Haw. Code R. § 16-7-18

Current through April, 2024
Section 16-7-18 - Underwriting standards

New and renewal applications for insurance under the plan shall be submitted to the servicing carrier through the office of the plan. All new and renewal applications shall be reviewed by the carrier for completeness, and subjected to the regular scrutiny for the purposes of evaluation as to insurability. If the servicing carrier determines that an application does not meet the standards for insurability, taking into consideration claims history, ethical violations, mode of practice, physical conditions, safety practices, and other factors material to the risk, the servicing carrier shall refer the application to the office of the plan and in turn it will be referred to such subcommittee as necessary to determine the insurability.

Review boards consisting of not less than five nor more than nine members appointed by the board of directors from a list of nominees submitted by the Hawaii Medical Association and the Hawaii Hospital Association shall be established. The members of the review boards shall serve for terms of two years providing that primary appointments shall be made in such a manner that not more than two-thirds of the review board shall leave office in any one year. The review board shall examine all applications that are referred to it by the board of directors.

The review board may confer with consultants, examine records of peer review committees relating to the applicant, and conduct such other investigatory procedures that they deem necessary to arrive at a satisfactory evaluation of such application. The review board may recommend to the board of directors non-issuance of the policy that has been applied for, the issuance of a binder for a limited time, or the issuance of a policy. The applicant may appeal the decision as provided for under section 435C-7, HRS.

Haw. Code R. § 16-7-18

[Eff 6/22/81] (Auth: HRS § 435C-2) (Imp: HRS § 435C-3)