Section 500.1352. Premium dispute; appeal to commissioner.

(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.