date for coverage on or after June 1, 2010. The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state with an effective date for coverage…

supplement benefit plan policies or certificates issued for delivery on or after January 1, 1992, and with an effective date for coverage prior to June 1, 2010. 1. An issuer shall make available to each prospective policyholder and certificate holder a policy form or certificate …

Medicare supplement benefit plan policies or certificates issued for delivery with an effective date for coverage on or after June 1, 2010. The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state wi…

Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020. The Medicare Access and CHIP Reauthorization Act of 2015 requires the following standards are applicable to all Medicare supplemen…

1. a. This section applies to Medicare select policies and certificates, as defined in this section. b. No policy or certificate may be advertised as a Medicare select policy or certificate unless it meets the requirements of this section. 2. For the purposes of this section: a. …

1. Any issuer may not deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state, or discriminate in the pricing of such a policy or certificate because of the health status, claims experience, receipt of heal…

1. Guaranteed issue. a. Eligible persons are those individuals described in subsection 2 who seek to enroll under the policy during the period specified in subsection 3, and who submit evidence of the date of termination, disenrollment, or Medicare part D enrollment with the appl…

1. An issuer must comply with section 1882(c)(3) of the Social Security Act [as enacted by section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (Pub. L. 100-203; 101 Stat. 1330; 42 U.S.C. 1395ss(c)(3))] by: a. Accepting a notice from a Medicare carrier on dually…

1. Loss ratio standards. a. (1) A Medicare supplement policy form or certificate form may not be delivered or issued for delivery unless the policy form or certificate form can be expected, as estimated for the entire period for which rates are computed to provide coverage, to re…

1. An issuer may not deliver or issue for delivery a policy or certificate to a resident of this state unless the policy form or certificate form has been filed with and approved by the commissioner in accordance with filing requirements and procedures prescribed by the commissio…

1. An issuer or other entity must provide level commissions or other compensation to an agent or other representative for the sale of a Medicare supplement policy or certificate for the year of issuance and no fewer than five renewal years. 2. No issuer or other entity may provid…

1. General rules. a. Medicare supplement policies and certificates must include a renewal or continuation provision. The language or specifications of the provision must be consistent with the type of contract issued. Such provision must be appropriately captioned and must appear…

1. Application forms must include the following questions designed to elicit information as to whether, as of the date of the application, the applicant currently has Medicare supplement, Medicare advantage, Medicaid coverage, or other health insurance policy or certificate in fo…