N.D. Admin. Code 45-06-05-08

Current through Supplement No. 393, July, 2024
Section 45-06-05-08 - Loss ratio

Benefits under long-term care insurance policies must be deemed reasonable in relation to premiums provided the expected loss ratio is at least sixty percent, calculated in a manner which provides for adequate reserving of the long-term care 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. Experimental nature of the coverage;
11. Policy reserves;
12. Mix of business by risk classification; and
13. Product features such as long elimination periods, high deductibles, and high maximum limits.

N.D. Admin Code 45-06-05-08

Effective July 1, 1988; amended effective July 1, 1994.

General Authority: NDCC 28-32-02

Law Implemented: NDCC 26.1-45