Utah Code » Title 31A, Chapter 22 — Contracts in Specific Lines; part 31A-22-8 — Credit Life and Accident and Health Insurance
Utah Code

Utah Code § 31A-22-807 (2026)

Filing and approval of forms -- Loss ratio standards

✓ current as of May 2026
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A policy, certificate of insurance, statement of insurance, or endorsement form intended for use in Utah is subject to Section 31A-21-201.
In addition to the grounds for prohibiting use of a form under Subsection 31A-21-201(3), it is a ground to prohibit the use of a form that the benefits provided in the form are not reasonable in relation to the premium charge.
In ascertaining whether the benefits are reasonable in relation to the premium charged, the commissioner shall consider:
the mortality cost of the life insurance;
the morbidity cost of the accident and health insurance; and
the reserves set up for the payment of claims unreported or in the process of settlement.
For purposes of this section, benefits are considered reasonable in relation to the premium charged if, given the costs described in this Subsection (3), the premium rate charged develops or may reasonably be expected to develop a loss ratio of:
not less than 50% for credit life insurance; and
not less than 55% for credit accident and health insurance.
Benefits are considered reasonable in relation to premium charged if the ratio of claims incurred to premium earned during the most recent four-year period at the rates in use produces a loss ratio that is equal to or exceeds the minimum loss ratio standard specified in Subsection (3).
If the minimum loss ratio test produces a loss ratio that exceeds the minimum loss ratio standard in Subsection (4) by five percentage points or more, the insurer may file for approval and use a rate that is higher than the prima facie rate, if it can be expected that the use of the higher rate will continue to produce a loss ratio for an account to which it is applied that will satisfy the minimum loss ratio test.
If the minimum loss ratio test produces a loss ratio that is lower than the minimum loss standard in Subsection (4) by five percentage points or more, the commissioner may require that the insurer:
file an adjusted rate that can be expected to produce a loss ratio that will satisfy the minimum loss ratio test; or
submit reasons acceptable to the commissioner why the insurer should not be required to file an adjusted rate.
Notes of Decisions
Cited in 3 cases, 1993–2002 · leading case: Prince v. Bear River Mut. Ins. Co., 2002 UT 68 (Utah 2002).
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Prince v. Bear River Mut. Ins. Co., 2002 UT 68 (Utah 2002). · cites it 3× “ambulance, hospital, and nursing services" incurred as a result of the accident that do not "exceed a total of $3,000," Utah Code Ann. § 31A-22-807(1)(a) (2001), "within 30 days after the insurer receives reasonable proof of the fact and amount of expenses incurred," id.”
Burns Chiropractic Clinic v. Allstate Ins. Co., 851 P.2d 1209 (Utah Ct. App. 1993). · cites it 2× “The trial court, however, misapplied Utah Code Ann. § 31A-22-807(2)(d) (1991) (current version at id.”
Regal Ins. Co. v. Bott, 2001 UT 71 (Utah 2001). · cites it 2× “Such an interpretation of the statute would, for instance, produce the obviously unintended result of providing funerary and survivor benefits to an injured individual who is still living. Rather, the statute limits the benefits a living person may receive to health care…”
— Utah Code § 31A-22-807(1)(a) — 1 case
Prince v. Bear River Mut. Ins. Co., 2002 UT 68 (Utah 2002). “ambulance, hospital, and nursing services" incurred as a result of the accident that do not "exceed a total of $3,000," Utah Code Ann. § 31A-22-807(1)(a) (2001), "within 30 days after the insurer receives reasonable proof of the fact and amount of expenses incurred," id.”
— Utah Code § 31A-22-807(2)(d) — 1 case
Burns Chiropractic Clinic v. Allstate Ins. Co., 851 P.2d 1209 (Utah Ct. App. 1993). “The trial court, however, misapplied Utah Code Ann. § 31A-22-807(2)(d) (1991) (current version at id.”
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