North Dakota Administrative Code
Title 45 - Insurance, Commissioner of
Article 45-06 - Accident and Health Insurance
Chapter 45-06-15 - Short-Term Care Insurance
Section 45-06-15-09 - Loss ratio
Current through Supplement No. 394, October, 2024
Benefits under short-term care insurance policies must be deemed reasonable in relation to premiums provided the expected loss ratio is at least seventy percent, calculated in a manner which provides for adequate reserving of the insurance risk. In evaluating the expected loss ratio, due consideration must be given to all relevant factors, including:
1. Statistical credibility of incurred claims experience and earned premiums;
2. The period for which rates are computed to provide coverage;
3. Experienced and projected trends;
4. Concentration of experience within early policy duration;
5. Expected claim fluctuation;
6. Experience refunds, adjustments, or dividends;
7. Renewability features;
8. All appropriate expense factors;
9. Interest;
10. Policy reserves;
11. Mix of business by risk classification; and
12. Product features such as elimination periods, deductibles, and maximum limits.
General Authority: NDCC 28-32-02
Law Implemented: NDCC 26.1-36-48
